Care Home: The Old Post Office Residential Home

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What the care home does well Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way. Each person using the service has a person centred plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of educational, leisure and social activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills, to complete domestic chores in the home, and to take some responsibility for shopping and cooking. Staff said they are committed to supporting people to achieve identified goals. People are supported to go out for meals, or to the pub, and food is prepared and cooked by individuals, with the support of staff members. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter. What has improved since the last inspection? The Annual Quality Assurance Assessment (AQAA) document which is completed by the care manager told us: "Over the past 12 months, The Old Post Office has built a good relationship with Staffordshire and Stoke on Trent and other areas, and is highly renowned for care that we offer for those who use our service. The Old Post Office had one new admission since the last AQAA was submitted. Due to reputation and interest regarding vacancies the home has plans to extend by a further two beds by the end of 2009. Over the last 12 months, the Activities Coordinator has encouraged the service users to access recreational activities throughout the wider community. The service users have been encouraged to give feedback on the effectiveness of the activities. By increasing the activity programme and being able to offer more choice, this has increased participation by the service users that has helped to reduce boredom and anger. We have focused on encouraging all of the service users to participate in activities that provide them with essential every day life skills. They have been actively involved with compiling a weekly shopping list for the home, which they have used with the guidance from staff. They have also been encouraged to handle the money and make payment. One of service user enjoys using public transport to go to town, which he also makes payment himself in the presence of a staff member. The Old Post Office is currently in the process of obtaining additional professional support for the people who use our service through the NHS. Forms have been completed and returned to New Burton House regarding a Psychologist and community Learning Disability Nurse. The home has also focused on improving communication skills for each of its service users, by introducing support from a speech and language therapist. All information regarding inter agencies for vulnerable Adults for Staffordshire and Stoke on Trent, Coventry and Birmingham have been renewed. New copies are available for the people who use our service. Most staff have undertaken adult abuse training. We have created two living areas on the ground floor, that`s improved and given families and friends who visit The Old Post Office more privacy. Those who use our service have openly welcomed this. The Old Post Office has built over the last 12 month a good working relationship, that offers those who wish to be employed a career pathway in care and job satisfaction. The Old Post Office has continued to encourage all members of staff who wish to develop further. For those who may find areas of training difficult, management and senior members of the team support them." What the care home could do better: There were no requirements or recommendations made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: The Old Post Office Residential Home Newport Road Haughton Stafford ST18 9JH     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: Pam Grace     Date: 0 1 0 7 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 29 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 29 Information about the care home Name of care home: Address: The Old Post Office Residential Home Newport Road Haughton Stafford ST18 9JH 01785780817 01785780883 kevin.betts@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Old Posting Office (Haughton) Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) 5 Learning Disability (LD) 5 Date of last inspection Brief description of the care home The Old Post Office is a residential home located in Haughton, Stafford having easy access to public transport and local amenities. The home provides a service for adults of both genders [though currently all are male] who have a learning disability and a mental disorder. The two-storey detached property is situated within its own grounds; all bedrooms are of single occupancy equipped with en suite. Toilets and bathrooms are located throughout the home and are in close proximity to bedrooms and communal areas. The design and layout of the property would not be suitable for Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 5 5 Brief description of the care home individuals who have a physical disability; there are no specialist equipment or passenger lift in place. The home provides a large lounge and separate dining area that is pleasantly decorated and equipped with essential furnishings and items to provide a comfortable area. People who use this service have access to a large domestic style kitchen; a separate laundry area is also provided. Limited car parking is provided at the rear of the property. The home offers a well-maintained garden, which is accessible to all service users. Staffing is provided within the home on a 24-hour basis, to ensure the total supervision and support of the individual people who use the service. 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: This visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over approximately five and a half hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Audit (AQAA) for us. A tour of the home was undertaken. On the day of the inspection the home was accommodating four people. Due to the complex needs of some people living in the home, we were unable to communicate Care Homes for Adults (18-65 years) Page 6 of 29 effectively with all individuals present during the visit. We spoke with people who use the service, examined records, carried out indirect observation, and spoke with staff on duty. Two care plans and three staff records were examined and observation of daily events took place. Medication procedures were inspected so that we could see how safe they were. There are satisfactory medication systems in place and the staff have a good knowledge of medication and of drug usage. A weekly audit of all medicines is carried out. We did not make any requirements or recommendations as a result of this unannounced inspection. The fees charged for the service at The Old Post Office, are from 1695.24. pounds to 2225.72 pounds per week. The fee information included in this report applied at the time of inspection, the reader may wish to obtain more up to date information from the care service. