Care Home: The Glen

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What the care home does well The home is well run. The registered manager gives support, direction and guidance to the people at the home and the staff group. She makes sure that the aims and objectives of the home are met and that the service users receive the care they need. The Glen provides the necessary information for prospective service users and their families and representatives to help them make an informed decision as to whether or not the home is a suitable place for them to live in. Information is written in pictures and symbols which makes it more understandable for people who use the service. Each person has a care plan. This gives the staff the information they require to support and care for the service users in a way that meets all their needs. The plans allow them to live a fulfilling life while keeping them as safe as possible. In the surveys we received one person told us, " I am well looked after. I am happy here. I go out with staff to buy the things I want". The views of the people at the home are listened to and acted on. They are given choices about what they do and where they go. Their goals and aspirations are recognised and acted on. Everyone does different things depending on their interests and abilities. People told us they enjoy all the different activities and trips that they do. People are out and about in their local community and getting on with their lives. In the surveys people told us "We do different activities like art and crafts and baking. I like these". "I enjoy speaking to my family on the phone every evening". "We go on lots of holidays and day trips". The staff we spoke to have a knowledge and understanding of the people they support. The care staff on duty talked and interacted with the service users in a respectful and caring way. Comments in surveys indicated that the people at the home have positive relationships with the staff. They get on well together. The service users are encouraged and supported to do as much as possible for themselves and make independent choices and decisions. The routines of the home are flexible in order to support the individual and diverse needs of the people living in the home. Staff told us, "The service enables people to express themselves and get the best out of life". "The home provides people with choices in their daily life. They choose what they eat, how the home is decorated, what they do during the day. They are also supported to decide where they want to go on holiday". People are encouraged to express their concerns and can be confident that they will be listened to. The home does meet the physical and healthcare needs of people. There is input from the local specialist teams and people see their doctor when they need to. The AQAA gave us quotes from care managers and other specialists who are involved with people at The Glen. An Email from a care Manager stated, `I have asked the community nurse to put a supporting report about how staff have been proactive with supporting XXXXX complex and challenging needs`. Another stated, "Once again many thanks for responding so quickly to XXXXX needs! I know he will have a bright future now that he is placed with you". Each of the service users has their own rooms, which are personalised and reflect their individual tastes and choices What has improved since the last inspection? The service told us in the past twelve months they have accessed an in house entertainer at the request of the service users. This has enabled people to participate in a social gathering giving opportunity to have some fun and discuss other ideas of activities they would like to do. They have made better use of mainstream holiday and day trip providers to broaden social and cultural trips and holiday opportunities for people. They have made better use of public transport which has given a wider choice of activities for people on where they would like to go. There has also been significant improvements made to the homes environment and more work is planned. What the care home could do better: The home could make parts of the care plans and risk assessments more individualised and person centred. The home needs to further develop their quality assurance systems to ensure that it is meeting its aims and objectives and is improving the service for the people living at The Glen. Key inspection report Care homes for adults (18-65 years) Name: Address: The Glen 162 Folkestone Road Dover Kent CT17 9SN     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: Mary Cochrane     Date: 0 6 0 4 2 0 1 0 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 33 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: The Glen 162 Folkestone Road Dover Kent CT17 9SN 01304330133 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Learning Disabilities Care (Dover) Ltd Name of registered manager (if applicable) Mrs Jennifer Penelope Marsh Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 9 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission are within the following category : Learning disability (LD) Date of last inspection Brief description of the care home The Glen is a large detached house standing in Folkestone Road, Dover, a local bus service runs along this road, and the main line train station is situated approximately half a mile down the road. Dover town centre is approximately two miles from the home. The house stands on a fairly large plot, with a large garden area to the rear of the property. The car parking facilities are also situated outside the garden area to the rear Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 9 Brief description of the care home of the property. The Glen is registered to provide accommodation and care to nine adults with a learning disability. Accommodation in the home is situated over three floors, the ground floor offers a communal lounge, dining room and kitchen, and two bedrooms, one with en suite facilities. Bedrooms are located on all three floors. One of the bedrooms on the second floor is en-suite. The homes current fees range from £1000 - £2000 per week. Information about the home, including the inspection report from the Care Quality Commission are available on request. Care Homes for Adults (18-65 years) Page 5 of 33 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 quality rating for this service is 3 Star. This means that the people who use this service experience excellent quality outcomes. We did our last Key Inspection at the home on 24th April 2007. We arrived unannounced at the home at 9:45 and we were there for about five hours. The inspection was a thorough look at how well things are going. We took into account information provided by the Registered Manager in the self assessment. This is called the Annual Quality Assurance Assessment. (AQAA). We received this on time and it contained the information we needed to assist us with the inspection. We looked at any other information that we have received about the Service in the past twelve months. Care Homes for Adults (18-65 years) Page 6 of 33 Before we visited the Service, we sent surveys to some of the people who live there and the staff. We wanted them to tell us what they think of The Glen. We will tell you some of the comments that were made in the report. We had a look around the home and various records were inspected. We looked at and discussed individuals support plans and their risk assessments. We looked at medication procedures and records. We also looked at staff files and training records. We saw how the service recruits their staff and the homes quality assurance systems. We also looked at some of the homes health and safety checks. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: The home is well run. The registered manager gives support, direction and guidance to the people at the home and the staff group. She makes sure that the aims and objectives of the home are met and that the service users receive the care they need. The Glen provides the necessary information for prospective service users and their families and representatives to help them make an informed decision as to whether or not the home is a suitable place for them to live in. Information is written in pictures and symbols which makes it more understandable for people who use the service. Each person has a care plan. This gives the staff the information they require to support and care for the service users in a way that meets all their needs. The plans allow them to live a fulfilling life while keeping them as safe as possible. In the surveys we received one person told us, I am well looked after. I am happy here. I go out with staff to buy the things I want. The views of the people at the home are listened to and acted on. They are given choices about what they do and where they go. Their goals and aspirations are recognised and acted on. Everyone does different things depending on their interests and abilities. People told us they enjoy all the different activities and trips that they do. People are out and about in their local community and getting on with their lives. In the surveys people told us We do different activities like art and crafts and baking. I like these. I enjoy speaking to my family on the phone every evening. We go on lots of holidays and day trips. The staff we spoke to have a knowledge and understanding of the people they support. The care staff on duty talked and interacted with the service users in a respectful and caring way. Comments in surveys indicated that the people at the home have positive relationships with the staff. They get on well together. The service users are encouraged and supported to do as much as possible for themselves and make independent choices and decisions. The routines of the home are flexible in order to support the individual and diverse needs of the people living in the home. Staff told us, The service enables people to express themselves and get the best out of life. The home provides people with choices in their daily life. They choose what they eat, how the home is decorated, what they do during the day. They are also supported to Care Homes for Adults (18-65 years) Page 8 of 33 decide where they want to go on holiday. People are encouraged to express their concerns and can be confident that they will be listened to. The home does meet the physical and healthcare needs of people. There is input from the local specialist teams and people see their doctor when they need to. The AQAA gave us quotes from care managers and other specialists who are involved with people at The Glen. An Email from a care Manager stated, I have asked the community nurse to put a supporting report about how staff have been proactive with supporting XXXXX complex and challenging needs. Another stated, Once again many thanks for responding so quickly to XXXXX needs! I know he will have a bright future now that he is placed with you. Each of the service users has their own rooms, which are personalised and reflect their individual tastes and choices What has improved since the last inspection? What they could do better: The home could make parts of the care plans and risk assessments more individualised and person centred. Care Homes for Adults (18-65 years) Page 9 of 33 The home needs to further develop their quality assurance systems to ensure that it is meeting its aims and objectives and is improving the service for the people living at The Glen. 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 10 of 33 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 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need in a format they can understand to help them make a decision about this home. People are assessed so the home can be sure it can meet a persons needs. Evidence: The manager or the deputy of the service carries out the assessments for people who are thinking about coming to live at the home. We looked at three of these. One was of the most recent person who has come to live at the home. The manager/deputy visits the person, the persons family if possible to carry the initial assessment. This includes discussing and recording all aspects of daily life and personal care. It also looks at peoples life histories, health and social support needs. The assessments completed by social services care management teams or other health care professionals are also included. This ensures that the service have a good understanding of a persons needs before they move in. It gives the home a base line to then develop a support plan for the individual. Care Homes for Adults (18-65 years) Page 12 of 33 Evidence: The AQAA told us that the staff also think about the compatibility with other people who are living at the home before a new person moves in. They said, The placements that have been made in the last three years have been good placements. The individuals have settled well and the assessment has enabled a good care package to be provided from the outset. Care Homes for Adults (18-65 years) Page 13 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have individual care and support plans that identify their needs and personal goals. They are supported in taking risks as part of an independent lifestyle. People are consulted and given choices about how they live their lives. Evidence: All the people living at the home have a support/care plan. We looked at three of these in detail. The plans contained information on how the service users are best supported and cared for. These support plans contain information about peoples preferences, likes and dislikes and how they prefer to be supported and what they like to do. There