Care Home: Triple S Care and Support Services

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What the care home does well People can visit the home before they move in to see if they like it.People have care plans. These tell staff how to help the person.Staff ask people what they would like to do during the day.Staff help the people living in the home keep in touch with people who are important to them. If this is what they want.Staff help people to do things for themselves.People living in the home can choose what they want to eat and drink. Their diet helps to keep them healthy.Staff are very friendly and make people feel comfortable.Staff support people to go to see the doctor when needed to ensure they stay well.Staff do health and safety checks so that the home is safe for the people who live there. What has improved since the last inspection? This is the home`s first inspection. What the care home could do better: Information about people could be kept more private.Staff should write down what each person has eaten. This will make sure they are getting the food they need to be well and what they like.Records about what happened at the doctors need to be easier to find so that staff have all the information they need to support people. People should have information so that they know how to make a complaint if they are not happy.New staff need to have some more training to ensure people are kept safe all the time. Key inspection report Care homes for adults (18-65 years) Name: Address: Triple S Care and Support Services 87-89 Stirling Road Edgbaston Birmingham B16 9BD 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: Brenda ONeill Date: 2 6 0 1 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 38 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 © (2010) 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 38 Information about the care home Name of care home: Address: Triple S Care and Support Services 87-89 Stirling Road Edgbaston Birmingham B16 9BD 01214548864 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Roshan Dass care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. 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 (LD) 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Triple S Care and Support is a new home in Edgbaston, Birmingham. Six people with a learning disability can live there. Everyone living there has their own flat with open plan kitchen, lounge and dining area, a bedroom and bathroom. The flats are very modern and look nice. Care Homes for Adults (18-65 years) Page 5 of 38 X3 There are three flats on the ground floor and three on the first floor. The ones on the ground floor can be used by people who need a wheelchair. There is also a large lounge that can be used by everyone in the home. There is a garden/patio area at the back of the home for people to use. People who use wheelchairs will also be able to use this area. Care Homes for Adults (18-65 years) Page 6 of 38 There are bus routes close by that take you into the City Centre. The reader should ask the manager how much it is to live there. This may be different for each person as it depends on the persons needs. Care Homes for Adults (18-65 years) Page 7 of 38 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 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home One inspector visited the home and did the inspection in one day. The home did not know we were going to visit. We looked at what it is like to live there. We asked the person living there what they thought of their home. Care Homes for Adults (18-65 years) Page 9 of 38 We looked at how well the home meets peoples’ needs. We looked at how the home can do things better. Before we visited we looked at things we had been told about the home. The manager sent us the Annual Quality Assurance Assessment (AQAA). It tells us how they think they are meeting the regulations. Care Homes for Adults (18-65 years) Page 10 of 38 One person who was living in the home was case tracked. We do this by meeting and observing them and talking to staff about their care. We also looked at their care files. Tracking peoples care helps us find out what it is like to live in the home. We looked at parts of the home and records about staff and health and safety. What the care home does well Care Homes for Adults (18-65 years) Page 11 of 38 People can visit the home before they move in to see if they like it. People have care plans. These tell staff how to help the person. Staff ask people what they would like to do during the day. Care Homes for Adults (18-65 years) Page 12 of 38 Staff help the people living in the home keep in touch with people who are important to them. If this is what they want. Staff help people to do things for themselves. People living in the home can choose what they want to eat and drink. Their diet helps to keep them healthy. Care Homes for Adults (18-65 years) Page 13 of 38 Staff are very friendly and make people feel comfortable. Staff support people to go to see the doctor when needed to ensure they stay well. Staff do health and safety checks so that the home is safe for the people who live there. Care Homes for Adults (18-65 years) Page 14 of 38 What has got better from the last inspection What the care home could do better Information about people could be kept more private. Staff should write down what each person has eaten. This will make sure they are getting the food they need to be well and what they like. Care Homes for Adults (18-65 years) Page 15 of 38 Records about what happened at the doctors need to be easier to find so that staff have all the information they need to support people. People should have information so that they know how to make a complaint if they are not happy. New staff need to have some more training to ensure people are kept safe all the time. Care Homes for Adults (18-65 years) Page 16 of 38 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 