Care Home: The Gables - Sandwell Mind

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What the care home does well The Gables continues to provide people with a comfortable, well-maintained and safe environment in which to live. The service is run by an experienced manager and people`s care needs are met in the way they prefer by a stable and competent staff team. All staff holds a recognised qualification in health and social care. Care plans are produced and regularly reviewed to ensure people`s needs and personal preferences are met. Risk assessments are undertaken, strategies identified to keep people safe from harm and support them to live independent lifestyles. They are encouraged to make their own decisions, maintain contact with family and friends and provided with opportunities to participate in a range of activities. What has improved since the last inspection? Since our last visit the service has provided people with increased opportunities to meet with their key worker/s to discuss their care and express their views on the dayto-day running of the home. This continues to ensure people are actively involved in planning for their own care and their views continue to be listened to and acted upon. A colour coded system has been introduced into systems for managing medication. This is to ensure the risks of any errors occurring are reduced further. Systems for risk assessment and self auditing have been revised to ensure people continue to be kept safe and areas for improvement in the service are identified and addressed in a timely manner. What the care home could do better: There are no requirements following this inspection. However, there are some shortfalls in the service`s training programme. These should be reviewed regularly to ensure people`s specific needs are full met by a confident and competent staff team; for example caring for people with diabetes. Basic food hygiene training should be undertaken by all staff to ensure good practice is followed when preparing, or supporting people to prepare, meals or snacks. Good recruitment procedures and induction programmes are in place to ensure the well being and safety of people living in the home. It is advisable for the manager to ask for details from referees about their position, place of work and relationship with applicants when requesting references. Key inspection report Care homes for adults (18-65 years) Name: Address: The Gables - Sandwell Mind 109 St Pauls Road Smethwick West Midlands B66 1EY     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: Linda Elsaleh     Date: 1 8 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 27 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 27 Information about the care home Name of care home: Address: The Gables - Sandwell Mind 109 St Pauls Road Smethwick West Midlands B66 1EY 01215586085 F/P01215586085 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sandwell Association for Mental Health care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 14 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: Mental disorder, excluding learning disability or dementia (MD) 14 Date of last inspection Brief description of the care home The Gables is an independent sector home registered to provide residential care for 14 people experiencing mental ill health. The home was formally a vicarage and is situated in a residential area of Smethwick, close to shops, post office, and other local amenities. It is easily accessible by public transport and there are parking facilities to the side of the property. Landscaped gardens at the rear have level paving to enable access to all areas for wheelchair users. Entry is monitored through a security camera and intercom. Sandwell MIND has responsibility for both the management and staffing of the service Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 14 Brief description of the care home whilst Jephson Housing Association is responsible for the maintenance of the building. Accommodation is provided over 2 floors accessible via 2 staircases or a vertical lift. On the ground floor there are 2 toilets, 1 for people with disabilities and the other with a shower room. A further 4 toilets are on the first floor, 1 for people with disabilities, 1 with a shower and 2 with a bath, 1 of which has a hoist installed. Communal areas include an activity room for art and craft and games, a quiet area, a main lounge and dining room. For up to date information about fees the reader should contact the service. Care Homes for Adults (18-65 years) Page 5 of 27 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: The service is required to complete an Annual Quality Assurance Assessment (AQAA). This provides us with information about what has happened in the home during the last 12 months. This was returned to us when requested and contained the information we asked for. We looked at this and other information we have received about the service since our last visit. Comments received about the service were positive and have been included in this report. This unannounced visit was carried out by one inspector on 18th November 2009. We spoke to the manager, staff, people who live here and looked at the care files for two people and two staff as well as other records and documents kept by the service. This was to help us to assess the quality of life for people who live in the home and the services performance against the national minimum standards. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: 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 7 of 27 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 8 of 27 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 are provided with the information they need to make an informed choice about where to live. They know their needs can be met by the service because they are involved in the assessment process and provided with opportunities to visit the home before they move in. Evidence: People we spoke to told us they were provided with sufficient information to enable them to make an informed choice about where they wanted to live. The service arranges for people to visit before they move in. This provides them with opportunities to look around the home, talk to the people who live here and meet the staff. This is evidenced in the records kept by the service on the peoples individual files. Two people have come to live at The Gables during the last twelve months. Their files contain copy of reports from relevant health and social care agencies and the services assessment of their needs. Staff we spoke to said they have become more involved in the assessment process and this continues during the persons settling in period. This is to ensure the information is accurate and the support being provided meets the Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: persons needs and wishes. Care Homes for Adults (18-65 years) Page 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in the planning for their care, encouraged to make their own decisions and participate the day-to-day running of the home. Risk assessments are undertaken with individuals to protect their well being and support them to take risks, within agreed boundaries, to enable them to live independent lifestyles. Evidence: A care plan is produced for each person based on the information obtained through the assessment process. It details how their needs are to be met and the support they require to enable them to reach their individual goals. Two plans we looked at included details of their personal care, physical and mental health, medication, daily living tasks and, where applicable, preparations for moving towards more independent living. Regular discussions are held with the individual and their key worker/s. The manager also meets with them to review their care and the support being provided. People we spoke to expressed satisfaction with the key worker arrangements and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: confirmed regular meetings take to discuss their progress and plans for the future. However, there are times when they do not feel like talking and their decision is respected by staff. Records of these meetings are kept on the peoples files. Regular house meetings are held. This provides people with opportunities to voice their views about the service and be more involved in the day-to-day running of the home. Staff told us that some people prefer not to attend or express their views in a group setting. Therefore, information is provided to them during one-to-one meetings and they are asked if there are any issues they would like to be brought to the house meeting on their behalf. One person we spoke to told us they do not attend house meetings but are kept up to date by their key worker. The staff team for supporting people to express their views in settings they feel most comfortable shows us people are treated with dignity and respect. Individual risk assessments are carried out to ensure suitable strategies are in place to keep people safe and also to enable them to take risks, within agreed boundaries, to maintain and develop their skills and confidence. There are records of early warning signs for individuals mental health and relapse prevention plans. One person living in the home is a wheelchair user and her/his risk assessment identifies what they can do independently and where support is needed. A short-term needs assessment and risk assessment was carried out for a person who required the temporary use of a wheelchair. This shows us the service responds appropriately to peoples changing needs. There are also risk assessments for individual activities carried out both inside and outside the home. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to follow their own routines and have opportunities to participate in a range of activities. They are supported to maintain and develop relationships with family and friends. Mealtimes are flexible and met peoples dietary and personal preferences. In order to demonstrate more fully that peoples dietary needs are being met at all times care staff should be provided with relevant training. Evidence: People have access to a range of activities in the home such as table top games, cards and dominoes. Community-based activities include the cinema bowling and dining out. They also go on holidays to destinations of their choice. MIND newsletters and local information, such as college courses, clubs and transport details, are displayed on the notice boards in the reception areas. There are also photographs of the staff team and Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: activities people have enjoyed. During this visit we saw staff supporting people to develop their daily living skills and participating in activities. One person we spoke to told us they had been shopping with a member of staff for new furniture and soft furnishings for their bedroom. Visitors are welcome between the hours of 9am and 9pm or at other times with prior agreement. This information is also displayed in reception. People can receive their visitors in one of the lounges or in their own bedroom. A visiting health care worker commented that her/his client had settled in very well, sooner than expected and the staff provide her/him with a very good level of care and support. People have their own key for their bedrooms providing them with privacy. The doors are fitted with an override device for use by staff in the case of emergencies. Similar locks are fitted to bathrooms doors. There is unrestricted access to all communal areas and the garden. People told us they are able to follow their own daily routines and were seen coming and going from the home, making their own drinks and choosing when to get up or retire to bed (as agreed, where applicable, in their plan). We saw staff interacting well with people in the home, addressing them by their preferred names and respecting their right to privacy. The menu for the day is displayed on the notice board in the dining room. People tell us they are consulted about meals and mealtimes. The main meals are provided by the full-time cook and people were complimentary about her/his cooking. Other meals and snacks are prepared by the care staff and people, who wish to, are supported to prepare their own. The training records show care staff have not attended training in basic food hygiene. This was confirmed