Care Home: The Manor House

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What the care home does well The people live in clean and comfortable accommodation. Each person is encouraged and supported to be as independent as possible and encouraged to take part in meaningful activities. They are also 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. 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 although new to this home has extensive knowledge about the needs of people who experience sensory impairments. 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, help and support the people living in the home. What has improved since the last inspection? 3 bedrooms have been redecorated with the involvement of the people who have chosen colours, textures, stencils to suit their wishes. A new laminated floor has been provided on the ground floor as well as new carpets laid in 2 lounges. A large flat screen television has been provided in the main lounge. A patio area with a new swing has been provided. What the care home could do better: Where improvements were identified, they were already being addressed by Sense, the manager or staff in the home. Sense carry out regular quality assurance monitoring audits. As a result of discussions during this inspection the manager agreed to up date information about us to include our new name, address and contact telephone number. The manager agreed to obtain an up to date copy of Lincolnshire County Council`s Adult Protection policy and reorganise the office as some of the information was disorganised and difficult to find. Key inspection report Care homes for adults (18-65 years) Name: Address: The Manor House 72 Church Street Market Deeping Lincs PE6 8AL     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: Tobias Payne     Date: 2 1 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Manor House 72 Church Street Market Deeping Lincs PE6 8AL 01778344921 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Leegranger@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: Date of last inspection Brief description of the care home Manor House is part of the Sense organisation and is registered to provide care and accommodation for up to seven people over the age of eighteen years affected by deaf/blindness caused by rubella. This home shares a site with Manor Court, another care home and within the grounds are a patio, garden, hydrotherapy swimming pool, interactive multi-sensory room and administrative offices. The people attend a day care facility in Bourne also managed by Sense. Transport is provided through the use of a minibus or via a regular bus service. The home is located in the town of Market Deeping, which has a variety of facilities and services. Sense has a model of service which states Sense seeks to acknowledge and respect the individuality of every deafblind person. Each persons combination of disabilities is different. Areas of strength and level of ability vary between individuals. In oder to meet such a variety on individual needs. Sense seeks to develop a unique and individualised service that can respond to the unique needs of each individual. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 0 7 7 Brief description of the care home The weekly fees on the day of our inspection visit to ther home ranged from ranged from £1,464.23p to £2,256.73p. Information about the home including the statement of purpose, service users guide and a copy of the last inspection report can be obtained from the manager of the home. This information can be made available in Braille, pictures, symbols and other languages on request. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The previous key unannounced inspection was on the 11/11/2006. This key inspection used a review of all the information available to the commission about Manor House and included an unannounced visit to the service. It took place over 5 hours. In order to be sensitive to the communication needs of the 6 people living in the home, we used our observations between the staff and the people who live there, information provided by the manager, staff members and records as evidence as to whether standards were being met. This observation also ensured we could use our evidence to judge whether the outcomes experienced by people were what they wanted. We spoke with 4 members of staff including the manager. The main method of inspection used during our visit was called case tracking. This involved selecting 2 Care Homes for Adults (18-65 years) Page 6 of 27 people and tracking the care they received through the checking of records, discussions with the care staff and observation of how staff responded to their needs and that of the other people who lived there. We also looked closely at the annual quality assurance assessment (AQAA) that was sent to us by the manager before this key inspection visit. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the home. It was very clear and detailed. Before making our visit we asked the people who live there to send us comments about the support they receive. We received 4 comments which were very positive. We also received very positive comments from 6 members of staff. Their views are reflected throughout the report. Where the use of we or us has been used in this report it refers to the Care Quality Commission. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good and clear information is provided in a variety of formats to people to enable them make an informed choice of where to live. They are assessed before they come to the home which ensures that individual needs can be met within the home. Evidence: There was a statement of purpose and service users guide. The information was very clear and detailed and included Senses mission statement, values, aims and objectives together with specific aims and objectives for the Manor House. We noticed that the information did not refer to our new name, address and telephone number. The manager agreed to act on this as soon as possible. There is an established group of people currently living at the service and it was confirmed by the manager that no person had been admitted since 2005. The manager told us that where a person was admitted Sense had very clear procedures to ensure that a detailed assessment would be carried out to ensure that they could meet all the assessed needs of that person. The manager confirmed that, where appropriate all those involved in the persons life would be consulted to ensure a Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: smooth transition took place. Each person had a contract/terms and conditions of residency. This contained Sense East terms and conditions. This was clearly outlined in the statement of purpose and service users guide. The fee included all costs, rent, utility charges, personal care, laundry, food, and comprehensive programme of choices, activities inclusive of a 7 day holiday or equivalent. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and social care needs of the people are being met in a safe and dignified manner. Evidence: Each person had sensory impairment and communication difficulties. We looked in detail at 2 peoples care records. We found care plans were very detailed and included an information sheet with photograph, terms of residence, description of the premises, what the fee includes, furniture provided by Sense, layout of the room, inventory of their personal belongings, their background and family, birthday, mobility, health and professional involvement, personal care, eating and drinking, communication, social and emotional, making choice and specific needs including religious and cultural needs. Since our last inspection care plans have been further improved and now included a capacity assessment for each person and 6 people had specific care plans relating to their rights and choices. Each person also had information about how staff could help Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: with their individual needs. There were also very detailed risk assessments covering all aspects of their life. The manager told us that it was not possible to involve the people in their care plan and these reasons were recorded. A comprehensive My Health Record was kept for each person, which had details about their health needs and any specialist equipment required. These plans were available for each person to access if needed. Sense had detailed policies and procedures concerning accessing personal records, confidentiality and data protection. Training records also showed staff were trained to respect confidences. Choice and decision making was clearly shown in the care plans. The people were given choices 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. Reviews took place every 6 months. These included wherever possible the person and their family and or advocate, people who provide daytime support, their key worker and manager for the home. Before this there was a meeting to obtain all information concerning the person. Sense carried out a finance audit in April 2009 and found a good standard of control over benefits received, security of cash, recording of transactions and inventories of personal possessions. There are currently no formal group meetings with the people living in the home. The manager however told us that staff ensured individual support was given and time was taken to obtain feedback so that that the people living in the home were involved in running the home wherever possible. The manager also told us they used the advice and or support of a behavioural therapist who visited the home every 6 months. The manager and staff had received training in order to manage challenging behaviours. There were also detailed policies and procedures. We saw that records were kept securely. This makes sure peoples personal information about their needs is private and only used by the staff team to meet their needs. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The wide range of social and cultural opportunities ensures that peoples needs are met. Evidence: People who live at the service attend an activity centre at Bourne operated by Sense Monday to Friday between 9.30 am and 4 pm. People are taken there in a range of mini buses accompanied by staff. A wide range of activities are available at the centre, which include cookery, pottery, horticulture, creative art, office skills, personal and social development, music, numeracy and literacy, local history and citizenship. Each person had their own activity and social programme. Four of the people had a community day each week which they spent at home with their key worker and decided with their key worker about how they wished to spend their day. One person worked in a local supermarket one day a week with the support of their day service tutor and the staff at the super market who had been involved extensively in the Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: placement which we were told was proving very beneficial to the person. The manager told us that activities outside the resource centre included swimming, bowling, visiting friends, BBQs, church services, pubs, horse riding, yoga, rambling, tobaganning and local clubs. The home actively welcomed visitors at any reasonable time. People had also been on holiday supported by staff. The manager told us that they had established close relationships with relatives of the people who because of distance found it difficult to visit. The manager told us that they were to review the range of activities in the home taking into account the changing needs of the people living in the home. Risk assessments we looked at showed how people were supported safely and were guided in activities to promote more independence for example, housework, which included cleaning, laundry and cooking. Comments we received included, they try to make people more indpendent, help people with choices and cater for individual needs and offers life long education. Staff monitored the nutritional needs of the people living in the home. We saw the people having breakfast during our visit. This was taking place in the dining area of the kitchen. There was a very relaxed atmosphere. We heard and saw staff taking time, speaking quietly and asking the people what they wanted to have for breakfast and later asking them whether they would like to sit in the lounge whilst they waited for the mini-bus to take them to the resource centre. At breakfast there was a choice including a hot meal. At lunch, when attending the resource centre there was a packed lunch and an evening meal provided a hot meal including a choice. Meals were taken in the dining area in the kitchen whcih was to be refurbished in the very near future on the ground floor. All staff members help and support meal preparation and all had food hygiene training provided. We heard staff asking a person do you want your music on, what would you like to eat today and shall we go to the lounge when you are ready. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of the people are met in a digified and supported manner. Medication is given safely by staff who knwo what they are doing. Evidence: Care records showed that any health or emotional needs were being met either by staff, specialist staff from Sense East or by their own local doctor. The manager told us that they had established close working relationships with the local doctors and they were working with the community physiotherapist. When needed, with permission from the person, people were referred to their local doctor, Community Nurse, Continence Nurse, Dentist and Optician and Podiatry. Sense also had access to a behavioural therapist, physiotherapist and speech and language specialist. There were also 6 monthly audiology and dental checks. Where required, staff accompanied the people to these services. Each person had an annual health check. Comments we received included they provide good physical and health care with intellectual stimulation and all health matters are dealt with well and promptly by staff contacting the relevant medical expert. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: The manager showed she had a key worker system in order to provide consistent support with communication and to give a specific member of staff responsibilities for each person. All of the people living at the service needed support in order to take their medicines safely. Sense had a very detailed and clearly written medication policy. Over the last year we had been made aware by the home of one medication error, which did not put any person at risk. The manager told us she had taken action and assessed each staff member responsible for supporting people with their medicines and monitored their practice. The manager told us that care leaders gave out medication. There was a policy and procedure for this and each person was assessed by the manager before they were considered safe to administer medication. Records we saw were clear and well maintained with a good audit trail. The home also received regular pharmacy inspections the last on the 10/7/2009. There were no concerns. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are supported and know how to make a complaint and feel that staff will listen to their concerns and views. Evidence: Sense East have a Resolving Issues policy, which gave written and pictorial guidance concerning how any person could raise any issues. This could be provided in Braille, tape or other languages other than English. No complaints or safe guarding adults issues had been received by the commission and the home over the last year. We asked, and it was agreed that the manager would amend the complaints procedure with our new name, contact address and telephone number. During our inspection no person had any complaints about the service. The manager also agreed to obtain an up to date copy of Lincolnshire County Councils adult protection procedures as this could not be found. Staff during their induction received training about safeguarding adults as well as a yearly refresher training programme in the form of a questionnaire about safeguarding people at their appraisal. We also spoke with 3 staff who confirmed this and told us correctly what they would do if they suspected abuse. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in safe, comofrortable and well maintained accommodation. Evidence: Accommodation was well maintained throughout. One of the bedrooms on the ground floor had been provided with an en suite bathroom to assist the persons changing needs. The accommodation although in an old building had been designed for people who had visual needs making good use of colour and texture contrasts in decor and furnishings with tactile information. Bedrooms are decorated and equipped to meet the needs of each person to reflect their tastes and preferences. All bedrooms are lockable to aid privacy. One bedroom has a flashing light so that that the person is aware that there is someone at their door. Comments we received included, the home is warm, clean and comfortable and his room has had more makeovers than the Queens palace. There were 3 living rooms with comfortable chairs and settees and a kitchen and dining/sitting area. One of the lounges had a new large television and an induction loop system had been installed in the room for the television and in 2 peoples bedrooms to aid hearing for those who wear hearing aids. There was a utility room with a washing machine with sluice cycle with a tumble dryer. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: The manager told us they were waiting for the installation of a new kitchen in the near future. There was a very attractive garden which is shared with another Sense home and they have their own paved patio area and gazebo with swing seat and water feature. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: The manager showed that she had made sure there were enough staff available each day to support people safely and promote their independence. Recruitment and training records showed they were experienced and competent to care for people who had sensory needs. She told us she had recruited a number of new staff who were on their induction to the home. During the day there were 4 staff and at night there was 2 wakeful staff. The manager told us she monitored the dependency of the people in the home and monitored their changing needs. Each new member of staff was recruited correctly with a check by the Criminal Records Bureau. They had a 13 day induction programme to prepare them for their role. They then completed a Skills for Care certificate and post induction training in the first six months. They also received monthly supervision sessions and an annual appraisal. All staff had or were being trained to communicate using total communication skills and to understand each persons differences and needs by signing. The manager told us training over the past year had included moving and Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: handling, fire prevention, safeguarding adults, infection control, medication, food hygiene, health and safety and oral hygiene. In addition, staff were encouraged to study for a nationally recognised qualification in care (National Vocational Qualification). One member of staff had a NVQ level 3, eight staff have NVQ level 2 and one person is working towards this qualification. There were therefore 70 of the staff with or studying for an NVQ. Sense had achieved the Investors in People award as a result of its commitment to staff education and development. Staff spoke of the support they received and of the supervision and appraisal systems in place. All staff were responsible for care, catering, domestic and laundry duties. They were therefore responsible for all services in the home. The staff felt they could meet the needs of people and felt they had sufficient time. This was observed during our visit by staff taking particular time to communicate with the people in a calm, kind, friendly and sensitive manner. Staff members spoke of the support they received and of working as a team. Comments we received from staff included, I had a thorough CRB check before I started and was kept fully informed. My induction was excellent it covered everything I needed to fulfil my job correctly and I learnt a lot more, it has been the best induction I have had, I have had a lot of training which has helped me understand things like equality and discrimination, I meet with my manager every 6 weeks for supervision which I get a lot of advice and support, I also attend staff meeting, we always receive refresher training as there is always something new to learn and The manager and deputy are always approachable and ready to listen to any comments you have to make. I love my job. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people and staff benefit from the positive leadership of the management team. Evidence: In March 2008 we registered a new manager for the home. This person had extensive knowledge about the needs of people with sensory impairments. She had obtained a management qualification and was working towards a care qualification. She was supported in her role by 2 deputy managers. Comments we received showed that people had confidence in the management. Comments on behalf of the people living in the home included, we are satisfied with the home in every aspect and he loves it there and is doing well and is very happy and the home tries to make people more independent, helps people make choices, caters for individual needs and offers lifelong education. Staff comments included, My manager is always there for support and advice. We are generally well staffed. All the staff work with their heart and do all they can to provide, encourage and support deaf blind people to live a fulfilled life and Since the new manager the service has improved, we are encouraged to bring new ideas which are tried for the benefit of the service users. There is a real sense of team work. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: There were detailed policies and procedures, which enabled staff to deliver care and support the people in the home. Sense have an establised quality assurance system. A detailed audit took place on the 17/6/2009. This looked at every aspect in the home including care and support. The report noted, a positive audit and one that is meeting operational standards at a high level. The report considered the home to be a well run and managed service. Sense carried out a survey of the people living in the home and of the parents views of the care and support offered in June 2009. There were no negative comments. Comments from parents included, we are pleased with Manor House. They have helped more than other places, you are meeting every need. Choice and independence these are followed within the limitations of their intelectual ability. Other comments included, I consider we have a good working relationship with the manager and staff team. Any contact has always been professional. Records showed that Sense made monthly unannounced monitoring visits. We looked at the reports written about the visits made and found them detailed and well maintained. There had been no concerns. Records throughout our visit were available, up to date and well maintained. We did discuss with the manager that some of the records were difficult to find and storage arrangement were a little disorganised. She agreed with this observation and agreed to address this in the future. Monthly meetings were held with staff. They told us that they felt valued and supported. Staff were seen to support people in a confident, knowledgeable and sensitive manner. Our observations confirmed they clearly knew the needs of each person and showed excellent communication skills. Throughout our visit there was a relaxed atmosphere. Sense had comprehensive health and safety policies, which also included detailed and up to date risk assessments. These included risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were regular tests of the fire system as well as regular fire drills. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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