Care Home: The Mount

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• Clover House
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• Hudson Road
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What the care home does well People that use services are able to stay in a comfortable homelike care home, which offers bright, comfortable living areas. Externally the building has been repainted and internally the home is well maintained so offers comfortable safe living accommodation. People that live at the home made positive comments about living at the Mount and said, "I really like coming here, it is a place I can relax in and see people I know and trust and who will listen if I have any worries." There is a stable staff group who have positive attitudes to the people that live there so staff treat people with dignity and respect. Appropriate staffing levels are provided so people that use services were supported around their needs. The personal care and health needs of people that use services are met to a very good standard so they are supported to maintain their personal appearance and hygiene.A varied menu is available so people that use services can choose different meals. A programme of redecoration and replacement of furniture and equipment isongoing so people that use services live in a safe and well maintained building. What has improved since the last inspection? The care or support plans of people that use services had improved with the Mount using person centred thinking and planning to provide care and support so people that use services received individualised care and support. Detailed information had been gathered about the lives, life histories, relationships, lifestyles, interests and hobbies of people using the service so this information was available in care or support plans so staff could support people to plan and access activities they enjoyed or had important information about their lives and relationships so could use the information to provide care and support. Care or support plans held important information about the health care needs of people using the service so staff were familiar with individual peoples` needs. The outside of the building had been repainted so looked clean and well maintained. What the care home could do better: Reviews of care should be more regular and informative about how care and support agreed with people that use services benefits them or if care and support plans need to be changed so people that use services are confident they receive the right care as their needs change. Information about the facilities and services available at the Mount as well as how people with sensory, physical and learning disabilities can use the safeguarding procedure needs to improve so they are aware of the facilities and services available and can raise concerns if they are not treated with dignity and respect or believe they have been neglected or abused. Key inspection report Care homes for adults (18-65 years) Name: Address: The Mount 6 Liverpool Road, North Burscough Nr Ormskirk Lancashire L40 5TP The quality rating for this care home is: two star good 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: Anthony Cliffe Date: 2 2 0 3 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 31 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 31 Information about the care home Name of care home: Address: The Mount 6 Liverpool Road, North Burscough Nr Ormskirk Lancashire L40 5TP 01704893907 01704896181 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Social Services Directorate Name of registered manager (if applicable) Mrs Sarah Birtwell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: 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 The maximum number of service users who can be accommodated is: 4 Date of last inspection 3 0 0 4 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home The Mount is owned and run by Lancashire County Council and provides respite and short term care for a maximum of four people over 18 years of age with learning disabilities. The Mount is on a busy main road and is in walking distance of local amenities and public transport. The home is a dormer bungalow with 4 single bedrooms. There is a lounge/dining room and conservatory area communal space. There are facilities such as a ramp, disabled toilet and other aids to help service users remain as independent as possible. A large, well-maintained and secure garden to the rear of The Mount gives additional space when the weather is good. The Local Authority usually funds people that use the short break services who pay a nominal fee but not the full cost of their stay at the Mount. There was information available to people who may chose to use the service and their families advising them of the service and giving them details about the type of service they could expect. Information about the cost of fees and facilities and services available at the Mount can be obtaine dby contacting the home manager. Care Homes for Adults (18-65 years) Page 5 of 31 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: two star good 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home References to we, our or us represent the Care Quality Commission This unannounced visit took place on the 22nd March 2010 and lasted four hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide us with up to date information about the services provided. This helps us to determine if the management of the home see the service they provide in the same way we do and if our judgements are consistent with providers or managers. During the visit various records and the premises were looked at. People that use services, staff and the manager were spoken with and gave their views about the service. We provided questionnaires to people using the service, staff and health and social care professionals involved in their care so they can tell us their views about the service the home provides. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well People that use services are able to stay in a comfortable homelike care home, which offers bright, comfortable living areas. Externally the building has been repainted and internally the home is well maintained so offers comfortable safe living accommodation. People that live at the home made positive comments about living at the Mount and said, I really like coming here, it is a place I can relax in and see people I know and trust and who will listen if I have any worries. There is a stable staff group who have positive attitudes to the people that live there so staff treat people with dignity and respect. Appropriate staffing levels are provided so people that use services were supported around their needs. The personal care and health needs of people that use services are met to a very good standard so they are supported to maintain their personal appearance and hygiene. A varied menu is available so people that use services can choose different meals. A programme of redecoration and replacement of furniture and equipment is Care Homes for Adults (18-65 years) Page 8 of 31 ongoing so people that use services live in a safe and well maintained building. What has got better from the last inspection The care or support plans of people that use services had improved with the Mount using person centred thinking and planning to provide care and support so people that use services received individualised care and support. Detailed information had been gathered about the lives, life histories, relationships, lifestyles, interests and hobbies of people using the service so this information was available in care or support plans so staff could support people to plan and access activities they enjoyed or had important information about their lives and relationships so could use the information to provide care and support. Care or support plans held important information about the health care needs of people using the service so staff were familiar with individual peoples needs. The outside of the building had been repainted so looked clean and well maintained. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Anthony Cliffe Care Homes for Adults (18-65 years) Page 10 of 31 3rd Floor Unit 1 Tustin Court Port Way Preston Lancashire PR2 2YQ 01772730100 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 11 of 31 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 12 of 31 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. Information needs to be provided to people that use services about the Mount in a way they can understand so they can decide if the home is suitable to meet their needs. Information is gathered about their needs and choices so they can decide if the home can meet their needs. Evidence: The information provided to people that use services called the statement of purpose and service user guide were made available to people choosing to use the mount short break service. This information is not available in an easy to understand format that they could understand and the information is made available as a standard typed form with some pictures of the home. So information needs to be provided to help people with learning and sensory disabilities to help them decide if they wanted to live at the home. We could see that people that use services had individual information gathered about their needs before they moved into the home and we saw recent information gathered about two people who had chosen to use the short break services at the Mount.We could see that people that use services were consulted about their future and what they wanted to achieve in their lives. The care records we looked at contained lots of information Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: about them. Each person has a person centred plan which contained information gathered from people that use services and involved gathering information from families and other professionals involved in their care where possible so staff at the home had helpful information to help them provide the right support and care. The home use a person centred approach and person centred planning to care for and support people that use services so their care was based on their daily routines and preferences. The information we saw gathered about people before they moved into the home included details about their needs and we saw this covered information about their social interests and hobbies, medical information on their physical and mental health, how they communicated with people, maintaining their safety, managing finances, help with personal care, and their life histories so staff had information about the people they cared for and supported. We could see that in other records gathering information usually involved families and health and social care professionals and important information was obtained about people that use services from families and health and care professionals so staff had information about them before they moved into the home. Care Homes for Adults (18-65 years) Page 14 of 31 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 supported to live a lifestyle of their choice and information held about them shows that they are included in the decision making process so are usually involved in everyday decisions. Evidence: We saw that a lot of information was gathered about the needs of people that use services so staff had information to provide support and care. The home uses person centred thinking and planning to provide care and support to people living at the home so their care is based around their needs. Person centred planning is a really good way for people that use services to take control of their lives. Person centred thinking helps staff that care and support people that use services to listen to them and then to get what they want. A person centred plan contains information on what is positive about people that use services for example what people like and admire about them and their gifts and talents. Information should be included about what and who is important to people that use services from their viewpoint, as well as what people want for their future. A person centred plan should have information about how people that use services want to be supported, so stay healthy, safe and well. This is called a support plan but may be called Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: a care plan. This should be detailed enough to provide a living description of how people that use services want to be supported, how they make decisions and says who will do what by when. We saw the home used a person centred plan for people that use services which included details on their life history, important people that supported their needs, support with personal care and leisure activities and how to support them to stay safe and healthy. Information about how staff could support people that use services to care for themselves and what skills they had in caring for or could be supported to care for themselves were recorded so staff knew how and when to support and care for them. Some people that use services had behaviours that meant their safety and the safety of others was at risk called risk assessments. Their