Care Home: The Berkeley

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What the care home does well The service has an easy read service users guide which tells people about the home. Everyone who lives at The Berkley is supported to make choices and are are able to choose how to spend their time. The people who live at the Berkeley are involved in making decisions about the home such as the decoration and the range of activities. One person told us I like to go to the shops with the staff every Friday. Another told us about the activities that they enjoyed such as going swimming and to a local social club. People told us that they were able to choose the food that they wanted and that it was good. We saw that there were other choices available and that people had enough to eat. People told us that they were supported to maintain links with their family and friends. Another person told us that their Key worker was coming on duty later and thatthey got on well with them and said `My Key Worker knows how I like to be cared for`. People told us that they felt well cared for one person said `I have lived here for a long time and if I didn`t like it then I would not be still here`. People who use the service have access to the right health and social care support. Staff have the right checks before they start working in the home What has improved since the last inspection? The information about the home has been improved so that people have access to up to date information about the service. Medication systems have been improved so that people who use the service receive their medication as it is prescribed. The home has a new manager and she has applied for registration with the Commission. All of the people who live at the Berkley now have their own bedrooms. The boiler has been replaced and the home is being redecorated and new furnishings are being provided. What the care home could do better: The management need to make sure that the Statement of Purpose contains all of the right information. People who live at the Berkeley should have their contacts reviewed to make sure that they contain the right information and that they have the option of a seven day paid holiday the same as the other people who live in other homes within the group. The staff should make sure that people who use the service have risk assessments in place to ensure that people are safe during very hot and very cold weather. The risk assessments for people who smoke should be reviewed to make sure that they are up to date and that people know about the support that is now available. The management need to make sure that as people age that they have the right checks in place to ensure their health and safety. The complaints policy needs to be reviewed to make sure that it has all of the right information in it. The management need to make sure that the theft of a lap top from the premises is followed up with the insurance company.The management should review the bathing arrangements on the lower ground floor to make sure that they are accessible to people with physical disability. Staffing levels need to be reviewed to make sure that there are always enough staff on duty. The management need to make sure that the certificate or registration is up to date. Key inspection report Care homes for adults (18-65 years) Name: Address: The Berkeley 1 & 2 Elysium Terrace Kingsthorpe Road Northampton NN2 6EN 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: Stephanie Vaughan Date: 2 9 0 6 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 35 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 35 Information about the care home Name of care home: Address: The Berkeley 1 & 2 Elysium Terrace Kingsthorpe Road Northampton NN2 6EN 01604722033 01604712155 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) : www.mentauruk.com Mentaur Limited care home 14 Number of places (if applicable): Under 65 Over 65 14 2 learning disability Additional conditions: It is a condition of this registration that the home is authorised to care for the two current named Service Users who have Learning Difficulties and additional Mental Health needs, and one named Service user who has Sensory Impairment in addition to her Learning Difficulties. To include up to 2 people over the age of 65 years Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home The Berkeley is near to Northampton town centre and local facilities such as buses, shops and a park. The provider also runs a day centre in Northampton, which people who use the service can use. The Berkeley is a large town house with four floors. All of the people who live there now have their own bedroom. There is a lounge and dining room on the ground floor. The home has a back garden at ground floor level. There is a steep set of steps to the front door but people tend to use either the side or back door. Care Homes for Adults (18-65 years) Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 35 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced inspection, which took place during the day. We selected four people who use the service to case track which involved reviewing the care they receive through review of their records, meeting with them and with the staff. The inspection also took account of all information received since the date of the last visit no comment cards were received. An annual service review was done in June last year which did not change our view of the service provided. We have received no concerns or complaints about this service however we have received four safeguarding allegations about this service, the service has shown that it responds in the right way and ensures that these are referred to the local authority for review. In one of these cases an allegation against a staff member was determined as unfounded the outcome of three other allegations remain outstanding. At the time of the inspection the fees ranged from £446 to £1,020 per week. Additional top up fees are also charged depending on the needs of the people who use the service. The fees to not cover items such as clothing, hairdressing and Care Homes for Adults (18-65 years) Page 7 of 35 other personal items. What the care home does well The service has an easy read service users guide which tells people about the home. Everyone who lives at The Berkley is supported to make choices and are are able