are also plans on, eating and drinking needs, personal hygiene care, medical and specialist needs, and individual management. The care plans include risk assessments that give staff guidelines for how to support people and minimise risk. Staff use the risk assessments to help people do things and they are not used as restriction. We did find that some of the risk assessments did not Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: give staff direct guidance on how to manage risk situations. For example when a person was a risk of absconding when in the community the assessment did not tell staff exactly what they had to do to manage this situation in the best way for that individual. Instead it said to refer to policies and procedures. Another plan identified a risk of choking but did give guidance to let staff know exactly what to do if this occurred. The staff were able to tell us exactly what they would do and the manager told us that staff had received the necessary training to deal with these situations but it had not been recorded in the individuals plan. The manager told us that this would be addressed immediately. There is a great deal of paper work kept in different places for each person so much so that it is difficult to find information quickly and easily. The manager told us that they plan to stream-line the support plans. They are also in the process of reviewing and updating the care planning systems to make sure that it is more centred around the individuals specific support needs. The AQAA stated The plans include information from multi agencies including the positive behavioural support team who with the home carry out detailed assessments of each persons behaviour and needs. The assessment is a detailed process for each individual and forms a positive interaction profile. The home has implemented the profiles for each service user. Staff support people to make their own decisions by discussion and asking them what they wish to do, this is supported by using pictures cards, drawings, objects of reference, and books to help with communication. We observed a staff member communicating in an effective and sensitive way with one person. The person was able to make their needs known and the outcome was positive. Daily records contain relevant information about what people have done during the day. It was possible to cross reference information to show that care plans and risk assessments are being used to provide the necessary care and input on a daily basis. The home arranges regular reviews for each service user. Prior to the review all relevant information is brought together into a format that is easy to understand and follow. The review format identifies achievements, progress and outcomes for each individual. It also incorporates how people are going to work towards new goals and Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: aspirations. The service does recognise the rights of the service users to take control of their lives and make as many choices and decisions as much as possible. Through observation and talking to staff and service users we saw that some people were able to make choices about what they did in some aspects of their lives. People could decide on a daily basis what they wanted to do. They could decide when to get up go to bed and when and where they had their meals. We observed one person planning what they wanted to do that evening. Staff supported the person to make sure the activity would happen and their goal would be achieved. Care Homes for Adults (18-65 years) Page 16 of 33 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. People are supported and encouraged to take part in activities of their choice. They are able to maintain family contact and assisted to exercise choice over their lives. Nutrition is well managed, promoting health eating with choice and variety. Evidence: We saw that peoples hobbies and things that they like to do are identified. The home has a planned flexible activity programme, which is structured around each persons wishes and choices. Staff told us Service users are offered a lot of choices about what they do. Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: Each persons activities are tailored to meet individual needs. We looked at what three of the people did and this was cross-referenced with the daily records. The records showed that people had participated in the activities that were planned for them. Each of the people has their own individual diary where a record is kept about what people did and whether they enjoyed it or not. The diaries also contain pictures to remind people of the events that they have done. We heard staff discussing with individuals about what they would like to do that day. We saw that staff actively encourage and support service users to participate in activities. The AQAA told us that one person is currently being supported by a Psychologist, in conjunction with the staff, to develop an individual relaxation programme to help them with their anxiety. The home has a weekly visit by a reflexologist who offers hand and foot massages and spas. The people living at the home are well known and supported in the local vicinity. Some people also enjoy trips to the cinema when films that they want to see are released. Other regular activities include; trampolining, swimming, bowling and access to the Special Olympics. There is a list of events that are planned for people to go if they want to. In March people had the opportunity to go and see Mama Mia and the X factor live tour. Events planned for later in the year include Strictly Come Dancing, The Biggin Hill Air Show Duxford Battle of Britain Air Show and Disney on Ice. We saw that staff supported and encouraged service users to do things in the house if they did not go out. People told us they enjoyed doing things inside and out-side the home. The manager told us she is continually looking at ways to improve and develop the activities and leisure pursuits. The service users are encouraged and supported to maintain contact with their family and friends. People go on home visits and holidays are arranged. Members of staff were observed demonstrating good body language and communication skills when interacting with the service users. They were seen to talk and interact in a positive way and involved and included service users in conversations. Meals eaten are recorded on the daily reports and staff say they always offer an alternative when the person wishes. There are currently no special dietary requirements but people are encouraged and supported individually to maintain a Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: healthy diet. Pictures are used to demonstrate daily menus. People have the opportunity to have take away meals or visit the local restaurants/cafes in Dover. Care Homes for