care or support plans plans advised staff how to respond rather than prevent this so staff supported people to take risks without reducing their choices. Care plans recorded what dreams or aspirations that people had for their future so staff knew what they wanted to achieve in their lives. Staff were using an approach by where they asked themselves what was working or nor working when caring for and supporting people that use services so they were able to identify if additional support, training or a different approach to care was needed. The home is in the process of re writing the person centred plans for people that use the short break service. We saw that care and support plans had improved and that information gathered about people was used to support their needs so staff had useful information to support people to make decisions about their care. Reviews of care showed that relatives, supporters, social and health care professionals and advocates were not always invited to reviews. As the short break service usually provides accommodation on a short term basis staff from the service attend other professionals reviews of care so are able to gather and share important information about people that use services.The plans we saw had been re written and were overdue for a review. The manager had introduced a format for staff to use so they new when reviews were needed so improvement in reviews were being made. Attending reviews provided staff at the Mount with information and guidance on how to manage medical conditions such as epilepsy or mobility problems associated with people so staff had information on what to do if medical emergencies occurred. Information was also included on how people that use services communicated called communication plans so helped staff understand peoples different ways of communicating. Communication plans were also supported by a set of questions staff could ask people to use services so they knew if they could understand for example if the knew how to tell staff if things had happened to them or had difficulty in understanding questions so were able to help people communicate better. Each person using the service had a pen picture, as a quick introduction for new staff which contained information about what people liked and admired about them, people that supported them and what gifts and talents they had as well as what was important to them and for them so staff provided care based on their wishes. We saw that staff Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: treated people that use services with courtesy, dignity and respect and sought their views about how they wanted to be supported and saw staff help them make decisions. We saw information about how people that use services made decisions or where they lacked capacity, experience or judgement to make decisions so staff could help them make decisions about their lifestyle, health and safety. Care Homes for Adults (18-65 years) Page 17 of 31 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 that use services are supported to have good relationships and make choices about their lifestyles and leisure activities in keeping with their age, wishes and choices so they receive support and have a healthy diet based on their personal choices. Evidence: We could see that people that use services had the opportunity to be involved in a variety of activities which included day care, leisure and recreational activities such as karaoke, going to a local disco, eating out, going for walks, social clubs and bowling. Support plans detailed what people that use services enjoy doing such as listening to music, using computer games, reading, socialising and social drinking so we could see they had a varied lifestyle while staying at the Mount. At the time of the visit the four people staying at the mount needed help with their physical disabilities. The manager worked a late shift so if any of the people staying there wanted to do an individual activity there were sufficient staff to do so. We received a survey from a social care professional that said people using the Mount said opportunities for them to socialise outside of the home were sometimes limited by staff availability. Staff was available for unplanned activities most Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: evenings so people that use services had flexible support. People that use services could also involved in doing chores, preparing drinks and snacks and their laundry if the wished so were able to do normal everyday things they would in their own home. Support plans detail the level of contact with families while staying at the Mount so were able to maintain family relationships as well as contact with friends. People that use services were encouraged to take responsible risks such as going out alone and plans called risk assessments were in place so they could be helped to maintain their safety. The routines of the home were flexible and meals were seen to be varied and supported a balanced diet. Meals were prepared by staff or with help from people using the service. Staff asked the people using the short break service what they wanted and they decided among themselves so staff prepared sausage, mashed potatoes and vegetables. People that use services were involved in the running of the house and developing skills. We could see that the support plans of people that use said if they needed to gain experience to do their shopping, cooking and cleaning so were supported to care for themselves. Care Homes for Adults (18-65 years) Page 19 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical, emotional and personal needs of people using the service were looked after and they received support to look after their medicines or support to take them safely so their health and welfare was cared for. Evidence: Support plans gave details as to the personal help and support needed by people using the service so staff knew when to provide help and support and what care people using the service could provide for themselves. Support plans contained information on how and when people using services wanted or needed help and support to remain healthy. We could see that people that use services had health action plans that informed staff what support they needed to keep healthy and safe and who was responsible for getting help and support. Examples of this included getting help for a person who was staying at the home on a short term basis and had been seen by her doctor and mental health professionals while staying at the Mount. Information in health action plans provided personal