Care Home: The Hawthorns

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What the care home does well People coming into this home receive sensitive, individual and detailed assessments. The staff go out of their way to ensure that they can meet each persons needs. There are high levels of staff to allow the people to receive the support and care they need. People are encouraged and supported to make choices about what they wish to do and contribute to the running of the home through the weekly resident`s meetings. The people live in comfortable accommodation. Each person is encouraged and supported to be independent and take part in meaningful activities. They are also were offered choices about what they wish to do and to make decisions about how they spend their lives. They are encouraged and supported to have control over their lives. The people like the way the home is run, and enjoy staying at the home. There are plenty of activities for the people to enjoy. Staff communicate well with them, and respect their choices and decisions. People living in the home are cared for and supported by a caring, educated and committed team of staff. They are in turn lead by an experienced manager who has extensive knowledge about the needs of people with a learning disability. There is a comprehensive programme of education and training provided for staff, which ensures that staff know how to care and support the people who live at the home. The staff feel valued by the management and feel part of a team to improve, to help and support the people living in the home. What has improved since the last inspection? Information and care plans are more person focused and clearer and in easy to read formats. This has included a new service users guide "Your guide to The Hawthorns" a daily diary, review and fire plans. They have also increased the amount of information easily accessed and understood by the people to empower them and have greater control over their lives and the running of the home. This has resulted in the people being involved in staff interviews and their views obtained in Voices the service user`s council. They have recruited sufficient staff to make a full team with no staff vacancies The range of activities has improved which has included drama sessions to give more individual choice to each person and this has been improved further by an activities room with a sensory unit. Accommodation has been more personalised with 3 bedrooms being redecorated to suit each person with their involvement. What the care home could do better: There were no requirements from this inspection. We discussed with the manager the need to ensure that all care plans should contain information about recent legislation that is designed to protect people`s rights and choices. The manager agreed to act on this. We have recommended that the views of the people are obtained as part of the home`s quality assurance as the last survey took place in 2007. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Hawthorns 53 Station Road Bardney Lincs LN3 5UD     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tobias Payne     Date: 2 4 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Hawthorns 53 Station Road Bardney Lincs LN3 5UD 01526399868 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : mick.bell@homefromhomecare.com Home From Home Care Ltd care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home The Hawthorns is in the village of Bardney. The home is owned by Home from Home Care, who operate other care homes in Lincolnshire and is a large detached building set in large grounds. It has been refurbished to a high standard, with a good range of communal space. Accommodation is spacious, and includes a lounge, kitchen diner, conservatory, quiet lounge, sensory room and activity room. All bedrooms are en-suite and are on both ground floor and first floor, which is accessed by a shaft lift. The front of the property has lawns and a gravel driveway and parking area. The rear of the property is enclosed and laid to lawns and flowerbeds, with a large patio area. There is a new activity centre with a sensory room in the grounds of the home. The manager of the home is Claire Gordon and can be contacted at Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home claire.gordon@homefromhomecare.com. The companys website is www.homefromhomecare.com The home is registered to provide personal care for 7 adults with learning disabilities who require support with daily living. The Companys stated aim is we want to provide a home and support that helps you to make your own choices about your life and do things you want to do. The fees at the inspection visit on the 25/6/2009 ranged from £2,500 to £2,800 a week. Extras were for personal clothing, toiletries, newspapers and magazines. The statement of purpose, service users guide, copy of the last inspection report and information about the home in easy read format can be obtained from the manager of the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection which was unannounced took place over 6 hours. The registered manager was present as was a representative of the company throughout the inspection and was given feedback at the end of the inspection. The main method of inspection used was called case tracking which involved selecting 2 people and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and the people living in the home and related care practices. We looked at a sample of care records and walked around the home to see the quality of accommodation and visited some of the bedrooms with the permission of the people living in the home. We spoke with 3 people living in the home, as well as 4 members of Care Homes for Adults (18-65 years) Page 6 of 29 staff. An (AQAA) Annual quality assurance assessment was completed by the manager and sent to us prior to this report being completed. This is a self-assessment document completed by the manager of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. Before making our visit we asked the people who live there to send us comments about the support they receive. We received comment cards from 2 of the people living in the home and 2 staff. All comments were very positive. Where the use of we or us has been used throughout this report it refers to the Care Quality Commission. The last key inspection took place on the 18th July 2007. What the care home does well: What has improved since the last inspection? What they could do better: There were no requirements from this inspection. We discussed with the manager the need to ensure that all care plans should contain information about recent legislation that is designed to protect peoples rights and choices. The manager agreed to act on this. We have recommended that the views of the people are obtained as part of the homes quality assurance as the last survey took place in 2007. