Care Home: The Grove

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What the care home does well People are supported to go out when they want to and do the things they enjoy doing. They are supported to keep in touch with their families and friends, so they do not lose relationships that are important to them. People have good care plans that tell staff the support they need and want. Their health needs are closely monitored to ensure they receive the appropriate help and support they need. People who live at The Grove are supported to raise concerns or complaints and are supported by staff who know how to safeguard adults from harm and abuse. Staff have the training they need so they know how to support people living at The Grove. Two relatives of people who live at The Grove provided comments in their surveys; "We know that (our son) is well looked after and happy. The staff are cheerful and conscientious and take good care of him. That is what we,his parents, care about" "The home does everything well, whenever I visit it is always clean and comfortable and there is always a happy atmosphere". Some of the staff comments received include "The home provides a happy and friendly and welcoming environment to the people we support and their families" "The home provides an extensive range of activities for the men who live here. They make decisions about every aspect of their lives, staff are respectful and treat the men as adults". "The home does well at making sure people`s needs are met and help them live the life that they want to lead. I always feel supported by my manager/senior. I really enjoy my job at The Grove. It is a very positive place to work". "The team at The Grove work well together to provide the best support to the gentlemen. The gentlemen lead active lifestyles and their independent skills are constantly developing". What has improved since the last inspection? At the last inspection it was recommended that staff undertook some training in safeguarding adults and the Mental Capacity Act. Most staff have now received this training with further training planned for remaining staff to attend. Staff who had recently started employment at the time of the last inspection have attended training in safe working practice topics, so they know how to help keep people safe. The manager took appropriate action after the inspection to look at whether a gate at the side of the property restricted people`s access. At this inspection we saw that changes have recently been made to the front of the home so that access is no longer through a side gate, but through a newly fitted new front door and spacious and welcoming hallway. The manager and staff team have provided stability for the people who live at The Grove, which has had a positive impact on the overall quality of the service and the outcomes people experience. One relative commented that the home has been a better place with a more settled staffing group. A staff member told us " I feel The Grove has improved and the people we support are carrying out everyday tasks, holidays and dreams they have". Another staff member commented " The Grove is a great place to work and as a team we have overcome many challenges". What the care home could do better: No requirements or recommendations were made as a result of this inspection. It is identified that the service is able to identify weaknesses and manage them well. The service recognises improvements to the environment will benefit the people who live at The Grove and we saw a schedule showing planned improvements for the forthcoming year, which also demonstrated that people living at The Grove are involved in this. One staff member commented "there are improvement plans for the building, these will make a difference to the feel of the building" Another staff member commented in their survey " find more activities, that are of interest to the people we support, instead of sticking to the same activities". However our findings from the inspection show that people are supported with varying activities and meaningful lifestyles. Key inspection report Care homes for adults (18-65 years) Name: Address: The Grove The Grove 74 King Street Dawley Telford Shropshire TF4 2AQ     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: Rosalind Dennis     Date: 1 2 0 5 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 28 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 28 Information about the care home Name of care home: Address: The Grove The Grove 74 King Street Dawley Telford Shropshire TF4 2AQ 01952501202 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.dimensions-uk.org Dimensions (UK) Ltd Name of registered manager (if applicable) Miss Victoria Anne Shakespeare Type of registration: Number of places registered: care home 5 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: 5 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 (LD) 5 Date of last inspection Brief description of the care home The Grove is registered with the Care Quality Commission (CQC) to provide accommodation and personal care for up to five adults with a learning disability. The Grove is a large detached property situated in the town of Dawley, Telford. The home offers access to local amenities and public transport and is in keeping with the local community. The accommodation is based over two floors providing five single Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 2 0 0 4 2 0 0 9 Brief description of the care home bedrooms, a kitchen, lounge, dining room, conservatory and large enclosed gardens. There is a car parking area at the front of the home. The home has its own car. Four adults currently live at The Grove. People who use the service and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CQC can be obtained direct from The Grove or from CQCs website at www.CQC.org.uk. Care Homes for Adults (18-65 years) Page 5 of 28 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: This inspection was carried out over half a day by one inspector. The home did not know we were going to visit. The focus of inspections we, the Commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included