information about physical, psychological and the mental health of people using the service so consistent care could be provided for them. Medication policies were detailed so staff had guidance on how to receive, store, administer, record and dispose of medicines safely. The home has medicine storage Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: facilities in the main kitchen area. The medication policies and procedures for medicine administration were kept in the staff office. Staff responsible for administering medicines had their specimen signatures kept with medicine administration records so staff were aware of their responsibility and accountability for managing and administering medicines. Storage included controlled drugs storage but no people using the services were prescribed controlled drugs at the time of the visit. People that use services were able to manage their own medicines so could take them independently. We saw how staff recorded each persons medicines as they arrived at the Mount. Medicine receipt was recorded on each persons medicine administration records so there was an accurate record of the amount of medicines each person had brought in. We saw the medicine administration records used and saw that as people were only staying for a short period of time only small quantiles of medicines were brought by people. Care Homes for Adults (18-65 years) Page 21 of 31 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 that use services are protected by the safeguarding adults procedure in place so people that use services will be confident they are protected at all times. Evidence: During the visit we saw the complaints policy was available in an accessible format and displayed for people using the service to see so they had access to it. This contained a flowchart with pictures explaining to people with learning or sensory disabilities how to use the complaints procedure so people could make a complaint. The records we saw also contained a copy of the complaints, compliments and comments procedure. We had not received any complaints about the home since our last visit and the home had not received any either. During the visit we asked a person using the service about what they would do if they were unhappy with anything and they said, I talk to the staff all the time and I will tell them if I am not happy. We received surveys back from people using the service and they said they knew who to talk to if they were unhappy with anything and how to use the complaints procedure. Policies and procedures were in place to protect vulnerable adults called the safeguarding adults procedures. The safeguarding adults procedure is how we, the local council, police and other agencies respond to and manage allegations or suspicions of abuse against vulnerable adults. The Mount had not made any safeguarding referrals since the last visit and we had not received any safeguarding concerns about the Mount. The home had produced information for people using the short break service on the safeguarding adults procedure. This was available to people but not in a format that people with learning or Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: sensory disabilities could understand so they would not be able to use the procedure. Staff at the Mount had received safeguarding training which helped them to respond to suspicions or allegations of abuse or neglect to make sure vulnerable adults were protected. Staff spoken with said they received safeguarding adults training during their induction. Staff spoken with during the visit were knowledgeable about the safeguarding adults procedure and how to report their concerns so could protect vulnerable people. Care Homes for Adults (18-65 years) Page 23 of 31 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 that use services live in a comfortable and safely maintained building that supports people with physical, learning and sensory disabilities to be safe during their stay so their safety is promoted. Evidence: We looked around the building and saw that the building offered comfortable accommodation and was suitable equipped for people with physical disabilities. Improvements had been made to the decoration of the building both internally and externally with the outside of the building being re painted as recommended at our last visit so the owner makes improvements to the building as is needed. People that use the Mount can take personal possessions with them during their stay so personalise their bedrooms to their tastes as best they can. The lounge areas was seen to be comfortable and homelike in appearance so people had a comfortable place to sit and socialise during their stay. Staff were mainly responsible for the cleaning of the building and people that use services could be involved in the cleaning of the home so they had some responsibility for the cleanliness of the home. Care Homes for Adults (18-65 years) Page 24 of 31 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. Good employment policies, procedures and training is in place so staff understand the needs of people that use services and they receive appropriate care. Evidence: We saw the staff numbers in place supported the needs of people that use services so they had sufficient help with their needs. There were three staff on duty including the manager. Additional staff were not available so the manager was working a late shift to support people going out and provide help for people with personal care. Staff we spoke with described training as good and varied and provided staff with the knowledge, skills and experience they needed to do their jobs so they were kept up to date with working practise. Staff had received training on person centred thinking and planning and had been responsible for writing person centred plans with people that use services so they could provide care based on their wishes. Staff said that person centred thinking and planning had been positive and helped them to use new ways of thinking and recording how they helped and supported people that use services so had a positive effect on how they did their jobs. Staff said they received supervision and support. We received surveys back from staff working at the Mount that said the manager regularly Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: met with them to offer support and guidance so they had opportunities to discuss how they did their jobs and how they could develop. Staff said they had the opportunity to complete NVQ level 2 and 3 qualifications which area nationally recognised qualification in social care. The information