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home receive clear and detailed information to suit their needs to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home careful and sensitive assessments take place for each person being admitted to the home to ensure that it meets their needs. Evidence: There was a statement of purpose and service users guide in the form of a very detailed Your Guide to The Hawthorns. Both documents were in words and in an easy read format with pictures. The guide to The Hawthorns had photographs and information about the home the area, accommodation and leisure. The manager told us that it had recently been produced and needed a few adjustments before a copy would be given to each person. The representative of the company agreed to ensure that our new name and contact details were in all the relevant information. The manager told us that where a referral was received an assessment manager would Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: initially assess the persons needs to ensure that Home from Home Care could meet their needs. Thereafter the person would be referred to the manager who would continue with the assessment process. She told us she would arrange to meet the person, invite them to visit the home for the day, later on invite them to visit and see or take part in an activity, later stay for an evening meal or overnight stay. The process was to ensure it did not cause distress to the person and it could in the case of the last person to be admitted to the home take over 6 weeks. During this process the manager told us information was obtained from the person their family and other people connected with their care and support. Written confirmation would be sent to confirm the home could meet their needs based on this assessment. It was clear to us that considerable time and effort was made to ensure any admission went well. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is detailed care planning which includes risk assessments. People enjoy choices about what activities they want to get involved and have a varied social programme. People are encouraged to make decisions for themselves and be independent with the support and guidance from staff. Evidence: Each person had a care plan. The records included, personal information, their likes and dislikes, photograph, daily support plan,communication record, my health action plan and a detailed initial assessment. From this a care plan had been produced which was clear and detailed. The care plan outlined the presenting need, objectives, action and review date. Each aspect of care and support was very detailed and specific to each person. There was also a hospital passport with comprehensive information in case a person was admitted to hospital. In addition there was information about communication and a recent food and activity plan with weight and height record as well as nutrition and healthy living programme. There was evidence of review dates Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: and the care plan was reviewed monthly. Care plans were individual and the daily records well written, factual and dated and cross referenced with the care plan. During the inspection visit we saw staff offered and respected choices and were flexible in their approach with good clear communication skills towards the people. The manager acknowledged that although staff had received training about the Mental Capacity Act 2005 the care plans had not yet include a capacity assessment. She agreed to act on this in the near future. We saw staff throughout our visit talking and communicating with the people in a kind, calm and sensitive approach respecting their views and opinions. Choice and decision making was clearly shown in the care plans. The people were given choice concerning their interests, activities and lifestyle. Staff received training to assist and support them. The care records were very detailed, person focused and reviewed regularly. This information enabled staff to understand and support each person. There were also very detailed risk assessments covering transport, activities and where required cooking or working in the kitchen. All entries were dated with signatures from staff. We looked at the financial records for the people living in the home. They were well maintained with receipts and signatures. Records were kept securely. During the visit the people we spoke with talked about how they are supported to make decisions and choices about holidays, meals and activities. One person told us the staff are perfect and my key worker understands my needs. Staff we spoke with told us of the support they gave to enable the people make choices about the decisions they made each day concerning what clothes to wear, what they want to eat and where they want to go. They also talked about how they help the people to maintain and develop their independence with, for example, cooking skills. There is a large kitchen available for the people to be able to do this with the support and guidance from staff. The manager told us that they have a weekly meeting at which issues such as activities and meals are discussed. The people confirmed that they are involved in meetings and said that they are able to talk about the things that they want to. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 in meaningful and appropriate activities, which include educational and recreational activities. They enjoy varied and nutritious meals which within their capabilities they are involved in. Evidence: Each person had an individual timetable, which provided a combination of educational, vocational and leisure activities. There were also a wide range of home and community based activities. Good links had also been established with other companys homes in Lincolnshire where social activities were shared. There was a white board in the office with details of each persons activities. On the day of our inspection visit 4 people were going into Lincoln for a shopping trip accompanied by staff. We could see that these arrangements could be flexible reflecting the persons wishes on the day. There were also a range of other activities, which included drama, picnics, play zone bowling, Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: swimming and visits to local pubs. There was a trampoline in the garden and a purpose built very well equipped sensory room. The home had a people carrier. The manager told us that last years holiday had been to Euro Disney and they were planning with the involvement of the people living in the home this years holiday during which they would be accompanied by staff. There was a weekly residents meeting at which the people were asked for suggestions, so that they could choose their favourite meals and decide what they wanted to do. We saw a person preparing their breakfast with the support and guidance of a member of staff. There were photographs of meals to give guidance to the people to decide what they want to eat. As a result of the last inspection by East Lindsey District Council on the 2/3/2007 they were awarded 4 stars very good in recognition of the catering standards. The people within their risk assessments were supported and guided in cooking or preparing food or helping in the kitchen. All staff were required to prepare meals and all had food hygiene training provided. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that peoples health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. Evidence: Staffing levels allow a high level of support to be provided for the people living in home. We saw staff throughout our inspection visit show a person focused approach to care, using a flexible, sensitive and relaxed approach. Each person had very clear information about their preferred routines to staff. Each person was registered with a local GP surgery and other services such as psychology were available by referral. The service had established very close working relationships with an optician and hearing service who were able to visit the people in the home and had specific skills in understanding and supporting people with a learning disability. Similar arrangements had been arranged with NHS dental services as well as the community learning disability team. Each person had a detailed Health Action Plan, a nationally recognised health check assessment and a health profile. In addition each person had a hospital Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: passport with detailed information in case a person was admitted to hospital. There were also clear plans and risk management strategies in place for supporting people with behavioural needs. Each person had a nutritional assessment and their weight was monitored each week. The team leaders were responsible for medication and did this after they had been assessed as competent to administer medication. Records were well maintained with receipt and disposal records. All the people needed assistance with medication to ensure it was given safely. The manager also carried out weekly audits and reports of findings and action required were kept. During the inspection visit staff were observed using effective methods of care practice to divert possible challenging behaviour in a sensitive and supportive way, which left the person in control of each situation whilst free from the risk of physical restraint. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints received were treated properly. Staff are recruited correctly to ensure that the people were protected from abuse. Staff have a good knowledge of the adult protection procedures. Evidence: Each person had a pictorial complaints procedure in Your Guide about The Hawthorns and during our visit information about our new name was included in it. The service had a satisfaction and complaints book and information provided by the manager told us they had received 2 complaints both of which had been investigated by the service using their complaints procedure but none of the issues had been upheld. We had received no complaints. We had been aware of a safeguarding adults issue which was being investigated by Lincolnshire County Council but had not yet been completed. We were told by Lincolnshire County Council that they had received full co-operation and assistance from the manager of the home throughout their investigation. The home had an adult protection policy and all staff as part of their induction received abuse training. The home also had a copy of Lincolnshire County Councils adult protection procedures. We spoke with 2 members of staff who knew about abuse and what they should do if they suspected abuse. There are procedures available on individual care plans regarding physical intervention to make sure people are protected properly and detailed records are kept in order to support residents with their finances. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: During our visit no person living in the home or staff had any concerns about the home. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in clean, safe, and comfortable accommodation suited to their needs. Evidence: The Hawthorns is decorated to a high standard. It provided a range of spacious lounge, dining, sitting and recreational areas. There was a large enclosed lawned garden with a trampoline, sitting areas and patio and garden areas. Each person had a large en-suite bedroom. Communal spaces included lounge, kitchen diner, large conservatory leading to the garden, quiet lounge, well designed and equipped sensory room and craft/activity room. Furniture and fittings were of a very good quality, and the home was very well maintained. Their bedrooms were individual and there was a shaft lift to accommodation on the first floor. One person told us I have just had my bedroom redecorated and I was involved in choosing the colours for the room and I like my room, it is decorated to suit what I like. They also told us they were able to keep their room in the way they wished and that they were responsible for the tidiness of their room with support from their individual key workers. The kitchen area of the home had menus with pictures. We saw 2 people making their own meal or preparing food with support from their key worker. Staff told us that the amount of space available in the kitchen and communal areas