Care Home: The Gable

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What the care home does well The residents were provided with useful information in a suitable format so they could read about the services and facilities available in the home. The residents` needs were properly assessed and reviewed at regular intervals. This meant the staff were aware of the residents` current needs and how best to provide care and support. Each resident had a support plan based on their assessment of needs and they were supported to participate in the review and development of their plans. The plans were underpinned with risk assessments, which meant the staff had information about how to manage and respond to any areas of identified risk. The daily routines were flexible and designed to meet the needs and wishes of the residents. This meant the residents were able to choose their preferred lifestyle and their individual preferences were recognised. The residents spoken to felt they were well supported and the staff treated them with respect. The residents pursued a range of activities both inside and outside the home. This approach enabled the residents to participate in the life of the home and gave them the opportunity to meet other people. Appropriate policies and procedures were in place to ensure the residents were listened to and protected from harm. The residents spoken to felt confident that any concerns would be taken seriously and acted upon. The residents were provided with a clean, safe and comfortable home, which they enjoyed living in. Staff were provided with a broad range of training opportunities, which gave them an understanding of the needs of the residents. All the staff had achieved NVQ (National Vocational Qualifications) level 2 or above, which meant they had the necessary qualifications to carry out their role effectively. Relationships within the home were positive and the atmosphere was open and friendly. One resident commented, "It`s a brilliant place to live, I like everything". What has improved since the last inspection? Since the last inspection, the care plan documentation had been amalgamated into one file, which made the documents easier to follow and use. The residents had been involved in planning individual activity schedules, which gave structure and variety to their daily lives. To ensure the schedules were workable the registered manager had made sure that the plans were flexible so that changes could be easily made, if the residents` wished to pursue other interests. A number of improvements had been made to the premises, to aid the comfort and independence of the residents. For example, a new carpet had been fitted in the lounge; two bedrooms had been redecorated and the bathroom and toilet floors had been retiled. Work had been also been completed on the fire alarm system and a new washer and dryer had been purchased. The registered manager had acquired access to the LWDP (Lancashire WorkforceDevelopment Plan), which is an internet data base. The system displayed a training record for each member of staff and highlighted when mandatory training was due. This enabled the registered manager to plan future staff training effectively, in line with the needs of residents. What the care home could do better: The electrical safety certificate must be renewed to demonstrate the electrical installations are safe. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Gable 75 Albion Street Burnley Lancashire BB11 4LY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Playfer     Date: 0 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: The Gable 75 Albion Street Burnley Lancashire BB11 4LY 01282454577 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) : Alliance In Care Limited care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home The Gable provides accommodation and personal care for six adults with a Learning Disability aged between 18 and 65 years. The home is an end terrace property, providing accommodation in five single rooms and one shared room, none of the rooms have an ensuite facility. The communal space is provided in a lounge/dining room and kitchen. The home also has one bathroom and a shower room. The home is located approximately half a mile from Burnley town centre and is near to local amenities. There is a yard at the rear of the property, which has a seating area. According to information supplied by the registered manager the scale of fees at the Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home time of the inspection was £363.00 to £377.50 per week. Additional charges were made for activities, toiletries and haircuts. The home has a statement of purpose and service users guide, which informs the current and prospective residents about the services and facilities available at the home. Previous inspection reports can be viewed in the home or downloaded free of charge from the Commissions website: www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A key unannounced inspection, which included a visit to the home, was conducted at The Gable on 3rd June 2009. The inspection was carried out by one inspector, however, the report refers to we as it was written on behalf of the commission. We lasted visited this service on 13th June 2007 and an annual service review was carried out on 11th June 2008. There have been no additional visits to the home since the last key inspection. At the time of the visit, there were six residents accommodated in the home. During the inspection we spent time with the residents, looked round the home, read some of the residents care records and other documents and talked to the staff and the registered manager. We also consulted our records about the service and the Care Homes for Adults (18-65 years) Page 6 of 30 information we have received since the last key inspection. As part of the inspection process we used case tracking as a means of gathering information. This process allows us to focus on a small group of people living at the home, to assess the quality of the service provided. Prior to the inspection, the registered manager completed an Annual Quality Assurance Assessment known as AQAA, which is a self assessment questionnaire covering all aspects of the management of the home. This provided us with useful information and evidence for the inspection. Satisfaction questionnaires were sent to the home for distribution to the residents. Five questionnaires were returned. The responses from the questionnaires were collated and used throughout the inspection process. What the care home does well: What has improved since the last inspection? Since the last inspection, the care plan documentation had been amalgamated into one file, which made the documents easier to follow and use. The residents had been involved in planning individual activity schedules, which gave structure and variety to their daily lives. To ensure the schedules were workable the registered manager had made sure that the plans were flexible so that changes could be easily made, if the residents wished to pursue other interests. A number of improvements had been made to the premises, to aid the comfort and independence of the residents. For example, a new carpet had been fitted in the lounge; two bedrooms had been redecorated and the bathroom and toilet floors had been retiled. Work had been also been completed on the fire alarm system and a new washer and dryer had been purchased. The registered manager had acquired access to the LWDP (Lancashire Workforce Care Homes for Adults (18-65 years) Page 8 of 30 Development Plan), which is an internet data base. The system displayed a training record for each member of staff and highlighted when mandatory training was due. This enabled the registered manager to plan future staff training effectively, in line with the needs of residents. 