Care Home: The Croft

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What the care home does well The registered providers believe in making sure that the people living at the home are supported in their personal development and are able to lead fulfilling lives and integrate where they wish to within the local community. The persons cared for are supported to be as independent as possible and where appropriate take responsibility for shopping and making drinks for themselves. Three of the people supported attend college three times a week and are studying `Literary and Numeracy` skills for life courses that include English, Maths and Cookery. All the people supported enjoy line dancing and shopping in the Arndale Centre, other activities include bingo. There are regular Mencap Meetings which are social evenings attended by the people in the home. A holiday takes place each year in Blackpool with the registered providers who also take them for meals and the cinema as one big family. All the people supported are happy and confirmed that they are treated with dignity and respect. By observation, the interaction between the people supported and the registered providers was relaxed and informal with their needs and wishes taken into account at all times. There was evidence of views obtained by the home about the services provided and the following comments had been received: `The owners have very high standards of care. I am really pleased with the activities, dancing, bingo, Mencap nights.` `Special little touches are what makes this a caring home.` `There is always a good, warm and family atmosphere.` `They always seem happy and contented.` `They all have their own well appointed rooms where one can chat in private if required.` `They have good fellowship at church and outside interests.` `The service users are given choices and offered opportunities to try new things.` `I have visited many times and always made to feel welcome.` The staff member employed has obtained a National Vocational Qualification (NVQ) at level 3 in Social Care. The NVQ in Social Care is the nationally recognised qualification necessary for staff working within the caring services. The staff member has also undertaken the Learning Disability Awards Framework (LDAF) and a formal induction programme. The LDAF ensures that staff working with persons with a learning disability are able to support them in a way that meets good practice guidelines.Both registered providers have a nursing qualification, Registered General Nursing (RGN) and they have kept this up to date with regular training. One of the registered providers has also obtained NVQ 4 in Care and Management and also has the Registered Manager`s Award (RMA). Equality and diversity is recognised at all times and all the people in the home are respected for their individuality regardless of age. race, ethnic background, language, culture, faith, gender, sexuality or disability. What has improved since the last inspection? The registered providers work closely with other learning disability professionals and have recently attended training on the Mental Capacity Act (MCA) and the Deprivation of Liberties Safeguards (DOLS). The MCA and DOLS are legal requirements that came into force to protect the interests of any person who lacks mental capacity and is unable to make a decision for themselves. Consideration is currently being given to changes to the menu for one of the people supported who would like burgers and hot dog and chips once or twice a week. The menu will remain the same for other people in the home if that is what they prefer. A `service user food satisfaction survey` is to be devised to ensure that the meals provided are suitable and satisfactory for the people cared for in the home. Consideration is being given for an opportunity for some of the persons cared for to self medicate following a risk assessment. As recommended at the last inspection the policies and procedures are regularly reviewed and a date for review is now recorded. There are new measures in place to ensure the quality of the service provide is maintained and the views of other social care professionals, friends and relatives are sought on a regular basis. Surveys had been distributed which provided good information about the services provided with many complimentary comments. Consideration is being given to allow for anonymous responses to surveys to ensure an honest response. What the care home could do better: There were no requirements or recommendations made at this inspection. The home continues to improve and provides an excellent lifestyle for the persons accommodated. Key inspection report Care homes for adults (18-65 years) Name: Address: The Croft 11a Albany Road Morecambe Lancashire LA4 4JY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Dale     Date: 2 4 1 1 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 Croft 11a Albany Road Morecambe Lancashire LA4 4JY 01524410972 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Mahendranath Bhowruth,Mrs Krisnawatee Bhowruth care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category/ies 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 The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home The Croft is a small registered home for up to six people of either sex who have a learning disability. The people are cared for within a homely environment within a family type setting. The home is owned and managed by the registered providers who both have lengthy experience in the provision of care and are well qualified. There is one other staff member who assists the registered providers and has been employed at the home for some time. The home is not purpose built, all the people accommodated are able to access all parts of the home. The registered providers also live within the home. The persons cared for are enabled and encouraged to be as independent as possible and lead fulfilling lives within the local community. The Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home routines of daily living are provided according to the needs, choices and wishes of the persons supported. Information about the services provided by the home are contained within a Statement of Purpose and Service User Guide which is made available to any interested party. The current fees are £358:00 rising to £449:50 per week. Further information about fees can be obtained from the registered providers of the home. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection process an unannounced site visit took place to Ashburnham House. This took place over a period of three hours on the 24th November 2009. Information was obtained by an Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. Information gathered about the home since the last key inspection was also taken into account. Various documents were examined including, records belonging to the people provided with a service and staff records. The registered providers who also manage the home were spoken with and the persons cared for in the home. Surveys were sent prior to the site visit; no surveys had been returned up to the date of writing this report. The last key inspection took place on the 14th December 2006. An annual service review took place on the 3rd March 2008 and the 24th March 2009. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: The registered providers believe in making sure that the people living at the home are supported in their personal development and are able to lead fulfilling lives and integrate where they wish to within the local community. The persons cared for are supported to be as independent as possible and where appropriate take responsibility for shopping and making drinks for themselves. Three of the people supported attend college three times a week and are studying Literary and Numeracy skills for life courses that include English, Maths and Cookery. All the people supported enjoy line dancing and shopping in the Arndale Centre, other activities include bingo. There are regular Mencap Meetings which are social evenings attended by the people in the home. A holiday takes place each year in Blackpool with the registered providers who also take them for meals and the cinema as one big family. All the people supported are happy and confirmed that they are treated with dignity and respect. By observation, the interaction between the people supported and the registered providers was relaxed and informal with their needs and wishes taken into account at all times. There was evidence of views obtained by the home about the services provided and the following comments had been received: The owners have very high standards of care. I am really pleased with the activities, dancing, bingo, Mencap nights. Special little touches are what makes this a caring home. There is always a good, warm and family atmosphere. They always seem happy and contented. They all have their own well appointed rooms where one can chat in private if required. They have good fellowship at church and outside interests. The service users are given choices and offered opportunities to try new things. I have visited many times and always made to feel welcome. The staff member employed has obtained a National Vocational Qualification (NVQ) at level 3 in Social Care. The NVQ in Social Care is the nationally recognised qualification necessary for staff working within the caring services. The staff member has also undertaken the Learning Disability Awards Framework (LDAF) and a formal induction programme. The LDAF ensures that staff working with persons with a learning disability are able to support them in a way that meets good practice guidelines. Care Homes for Adults (18-65 years) Page 8 of 29 Both registered providers have a nursing qualification, Registered General Nursing (RGN) and they have kept this up to date with regular training. One of the registered providers has also obtained NVQ 4 in Care and Management and also has the Registered Managers Award (RMA). Equality and diversity is recognised at all times and all the people in the home are respected for their individuality regardless of age. race, ethnic background, language, culture, faith, gender, sexuality or disability. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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. An assessment has taken place that ensures the services provided by the home are suitable and will meet individual physical and emotional needs and promote Independence. Evidence: The people supported within the home have been there for a number of years and there have been no recent new referrals. The registered providers are aware of the areas to be addressed when accepting a new person and a trial visit would be arranged. A Statement of Purpose and Service User Guide is available and has recently been reviewed and updated. The documents seen were user friendly and in large print for any person with poor sight. The registered providers work closely with other learning disability professionals and have recently attended training on the Mental Capacity Act (MCA) and the Deprivation of Liberties Safeguards (DOLS). The MCA and DOLS are legal requirements that came Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: into force to protect the interests of any person who lacks mental capacity and is unable to make a decision for themselves. The registered providers are aware of their duties and responsibilities under the MCA and DOLs and the need to ensure safeguards to protect the best interests of any person they support. 