Adults (18-65 years) Page 19 of 33 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 have the support they need regarding their personal care. Their privacy and dignity respected. Independence and preferences are promoted. People know that they will have the support they need to stay healthy. Medication practises are safe and well managed protecting the people who live in the home. Evidence: We saw that individual plans clearly record how people like to have their personal needs met. They focus on what people can do for themselves and detail how staff will give the support needed while allowing individuals to be as independent as possible. Staff have got to know each person well and have found out how they like to be supported with their personal care. Routines have been established and guidelines have been written for the staff so that everyone is doing the same thing. There is a flexible approach to daily living activities e.g. getting up, going out, bed, Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: bath and mealtimes. People choose their own clothes and are supported to shop. Staff were seen to approach people in a caring and supportive manner. The staff group is balanced to allow for choice of male, female preferences. Aids and equipment are provided to maximise peoples independence. Staff members are alert to changes in mood, behaviour and general well being. Some of the people have complex health needs. The service was able to evidence that these are well managed. There is information in the plans, which highlights early warning signs of identified health needs, this means staff can take immediate and appropriate action. The service makes sure that people have access to all the health care facilities. We saw that routine checks and monitoring are carried out at the necessary intervals. People are promptly referred to specialists when the need arises. We saw that people had contact with the speech therapist, psychologist, the local learning disability team. Staff have specific training from the Positive Support Team for individual behaviour and emotional issues. Medication is stored safely and at the correct temperature. The home uses a predispensed system for administering medicines. This means that the medication is administered to people more safely as it has been pre-packed by the pharmacist in blister packs. Some medication is stored in its original packing. All prescriptions sheets had been signed to indicate that service users have received their medication on time and safely. The staff who administer medication have received the necessary training and their competencies are checked. We looked at the prescription sheets. The recording of receipt, administration and disposal of drugs is sufficient to allow an audit trail. The people living at the home receive their medication as prescribed by their doctors. The home does have guidance in place for people who receive medication on a when required basis. Some of the guidance was not specific to meet the individual needs of the person receiving it. The manager told us she would address this. Care Homes for Adults (18-65 years) Page 21 of 33 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 home has a satisfactory complaints system and people are protected from harm and abuse. Evidence: The home encourages and support people to express their views and concerns. Everyone has access to a copy of the complaints procedure which is written in a picture and symbol format. This means that it is more understandable for the people who use the service. If people have a concern or complaint they are able to effectively let the staff know. One service user told us if they are worried about anything they would speak to the manager. There are also regular meetings with the people who live at the home where they can express their concerns and how they want things to be done in the home. The service knows when to report any incidences to the local social services safeguarding vulnerable adults team. The AQAA told that one referral made to this team but no alert has been raised as it was decided that the home have the competency to manage the situations according to their policies and procedures and people are protected. Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: The majority of staff have received training in safe guarding vulnerable adults and for the few who havent training is being booked. People can access advocacy services if they need to. We were told that two people have contact with advocates. This means that people get independent support and advice in areas that affect decisions around how they prefer to live their lives. The homes recruitment procedure includes undertaking formal checks to make sure that potential employees are suitable to work with vulnerable adults. There are financial systems in place to record and protect peoples finances. Care Homes for Adults (18-65 years) Page 23 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment that is appropriate to the needs of the people who live there. It provides people with an attractive, safe and comfortable place to live. Evidence: The home is well maintained and decorated to a good standard. There is an on going programme of maintenance and redecoration. The home is clean and tidy and individual bedrooms are very personalised to individual choices and preferences. There are adaptations to maintain and maximise independence like assisted baths and hoists. The back garden is secure with a trampoline, swimming pool, gazebo, and seating. People enjoy being in the garden and using the facilities, which is accessible to wheelchair users. There are sufficient laundry facilities in place and all staff have received training in infection control. There are procedures in pace to reduce the risk of infection. The AQAA told us that in 2009 The Glen had a massive refurbishment. This work included replacing the existing roof, replacing the existing windows with uPVC windows. A separate area was built for the washing machines and tumble driers which supports with infection control. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: During the next twelve months all bathrooms will be refurbished. The communal areas will be re-decorated including walls, flooring and new furniture. They told us that colour schemes and furnishings swatches will be shown to the people at the home and a series of meetings will take place with them so they can choose the colour schemes/themes and furniture for the identified areas. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff to support the people living at the home. Staff have had the training to make sure they have the competencies and skills to support people. On the whole the recruitment practises protect the people living at the home. Evidence: We sent surveys to staff who work at the home they told us, In the three years I have worked at this home I have enjoyed learning all aspects of the job. Through training and support I continue to learn new skills every day. We care for all the service users to a high standard inside and outside the home. We help service users express themselves and get the best out of life. The service employ enough staff to give support and care to each individual at all times. We saw that the staff support and communicate with people in a respectful manner and are accessible and approachable. It was evidenced that the staff on duty put the Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: needs of the people living at the home first. People responded positively and openly to staff. A lot of the staff have worked at the home for a reasonable length of time and have a good knowledge and understanding of the individuals. The staff were professional and responsive on the day of our visit. They were able to explain in detail about the support and care that is given to people and how this was done in a way that suited the person best. They were able to explain about risks and behaviours of the service users and explained ways that the risks could be reduced. We were told that all new members of staff receive an induction into the home and have an induction training programme in place. This programme is linked to skills for care. We saw evidence of this during the inspection. The AQAA told us over 50 of staff hold NVQ 2 and above and there is an ongoing NVQ programme in place. The home has a training matrix in place and we could see that staff have received the necessary mandatory training and had acquired the knowledge and skills to do their jobs effectively and safely. Staff told us that they receive all the training they need and are encouraged and supported by the management to develop. The Director of Care told us that staff receive specialist training to meet the individual needs of the people they support. Staff have completed training in autism, epilepsy and specialist drug administration. They are also in the process of doing Mental capacity Act training. More training is planned for the coming year. The company recognises that The Glen can be a very intense environment for staff to work. They now have their own offices in Folkestone which we have started to use for staff to have staff meetings and sessions at. The AQAA told us that this is working really well as it gives staff a chance to step away from the service from time to time to reflect and plan. We are also making it possible for staff to use designated computers at the office for updating and reviewing paperwork. Staff have regular meetings to discuss any issues that have been identified. They look at what is working well at the home and what areas need to be improved. This means the support people are receiving is continually reviewed and changes are made to improve their lives. All staff files are kept in the central office in Folkestone. We asked to look at three staff files and they were brought to the home during the inspection. The Registered Manager is required to complete a number of security checks on staff. Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: These include things such as confirming their identity, taking up references and doing a police check. This is done to make sure that they are trustworthy people to work in the home. We looked at the checks that have been completed. We saw that the majority of checks had been done. However we did find that one person only had one reference and a reference had not been sought from a care home they had previously worked at. The company also were not obtaining a full employment history from staff. The Director of Care informed that these issues would be addressed immediately to make sure their recruitment procedures are as robust as possible to protect the people in the home. They have subsequently told us that all staff files have been audited and any missing information is being obtained. Care Homes for Adults (18-65 years) Page 28 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager is qualified and has relevant experience to run the home. She is aware of the areas that need improvement and has plans to do this. People can be sure that their health,safety and welfare is promoted and protected. Evidence: The Manager of Care has the skills and a qualifications required to manage the home and is supported by the Registered Manager of The Glen and also from Lara Marsh the Director Of Care and the Registered Manager of Little Glen and Reddington House (sister homes of The Glen). Staff say they are supported well by the management team. The staff work well as a team and are committed to the home being run in the best interests of the people who live there. The atmosphere in the home is positive and enthusiastic providing good quality care. We observed at the visit that the people at the home have a positive and relaxed Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: relationship with the manager. Staff told us that the manager is approachable and understanding. They said that they could speak to her about any concerns they might have. Management keep up to date with current trends and training. They regularly attend local work-shops, forums and meetings. This helps the organisation stay in touch with a wider element of the sector and discuss issues in a relevant forum. The Manager of Care and senior staff have received Mental Capacity Act training and Deprivation of Liberties training. Quality Assurance systems are in place and these are being developed. The last annual assurance report was completed in March 2009. The home is in the process of developing the quality assurance questionnaires to include all stakeholders, visitors and relatives. There are questionnaires for the people who live in the home in a picture format. This is sometimes altered if the service wants to focus on a particular theme. When all the surveys have been returned the service they will then be collated to identify the strengths and weakness of the home. This means the home will be able to improve the service given to the people who live at The Glen. A sample of the safety checks was carried out and accidents have been recorded appropriately and action taken. The fire book was in good order and weekly fire tests have been completed. The home has completed a fire risk assessment. Environmental risk assessments are also in place. Mandatory training has been provided for all staff and the induction for new staff is in line with Skills for Care. Care Homes for Adults (18-65 years) Page 30 of 33 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 31 of 33 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 32 of 33 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. 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