notifications received from the home. These are reports about things that have happened in the home that they have to let us know about by law, and an Annual Quality Assurance Assessment (AQAA). This is a document that provides information about the home and how they think it meets the needs of people living there. The AQAA had been completed by the manager and contained comprehensive information about all aspects of the service. We used this information to assist with our inspection. Care Homes for Adults (18-65 years) Page 6 of 28 Two people living in the home were case tracked. This involves establishing individuals experiences of living in the care home by meeting them, observing the care and support they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. People living at the home were not able to comment on the care and support they receive, so we observed the support given by staff and how staff interacted with them. We looked at feedback given by relatives and staff when they completed surveys for us. We looked around the home and observed a sample of care, staff and health and safety records. We spoke with the manager and staff during the inspection to establish their views of working at the home and if anything needs to be improved. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? At the last inspection it was recommended that staff undertook some training in safeguarding adults and the Mental Capacity Act. Most staff have now received this training with further training planned for remaining staff to attend. Staff who had recently started employment at the time of the last inspection have attended training in safe working practice topics, so they know how to help keep people safe. The manager took appropriate action after the inspection to look at whether a gate at the side of the property restricted peoples access. At this inspection we saw that Care Homes for Adults (18-65 years) Page 8 of 28 changes have recently been made to the front of the home so that access is no longer through a side gate, but through a newly fitted new front door and spacious and welcoming hallway. The manager and staff team have provided stability for the people who live at The Grove, which has had a positive impact on the overall quality of the service and the outcomes people experience. One relative commented that the home has been a better place with a more settled staffing group. A staff member told us I feel The Grove has improved and the people we support are carrying out everyday tasks, holidays and dreams they have. Another staff member commented The Grove is a great place to work and as a team we have overcome many challenges. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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 28 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 can be confident that when they move into The Grove they will have all the information they need about the home and staff will know how they want to be supported. Evidence: The four people who currently live at The Grove have lived there for sometime and we observed staff supporting these people well. We saw that the home has the processes in place to support people through their admission to the home. The manager explained that if a decision was made to admit another person to The Grove then very careful consideration would be given to make sure that anyone admitted would be compatible with the people already living at the home. We saw that a copy of the service user guide is kept in each persons support plan. The guide contains a good level of clear information about the service and is written in an easy read format, including photos and pictures to assist people with their understanding of what the service provides. Care Homes for Adults (18-65 years) Page 11 of 28 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 are involved with decisions about their lives and play an active role in planning the care and support they need. Evidence: We looked at two peoples support plans which were very detailed in explaining how people want their needs to be met. The plans contain detailed instructions of the actions staff need to take to support the person in order to meet their individual needs in relation to all aspects of their daily lives including their personal care, communication, health care and social needs. Support plans include short and longterm goals and focus on the person strengths, abilities, likes and dislikes. People also have a one page profile which tells staff and others about what is important to them and what staff need to know to support them effectively. Staff have also completed their own support profiles about themselves, which shows that staff are open and transparent with the people they support and the other staff they work with. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Twenty-four hour support plans are in place, which describe the persons needs and preferred routines over a twenty-four hour period so that new or agency staff can establish quickly how a person wants and should have their needs met. We spoke with an agency member of staff who confirmed they looked at the plans when they first started being involved with people at The Grove. We saw that staff also have a resource file so they can easily access further information on developing ways to support people through person centred approaches. We saw risk assessments which shows that staff look at how to support the person to take risks whilst ensuring that they could be as independent and as safe as possible. Risk assessments are reviewed and updated when the persons needs change. People were unable to share their own experiences with us about how they are supported to make choices about their lifestyle. We saw that staff provide encouragement to people to communicate through their own methods of communication, such as gestures and saw that staff are very good at knowing how each person makes their wishes and choices known. We saw that staff include the people who live at The Grove in all aspects of day to day life. Staff keep detailed records of how