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. The people cared for within the home are supported by a daily living plan that encourages Independence within a risk assessment framework that supports their chosen lifestyle. Evidence: There are currently six people supported within the home and four care plans were examined. The details seen included short and long term goals and a detailed plan of care was recorded over day to day living and physical and emotional requirements. Individual choices and wishes had been taken into account at all times. Day to day living is specific according to individual needs and choices; the care plans are flexible and focused on individual outcomes. For example three persons attend college and are able to choose the subjects they wished to study; on the day of the site visit, one person attending college was going to make mince pies. Two people in the home were knitting in the lounge and relaxing before their Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: lunchtime meal. The persons cared for are supported to be as independent as possible and where appropriate take responsibility for shopping and making drinks for themselves. The registered providers usually accompany individuals on shopping trips and help them to choose items wisely and budget accordingly. Assessments are undertaken on whether a person is able to handle their own finances and support is provided where needed. Risk assessments had been incorporated within the care plans and there was evidence of a separate additional risk assessment for one person who had fallen and needed extra help. All the persons cared for are encouraged to have their own routines and lifestyle within a risk assessment framework that ensures they are protected as much as possible. Regular meetings have taken place and the person cared for has been present and supported with their decisions about daily life. The care plans seen had been reviewed on a regular basis and had been signed by the individual concerned as well as any other professionals involved. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are supported in their chosen lifestyle and encouraged and enabled to be part of the local community. Leisure activities are in place according to the wishes of the people supported. Evidence: The registered provider believe in making sure that the people living at the home are supported in their personal development and are able to lead fulfilling lives and integrate where they wish to within the local community. Three of the people supported attend college three times a week and are studying Literary and Numeracy skills for life courses that include English, Maths and Cookery. All the people supported have a bus pass and either use public transport or a taxi or the registered providers take them in their own car. Four of the people supported attend church services at the local Church of England. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: A programme of activities is recorded and placed in the hallway of the home. All the people supported are enjoy line dancing and shopping in the Arndale Centre, other activities include bingo. There are regular Mencap Meetings which are social evenings attended by the people in the home. A holiday takes place each year in Blackpool with the registered providers who also take them for meals and the cinema as one big family. Relatives are invited for birthday teas and are welcome at any time. All the people supported are happy and confirmed that they are treated with dignity and respect. By observation, the interaction between the people supported and the registered providers was relaxed and informal with their needs and wishes taken into account at all times. Meetings are held once a month to provide an opportunity for the persons supported to have their say about their wishes and choices. There was evidence of views obtained by the home about the services provided and the following comments had been received: The owners have very high standards of care. I am really pleased with the activities, dancing, bingo, Mencap nights. Special little touches are what makes this a caring home. There is always a good, warm and family atmosphere. They always seem happy and contented. They all have their own well appointed rooms where one can chat in private if required. They have good fellowship at church and outside interests. The service users are given choices and offered opportunities to try new things. I have visited many times and always made to feel welcome. The registered providers make all the meals and ensure that they are provided at Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: times according to the individual and their choice of activities for the day. Meals provide choice and fresh fruit is available. Nutritional assessments take place and special diets are catered for. The people supported confirmed they are happy with the meals provided. Consideration is currently being given to changes to the menu for one of the people supported who would like burgers and hot dog and chips once or twice a week. The menu will remain the same for other people in the home if that is what they prefer. A service user food satisfaction survey is to be devised to ensure that the meals provided are suitable and satisfactory for the people cared for in the home. Equality and diversity is recognised at all times and all the people in the home are respected for their individuality regardless of age. race, ethnic background, language, culture, faith, gender, sexuality or disability. Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal care and healthcare requirements of the people supported are fully met by the policies and procedures operating within the home. Evidence: The persons spoken with were all very happy with the level of care provided and the records indicated that all of the people supported are set achievable goals that encourages Independence. The goals are reviewed on a regular basis and support to achieve the goals is provided by the registered providers and a member of staff. All of the people cared for in the home are able to make decisions for themselves on a daily basis and have flourished with the support, care and attention provided. The care plans indicated where support and prompting was required, for example personal hygiene. At the review of the care plan, a record was made on whether personal hygiene had been achieved without too much prompting. There was evidence on the records of liaison with health professionals and hospital visits at which, where necessary they are always accompanied by the registered provider. The diary sheets provided clear evidence of the support and healthcare Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: received leading to improvement to the health of the person concerned. Meetings had taken place with the person supported and health professionals and a care plan or risk assessment devised with a review date; the details were signed by all the people present at the meeting. Medication Administration Records (MAR) are maintained and were in good