Brenda ONeill City gate Gallowgate CQC West Midlands Newcastle upon Tyne 03000616161 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 17 of 38 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 18 of 38 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. There was information available for people wanting to move into the home to help them decide if the home was right for them. People could be confident that their needs could be met by the staff at the home. Evidence: There was a service user guide for the home which included the majority of the required information. It told people what they could expect from the home and what the core charges were. If people required one to one support this was calculated on an hourly basis and added to the core charges. Further information could be included about how people are able to make complaints if necessary. There were some pictures and photographs in the service user guide and it was available in large print. This made it more accessible for people who may wish to use the service. The manager was looking to review the document and include more pictures and photographs so that it would be easier to understand. This should ensure that people have all the information they need to help them decide if they like the home or not. The home had been open for almost a year. Due to funding issues there was only one person living there and they had only been there for a few weeks. Another person was Care Homes for Adults (18-65 years) Page 19 of 38 Evidence: being admitted to the home on the day of the inspection. Both the manager and the assistant manager were very knowledgeable about both peoples needs and had clearly met both of them before they were admitted to the home. We were told that both had visited the home but no written notes of the visits had been made the only evidence were the dates in the diary. It was recommended that some records of pre admission visits are kept that show if the individuals liked the home and if there were any issues that need to be addressed. The records for the person who had lived at the home for a few weeks were looked at. These included a comprehensive pre admission assessment that had been completed by the managers at the home. The assessment was undertaken over a period of time and it showed that the individual concerned had been involved and asked questions about many areas of their lives and what they wanted to do in the future. The individual was seen and spoken with and told us they had settled in well, was very happy and that staff helped when needed. Care Homes for Adults (18-65 years) Page 20 of 38 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. Arrangements were in place to ensure people received the support they needed safely and in the way they preferred. People were supported to make decisions about their lives Evidence: The records for one of the people living in the home were looked at. These included an extensive care plan. This detailed what the support needs of the individual were in various areas of their life. This included personal care, communication, culture, self help skills, leisure opportunities and general health. The care plan showed what the individual wanted to achieve and how staff were to support them to do this. The individual concerned was spoken with and what they told us showed that a lot of what was detailed on the care plan had been followed. For example staff were helping them to improve their literacy skills and do their ironing. This ensures they are they are enabled to become more independent. This will help this individual achieve their ultimate aim which they told us was to live more independently. Records showed that the person made decisions on a daily basis about their life including Care Homes for Adults (18-65 years) Page 21 of 38 Evidence: what they did during the day, what they wore and so on. This was evidenced when the person living in the home told us such things as staff support them to go to the temple when they want to go. The only limitations that were in place had been agreed with the individual and were in relation to such things as alcohol consumption. Staff spoken with were well aware of the persons support needs and what they liked doing. This ensured people got the support they needed in a way they liked. Several risk assessments had been undertaken and management plans were in place for such things as peoples vulnerability, any challenging behaviours, going out into the community and so on. These told staff how they should support people to take risks whilst ensuring their safety as much as possible. It was noted that a lot of personal information about people was being kept in a communal communication book. This conflicts with the regulations in respect of data protection and does not ensure privacy for the people living in the home. All information regarding them should be kept on their personal files so that they can be assured it is only seen by people that need to know. Care Homes for Adults (18-65 years) Page 22 of 38 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. Arrangements were in place to ensure that the people living in the home experience a meaningful lifestyle. Evidence: We looked at care plans and daily records to establish if people were leading meaningful lifestyles and taking part in activities that they enjoy. The care plan we saw detailed very clearly what support the individual needed to help them become more independent in the home with their self care skills. It was also clear that the individual needed support with such things as budgeting. There were extensive daily diary records which showed the individual was being helped with such things as keeping their flat clean, doing their own laundry including ironing, shopping preparing simple meals and so on. Staff were clearly helping the individual with budgeting their money by pointing out cheaper alternatives while they were out shopping. These