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 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents were provided with useful and appropriate information about the home and their needs were properly assessed and reviewed. Evidence: Written information was available for the residents in the form of a statement of purpose and service users guide. Both documents met regulatory requirements and had been updated in line with any changes in the service. The residents had been issued with a copy of the service user guide and the statement of purpose was displayed in the hallway. The guide was presented in an easy read format and had been explained to all the residents. The previous inspection report was available for the residents to look at in the hallway. This meant the residents were provided with up to date information about the services and facilities available in the home. All the residents had lived in the home for many years and were well established. Two of the residents files were looked at in detail as part of the case tracking process. From this we could see that the residents needs had been reassessed at regular Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: intervals by Social Services and the registered manager. The assessments focused on all areas of the residents needs and considered individual requirements in respect of social and cultural needs. This meant that staff had access to information about the residents current needs and preferences. The residents were issued with a contract with the company, which covered the terms and conditions of residence. This meant the residents were aware of what they could expect from the service. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents individual needs were fully addressed and the residents were well supported to enable them make their own decisions and participate in life in the home. Evidence: The case tracking process demonstrated that each person had an support plan, which reflected their health and welfare needs. Since the last inspection, the care plan documentation had been amalgamated into one file, which made the documents easier to follow and use. The support plans comprised of three overlapping plans covering the residents personal and health needs as well as their wishes and aspirations. The plans were person centred to ensure the residents fully participated in the development and review of their plans. The plans were written in plain language and looked at all areas of the residents life. The staff maintained daily records of care and support, which provided information about changing needs and any recurring difficulties. The records were detailed and the residents needs were described in Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: respectful and sensitive terms. A key worker system allowed staff to work on a one to one basis with the residents and supported the residents to make contributions to the development of their plans. The support plans were reviewed at six monthly intervals or more frequently in the event of changing needs. The residents fully participated in their reviews, which also involved consultation with others if necessary. Risk assessments had been carried out to help the residents take responsible risks and lead the life they wanted. The risk assessments were supported by risk management strategies or control measures which provided the staff with guidance on how best to manage and respond to particular risks. This meant risks were managed in a consistent and safe manner. During conversations with the residents, it was evident they were consulted both formally and informally about life in the home. This was achieved by way of residents meetings, daily conversations and satisfaction questionnaires. This meant the residents had various opportunities to express their views about life in the home. One resident was also invited to attend part of each staff meeting. This role was offered to each resident in turn and enabled them to discuss the outcomes of the residents meetings. Policies and procedures were in place to support the residents with their financial affairs. Records were made of all financial transactions and regular audits were carried out by the registered manager. A random check of money deposited in the home for safe keeping corresponded accurately with the records. This meant that the residents finances were fully accounted for and safeguarded. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents were able to make informed choices about their lifestyle and were well supported to develop their skills. Evidence: The individual plans and care records demonstrated that the residents had opportunities to maintain and develop practical life skills. As such, residents were supported and encouraged to identify their personal goals and work to achieve them. The residents were encouraged and supported to participate in life in the home and carried out domestic tasks commensurate with their abilities and interests. These tasks included tidying the bedrooms, helping in the kitchen, going to the local shops and light domestic chores. There was a rota displayed in the kitchen, which set out each persons tasks for the day to ensure the housework was distributed equally. The residents spoken to said they enjoyed participating in the tasks, especially helping in Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the kitchen. The residents were involved in a variety of activities, which were arranged in accordance with their individual interests, needs and capabilities. Wherever possible and appropriate the residents participated in community based events and accessed facilities within the local town for example leisure centres, restaurants, pubs and shops. Since the last inspection, the residents had been involved in planning individual activity schedules, which gave structure and variety to their daily lives. The schedules were flexible and were dependent on the residents wishes. Support was