to choose how to spend their time. The people who live at the Berkeley are involved in making decisions about the home such as the decoration and the range of activities. One person told us I like to go to the shops with the staff every Friday. Another told us about the activities that they enjoyed such as going swimming and to a local social club. People told us that they were able to choose the food that they wanted and that it was good. We saw that there were other choices available and that people had enough to eat. People told us that they were supported to maintain links with their family and friends. Another person told us that their Key worker was coming on duty later and that Care Homes for Adults (18-65 years) Page 8 of 35 they got on well with them and said My Key Worker knows how I like to be cared for. People told us that they felt well cared for one person said I have lived here for a long time and if I didnt like it then I would not be still here. People who use the service have access to the right health and social care support. Staff have the right checks before they start working in the home What has got better from the last inspection The information about the home has been improved so that people have access to up to date information about the service. Medication systems have been improved so that people who use the service receive their medication as it is prescribed. The home has a new manager and she has applied for registration with the Commission. All of the people who live at the Berkley now have their own bedrooms. The boiler has been replaced and the home is being redecorated and new furnishings are being provided. Care Homes for Adults (18-65 years) Page 9 of 35 What the care home could do better The management need to make sure that the Statement of Purpose contains all of the right information. People who live at the Berkeley should have their contacts reviewed to make sure that they contain the right information and that they have the option of a seven day paid holiday the same as the other people who live in other homes within the group. The staff should make sure that people who use the service have risk assessments in place to ensure that people are safe during very hot and very cold weather. The risk assessments for people who smoke should be reviewed to make sure that they are up to date and that people know about the support that is now available. The management need to make sure that as people age that they have the right checks in place to ensure their health and safety. The complaints policy needs to be reviewed to make sure that it has all of the right information in it. The management need to make sure that the theft of a lap top from the premises is followed up with the insurance company. Care Homes for Adults (18-65 years) Page 10 of 35 The management should review the bathing arrangements on the lower ground floor to make sure that they are accessible to people with physical disability. Staffing levels need to be reviewed to make sure that there are always enough staff on duty. The management need to make sure that the certificate or registration is up to date. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stephanie Vaughan CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 Care Homes for Adults (18-65 years) Page 11 of 35 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 12 of 35 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 13 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive clear and up to date information to enable them to make a judgment about whether or not they might wish to live at The Berkley. Evidence: The service has a statement of purpose has been reviewed and now contains up to date and most of the information needed however the management need to make sure that it has more information about emergency admissions, the arrangements for people to have annual holidays and the new contact details for the Care Quality Commission. Since the last inspection there have been no new admissions to the service, however there was evidence that the management obtain the right information before someone is admitted to the home to ensure that they are able to meet their needs. Admission procedures are in place to enable people to come to the home at varying times to meet the people who already live there and the staff. The people who use the service have contacts in place, these were last updated in February 2009, however these need to be reviewed to ensure that they contain all of the right information, including the option of a seven days paid annual holiday. Care Homes for Adults (18-65 years) Page 14 of 35 Evidence: The Service Users Guide is a comprehensive document has also been updated and is produced in an easy read version with large print and illustrations. Care Homes for Adults (18-65 years) Page 15 of 35 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. The people who use the service have an individual plan of care which indicates that they are treated as individuals and that they are supported to take risks. Evidence: The preadmission assessments conducted by the management and obtained from the funding authorities form the basis of the Individual Plans of Care. These are developed and reviewed with the involvement of the individuals concerned and their Key workers. The content of the information within the individual plans of care was in the main comprehensive. There is evidence that people are able to make decisions about their lives one of the people case tracked had decided not to continue to attend the day centre and chose to stay at home. One of the people living at the Berkley told us how he liked to go out shopping with the staff on Fridays there was also evidence that people are able to be involved in the preparation of snacks and drinks. There was also evidence that people who use the service are involved in the choice of the Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: decor of their personal accommodation and decisions about the decor of the communal accommodation have been made during house meetings. The service has a good range of risk assessments in place these were seen to have been updated following events such as falls, the management are mindful that as people age their physical needs can increase as such they have requested care management reviews to ensure that the service