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? The Annual Quality Assurance Assessment (AQAA) document which is completed by the care manager told us: Over the past 12 months, The Old Post Office has built a good relationship with Staffordshire and Stoke on Trent and other areas, and is highly renowned for care that we offer for those who use our service. The Old Post Office had one new admission since the last AQAA was submitted. Due to reputation and interest regarding vacancies the home has plans to extend by a further two beds by the end of 2009. Over the last 12 months, the Activities Coordinator has encouraged the service users to access recreational activities throughout the wider community. The service users have been encouraged to give feedback on the effectiveness of the activities. By increasing the activity programme and being able to offer more choice, this has increased participation by the service users that has helped to reduce boredom and anger. We have focused on encouraging all of the service users to participate in activities that provide them with essential every day life skills. They have been actively involved with compiling a weekly shopping list for the home, which they have used with the guidance from staff. They have also been encouraged to handle the money and make payment. One of service user enjoys using public transport to go to town, which he also makes payment himself in the presence of a staff member. The Old Post Office is currently in the process of obtaining additional professional support for the people who use our service through the NHS. Forms have been completed and returned to New Burton House regarding a Psychologist and community Learning Disability Nurse. The home has also focused on improving communication Care Homes for Adults (18-65 years) Page 8 of 29 skills for each of its service users, by introducing support from a speech and language therapist. All information regarding inter agencies for vulnerable Adults for Staffordshire and Stoke on Trent, Coventry and Birmingham have been renewed. New copies are available for the people who use our service. Most staff have undertaken adult abuse training. We have created two living areas on the ground floor, thats improved and given families and friends who visit The Old Post Office more privacy. Those who use our service have openly welcomed this. The Old Post Office has built over the last 12 month a good working relationship, that offers those who wish to be employed a career pathway in care and job satisfaction. The Old Post Office has continued to encourage all members of staff who wish to develop further. For those who may find areas of training difficult, management and senior members of the team support them. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information provided to people about the service ensures that they have the full facts about costs to enable them to make the decision about the suitability of the service and its ability to meet their needs. Evidence: The Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager, confirmed that peoples health, personal and social care needs are fully assessed prior to admission to the service. This also told us: The prospective service users are provided with full information and support prior moving into the home. This is to establish whether the home and the service provided would be suitable to meet their identified individual needs. The pictorial Statement of Purpose and Service user Guide which is specific to this service and the resident group, was available for us to view. These documents had been explained to people who use the service with the use of pictorial support. The Guide included details of the terms and conditions of occupancy and fee level. Each Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: person also had a Contract and or Terms and Conditions of service. The care manager and staff confirmed that pre admission assessments had originally been undertaken either by the home, by social services, and or the specialist community learning disabilities service. The people who use the service had been resident in the home for a number of years and there was one vacancy. One person spoken with, said that they were happy living at this home, and we get on alright with the staff here. Surveys we received confirmed that people had received enough information about the home, prior to making a decision to move in. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: The Annual Quality Assurance Assessment (AQAA) document, which was completed by the care manager, confirmed the following: Person centred care packages and approaches are implemented at The Old Post Office. To promote the feeling of well being, each service user is involved and encouraged to identify their needs, choices and preferences. This is supported by the multi disciplinary approach to decision making both with and for the service users. We looked at two care plans, these were up to date and very clear. Both care plans contained a detailed client profile with person centred information. Evidence of health services input was also seen. Each plan was individualised, and recognised the personality and needs of the person. The plans were reviewed on a regular basis, and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: any changes to the skills achieved were recorded. Staff know the people using the service very well, and the care and support they need. They confirmed that individuals are consulted on a daily basis, and are encouraged to be involved with their care plan reviews. This consultation was also confirmed when we spoke to people using the service who told us,we have meetings, and drink coffee with the staff, Staff help me to choose where to go for trips out, and for holidays, Im hoping to go to Blackpool soon. Recorded minutes of those meetings were available for us to view. We saw that people were asked by staff if they wanted drinks, food and snacks, which were made available throughout the day, with a choice of options for hot or cold food and or drinks. Surveys received confirmed that people are asked what they want to do each day. Risk assessments seen identified in detail the risks for each individual. These were very clear, up to date, and complete. Contingency plans were in place, ensuring the safety of each individual. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The Annual Quality Assurance Assessment document (AQAA), completed by the care manager, confirmed the following: The Old Post Office promotes person centred planning that is tailored to individual needs and preferences. We are able to promote social networking and relationships, recreational and educational activities as and when appropriate. Any decisions are supported by the multi disciplinary teams approach to helping people address any offending behaviour or extreme forms of challenging behaviours. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: We looked at two care plans. Information regarding triggers to any known behaviour, for example, what may upset a person, or known fears, were included within the care plan. Information was recorded in regard to how the person communicated. Assessments covered all aspects of daily living, for example traffic awareness, cooking skills, travelling in vehicles. Information relating to the persons culture and religious needs were included in the plan, and how these were to be met. Personal risk assessments recorded the identified risk, the level of risk and how to support the person. Contingency plans were clear and up to date. Thus ensuring the safety of individuals. People who use the service made the following comments in relation to lifestyle, I help sometimes with cooking, and I do my washing, I am happy here. Due to the complex needs of some people living in the home, we were unable to communicate effectively with all individuals present during the visit. However, those individuals appeared happy and well cared for. Staff had supported those individuals to participate in the development of their plans and information. From observation and discussion with staff it was evident that people who used the service were supported to make decisions about their daily routine. During the day, people were observed being able to choose how to spend their time in the home. Surveys received told us that people make decisions as to what they want to do, and can do what they want to do each day. Staffing levels are kept under review to ensure that individual needs are met, this ensures that people receive the support they need. Some people need 2:1 support whilst out in the community. Discussion took place with staff and people who use the service during the visit. This covered their daily programmes, activities, trips out, and visits to see their families and friends. Daily activities and life continued as normal during our visit. Staff explained the inspection process to people using the service, during the inspection visit. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed the following: The Promotion of independence is by far the most important mission of the home. The service users are encouraged and supported to be responsible for their own personal care. Safety has been managed and risks have been reduced by the effective supervision of the service users. The service users are encouraged to make their own choices and they have their needs for privacy and dignity respected. Health care support is provided and all service users have their own G.P. We looked at two health action plans, these recorded health care needs and how people were to be supported. A record was also maintained of health visits and any outcomes. Assessments of risk recorded the individual support needed from staff, for example how many staff were needed to support the person in the community and or Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: support in the home. Additional staffing had been provided to ensure the right level of support. Each person was registered with a local General Practitioner (GP). There were good relationships fostered between the home, the learning disabilities service, the GP and the local pharmacist. Other specialists maintain further contact and support. For example, Speech and Language Therapist, and where necessary, District Nurses were approached for advice, information and any equipment necessary. People using the service attend surgery and or clinics as appropriate to their health needs. The evidence to support this was contained within daily records, and care plans seen. The Medication Administration system showed no anomalies, and staff stated that there were no controlled medicines in use. The home had recently purchased a Medication Cabinet, which was being fitted during our visit. Observation of administration practices was satisfactory and staff were aware of the usage of the medication administered. Medication records contained required entries, and were signed. Where people needed as required(p.r.n.) medication, a protocol for usage is available. Discussion with staff revealed that they knew people well, and how to support each individual. Comments received via surveys, told us I am happy here, they take me to college and gym, they help me with my needs, they look after me a lot. 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. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. Evidence: The Annual Quality Assurance Assessment document, which was completed by the care manager, confirmed the following: The Old Post Office provides appropriate safety measures to protect those who use our service. Staff and service users have access to the Staffordshire and Stoke-onTrent, Coventry and Birmingham Inter Agency for Vulnerable Adults. This enables us to adhere to the policies and procedures that offer protection to the service user. All staff under go CRB/POVA checks and a minimum of two references are obtained before being successfully employed at the home. Qualified Nursing staff are checked against the NMC register for any issues and proof of qualification. At The Old Post Office we continue to welcome feedback and take all comments, positive and negative seriously. A compliments and complaints book is available to all visitors inside the building next to the homes visitors book, for people to utilise should they wish to. Policies are available that describes how the complaint will be handled and the timescales that action will be taken. We have an active Whistle Blowing policy, which can be activated by either service users, staff or visitor to offer protection to each individual. The home provides a written and pictorial format of the complaints Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: procedure for all service users. The home has a complaints procedure that is clearly written and easy to understand using a helpful system of pictures. There had been no complaints and one Safeguarding referral made since the previous inspection. The policies and procedures for safeguarding adults are available in the home and staff received training during their induction. Staff records demonstrated that people are able to keep updated with their knowledge, and attend regular training for Safeguarding adults and awareness of abuse. Staff recruitment records evidenced that staff are recruited following thorough procedures, which included Criminal Records Bureau (CRB)and Protection of Vulnerable Adults (POVA) checks prior to commencement of employment. Staff spoken with at the time of the inspection confirmed this. A spot check of peoples finances revealed that the home appropriately records and receipts all personal monies held for people who use the service. Surveys received confirmed that people know who to speak to if they are not happy, and how to make a complaint. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager confirmed the following: The Old Post Office has recently been re-furbished to a very high standard. The home exceeds the minimum standard areas for communal areas; each bedroom has a full en-suite facility. There is also access to a bath within the house. The home is cleaned and maintained to a high standard by the staff and service users. We have created two living areas on the ground floor, that has improved and given families and friends who visit The Old Post Office more privacy. Those who use our service have openly welcomed this. A tour of the building confirmed that all areas internally had been well maintained. There is an ongoing programme of redecoration and refurbishment for the service. However, the design and layout of the property would not be suitable for individuals who have a physical disability, as there is no specialist equipment or passenger lift in place. This limitation is recorded in the documentation that the providers make Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: available to prospective users of the service. Throughout the home adequate standards of hygiene were observed. The kitchen is domestic in nature. The lounge is big enough to accommodate the people who use the service. The separate dining room is well used for mealtimes, and has a further lounge area within it. There are modern and comfortable type furnishings in place, which people using the service had helped to choose. The outside rear has a level paved area, which enables people to safely use the garden. People told us that their bedrooms had been personalised, their furnishings and fittings were of a good standard, and rooms had been decorated to their individual choice. One person who uses the service told us that they were happy with their bedroom, and with their lounge, I can go up to my room any time and watch television, Ive got a television, radio and DVD player in my room. Surveys received, told us that the home is always fresh and clean. 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. Staff are trained, skilled and provided in sufficient numbers to support the people who use the service and to ensure the smooth running of the service. Evidence: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: We have an excellent recruitment and selection process that addresses all issues of competency and diversity of all employees. References and CRB and POVAs are sought for all staff prior to commencement in post. Any qualified nurses employed are checked against the NMC register. Service users are actively involved in recruiting new staff members. This is supported by an effective induction and training program. We also undertake a Grow your Own approach that recognises the abilities and development opportunities available to everyone; this also demonstrates equal opportunity in the workplace. From our discussions with staff, the care manager, and the examination of staff recruitment and training records, we were assured that the recruitment and training provided, promoted an effective staff team. Staff have achieved more training. There has been a maintainance of staffing levels on shift, which means there are enough Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: staff around to ensure all individuals have the support they need, this included the provision of extra staff where needed. Staff spoken with confirmed that staffing levels were flexible to meet the needs of the people who use the service, and their commitment to daily activities, for example; transport to an appointment, or a shopping trip. A member of the staff team and or the care manager would be available at the home during the day. The staff rota for June 2009 confirmed that staffing levels had been maintained. Three staff records were examined, those records evidenced that appropriate Police and security checks had been made prior to their employment, ensuring the safety of the people using the service. Staff spoken with confirmed that they had received an induction on commencement of employment, and tasks undertaken during this time had been overseen by a senior member of staff, and signed off using a checklist system. Staff records confirmed that staff are given update refresher and mandatory training according to their role and responsibilities. Staff spoken with confirmed this, and said that they received regular supervision via their line manager. Staff meetings are held wherever possible on a three monthly basis. Staff meeting minutes were available for us to view. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Further development of the quality assurance system already in place is needed. Evidence: The Annual Quality Assurance Assessment (AQAA) document which was completed by the care manager confirmed the following: We have a professional yet friendly approach to working practice at The Old Post Office. We have an open door policy that encourages effective communication and accountability at the home. The management/senior team at the home are all experienced qualified health care professionals all of whom are either about to complete NVQ3/4 in social care and ILM4/5 in management. The leadership and management team are competent and have experience in the learning disability sector. This style of management encourages the professional conduct of the staff and oversees the quality of the care provision. The management of the home is enhanced and complimented by the support of a Professor of Psychiatry and additional professional bodies. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Surveys are regularly completed by the people using the service, this feeds into the existing quality assurance system, and feedback is then discussed during meetings for people and staff. This ensures that people have a say in the day to day running of the service. It was evident from observation and discussion with staff, that the manager is extremely enthusiastic and committed to promoting peoples rights and providing a quality service. The manager understands the importance of person centred care and effective outcomes for people who use the service. Staff commented that they feel valued, and part of a supportive team, and would have no hesitation in approaching the manager. People who use the service are well supported by the sensitivity, training, and experience of the staff employed by the organisation. Meetings for people who use the service, and for staff are held on a regular basis. People are encouraged and supported to speak out at meetings. There is evidence that the service has a good recruitment procedure in place. This evidence came from the staff we spoke with, and records we sampled. The ethos of the home was reflected in the policies and procedures, the records, attitude and competence of the staff in addition to comments received from the people who use the service. Peoples citizenship and their rights, are protected by the staff and the training that they undertake. Surveys received told us everything is alright, its not like a mental hospital, were happy. The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, contained good information, and confirmed the improvements the service intends to make in the coming year. 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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