Care Home: The Watery Lane Project

Similar services:

• 5 Seafield Road
• Honeybourne House
• Longrun House
• Bodley Community Care Support Centre
• Thomas Pocklington Trust
• Chantry Gardens
• 25-27a Alexandra Road

What the care home does well Each service user who wrote to us said they like living in the home, are always listened to and are able to choose what they would like to do. The relatives wrote to us said they very satisfied with the quality of the care and support provided and think that staff have the right skills and experience to look after people properly. Staff members we spoke with or who wrote to us said they are always provided with up to date information about the care needs of the people they support. They are provided with appropriate training and remain well supported in their roles. The health professionals who wrote to us said service users` health care needs are well met and their privacy and dignity is respected. The Manager and the care team have a good knowledge of the support needs of service users and encourage them to lead fulfilling lives. They advocate appropriately for service users with higher levels of support needs. Staff receive specialist training to enable them to support the service users who do require a specialised service, particularly in the area of communication. The views of service users are actively sought and the home remains innovative in adapting methods of communication to enable these views to be expressed, understood and acted upon. There is an effective Quality Assurance process in operation. This helps to accurately measure the quality of the services provided and ensures the home remains committed to improve the service wherever possible. The quality of record keeping within the home is excellent. This helps to ensure a competent and accountable service for each person with an interest in the home. What has improved since the last inspection? All staff are now supervised regularly and a clear record kept within their personnel file. This helps to ensure all staff are supported to provide a good quality service. What the care home could do better: There are no improvements required or recommended following this Key Inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Watery Lane Project RNID Poolemead Centre Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: David Smith     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: The Watery Lane Project Watery Lane RNID Poolemead Centre Twerton Bath Bath & N E Somerset BA2 1RN 01225356749 Telephone number: Fax number: Email address: Provider web address: katharine.segrave@rnid.org.uk Name of registered provider(s): Type of registration: Number of places registered: RNID care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: May accommodate up to 3 people of either gender with dual sensory impairment aged 18-64 who require personal care only. Date of last inspection Brief description of the care home Watery Lane Cottage is a service operated by the Royal National Institute for Deaf People, known as the RNID. The home provides a specialist service to support three people who have a dual sensory impairment. The high staffing ratio provides each service user with many opportunities to access educational and leisure facilities locally and in the wider community. Staff who work in the home are confident in their use of sign language to communicate, such as Deaf Blind Manual Alphabet or British Sign Language. The building, which is situated on the main RNID Poolmead site, is on one level with en-suite bathrooms with specialist baths and showers, which enables service users to maintain and maximize their independence. There is a large spacious open plan room, which is designed for easy access and movement into the living area, dining area and kitchen. The hallway has support rails, which enable service users to access different sections of the home independently. Externally there is a ramp with Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 3 Brief description of the care home support rails on both sides, which lead to spacious, enclosed gardens where there are a number of places to sit. Some areas in the garden have been raised to enable service users to grow their own vegetables and flowers. There are many features around the home of a therapeutic and tactile nature, which offer stimulation and a positive environment for service users. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last Key inspection of this service was completed on 09/11/06. This was an unannounced visit to the home as part of a Key Inspection of this service. The pre-inspection planning involved reviewing the report of the last Key Inspection carried out in November 2006, the Annual Service Review carried out in May 2008 and the service history, which details all contact with the home. We (the CSCI) provided the home with their Annual Quality Assurance Assessment (known as an AQAA). This is a self-assessment, which focuses on how well outcomes are being met for the people who live at Watery Lane. The home sent us their AQAA Care Homes for Adults (18-65 years) Page 6 of 32 when we asked for it. It was clear and gave us all the information we asked for. We provided a number of surveys for service users, their relatives, health professionals and staff members to enable us to carry out the last Annual Service Review. Eighteen surveys were completed and returned and the views of the people who wrote to us have also been included in this Key Inspection report. We gathered additional information for this report by looking at a number of records within the home such as care plans and associated records, risk assessments, accident and incident reports, staff training, staffing rotas and health and safety records. We also viewed all communal areas of the home and the grounds. Although we did not