people spend their day, which enables staff to look at peoples care and ensure their care plan is being followed. Care Homes for Adults (18-65 years) Page 13 of 28 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 get the support they need to do things they value, go to places they like and keep in touch with people who are important to them. This means that they are able to be a part of the community in which they live. Evidence: People living at the home are supported to take part in their preferred activities. This has improved from when we last inspected the home in 2009, when we found that issues with staffing had impacted on lifestyle experience. During our inspection two people went out for lunch. Another person who was about to go out in the afternoon changed their mind and their decision was respected by staff. We saw people freely being able to access all areas of the home. There was no evidence of rigid routines. We saw people get up, go out and eat meals at different times. We saw records which demonstrate that people are supported to take part in a variety Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: of activities, inside and outside of the home. Two people had been supported to watch a circus a few days before the inspection and we were informed that people were also due to visit a truck show a few days after the inspection. One person is attending college. People have been supported to go to functions around diversity, such as Gay Pride and Diversifest. The home has its own transport which staff are able to drive so that people are able to go out. People go on holidays and day trips supported by staff. A large person-centred plan on the wall has pictorial representation about the preparation and plans for two people who are being supported to go on a holiday abroad. The manager described how the people have a fondness for planes so will experience flying in an aeroplane to their destination. Records show that people are enabled to keep in touch with their family and friends so they can maintain relationships with people who are important to them. We also saw that the home keeps their representatives informed of what is happening at The Grove through a newsletter. We saw that support plans detail peoples preferences in relation to meals and any support requirements. Pictures illustrating different food choices are displayed in the kitchen, to help people make their preferences known. The manager confirmed that people are supported to plan their meals, which may involve visits to supermarkets and on-line shopping. Staff keep written records of what people eat during the day and these records showed that people have a variety of meals and that their diet looks balanced and nutritious. The manager told us in the AQAA that mealtimes are seen as a social time and during our inspection we saw staff sitting with people whilst they ate and drank, so making it more of a social occasion. We saw that staff do food and storage safety checks, to ensure food is stored and prepared in a hygienic and safe manner. Care Homes for Adults (18-65 years) Page 15 of 28 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 and care in the way they prefer and need. Their health needs are met and their individuality is respected by the staff involved with supporting them. Evidence: Care plans detail the guidance and support needed to meet individual personal and health care needs. Care plans state what the person is able to do themselves which encourages them to be as independent as possible. The health needs of each person are recorded in their health action plan, which is a plan of what a person needs to stay healthy and the healthcare services they need to access. The plans are in an Easy Read format, and include pictures so making it easier to understand. We saw that health care professionals are involved in the care of people who live at The Grove. On each persons file we saw a document which they would take with them if they were admitted to hospital, which is very good practice as it shows how they would want to be cared for and supported by the hospital staff. Information was readily available to inform staff how to support a persons specific health condition and the interventions needed in an emergency so that the person is kept safe. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We looked at the medication administration records (MAR) for the two people we case tracked and saw that these records were up-to-date and properly completed by staff, which indicates that people receive their prescribed medication. Medication for each person is stored in a locked cupboard in their own bedroom so that people are not at risk of taking medication they are not prescribed. Health action plans include guidelines as to how people take their medicine so that staff know how to support them. We also saw that staff seek out information on the different medical conditions people may have and include this in the plan, so that staff know more about the person and any underlying condition so they can support them better. Training records show that staff involved in the administration of medicines have received training in safe administration. We also saw that staff have ongoing assessments of their competency to ensure they have the skills and knowledge to support people with their medication and put those skills into practice. Care Homes for Adults (18-65 years) Page 17 of 28 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 who live at The Grove are supported to raise concerns or complaints and the staff who work with them know how to safeguard adults from harm and abuse. Evidence: The home has a complaints procedure that is included in the service user guide and which the manager confirms is issued to all the people they support and their families. The procedure is in an easy read format to help make it easier for people to understand, although it is likely because of peoples needs they may need additional support to raise any concerns, such as through their family, friends or staff. An advocacy service visits the service to provide support to people to act on