helped them to provide care in a sensitive way. Care Homes for Adults (18-65 years) Page 21 of 29 Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well-trained, established, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: Each person living in the home had a key worker. Staff were responsible for care, catering and laundry. The manager told us she ensured that staff had the skills to support the particular needs of the the people. We saw recruitment records for 2 members of staff. These records showed they had been safely recruited with a check by the Criminal Records Bureau, application forms, 2 references and proof of identity. The company also ensures that representatives of the people living in the home are involved in the interview process for staff and managers. A representative of the company who was present during the inspection told us that these people will receive training and support so that they can be actively involved in the process. Once recruited each new member of staff had a 4 week supported induction. Records we saw confirmed this took place. The induction included an introduction to learning disability, Makaton communication, adult protection, infection control, equality and diversity, managing and understanding behaviours, medication, moving and handling and food hygiene and autism. The manager told us that they encourage the staff to work towards a national Vocational qualification in care. She also told us that the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: company were in the process of arranging for a new provider to be arranged so that the number of people studying for an NVQ could be increased above the current 30 who had obtained this or who were studying for this. Training over the year had also included Mental Capacity Act 2005 and Strategy Crisis Intervention Prevention, medication administration and risk assessment. We spoke with 2 new members of staff who told us I received a thorough induction during which I was supported and shadowed a member of staff until I felt confident to work on my own, I was introduced to the needs of each person and I have learnt so much, find the job interesting and enjoy helping these people to be independent and enjoy their lives. Staff told us they receive supervision and that they are supported to talk about their individual needs. Records confirmed this. We looked at staff rotas and they showed that there were enough staff on duty to meet the contracted hours for individual people. The company had a training co-ordinator, who was responsible for arranging training events, and ensuring that staff had received the necessary updates. There was an equality and diversity policy and a number of staff from outside the UK were working in the home. There were no equality and diversity or communication issues. The staff felt they could meet the needs of the people living in the home and felt they had sufficient time. During our inspection visit we saw staff taking particular time to communicate to the the people in a calm, kind and sensitive manner. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and staff benefit from the positive leadership of the management team. Management record systems show that peoples health, welfare, safety and choices are promoted. The management team ensures that the people living in the home with the support of the staff, relatives and staff have the opportunity to voice their views and opinions. Evidence: Since the last inspection we registered in April 2008 a new manager for the home. This person had worked in the home for 2 years and had many years of experience in autism and learning disability and was studying to obtain a management qualification. Staff had confidence in her and spoke of the supervision and support received. Throughout our visit we saw a very relaxed and happy atmosphere in the home and staff showed knowledge about the needs of the people living in the home. Internal quality audits took place in the form of a comprehensive service review and internal monthly audits done by managers from other homes within the company. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: These audits looked at personnel, the welfare of the people living in the home, health and safety, medication and finance. There were staff and team leaders meetings with minutes and the home had comprehensive policies and procedures. During our visit we found some records difficult to find and the manager agreed to review the way records were kept in the office. The company made monthly unannounced monitoring visits and detailed reports were available. Records we looked at were available, well maintained and up to date. Where money was kept on behalf of the people living in the home the records were well maintained. Each person had a cash box and their own bank account. We noted that the last survey to obtain the views of the people living in the home and other people was last sent out 2007. The manager acknowledged no survey had taken place since that date. However our surveys we received before this inspection showed that people were satisfied with the home. Comments from staff included, We provide a good quality of staff and care to each individual and provide care to the service users in the best possible way. A survey from a person living in the home told us I like the conservatory, my bedroom, going into the garden, cutting the lawn, going out, the trampoline, playing cricket and the food. The home had a comprehensive and detailed health and safety policy together with detailed risk assessments covering all aspects of daily living activities. We saw a detailed health and safety inspection report on behalf of the company which took place on the 18/6/2009 and provided a new health and safety policy. A detailed fire risk assessment had also been carried out on the 22/3/2007 and during our visit a future fire safety inspection was being planned. There were regular tests of the fire system as well as regular fire drills. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 37 As part of the quality assurance system the views of the people living in the home should be obtained as well as representatives and other interested parties. This will ensure that their views are obtained and results acted upon where improvements have been identified. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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