arrangements ensured the individual led a meaningful life and was being helped to increase their independence. The individual had achieved a great deal in a short space of Care Homes for Adults (18-65 years) Page 23 of 38 Evidence: time with the support of the staff at the home. The individual told us staff were helping when it was needed. They told us it was their shopping day and they were going to a large supermarket close by to do their weekly shop. They also told us that staff support them to go to the temple twice a week. The individuals care plan showed this person needed the opportunity to explore a range of leisure opportunities so they were able to identify what they liked doing. The individual told us they were hoping to go to college to help with their reading and writing. Records showed staff had pursued and obtained information for the individual about college courses and that they were supporting them in house with this. The individual was also going to the library to access appropriate reading material. The care plan we saw was very specific about what arrangements the individual wanted in place to keep in touch with their family. Records showed this contact had been enabled as the person wanted. All the flats had their own kitchens and people were to be supported to prepare and cook their own meals. We were told that where possible people planned their menus on a weekly basis with staff support who encouraged people to eat healthily. People were given a weekly budget to shop for their provisions with staff. Records showed that people were taking part in preparing their meals and doing some basic cooking. One person told us they chose what they wanted to eat and then went shopping and they were starting to help with cooking. This further enhanced the individual’s independence. The records of what people were eating were not always completed. These are needed to show that people are receiving a varied and nutritious diet on an ongoing basis and that they are getting the food they like. Care Homes for Adults (18-65 years) Page 24 of 38 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. Arrangements are in place to ensure the personal and health care needs of the people living in the home are being met in the way they prefer. Evidence: The care plans included information on what support people needed with their personal care and what they were able to do themselves. The care plan we saw indicated the individual was quite independent in this area and would probably only need prompting. However it was also indicated that staff should discreetly monitor this during the assessment period to get the full picture. The individual was seen and was well groomed and dressed appropriately for their gender, age and in a way they liked. This is good for their self esteem and well being. Records showed that people were registered with a G.P. when they moved into the home. One appointment date was seen for a general check up. It could not be determined if this had been attended. The manager said the person had attended the appointment and that records would be in the daily notes. It was discussed with the manager that any attendance at health care appointments and so on should be recorded separately so that the information is easy to track. This will ensure staff have easy access to the information they need to support people appropriately. Care Homes for Adults (18-65 years) Page 25 of 38 Evidence: As the home had only recently had people living in it there had been little need for contact with health care professionals. However it was seen that people had access to support groups and counsellors for specific topics where needed. This should ensure peoples general well being. The manager spoke to us about having systems in place to try and encourage people to live healthy lifestyles such as joining a gym, this was being pursued for one person, healthy eating, regular dental check ups and so on. These arrangements should ensure people remain as healthy as possible. The person living in the home did not take any medication therefore it was not possible to fully assess this standard. However there were numerous policies and procedures in relation to the safe storage, administration and documentation needed to ensure the procedures followed are safe. The manager received some medication on the day of the inspection for a person due to move in. He was very clear about how this was to be stored and booked into the home. The arrangements in place should ensure people receive their medication as prescribed. Care Homes for Adults (18-65 years) Page 26 of 38 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. Arrangements are in place to ensure peoples views are listened to and that they are safeguarded from harm. Evidence: The service user guide for the home did not include a specific complaints procedure it stated: Service users are encouraged to make suggestions, compliments and complaints. This could be about the service, the home, staffing and general day to day management. Service users have the opportunity to express their feelings during monthly service user meetings. This is when service users get together as a group to voice and suggest new ideas. Service users also have the opportunity to discuss more personal issues with their key worker. Clearly staff were listening to people. A lot of work had been done with one individual in the home after listening to what they wanted to do with their life. The individual had also raised some concerns about how warm their flat was and staff had responded to this and resolved the issue. This shows people are listened to and their views acted on. There was a complaints procedure for staff to follow should anyone should anyone living in the home or any visitors wish to complain. There should also be a procedure available for the Care Homes for Adults (18-65 years) Page 27 of 38 Evidence: people living in the home. This