by the manager who has agreed to arrange for this training to be provided. Three people were identified to us as diabetics (insulin dependent) and two people where this is diet controlled. Records are kept of meals taken for monitoring purposes and the manager told us arrangements had been made for the cook to attend training in preparing meals for people who have diabetes. The manager is advised to arrange training in caring for people with diabetes for all staff. This will ensure these peoples needs are met by a fully confident and competent staff team. Care Homes for Adults (18-65 years) Page 14 of 27 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. People receive support from staff with their personal care where required and in the way they prefer. The service has good systems for monitoring peoples physical and mental health to ensure they receive the support they need. People are supported, wherever possible, to retain and administer their own medication. The services procedures and training provided to staff, who deal with medication, ensure peoples health and well being is protected. Evidence: Information provided to us by the service shows the different levels of support people need in respect of their personal care; for example if someone requires support with bathing. Details of the assistance and/or prompts required are included in the care plans we looked at. Discussions held with staff confirm they are aware of these and the importance of supporting people to maintain and develop areas of independence. Training records we looked at show there are some gaps in staff training with respect to client-centred issues; such as caring for a person with impaired vision. This was raised with the manager who stated this is discussed with staff and guidelines for this persons care are provided. She has agreed to seek relevant client-centred training Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: courses and review the services training programme. Comments from relatives tell us they feel a good level of care and support is provided by staff. Individual record sheets show people have regular access to community-based health care services such as their GP, optician and chiropodist. Support is provided to people to attend these and appointments with specialist health care workers such as; consultant psychiatrists and community psychiatric nurses (CPNs). Copies of review reports are available on the individuals file. Peoples right to decline this support is respected and this is recorded on their files for monitoring purposes. The key worker system helps to ensure that all staff are aware of peoples health care needs. As previously stated, positive comments were received from health and social professionals about the care and support the service provides. This tells us the service works well with other agencies to ensure peoples needs are being fully met. Staff who have responsibility for handling and administering medication demonstrated a good understanding of the services procedures and spoke confidently about the different tasks involved. Staff confirmed they are provided with suitable training to ensure they are competent in carrying out their duties. Copies of certificates of training were made available. The medication folder is well organised and contains samples signatures and initials of staff responsible for medication, together with details of peoples medication and possible side affects. There are no records of any medication errors, however, the service has introduced a colour coded system for the medication administration record (MAR) sheets to further reduce the risk of errors occurring. The service has suitable facilities for storing medication it manages on behalf of people living in the home. Lockable facilities are provided for people who look after their own medication. The service continues to keep good records for all medication ordered, administered and returned to the pharmacist for disposal. A written consent form is held on individual files of people who have their medication managed for them by the service. Risk assessments are undertaken for people who wish to manage/part manage their own medication. Regular, random checks are made by the staff to ensure people continue to be confident in doing this as detailed in their care plans. The manager and staff told us they have a good relationship with the pharmacist, who is available to provide them with advice. No issues were raised by the pharmacist at their last monitoring visit. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are regularly consulted about their care and the day-to-day running of the service and feel their views are listened to and acted upon. Suitable procedures are in place to promote peoples well being and protect them from harm. Evidence: The services complaints procedure is displayed in reception and contains details of how the service will respond to any concerns raised with them. Comments received from people who use the service and relatives/representatives tell us they are aware of the complaints procedure and are confident the service would respond in a positive manner to resolve any issues they may have. The service provides people living in the home with opportunities to raise any issues they may have at an earlier stage and for these to be dealt with promptly. Other notices on display include an advocacy service, minutes from in-house meetings, the services Statement of Purpose, Service User Guides and a copy of the latest inspection report. There is also a collection box available for written feedback. MIND has a policy and procedure for adult protection and whistle blowing. Each member of staff signs to confirm that they have read and understood the contents. There is also a copy of the social services procedures for Safeguarding Vulnerable Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: Adults and training is provided for staff. Information provided by the service tells us no complaints have been received by them and no safeguarding issues. No complaints or safeguarding concerns have been reported to us, Care Quality Commission (CQC). Care Homes for Adults (18-65 years) Page 18 of 27 