also given to the residents who wished to pursue occupational and educational activities, such as attending the local college or working in a part time job. The staff team helped the residents with their communication skills, to enable them to fully participate in daily living activities and have valued roles in the community. This meant the residents were able to develop an individual lifestyle which met with their needs, interests and preferences. On the day of inspection, the residents were observed to pursue a variety of activities. For example, one resident attended a luncheon club, one resident went to a local day centre and one resident visited a nearby library. The residents went away on holiday once a year and they said they were greatly looking forward to a forthcoming holiday in Devon. This enabled the residents to have a break from the home and spend time doing different activities. The residents had the opportunity to develop and maintain important personal and family relationships. As such friends and family were welcome to visit at anytime convenient to the residents. Some residents also visited their families on a regular basis and were provided personal support and help with any arrangements. The residents had unrestricted access to the communal areas and grounds. The residents were also able to use their room at anytime should they wish to spend time alone. One resident said he enjoyed spending time in his room watching the DVDs on his television. All the residents had been issued with keys, so they could lock the door to their private accommodation. The residents participated in planning, purchasing and preparing the meals. The menu was devised a week in advance and provided the residents with a choice of food each mealtime. Meals were provided three times a day with a range of drinks and snacks available at all other times. The residents spoken to said they liked the food and confirmed there was always plenty to eat. The record of food served demonstrated that the residents were provided with a nutritious and balanced diet, which catered for Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: individual dietary requirements and preferences. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care received by residents was based on their individual needs. There were arrangements in place to manage medication safely and effectively. Evidence: The individual plans set out the personal support required by each resident and provided guidance to staff on how the residents wished to receive this support. The residents spoken to confirmed that personal care was responsive to their needs and preferences. Comments included, The staff are brilliant, they are all good and friendly. Discussion with staff and the registered manager demonstrated their awareness of the residents rights to privacy and dignity and the need to respond sensitively to individual issues and changing needs. This meant that the delivery of personal care was flexible, reliable and person centred. Health care needs were appropriately assessed and were included in the support plans. Specific information was included in the health action plans, which provided details about past and present medical conditions and how these impacted on the residents current lifestyle. A separate record was made of medical appointments and there was Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: evidence to indicate the residents had access to NHS services such as General Practitioners and Consultants. The residents also attended routine health appointments with the chiropodist, dentist and optician. This meant the residents healthcare needs were understood by the staff team and an appropriate response was made to changing needs. Policies and procedures were in place to cover the management of medicines and were available for staff reference in the medication file. The home operated a monitored dosage system of medication, which was dispensed into cassette trays by a local Pharmacist. Appropriate records were in place for the receipt, administration and disposal of medication and all records seen were complete and up to date. Staff designated to administer medication had received accredited training. This meant that the staff had received the necessary training to ensure that medication was managed in a safe and consistent manner. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were able to express their views and any concerns and had access to a clear complaints procedure. There were established ways of working to respond effectively to any suspicion or allegation of harmful practice. Evidence: The registered manager fostered an open culture in the home to ensure the residents were able to express their views in a safe and understanding environment. As such ways of working were in place such as residents meetings, daily conversations and satisfaction questionnaires, which provided the residents with various opportunities to discuss life in the home. The residents spoken to said they felt comfortable about expressing their views and were aware of whom to speak to in the event of a concern. The full complaints procedure was incorporated into the service users guide, along with an easy read version which included a pictorial flow chart. The procedure contained the necessary information and included the relevant telephone numbers and contact details should a resident wish to raise a concern. The registered manager had not received any complaints, since the last inspection. Policies and procedures for safeguarding vulnerable adults were available, which provided guidance for staff should they suspect or witness any harmful practice. These issues were incorporated into the induction training and staff received specific tuition Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: as part of their NVQ and mandatory training. The staff also had access to a whistle blowing procedure. This procedure set out a system for staff to report any concerns about colleagues or managers to the relevant authorities. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were provided with a clean, pleasant and well-maintained environment, which promoted their comfort and independence. Evidence: The Gable is an end terraced property located approximately half a mile from Burnley town centre. The premises are in keeping with the neighbouring community and are close to local amenities such as shops. Accommodation is provided in five single rooms and one shared room. There is also one bathroom and one shower room. The bedrooms were decorated and furnished according to personal taste. The residents said they liked their rooms and commented that they liked to spend time on their own in their bedrooms. The furnishings and fittings were domestic in character and a satisfactory standard throughout. Since the last inspection, a number of improvements had been made to the premises, to aid the comfort and independence of the residents. For example, a new carpet had been fitted in the lounge, two bedrooms had been redecorated and the bathroom and toilet floors had been retiled. Work had been also been completed on the fire alarm system. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Appropriate arrangements were in place for general maintenance and repairs. This meant that routine problems with the building were promptly rectified. The home had a good standard of cleanliness in all areas seen and was free from offensive odours. Arrangements were in place for the residents to do their own laundry. This meant the residents could maintain and build on their independence skills. Since the last inspection, a new washer and dryer had been purchased and the laundry had been repainted. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements in place to manage staff recruitment and training ensured the residents were supported safely. Evidence: Staff had been issued with an appropriate job description during the recruitment process, which clearly set out their roles and responsibilities. During conversations with the staff, it was evident they were aware of the limitations of their role and had a good understanding of the needs of the residents. Staff referred to the residents in respectful terms and were observed to interact with the residents in a pleasant way. A staff duty roster was drawn up in advance and provided a record of the number of hours worked by the staff in the home. The roster indicated that a sufficient number of care staff were on duty throughout the waking day. One member of staff carried out a sleeping in duty during the night with an additional person available on call. All staff left in charge of the building were aged over 21. Many of the staff had worked at the home for some time, which meant they had a good knowledge of the needs of the residents. A recruitment and selection procedure was available and a checklist was used to track Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: the receipt of documentation during the recruitment process. The file of one member of staff was looked at in detail. It was evident that the applicant had completed an application form and provided a full working history. CRB (Criminal Records Bureau) and POVA (Protection of Vulnerable Adults) checks had been obtained prior to the applicant commencing work in the home, along with two written references. This meant that the registered manager had collated all records and checks in accordance with regulatory requirements. Arrangements were in place for all new employees to undertake induction training, which incorporated the Skills for Care standards. The latter provided underpinning knowledge for NVQ level 2. According to information supplied by the registered manager, all care staff had completed NVQ level 2. This meant the staff team had achieved the necessary qualifications to enable them to carry out their role effectively. Staff attended both internal and external training courses and had at least three paid days training a year. Staff discussed their individual training needs during their supervision sessions and staff meetings. Since the last inspection, the registered manager had acquired access to the LWDP (Lancashire Workforce Development Plan), which is an internet data base. The system displayed a training record for each member of staff and highlighted when mandatory training was due. This enabled the registered manager to plan future staff training effectively, in line with the needs of residents. Consultation with staff was ongoing and handover meetings were held on a daily basis. Staff had the opportunity to attend meetings on at regular intervals and minutes were seen of the last meeting held in the home. The staff were encouraged to add to the agenda and openly discuss issues affecting the operation of the home. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management and administration practices were effective in ensuring the home was run in the best interests of the residents. Evidence: The registered manager had overall responsibility for the day to day operation of the home. The manager had completed an NVQ level 4 in Care and Management and the Registered Managers Award. The manager had also undertaken periodic training to refresh her skills and knowledge. The management approach was consultative and there were established ways of working to consult the staff and residents on an ongoing basis. Relationships within the home were positive and staff spoke to and about the residents and other staff in respectful terms. The service was reaccredited with an Investors in People Award in July 2008. This is a professionally recognised quality assurance award. The registered manager had Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: established systems to monitor the quality the quality of the service, which included regular internal audits. Satisfaction questionnaires had been distributed to residents and their families in October 2008. The results had been collated and feedback had been given. The registered manager had produced an annual development plan, but this had not been updated for 2009. This meant it was difficult to determine the managers priorities and plans for the forthcoming year. Further to this, the manager agreed to update the plan in line with the outcomes of the quality assurance processes. There was a set of health and safety policies and procedures, which included the safe storage of hazardous substances, food safety and infection control. Staff received mandatory health and safety training, which included food hygiene, first aid and fire safety. Documentation seen during the inspection and information supplied in the AQAA indicated that the electrical, gas and fire systems were serviced at regular intervals. However, it was noted that the electrical safety certificate had expired. Further to this the manager gave assurances that immediate arrangements would be made to ensure the certificate was renewed. The fire log demonstrated that the staff had received instructions about the fire procedures during their induction and had participated in regular fire drills. Arrangements were in place to record accidents and incidents in the home. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 13 The electrical safety 03/07/2009 certificate must be renewed. This is to ensure the electrical installations are safe. 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 39 The annual development plan should be updated to reflect the outcomes of the quality assurance processes and the planned developments for the forthcoming year. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: 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) Commission for Social Care Inspection (CSCI). 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. 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