should be made available in a variety of formats so that it is easy for people to understand. This would enable them to raise a formal complaint if they wanted to and know who else they can raise issues with if they do not want to raise issues in house. There were comprehensive policies and procedures in the home in relation to safeguarding, whistle blowing, managing challenging behaviour and restraint. There were robust management plans in place for challenging behaviours individuals may have. These made it very clear that physical restraint was only ever to be used as a last resort and in order to protect individuals from harming themselves. The manager was able to tell us what had to be done should there be any incidents of abuse. He had some experience of having to follow up safeguarding issues. Staff had either had training in safeguarding issues or this was being arranged. The arrangements in place should ensure people are safeguarded from harm. Systems were in place for helping people to manage their money. Records for this were sampled and showed that all income and expenditure was recorded. Where purchases were made on behalf of the people living in the home receipts were available. Where possible the people living in the home were signing for any expenditure. The balance of the money held was checked and was found to be correct. The system in place should ensure peoples money is spent appropriately and that they are safeguarded from abuse. Care Homes for Adults (18-65 years) Page 28 of 38 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 home provided people with a very high standard of accommodation which meets their needs. Evidence: The home was registered in January 2009 and provides a very good standard of accommodation for 6 people with a learning disability. The home comprises of six individual flats that all have a combined lounge and dining area, a bedroom and a bathroom with shower and toilet. All the furniture and fittings in the flats is of a very good standard. The person living in the home showed us their flat which they were quite clearly very happy with and had begun to personalise to their liking. The individual had their own key so they could ensure their possessions were kept private. Three of the flats were on the ground floor and three on the first floor. The home does not have a lift therefore people with any mobility difficulties would not be able to access the upper floors. The flats on the ground floor were accessible to people in wheelchairs. The showers in the bathroom were floor level to ensure people with mobility difficulties were able to access. One person who used a wheelchair was moving into the home. The manager spoke to us of having further adaptations made to the persons flat so that the hob and work surfaces were accessible from a wheelchair. This will ensure the person can Care Homes for Adults (18-65 years) Page 29 of 38 Evidence: retain/develop their independent living skills. All the flats are fitted with a call system that enables staff to call for assistance should they need it when supporting the people in the home ensuring they are kept safe. There is also a communal lounge that is well furnished and has a large screen television. This means people will be able to spend time with each other if they wish. Leading off this area is an additional toilet and a communal laundry equipped with washing machine and ironing equipment. This facility also helps people develop their independent living skills. There is a garden/patio area to the rear of the home so that people are able to exercise in the fresh air if they wish. All the ground floor facilities are accessible to people in a wheelchair with all doorways and halls widened to allow ease of access to people who use wheelchairs. There is a small reception area in the entrance hall of the home with a notice board. Information about the local facilities and forthcoming events were posted on here so that it was accessible to the people living in the home and visitors. Staff facilities are located on the second floor of the home and include, offices, meeting rooms, kitchen and shower. Care Homes for Adults (18-65 years) Page 30 of 38 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements generally ensure that the people living in the home are supported by staff that are qualified and competent to meet their needs. The recruitment practices protect the people living there so they are safeguarded from harm. Evidence: There was only one person living in the home until the day of the inspection when a second person was admitted. There were five permanent staff employed at the home. This included the manager and assistant manager. The staffing rotas were supplemented by agency staff where necessary. The manager told us they always used the same agency staff and they had an induction into the home to ensure they could support the individual appropriately. Using the same staff ensured some consistency for the individual living in the home. The manager told us that more staff were to be employed as more people moved into the home and this would lessen the need for agency staff. The person living in the home told us staff were helpful when needed. They were very comfortable in the presence of the staff and relationships were friendly. The recruitment records for three new staff were sampled. Criminal Records Bureau checks (CRB) had been made and written references received before employees began Care Homes for Adults (18-65 years) Page 31 of 38 Evidence: work so that people were protected from the risk of having unsuitable staff work in the home with them. It was noted the application forms did not have space for people to give the details of two referees. This should be included so that managers can ensure the referees are appropriate and obtain all the appropriate information as soon as possible. Two of the support workers who had been employed had extensive experience working