their behalf if needed. Three representatives of people who live at The Grove confirmed in the surveys they sent to us that they know how to make a complaint, although another representative indicated they didnt know. We saw from where the home records complaints that it has not received any complaints for over twelve months and we have not received any concerns or complaints directly about the service. The people we case tracked need support to manage their money and we saw that detailed information is included within support plans and a financial passport to explain peoples abilities and capabilities with finances, so that staff know the support needed. We saw that representatives from the local authority recently visited the service and looked in detail at the processes the home uses to look after peoples money. Their visit demonstrated that overall the home has robust processes in place to ensure people have access to their money and that it is looked after appropriately. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The training planner we looked at and the staff we spoke with demonstrates that all staff working at The Grove receive training on safeguarding vulnerable adults from the risk of abuse. We also saw from looking at the homes training planner that the staff team have attended awareness training in the Mental Capacity Act (2005). The Act governs decision making on behalf of adults, and applies when people lose mental capacity at some point in their lives or where the incapacitating condition has been present since birth and it is important that staff know how to put the Act into every day practice. Over half of the staff have also attended training on Deprivation of Liberty Safeguards, with further training planned for remaining staff to attend. The manager demonstrated a good knowledge of adult protection, the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards and knows when to refer and involve other professionals to ensure peoples best interests are continually promoted. Two people who live at The Grove may demonstrate behaviour that determines staff must work with them in a particular way to help keep them safe and well. We saw guidelines in care plans which explain how the staff should support people with these needs. Training records show that staff receive training and updates in the management of actual and physical aggression, so they should know how to respond appropriately to safeguard people from harm when they show particular behaviours of concern. Care Homes for Adults (18-65 years) Page 19 of 28 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. People living at The Grove are provided with an environment which is safe and homely. Planned improvements will enhance the home which will benefit the people who live there. Evidence: The home is situated in a residential area in Dawley. There are a range of shops, public transport links and leisure facilities close by. This is important to the people who live there as they make regular use of these amenities, supported by the staff who work with them. The home is a large detached property set out over two floors. Downstairs is a kitchen, two lounges and a conservatory which is used as a dining and activities area. Seating area in the lounges is of good condition and homely and provides people with options about where they can choose to spend their time. The conservatory was not unduly warm on the day of our inspection but the manager knows that action will need to be taken to ensure the temperature is acceptable for people in the warmer weather. Changes have recently been made to the front of the home so that access is no longer through a side gate, but through a newly fitted new front door and spacious and welcoming hallway. There is a large garden at the rear, which is fully enclosed and well-maintained. Each person has their own bedroom, which are on the first floor. The Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: bedrooms we saw were decorated according to individual tastes and interests, although could do with some re-decoration, which is planned. We saw that staff support people to choose how they want the home and their bedrooms decorated, and saw a photograph of a person being supported at a DIY store with choosing wallpaper. The manager told us in the AQAA and during our inspection of plans to improve the interior of the building and communal living spaces. We saw a schedule showing planned improvements for the forthcoming year, which also demonstrated that people living at The Grove are involved in this. Although the lift is not currently in working order, this does not seem to have impacted on the lives of the people who live at The Grove. This was discussed with the manager who described that since the lift stopped working, people use the stairs to access the first and ground floor, rather than relying on the lift, and this has enhanced their mobility and independence. People do not have their own bathroom or toilet, which means they share facilities, although this did not appear to impact on people during our inspection. The home has a bath on the ground floor, which is equipped with equipment to assist people so they can access this safely. This bathroom has recently been refurbished. There is another bathroom on the first floor which has an over the bath shower facility. We saw from the staff training planner that staff receive training on the prevention of infection and management of infection control. We found the home to be clean. Care Homes for Adults (18-65 years) Page 21 of 28 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 staff who work together to meet their needs and who have the skills and knowledge to do so. Evidence: When we arrived at the home, staff were welcoming and informed people of our role so that they knew the reason for us visiting. We heard staff speaking respectfully to people and saw them supporting each person to do what they wanted to do. Staff demonstrate a very good understanding of peoples needs. Staff told us during our inspection and in the surveys they sent us that they view there is enough staff on duty to