order. Currently the registered providers administer any medication and permission has been gained from the people supported who prefer not to self medicate. Consideration is being given for an opportunity for some of the persons cared for to self medicate following a risk assessment. Care Homes for Adults (18-65 years) Page 19 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. The policies, procedures and training of staff ensures that the people cared for in the home are listened to and are protected from abuse, neglect and self harm Evidence: The home is run as one big family; there are only the two registered owner/providers, husband and wife and one other staff member. Every opportunity is provided for interaction with the people supported in the home. Individual wishes are taken into account at all times and any concern is dealt with swiftly. There are residents meetings every Monday evening and this encourages good communication and a time to plan and examine any issues that have arisen over the week. A complaints procedure is in place and the details seen had been updated with the new contact details of the Care Quality Commission. The registered providers and the staff member have all received training on the Protection of Vulnerable Adults (POVA) and are due to have refresher training in the near future. A policy and procedure is in place in the event of any suspected incident of abuse. 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 provides a homely, pleasant and safe place to live for the people being cared for. Evidence: The home is not purpose built but has a large extension on the side of the house and the people cared for in the home have rooms on the ground floor and the registered providers/owners live on the premises upstairs. The home does not employ a cleaner and the the owners and staff keep the home clean. A tour of the home took place and all parts of the home were clean and tidy. The rooms belonging to the people cared for had many personal possessions and the rooms were cozy and inviting. Two of the bedrooms have en-suite facilities. The stairway has been painted as recommended at the last inspection and the flooring around the shower area had been replaced. The garden is small and at the front of the house which is set on a corner; there is a patio area where people can sit outside. There are plans to redecorate a couple of the bedrooms and the choice of colour, curtains and bedlinen will be according to the individuals preference. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home has a no smoking policy and none of the persons accommodated smoke. Maintenance of equipment takes place on a regular basis and a fire record book is maintained. Two staff have received training in the prevention and control of infection. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered providers and staff member work as a team and are well trained and competent providing excellent care to the people supported. Evidence: The home employs one member of staff who has worked for the registered providers for a number of years. There are suitable recruitment procedures in place but there are currently no plans to employ any more staff. The registered provider stated that if they did decide to employ further staff; they would include the persons cared for in the recruitment process. The staff member employed has obtained a National Vocational Qualification (NVQ) at level 3 in Social Care. The NVQ in Social Care is the nationally recognised qualification necessary for staff working within the caring services. The staff member has also undertaken the Learning Disability Awards Framework (LDAF) and a formal induction programme. The LDAF ensures that staff working with persons with a learning disability are able to support them in a way that meets good practice guidelines. The staff member has also undertaken Moving and Handling, First Aid, Food Hygiene and POVA. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Both registered providers live on the premises and are able to provide full time day and night cover to the people supported. One to one supervision takes place every three months and the details are recorded. Supervision provides an opportunity for any issues arising over the care of the people supported to be discussed and any need for staff training. The member of staff was not on duty at the time of this inspection but according to the registered providers they all work as a team. 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 excellent 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 and the best interests of the people supported are taken into account at all times. Evidence: Both registered providers have a nursing qualification, Registered General Nursing (RGN) and they have kept this up to date with regular training. One of the registered providers has also obtained NVQ 4 in Care and Management and also has the Registered Managers Award (RMA). Training is ongoing and all staff have received training in person centred approach care planning and this has helped to ensure that the people supported are at the centre with their individual needs and choices taken into account at all times. The opinions and views of the persons cared for are taken into account at all times and regular meetings take place both formally and informally. The home is well maintained and the equipment and facilities in the home are Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: regularly checked for safety. An accident book is maintained and regular fire drills take place. As recommended at the last inspection the policies and procedures are regularly reviewed and a date for review is now recorded. There are new measures in place to ensure the quality of the service provide is maintained and the views of other social care professionals, friends and relatives are sought on a regular basis. Surveys had been distributed which provided good information about the services provided with many complimentary comments. Consideration is being given to allow for anonymous responses. 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). 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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