speak with service users, significant time was spent informally observing interaction and communication between staff members and each of the people who live in the home. We spoke with some staff members who were working in the home on the day of our visit and the Senior Support Worker who was in charge of the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 32 Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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. Prospective service users are provided with information they need to make an informed choice of where to live and their needs and aspirations are thoroughly assessed. Evidence: The homes Statement of Purpose contains comprehensive information about the range of services the home is able to offer. It is well presented and includes many photographs of the grounds, communal areas and some of the bedrooms. This document has also been developed in Braille. Each service user who wrote to us said they did have enough information to decide if they wanted to move to Watery Lane. This service was specifically designed for the three people who currently live in the home and was therefore developed to meet their support needs and lifestyles. Thorough assessments were carried out as part of this process and the service users Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: visited the home whilst building work was being completed and chose colour schemes, furnishings and help to decide the layout of rooms. Care Homes for Adults (18-65 years) Page 12 of 32 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. The home ensures that the service provided to each individual takes into account their personal preferences, needs and goals, supported by written information in care plans and risk assessments which are subject to regular review. Individuals are consulted on, and participate in, all aspects of life in the home. Evidence: All three service users care records were examined and these provide comprehensive information on the areas of support each person requires. The main care records are kept in two files, the Evidence File and Daily Notes. Care records contain a photograph of each service user, a summary of relevant information and the Service User Plan of Care. Each of these plans is written in a person centred way and only includes the areas of support relevant to each person, such as independence, hygiene, medication, aggression, decision making and finances. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Each care plan continues to be signed by the Manager, Keyworkers and the service user, if they are able to do so. This is good practice. There are effective review processes used in the home. Regular formal reviews are held, which include service users, their families, Social Workers and Keyworkers. These are clearly recorded and the outcomes used to update individual care plans. In addition to this, the home continues to review care plans internally and assesses the progress made towards goals and objectives. Keywork teams meet regularly and provide reports to ensure each service user is provided with consistent and effective support. Either of these additional review processes can lead to care plan updates. Interaction between staff and all three service users was observed at various times during our visit. These demonstrate staff have a good knowledge of the support needs of service users and how to communicate and guide them effectively. The home provides a service for people who have a variety of complex needs, however each service user is encouraged and supported to make informed choices. Care plans clearly describe how to support each person with this. The service has recently developed an effective communication tool called My Say. This uses various tactile symbols and encourages individuals to discuss various topics, such as their interests, care, support and things they wish to do. Each individual is given time with staff to use this tool and detailed records are kept of these sessions. There have been positive outcomes form the use of this tool, such as one service user now planning and saving for a holiday to America. Each service user who wrote to us said they could choose what they wanted to do each day. Staff always listen to them and act on what they say. Each person who lives in the home is encouraged to make as many choices as possible and this is evident through both discussions with staff and observation of their communication and interaction with service users. They are actively involved in all aspects of home life such as cooking, cleaning, and gardening as well as deciding what activities outside of the home they would like to take part in. On the day of our visit individuals helped to prepare lunch, attended planned activities and were supported by staff to decide how to spend the rest of their day, such as one person choosing to go swimming. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: Each service user has a number of person centred Risk Assessments, which support them to take risks as part of their lifestyle. These form part of each persons care plan, are clearly written and are now subject to regular review. Care Homes for Adults (18-65 years) Page 15 of 32 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. Each individual has opportunities and appropriate support to develop, access leisure and educational facilities both locally and in the wider community and to maintain relationships with their family and friends. Each persons rights and responsibilities are recognised in their daily lives. A healthy and balanced diet for each individual is promoted. Evidence: The home has a person centred approach in supporting each service user to develop. The records maintained within the home enable each persons progress to be assessed and the support provided adapted accordingly. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: All service users have the opportunity to attend daily Educational Development Studies, known as EDS. Facilities available in the wider community are also used, including swimming, horse riding, going for walks, trips to local pubs and going out for meals. There are many photographs throughout the home of trips or events, such as recent holidays, day trips and of the party held to celebrate the homes fifth birthday. The home works hard to ensure service users are provided with new opportunities. One individual recently spent a day at a local supermarket learning how to prepare and cook food and this was reported upon by the local press. On the day of our visit, service users were supported to access both facilities on the main Poolemead site and the wider community. Each service user is supported to choose, organise and attend holidays. Staff said these continue to be tailored to individual needs and wishes. Recent trips include holidays to Spain, as well as locations in Britain. Individuals are supported to maintain contact with friends and family members and there are no restrictions on visiting times. Clear records are maintained relating to any contact with families or visits. Each family member who wrote to us said the home meets the needs of their relative, supports them to live fulfilling lives, helps them keep in touch with them, always keeps them up to date with important issues and they believe the staff who support them have the right skills and experience. One relative said our son is very lucky to live at Watery Lane. It is brilliant. Another family member said their relative is given every opportunity to live life to the full. Observation during our visit, comments from the people who wrote to us and discussions with staff show that each person who lives in the home continues to be treated with respect and dignity. Each person is seen as an individual and treated as such. Each person is offered a choice of meals and records are kept each day which show what each service user has chosen to eat. These show a wide range of food, which provide both a healthy and balanced diet. On the day we visited, one service user helped prepare lunch and others helped to wash up. Staff members provide sufficient time and space for service users to make the best use of their own skills and abilities and only provided assistance when they need to. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Care Homes for Adults (18-65 years) Page 18 of 32 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. Individuals are supported in their preferred manner and their personal and healthcare support needs are well met. Individuals are supported to retain and administer their own medication where possible. The homes policy relating to administration of medication ensures each persons welfare and safety. Evidence: The care plans in place for service users provide clear guidance for staff on how they should support those living at the home with their personal and health care. Individuals are registered with a local GP, dentist, optician and chiropodist. Other specialist services are accessed when an identified need arises. These are provided by Bridges Community Learning Disability Team. Records show the Occupational Therapist, Psychiatrist, Speech and Language Therapist and Intensive Support Nurse regularly support the home. Contact with each professional is clearly recorded in each service users file and the outcomes acted upon. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Staff spoken with continue to have a good knowledge of each individuals support needs and are clear on the support and guidance they should provide. The record keeping in this area is excellent and can be easily tracked. This process ensures that each persons health care is monitored and the support provided is subject to review. The health professionals who wrote to us said service users health care needs are well met, their privacy and dignity respected and the home seeks their advice and acts upon this to manage and improve individuals health care. One professional said the home is a wonderful resource and another said it is of a high standard which meets individual specialist needs. The home uses the Boots Monitored Dosage System of medicine administration. The medication records show profiles of each service user, recent photograph, details of their medication, times of administration and manufacturers notes on each of the prescribed medications administered within the home. One individual administers some of their own medication and signs their records. Another service user is currently being supported with a reduction in some of their medication and staff members said this is having a very positive effect on this person. Each service users medication record was correctly completed, with no gaps evident in the records. Two staff are required to check the medication administered to service users and sign the appropriate records. The storage facilities are clean and tidy. Each individual has their own named storage area for medication. There are clear guidelines to follow in relation to medication taken as and when necessary and a robust check of all stock is maintained. Staff are provided with a thorough in-house assessment and also receive formal medication administration training. Each health care professional who wrote to us said they felt service users medication was appropriately managed by the home. Care Homes for Adults (18-65 years) Page 20 of 32 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. Service users are enabled to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Service users are protected from abuse, neglect and self-harm. Evidence: The home has a formal Complaints Policy, an Adult Protection Policy and a Whistle Blowing Policy, which staff can use in confidence to raise any issue or concern they have regarding the service. There have been no complaints to the home since we last visited. We have not had any concerns or complaints direct regarding the service at Watery Lane. Each service user and relative who wrote to us said that they know who to speak to if they are unhappy and know how to make a complaint. The health care professionals who responded said they have never had cause to complain and had received no complaints themselves regarding the home. The home has clear guidelines and risk assessments in place for supporting service users who are distressed or presenting behaviours which may be perceived as challenging the service provided. Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: Staff receive training in responding to these behaviours using the Management of Actual or Potential Aggression system, which is accredited by the British Institute of Learning Disabilities. Staff record each incident of challenging behaviour. The home also maintains records of all other accidents and incidents and notifies us of any significant events which occur in the home. The members of staff we spoke with said that the levels of challenging behaviour have reduced for some service users. They felt this was due to consistency in staff approaches, improvements in methods of communication and by being able to offer individuals a wide range of choices. Staff are also provided with training in relation to the Protection of Vulnerable Adults, Child Protection and are subject to Criminal Record Bureau enhanced disclosures. Due to the vulnerability of the people living in the home, they would rely on staff raising concerns on their behalf. Staff spoken with continue to show a good knowledge of the action they would take if they suspected or witnessed abuse. They also use their daily interactions and observations when supporting people who live in the home to help alert them to any physical signs or changes in behaviour, which may cause them concern. Care Homes for Adults (18-65 years) Page 22 of 32 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. Watery Lane provides a homely, comfortable and safe environment for people to live in. The home has several adaptations which promote the independence of each service user. Evidence: Watery Lane Cottage is a large, detached bungalow. It is located on the main Poolemead site, however it detached from other services on the same site and has its own attractive grounds. The open plan kitchen, lounge and dining area promotes the independence of the people who live in the home. This lay out allows staff the opportunity to observe service users without the need to guide them unnecessarily or restrict their movement around the home. This helps to create a homely and relaxed atmosphere. This is supported by the specialist equipment in place. Flashing fire alarm system, a buzzer call system, lower light switches, tactile symbols and textile surfaces, and support rails both within and outside the front and rear of the home. Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: The home continues to display service users artwork and this has recently been added to by artwork created by staff on their recent team day. There are also many photographs of service users throughout the home and these, together with the artwork, helps with the homely feel. The home is well maintained. During the last year two of the service users bedrooms have been redecorated, extra support rails have been added in one bedroom to help one person with their mobility and some communal areas of the home have been repainted. Service users help with domestic tasks and these are noted in their care plans. The staff also help keep the home clean and tidy, as it was on the day we visited. The home has large, private garden areas. There is a vegetable plot, with a raised area to ensure service users with restricted moblity are able to use it. There are various places to sit and the grounds continue to be maintained to a high standard. Care Homes for Adults (18-65 years) Page 24 of 32 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. Service users benefit form the clarity of staff roles and responsibilities. Sevice users are supported by an effective, trained and well supported staff team. Evidence: A small, cohesive staff team supports the individuals who live at Watery Lane. The roles and responsibilities in the team are clear and the staff members we spoke with understand their own role and the roles of the management team. The staff members we spoke with or who wrote to us said they are always provided with up to date information about service users, are provided with relevant training and remain very well supported in their roles. One member of staff said the working atmosphere is fantastic, it is a nice supportive team and another said it is a really good, hard working team. We spent some time observing staff supporting people who live in the home. This showed that staff are aware of service users needs, know how to offer appropriate support, are confident in communicating with them and work well as a team. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: The RNID has a robust recruitment policy, which includes staff having to attend a formal interview, provide satisfactory references and being subject to an enhanced Criminal Record Bureau disclosure. Each member of staff we spoke with or who wrote to us said that all relevant checks were carried out before they could start work in the home. Staff are provided with a range of training opportunities, which are provided by the RNID or external trainers. The home keeps a record of all the training staff have attended and updates this regularly. Copies of certificates given to staff when they have completed a course are kept as part their individual training files. Discussions with staff and examination of their training files show that they have attended various courses such as First Aid, Food Hygiene, Fire Safety and Manual Handling. More specialist training including Deaf Awareness, Deaf Blind Communication, British Sign Language and Epilepsy has also been provided to staff to enable them to provide appropraite support to each service user. The home supports staff to attain a National Vocational Qualification. There has been good progress in this area and a majority of the staff team have either completed or are currently working towards this award. There are regular staff meetings where staff can discuss service users and more general issues relating to the home. Staff spoken with find these meetings useful and they said they are able to discuss issues in an open and honest way. The staff had a team day earlier this year, which they said they enjoyed. Part of this day was spent using aids so staff members could experience different forms of sensory impairments. Other time was spent on team building exercises and creating the artwork described earlier in this report. Each member of staff has an annual appraisal and are provided with formal supervision by meeting with their line manager. Although supervision records were not examined, each member of staff spoken with said they are supervised regularly and they found these sessions very useful. Care Homes for Adults (18-65 years) Page 26 of 32 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 home is very well run and service users benefit from the ethos, leadership and management approach of the home. The views of service users are actively sought in relation to reviewing, developing and improving the service. Each persons rights and best interests are promoted by the homes policies, procedures and record keeping. Each service user is provided with competent and accountable management of the service and their health, safety and welfare is promoted and protected. Evidence: The Registered Manager, Mr Foskett, has a number of years experience in the care sector. He has attained NVQ Level 4, the Registered Managers Award, Level 1 and 2 in British Sign Language and is a qualified NVQ Assessor. He continues to undertake Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: additional training to ensure he remains up to date on new ways of working. He is supported by a Deputy Manager and a Senior Support Worker. The overall management duties within the home are shared between these three members of staff and this appears to work very well. The management approach remains open and positive, with a clear sense of direction and leadership. The staff spoken with and those who wrote to us confirmed their views are always listened to and they feel very well supported by each member of the management team. Staff comments included the managers are very good, very supportive and all of the managers are very approachable. The service users who wrote to us said they are supported to air their views. They are listened to and staff always act on what they say. The use of the My Say communication tool, described earlier in this report, is an important part in ensuring the views of the people who live in the home are continually sought. The home has good systems in place to review the quality of the service and they actively seek the views of all people with an interest in the home. It is clear that all of the information they receive is used to identify and areas where the service can be improved and this forms part of the homes operational plan. There have been a number of improvements since our last visit, which show that peoples views have been listened to and that the home is aware of new ways of working. Some examples are the developments in communicating with the people who live in the home, making more information accessible to them by using formats which they can understand and providing new aids and equipment to enable people to become more independent. Further improvements are planned, which include the development of the person centred approaches to support service users, improve the environment further and to encourage and support service users to play an active role in the recruitment of new staff. The home continues to form and maintain good links with other organisations, such as Deafblind UK, Sense, the Royal National Institute for Blind People and Vision Bath who support service users with similar needs. This helps the home to keep up to date, share ideas and areas of good practice. The RNID has a number of policies and procedures which are designed to ensure the home complies with the law and remains aware of good practice guidelines. The home Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: has also developed a number of specific policies to support service users and continues to look at ways of making information more accessible to the people who live here. The registered providers representative continues to visit the home regularly and produces a very thorough report of their findings. Although these are no longer routinely sent to us we did examine a sample of reports completed since our last visit and these confirm the high quality of the service. The management systems and structures and very efficient. The record keeping remains excellent, with files and documents well organised, easy to access and stored appropriately. There are recording systems in place to promote the safety of people who live or work in the home. Records examined included fire safety, hazardous products used in the home and general health and safety checks. All of the checks are up to date. There are a number of general risk assessments in place, to promote safe working practices in the home. These have all been reviewed regularly. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!