with people with a learning disability and had undertaken quite a lot of training. One staff member was new to the role. There was evidence that this person had some induction training but only on the first day of employment. Staff must receive induction training in line with the specifications laid down by Skills for Care over the first 12 weeks of employment. This will ensure staff have all the required skills and knowledge to support people appropriately. There was a training matrix for the home but it did not include all the training staff had received and the dates training was undertaken were not included. As more staff were employed this would make it difficult to track that all staff had the required training to support people effectively and safely. Staff were receiving supervision from the managers. The records for this were quite detailed and showed that staff practice was overseen and any issues were discussed and resolved. The training needs of staff were also discussed during supervision. Care Homes for Adults (18-65 years) Page 32 of 38 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. The manager ensured the home was run in the best interests of the people living there. Evidence: The registered manager had been in post since the home opened. This was his first mangers post however he had a lot of experience of working with people with a learning disability. He had all the appropriate qualifications for his role. He demonstrated that he was very committed to meeting peoples’ needs. He was very satisfied with the support he received from the owners and the responsible individual for the home. Relationships between them were very good. The person living at the home at the time was receiving a good person centred service and the manager was determined to ensure this continued for any further admissions. We had received a completed Annual Quality Assurance Assessment from the manager before the inspection. This had been completed before any people had moved into the home. It included comprehensive information about how the home was to be run, how people were to be involved and consulted about the running of the home and their plans for the future. Care Homes for Adults (18-65 years) Page 33 of 38 Evidence: The manager was aware that they would need a formal system for monitoring quality as the occupancy of the home increased. Some checking systems were already in place including health and safety checks, staff meetings and regulation 26 visits. The manager also discussed with us the intention to have meetings with the people living in the home and satisfaction surveys for the people living in the home, staff and stake holders. The health and safety records in the home were sampled. The in house checks on the fire system were up to date and there had been to fire drills. This will ensure staff know how to keep people safe should there be a fire. The names of the people who are present for fire drills should be recorded so that it can be shown all staff know how to respond to the fire alarm and keep people safe. The fire risk assessment was not dated this should be done so that the manager knows when it needs to be reviewed. Staff were monitoring water temperatures and recording fridge and freezer temperatures. There was no evidence on site to show that the fire alarms, fire extinguishers, gas equipment and portable electrical appliances had been serviced. Service certificates were forwarded to us after the inspection showing the equipment was functioning appropriately and safe to use. The responsible individual had just begun to carry out the regulation 26 visits to the home and was writing up the first one. the manager told us this was very thorough and included action points for him that would improve the service further. Care Homes for Adults (18-65 years) Page 34 of 38 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 35 of 38 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 1 35 18 The registered person must 01/04/2010 ensure that staff undertake induction training in line with the specifications laid down by Skills for Care. This will ensure staff have all the necessary skills and knowledge to support the people living in the home. 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 4 Notes should be kept about the outcome of any pre admission visits to the home. This will ensure any issues are addressed prior to admission. To ensure the confidentiality of the people living in the home personal information should not be recorded in communal books. Records of the food eaten by the people living in the home Page 36 of 38 2 10 3 17 Care Homes for Adults (18-65 years) 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 should be kept to show they are receiving a varied and balanced diet on an ongoing basis. 4 19 Health care appointments and the outcomes should be recorded separately to ensure staff can easily track the information they need to support people. Procedures should be in place that enable the people living in the home to raise complaints formally or with people outside of the home should they wish to do so. Staff application forms should include all the necessary information to ensure all the appropriate information can be obtained. The training matrix should reflect the training staff have undertaken so it can be shown they have all the skills and knowledge they need to support people effectively. The fire risk assessment should be dated so that it is known when it should be reviewed. This will ensure it reduces the current risks of fire in the home. The names of staff attending fire drills should be recorded. This will show that all staff have been involved and know how to keep people safe. 5 22 6 34 7 35 8 42 9 42 Care Homes for Adults (18-65 years) Page 37 of 38 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) 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. 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