is able to continue to meet their needs. However the weather was extremely hot during the inspection and although the management had arranged for easy access to cold drinks and appropriate foods there were no care plans or risk assessments in place for the reduction of the risks associated with extreme weather conditions. In addition the management need to ensure that risk assessments for the risks of smoking be updated to include appropriate information. Care Homes for Adults (18-65 years) Page 17 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management ensure that people who use the service have are supported to maximise their independence and are able to make choices that promote their independence Evidence: People who use the service are able to attend the day centre during the week on a full or part time basis. There is also evidence that people can choose to opt out of this arrangement should they wish or need to do so. One person said I am going to Gateway tonight, its good I really like going there. Another told us that they had a girl friend at one of the other Mentaur homes and there was evidence that they were supported to maintain their relationship. People are also supported to maintain links with family and friends who are able to visit the home. Where people are not in contact with family and friends the service ensures that people have access to advocacy support and the support of the Independent Mental Capacity Advocate where specific decisions need to be made. People who use the service have access to a Key Worker on person told us my key Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: worker will be here soon, I like to keep the same person its good because they know how I like to be care for. Daily routines are flexible within the restrictions of peoples planned activities. Care plans and daily records indicated that people who use the service are supported to make choices within their daily lives including choice of clothing and personal appearance in line with their gender and culture. In general people who use the service were able to chose how and where to spend their time including access to the garden to enjoy the fine weather. However due to the limitations of the premises and the compromised mobility of at least one of the people who live there and as people age their ability to access other areas of the home become more limited. However the service has arranged for care management reviews to be conducted where there are indications that the service may no longer be able to accommodate their needs. Appropriate arrangements are in place to ensure that people are able to be involved in the planning of menus and that they have access to a varied and balanced diet that reflects the personal preferences. People told us that they were able to chose the food that was provided, that they liked the food and that they had adequate amounts. There was also evidence that the service was able to accommodate special diets such as low fat and reduced sugar diets. Supplements have also been arranged where people needed additional support with nutrition. Care Homes for Adults (18-65 years) Page 19 of 35 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 the service have an individual plan of care which demonstrates that their health, personnel and social care needs are met. Evidence: Personal care routines are flexible within the constraints of peoples planned activities and appointments. There is evidence that peoples preferences are complied with regarding times of rising and retiring to bed. There is a mix of staff which reflects the gender of the people who use the service. The acting manager is also mindful of the need to ensure that the culture and gender of the people who use the service is also reflected in the staff group. People who use the service are able to express their personalities and gender through their choice of clothing and general appearance. People appeared well presented and confirmed that they felt that they were well looked after. One person said I have lived here for a long time and if I didnt like it then I would not be still here. There is evidence that the people who use the service have access to appropriate health care specialists such as general practitioners, district nurses, podiatrists and opticians. There is evidence that the management seek care management assessments as the Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: needs of people change, however there are at present no care plans in place to show At present there are no care plans in place regarding the District Nurse activity. Some of the people living in the home are over the age of 65 or have significant health needs. The service needs to make sure that the put the right assessments in place to prevent and manage the risks of pressure and nutrition. There are already risk assessments in place for the movement and handling needs of individuals and risk assessments for the prevention of falls are also in place but could do with more detailed information. The acting manager has agreed to make contact with the dietician, district nurse and the falls coordinator to review the way that these risks are managed. Where people are moving toward more independent living care plans should be put in place to show how the service supports people to do this. Medication systems were reviewed and were found to be in good order the provider has complied with the previous requirement regarding the record keeping in relation to medication. The service no needs to make sure that the arrangements for the storage of medication complies with the new guidance issued by the Royal British Pharmaceutical Society. Care Homes for Adults (18-65 years) Page 21 of 35 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. Procedures are in place to ensure that the people who use the service can voice their concerns and be protected from abuse. Evidence: The service has a complaints policy which is produced in an easy read format and is included within the Statement of Purpose, Service Users Guide and is also displayed in the home. This contains most of the right information but needs to be reviewed to make sure that all of the contact details are up to date and that the right timescales are included for acknowledgment, investigation and response. The management has told us that they have received no complaints during the last twelve months. People that we spoke to told us that they would know what to do if they were unhappy about something and that the manager would respond appropriately. One person told us that the staff are lovely I get on well with them all, I have no complaints about anybody A new manager has been in post for three months and an application for registration has been submitted to the Care Quality Commission and is currently being processed. The management stability of the home is an important factor in ensuring the safeguarding of the people who use the service. The incidence of incidents between residents appear to have stabilised and this is most likely due to the fact that there is now a manager in post and that the service has reduced the number of people living at the home so that people who continue to live there have their own bedroom. Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: There have been two allegations of abuse by staff in one of these the investigation concluded that there was no evidence to support the allegations and the second allegation against a staff member is currently being investigated. The service has informed the Commission and the County Council about these events and has taken the right action to protect the people who use the service whilst the investigations are ongoing. Two other allegations remain outstanding including the theft of a lap top from the premises, and injury that was incurred whist people were on a group outing and an allegation. Staff spoken to were able to confirm that they had received training in safeguarding of adults. Records indicated that there is a training programme in place to ensure that all staff have access to training in the Mental Capacity Act and Deprivation of liberty Standards. Care Homes for Adults (18-65 years) Page 23 of 35 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 environment is clean, hygienic and is being maintained however it may not fully meet the needs of some of the people who currently use the service. Evidence: The home is a period property that has been converted to provide residential care for 14 people with Learning Difficulties. However since the last inspection the provider has reduced the number of people living there to ten, this means that they are all able to have their own bedrooms which is a significant improvement which has enhanced the lives of the people who live there. People who live at the Berkeley are able to personalise their rooms with their possessions and memorabilia. One of the people offered to show us his bedroom which was well furnished and comfortable and he was proud to show us his new flat screen television that he had purchased. Bedrooms are fitted with privacy locks and people who use the service are able to have a key to their bedroom door. Bedrooms are fitted aids and adaptations such as non slip mats and in some cases visible flashing fire alarms according to the needs of the individual. Bedrooms are also fitted with privacy locks and secure storage facilities. Staff were seen to be respectful of the privacy of the people who live there. The home is currently being refurbished, the first phase has been now been completed, including a pleasant restful lounge on the ground floor. People who use the service were Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: involved in decisions about the furnishing and colour schemes. The second phase of refurbishment has now been commenced and risk assessments are in place to minimise the risks and inconvenience to the people who live there. The service provides accommodation on all four levels and this presents staff with some challenges to meet the differing needs of the people who live there, some of the people who live there have been referred for care management assessments to see if the service is able to continue to meet their needs and this also needs to include an appropriate environment as at present their is no stair lift in place. There is an additional sitting room at the basement level for the people who have their bedrooms at that level. Some of the people have been assessed by an occupational therapist and stair and grab rails have been fitted in some circumstances. There may also come a time when people require mechanical hoisting equipment and there is limited space in which to use this equipment. There are also two bathrooms at the basement which are in need of considerable refurbishment, which again have limited space to provide assistance with bathing and consideration should be given to the provision of a wet-room to enable people to have walk in showers. The service should consider asking the Occupational Therapy Service to conduct an assessment of the premises to enable the service to continue to meet the needs of an aging group of people who already have some limitations in their mobility. The service is clean and hygienic with adequate supplies of hot water. Care Homes for Adults (18-65 years) Page 25 of 35 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The existing staffing levels may not be sufficient to meet the individual and collective needs of the people who live at the home . Evidence: The differing needs of the individuals living at the home and the layout of the building provides staff with some challenges in meeting the individual and collective needs of the people who use the service especially when all of the people are at home. Some people need at least two staff to provide personal care and in some case at least three staff can be required to manage challenging behavior or aggression between residents. Staffing levels need to be reviewed according to the dependency levels of the people who are using the service, their social activity needs and the layout of the premises. One of the staff files showed that the staff member was working toward the NVQ level 4 in care, however the other file did not reference any reference to an NVQ levels 2 having been obtained. Staff spoken to confirmed that they had been provided with opportunities to undertake the NVQ level 2. There is a rolling programme in place which indicates that staff have access to mandatory training such as Fire Safety, Basic Food Hygiene, Safe Administration of Medication and first Aid. Training is also being provided in the Mental Capacity Act and the Deprivation of Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: Liberty Standards. Staff also have training in the specific needs of the people who live there such as the management of challenging behavior, deescalation techniques and physical intervention techniques. Care Homes for Adults (18-65 years) Page 27 of 35 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 interests of the people who use the service are enhanced through the home being run in an organised manner which promotes their health and safety. Evidence: The provider has recently appointed a manager for the Berkeley and an application for registration with the Commission has been submitted. This means that the requirement specified in the previous Key Inspection report has now been met. The certificate of Registration dated 1st September 2008 is displayed in a prominent position in the home however this is now out of date as the Responsible Individual is no longer in the employment of the provider. In addition the provider has also enabled the people who live there to have single occupancy bedrooms which means that the certificate of registration should also be reviewed to ensure that it accurately reflects the number of people who are able to live there. The new manager conducts regular monthly audits of medication systems, care plans, the environment, petty cash and any money held by the service on behalf of the people who use the service. Weekly meetings are held with the staff and people who live at the Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: Berkley, this provided a forum where people can express their views about the service and make decisions about the running of the home. In addition the provider also conducts annual satisfaction surveys to establish the views of the people who use the service. The service is currently undergoing refurbishment, this has been done in two phases to restrict the disruption to the people who use the service and risk assessments are in place to reduce and manage the associated risks. Accident records are completed as necessary and held on file within the home. No hazards were identified during the inspection. Care Homes for Adults (18-65 years) Page 29 of 35 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 30 of 35 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 1 9 13 Risk assessments must be put in place for the management of extreme weather conditions and the effects on the people who use the service. 14/08/2009 To ensure the health and well being of the people who use the service 2 18 13 Nutritional risk assessemnst 01/08/2009 must be conducted for people over tha age of 65 or who are at nutritional risk. To ensure the health and well being pf the people who use the service. 3 18 13 Risk assessments must be conducted for people who are over 65 or who are vulnerable to the risks associated with pressure. 01/08/2009 Care Homes for Adults (18-65 years) Page 31 of 35 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 To ensure the health and well being pf the people who use the service. 4 18 13 The management must 01/09/2009 arrange for an Occupational Therapist to assess the needs of the people who use the service in relation to the environment in which they are cared for. To ensure the health safety and well being pf the people who use the service. 5 19 13 Medication sorage systems 01/09/2009 must be reviewed to ensure that they comply with the guidance issued by the BRPS To ensure the safe storage of medication 6 23 13 The management must 01/09/2009 ensure that the theft of a lap top belonging to a person who used to live at the home is reported to the insurance company to see if a claim can be submitted. To ensure that people are protected from the effects of abuse in this case theft from the premises. 7 33 18 Staffing levels must be 01/09/2009 Care Homes for Adults (18-65 years) Page 32 of 35 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 reviewed according to the assessed dependency of the people who use the service and the lay out of the building. To ensure that the individual and collective needs of the people who use the service can be met Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The statement of purpose should be further reviewed to ensure that it contains more detail about the arrangements for emergency admissions, annual holidays and new CQC contact information Residents contacts should be reviewed to ensure that they have an option of a 7 day paid holiday as per standard 14 of the NMS, to ensure equity with other services within the Mentaur Group. Risk assessments for the effects of smoking on the health of individuals should be reviewed to ensure that they are up to date and comply with current guidance. Guidance should be sought from the District Nursing Service regarding the use and content of assessments for nutritional risk, risks of pressure and movement and handling. Guidance should be sought from the local falls coordinator regarding the development of more detailed risk assessments and the prevention of falls. The complaints procedure should be reviewed to ensure Page 33 of 35 2 5 3 9 4 18 5 18 6 22 Care Homes for Adults (18-65 years) 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 that it contains up to date contact information and timescales for acknowledgment, investigation and response. 7 24 The Occupational Therapy Service should be asked to conduct are review of the whole premises to ensure that the service is able to meet the needs of an aging group of people some of whom have limited mobility as part of the ongoing refurbishment. Consideration should be given to the conversion of one of the basement level bathrooms into a wet room to provide improved access for people with limited mobility as part of the ongoing refurbishment. The management should ensure that at least 50 of staff obtain the NVQ level 2 in care. The provider should notify the Registration Team of the new Responsible Individual. The certificate of registration should be reviewed to ensure that the numbers of people for whom the service is registered is accurate and up to date now that people are enabled to have single occupancy bedrooms. 8 27 9 10 11 32 37 37 Care Homes for Adults (18-65 years) Page 34 of 35 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 © (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 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!