returned to us before the visit by the manager said 10 care staff were employed and seven of these had an NVQ level 3 qualification. Before the visit staff returned surveys to us and said they received training that keeps them up to date with new ways of working and helps them to understand their roles. Staff said they received training on understanding medication and medical conditions. Surveys said staff received regular supervision and support from the manager. We examined the recruitment records of the only staff member employed at the home since our last visit. Recruitment procedures were robust and included staff having to complete an application form, full employment history and two references sought about their suitability for employment. The recruitment of staff also included a Criminal Records Bureau (CRB) disclosure which is a check of staff to see they are suitable people to provide personal care and support to vulnerable adults. Staff were also issued with the General Social Care Council code of practise a guide for social care staff on the standards expected of them so they were aware of their responsibilities and practise when providing care to people that use social care services. Staff comments and records provided during the visit demonstrated that staff had regular training updates so were suitably trained to do their jobs. Staff had to complete an induction programme within 3 months of employment. People that use services had been involved in staff recruitment so could directly influence who worked with them. Staff had attended training in first aid, food hygiene, health and safety, medicine administration and management, safeguarding adults, customer care, equality and diversity, mental health and person centred thinking so had a variety of training to support them to do their jobs. Care Homes for Adults (18-65 years) Page 26 of 31 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. Quality assurance identifies areas for improvement so the welfare of people that use services is promoted. Evidence: The manager had worked at the home for over two years and has developed her experienced in managing care services at a management level. The manager had been registered as the manager at the Mount for over two years so we think she is a competent and fit person to manage the home. We saw during the visit that the manager is supported by her locality manager. Staff meetings were held regularly and there were good communication systems in place so staff were kept up to date with the running of the service. The support for the manager had improved with the appointment of two part time administrative staff appointed from the existing staff team so there is continuity within the home. Before the visit the manager had met with other managers from Lancashire County Council short break services and the locality manager to discuss improvements they could make across the service so good ideas and practise were identified and shared across the short break Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: services so there is more consistency in how the short break operates so people that use it benefit from consistent planned change. We looked at how the quality of life for people living at the home was promoted. We saw the locality manager and manager completed some checks on things in the home on behalf of the provider to make sure the home was managed properly, important information was gathered about the home, how safety was maintained and that people that lived there were satisfied with the care they received. This was called quality assurance and was done by doing lots of checks called audits so the provider could see how the home was managed and make a judgement on how everything was working and was aware of any matters in the home which needed to be improved upon and could tell the manager if she was doing a good job or needed to make improvements. The area manager was someone who new about how the provider looked at quality assurance to complete monthly quality assurance checks on their behalf. This involved talking to people that live at the home and staff and looking at important records so they can write a report to say if the think the home is being properly managed. These visits are called Regulation 26 visits. The area manager visited the home regularly and completed reports on behalf of the registered provider. We saw these reports and they looked at how the building was being maintained and improved, talking to people that live there about the standards of care and food provided and to staff about training so important matters were discussed with people living and working at the home. During the visit the responsible individual spoke with people staying at the home so they could give their views about living there and they said they were happy living at the Mount. Regular meetings between the manager and people living at the home were held so people that use services hand an opportunity to discuss the management of the home and the manager could discuss matters about health and safety and living together. We saw that all the required maintenance checks and health and safety checks had been completed as required so people that use services lived in a safe building. We checked the records for fire safety and found all fire safety systems were checked regularly so the safety of people that lived at the home was promoted. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  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 29 of 31 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 Description 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 Description 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 1 Information about the facilities and services available at the Mount should be provided in a format that people with sensory, physical and learning disabilities can understand so they are aware of the facilities and services available. Reviews of care should be more regular and informative about how care and support agreed with people that use services benefits them or if care and support plans need to be changed so people that use services are confident they receive the right care as their needs change. Information about how to use the safeguarding adults procedure should be made available in a format that people with sensory, physical and learning disabilities can use so they can say if they are treated with dignity and respect and if they believe they are being neglected or abused. 2 7 3 22 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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