meet peoples needs, including at night when there is one staff member awake on duty and another in the building on a sleep over shift. There is also an on-call arrangement which means staff have a more senior member of staff to contact in an emergency if they need to. We were informed and the AQAA shows that agency staff are used to supplement the homes permanent staff and we saw that the home ensures that agency staff are suitably skilled and receive an induction. The home confirmed that when it uses agency staff it ensures as far as possible that only staff who are familiar with the service work at the home. We spoke with an agency staff member who confirmed they received an induction when they first started working shifts at The Grove and were Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: also informed of the importance of recognising they are here as a guest of the people who live in the home. Staff we spoke with during our inspection and who completed surveys for us told us that they get the support and training they need to do their job. We saw a training planner which shows training undertaken and planned and confirms good training opportunities. This includes training in safe working practices and specific training to meet the needs of people who may live at the home including training in autism awareness, hydrotherapy and administration of specific medication. Most of the staff have attained or are working towards a recognised qualification in care (National Vocation Qualification) at Level 2 and some staff have achieved or are working towards Level 3. This should contribute to ensuring that the staff team have an effective knowledge of social care and be able to meet the individual needs of people living at The Grove. We saw documentation to show that meetings for staff take place on a regular basis and that they are provided with an effective formal supervision process which enables them to reflect on their practice and identify training and development needs. Staff are also provided with annual appraisals. We looked at the process used by the home to recruit a member of staff who started working at the home since the last key inspection. Information held at the home about staff are copies of information held centrally by the company. All parts of the recruitment process were accurately recorded and demonstrated that pre-employment information, such as references and Criminal Record Bureau Disclosures had been sought prior to the member of staff working at the home. We saw they had been provided with a comprehensive induction, which should ensure that new staff are knowledgeable about their role and what is expected from them. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager, Ms Vicky Shakespeare communicates a clear sense of direction, leadership and ensures the home is safe and run in the best interests for the people who live there. Evidence: The Registered Manager, Ms Vicky Shakespeare is appropriately qualified and experienced for the position of manager. The staff we spoke with and who completed surveys for us were very positive about the impact the manager has had on the service and for the people who live there. Staff said she is approachable and view she supports them well. The manager is currently providing some input at another service, and suitable arrangements have been put in place when this happens with a senior member of staff leading the staff team. In preparation for our visit the manager completed an Annual Quality Assurance Assessment (AQAA) which identifies the strengths of the home and areas for improvement. This was completed to a very good standard and was returned to us within the timescales given. The content of the AQAA was consistent with our findings during the visit in that the home is run well and in the best interests of the people who live there. During our inspection we observed a Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: certificate recently awarded by the company to the staff team recognising their achievements on how they work with the people who live at The Grove. A representative of the company monitors quality at regular intervals with monthly unannounced visits. We observed the reports which are produced as a result of these visits which shows the visits are comprehensive and look at a range of matters including general observations, health and safety, checks of medication, finances and whether any complaints have been received. An action plan is then produced so staff know the action to take and when. We saw that the company places great emphasis on ensuring peoples needs associated with equality and diversity are met and saw evidence of a diversity self audit and a regional equality and diversity action plan. Staff also receive training about equality and diversity. We observed results of surveys collated from people who live at Dimensions services in the West Midlands and shows that most people who responded are happy with the support they receive. An easy read action plan is drawn up from results of the surveys to inform people of the areas done well and areas needing improving. We saw that relatives, friends and staff are also provided with opportunity to comment on the service. Information was provided within the AQAA to confirm servicing and maintenance of equipment is undertaken and policies and procedures are reviewed. We saw that staff have regular training in health and safety, which ensures they are provided with the knowledge and skills to help people keep safe. We saw that staff check the temperature of hot water to ensure it is not too hot for people and documentation was available which showed that regular fire drills take place, so staff should be aware of the procedures to follow in the event of a fire. The home has a good process in place for incident and accident reporting, including scrutiny and monitoring of reports by the manager and regional manager. The home knows when to refer to other agencies. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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). 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