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 atmosphere in the home is relaxed and friendly and the environment is maintained to a good standard. The facilities meet the needs of the people who live here and there are good arrangements to ensure that the building is clean and hygienic. Evidence: There is space for off-road parking at the front of the building. On the ground floor, the communal areas include 2 lounges, (a television and a quiet/visitors lounge), dining room and kitchen and laundry room. There are two toilets on the ground floor (one with easy access for people with a physical disability). There is also access to a pleasantly landscaped garden. Bedrooms are located on the first floor and can be accessed via the stairs or by lift. On the day of our visit the home was clean and tidy. The manager told us a plan for the upkeep of the building is produced each year and the kitchen is being ear-marked for particular attention. People are provided with the relevant levels of support and/or supervision, where appropriate, in high-risk areas such as the kitchen. They are encouraged to participate in light household duties and are supported by staff to keep their own rooms clean and tidy. As previously stated; people are consulted about colour schemes and soft furnishing. They are encouraged to personalise their rooms with photographs and Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: items of interest and important to them. The staff team receive training in the prevention and control of infection and information about the safe handling of cleaning products are available in the COSHH (Control of Substances Hazardous to Health) folder. People we spoke to told us they like living at The Gables and one commented I like it here. It is nice and comfortable and I am well looked after. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a stable, competent and trained staff team. Their safety and well being is protected by the services recruitment policies, practices and staffing arrangements. Evidence: The care staff team consists of a manager, shift leaders and support workers, all of whom have clearly defined roles and responsibilities. Shift leaders are supported to develop skills that enable them to carry out a range of management tasks. For example; on the floor supervision of support workers. Support staff undertakes key worker responsibilities which includes monitoring care plans, one-to-one meetings with individuals and ensuring people receive the support they need. There are sufficient numbers of staff on duty to ensure people receive the level of care and support they need. This includes a senior member of staff on duty on each shift. The manager told us the service has reduced its use of bank/agency staff because, wherever possible, the staff team prefers to cover shortfalls, providing people with a more consistent level of care from staff they know and who know them. The service is to be commended for its commitment in supporting staff to obtain a recognised qualification. All staff members hold the National Vocational Qualification Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: (NVQ) Level 2 or above. Good recruitment and selection procedures are followed to ensure peoples safety and well being is protected. We sampled the file of the most recently employed member of staff. It contained the relevant information and the required checks such as; completed application form and criminal record bureau (CRB) check. However, the manager is advised to ask for details of the referees position, place of work and relationship with applicant when a requesting references. A six-week induction programme, followed by six month foundation training is provided for all new staff. One new member of staff told us they were pleased with the induction they received, in particular the arrangements for them to shadow a senior/experienced member of staff. They confirmed they had been provided with a mandatory training programme. As previously, mentioned there are some gaps in the training programme for specific client-centred courses which the manager has agreed to address. During this visit the staff on duty demonstrated that they had detailed knowledge of about peoples needs and supported them in a professional and friendly manner. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home, where their views underpin monitoring and development and their health, safety and welfare is promoted and protected. Evidence: The manager is registered with us, Care Quality Commission (CQC) and holds the Registered Managers Award. The staff we spoke to tells us the manager is available to discuss any issues or concerns they may have and they feel well supported. Internal quality assurance systems are in place and the service receives regular visits from its area manager. The manager showed us improvements made to systems for risk assessing and self audits. The area manager produces written reports of her/his unannounced visits. This forms part of the organisations quality monitoring of the service. Any issues/recommendations are discussed with the manager and plans are made for these to be addressed. As previously stated; people who use the service are provided with a range of opportunities to express their views about the service and feel these are listened to and acted upon. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Health and safety practices in the home are periodically reviewed. We looked at the services records for routine checks carried out on the premises and the servicing of appliances and equipment. These show suitable arrangements are in place to ensure people in the home are kept safe. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 17 Support staff should receive training in basic food hygiene to ensure good practices are followed when preparing, or supporting people, to prepare meals/snacks. Training in caring for people with diabetes should be provided for all staff to ensure their needs are fully met. Staff should be provided with training to ensure the needs of a person with impaired vision are being fully met. 2 3 17 18 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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