Care Home: Ulysses House

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What the care home does well Each person has their own care plan so that staff know how to support them to meet their needs and do the things they want to do. People living there said, ` I am happy`, ` I like living here, the staff are good.` The people living there have an individual health action plan. This is a personal plan about what a person needs to stay healthy. Staff know how to help each person to meet their health needs. When needed health professionals get involved to give advice and support so that individual`s health needs can be met. Each person has their own bedroom with a number of personal belongings in them. This gives them their personal and private space. People have the freedom to go out on their own if they want to and are able to. Staff make sure it is as safe as possible for them to do this. People who live there do the activities they enjoy doing and that help them to develop skills and meet their needs. Staff listen to what the people who live there say. They make changes to the home in the way that the people who live there want. Staff have training to make sure they know how to support individuals in the right way and keep them safe. Staff test the equipment in the home often. This helps to make sure it works well and is safe for people to use. What has improved since the last inspection? Some more rooms have been redecorated to make the home more homely and comfortable to live in. Some things had been repaired so the home is safe for people to live in. Two more people now have an en suite in their bedroom so they have more privacy when going to the toilet or having a shower. Where needed covers had been put on radiators so that people are not at risk of being scalded by them. All staff know about the Mental Capacity Act and what this means for the people living there. All staff know about autism and how this may affect some of the people living there so they can support them. The people who live there help to interview staff so they have a say in who works with them. What the care home could do better: The statement of purpose and service users guide should include the information people need to make a choice as to whether or not they want to live there. More meetings should be held with the people living there so they can make more choices about how the home is run. Staff should keep helping the people living there to eat a healthy diet and tell them how their diet affects their health. Records of people`s possessions should be updated more often so their things can be as safe as possible. There should be more staff meetings and supervisions so that staff are supported and know how to help the people living there. Staff records should include information about who they are so that the people living there have suitable staff working with them and are safe from harm. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ulysses House 28 Fountain Road Edgbaston Birmingham West Midlands B17 8NR     The quality rating for this care home is:   two star good 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: Sarah Bennett     Date: 2 3 0 4 2 0 0 9 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. 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. 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Ulysses House 28 Fountain Road Edgbaston Birmingham West Midlands B17 8NR 01214299555 01214299777 ulysses653@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ulysses Care Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can 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 Brief description of the care home Ulysses House offers accommodation for up to six young adults with learning disabilities who at times may behave in a way that is challenging to other people. It is a large, three storey, semi detached Victorian house. The home is located in a residential area in Edgbaston and is well served by public transport. It is within walking distance of local shops, pubs and restaurants, the centre of Bearwood and is a short bus ride from the centre of Birmingham. Each person living there has their own Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 6 Brief description of the care home bedroom, three of which have en suite facilities. The home has a large dining room and kitchen, comfortable sitting room, utility room and laundry. The staff sleeping in room is also used as the office. There is a bathroom and shower facilities on the first floor and a WC on all floors. The premises can accommodate fully mobile adults, and does not offer disabled access or adaptations. There is a large enclosed garden to the rear of the house offering a large patio area and a lawned area. Our inspection reports are available in the home for visitors to read if they wish to. The service users guide did not state the fees that are charged to live at the home. Readers are advised to contact the home for details of these. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. This inspection was carried out over one day, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2009 to 2010. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and an Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 31 completed by the manager. This provides information about the home and how they think it meets the needs of the people living there. We case tracked the care received by two people who live there. This involved establishing individuals experience of living in the care home by meeting and talking with them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at parts of the home and a sample of care, staff and health and safety records. We talked to the people who live there, staff and the manager. What the care home does well: What has improved since the last inspection? Some more rooms have been redecorated to make the home more homely and comfortable to live in. Some things had been repaired so the home is safe for people to live in. Two more people now have an en suite in their bedroom so they have more privacy when going to the toilet or having a shower. Where needed covers had been put on radiators so that people are not at risk of being scalded by them. All staff know about the Mental Capacity Act and what this means for the people living there. All staff know about autism and how this may affect some of the people living there so they can support them. The people who live there help to interview staff so they have a say in who works with Care Homes for Adults (18-65 years) Page 8 of 31 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 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 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users do not have all the information they need so they can make a choice as to whether or not they want to live there. Evidence: The statement of purpose did not include the current management arrangements so people would not have all the updated information about the home. It also stated our previous address so people may not have the information they need to contact us if they want to. Records sampled included a copy of the service users guide that was produced using pictures making it easier to understand. It also needed updating with the management details and our address. It did not state the fees charged to live there. The manager was not aware of these but had been trying to find out from the owner. The people who live there have done so for several years so there have been no people admitted to the home recently. Therefore, the standard relating to the assessment of peoples needs before admission was not looked at. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: Records sampled included an individual contract between the person and the home. This stated the terms and conditions of their stay including the persons rights and responsibilities. It was produced using pictures making it easier to understand. The contract had been signed by the persons relative on their behalf. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the information they need so they can support individuals in the way they want and need so ensuring their safety and well being. Evidence: The records of two of the people living there were looked at. These included an individual care plan. This detailed how staff are to support the person to meet their needs and achieve their goals. Daily records sampled and observations throughout the day showed that staff follow the care plans to ensure they support the person as they want and need. Each person who lives there has a key worker. Records sampled showed that their key worker had completed progress reports on how the person was responding to the support they get from staff and what they had been doing during the month. The person was involved in these. Recently they had not been completed monthly. These should continue as it helped the person to be more involved in their care and the choices they can make about their life. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: There had been some meetings held with the people who lived there to involve them in the running of the home. They included choosing the new kitchen, choosing the colours for redecoration and talking about where they would like to go on holiday. Minutes showed that there had been four meetings in the last year so they could be more regular. Minutes were produced in large print and with pictures making them easier to understand. During the day staff were observed helping people to make choices about what they wnated to do, what they wanted to eat and drink and where they wanted to spend their time. One person went out on their own and bought some new clothes. Records showed that some people needed support to buy their clothes but staff had helped them to choose these. Staff said that the people living there are now involved in interviewing for staff helping them to have a say in who works in the home. Records sampled included individual risk assessments. These stated how staff are to support the person to take risks in their day to day lives whilst minimising any risks to their safety and well being. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living there experience a meaningful lifestyle. People do not always have a healthy diet, which could impact on their health and well being. Evidence: Records sampled showed and it was observed that people take part in a range of activities that they enjoy. One person attends a work placement four days a week and they said that they like this. Some people used to attend college courses but no longer do so. Staff said and records sampled showed that people got bored with these as they were no longer helping them to develop and increase their knowledge. During the day people were observed doing different things that reflected their individual likes and dislikes. One person was out for most of the day with staff travelling to Coventry on public transport. Some people went either on their own if they were able to or with staff to the local shopping centre. Other people spent time in Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: their room watching TV or DVDs, playing games on the Nintendo Wii or cleaning their bedroom. Last year all but one person went on holiday with staff to Great Yarmouth and some people said they would like to go back to the same place this year. The other person went to Spain with staff and this year would like to go to a different part of Spain with staff. People also went on a short break to Blackpool. Photos of holidays were looked at and people were seen to be having a good time. Staff had asked people if they wanted to do anything to celebrate St Georges Day but they had not wanted to. People celebrate Christmas, their birthdays and Easter. Some people had visited their family over Easter and all people had been involved in making decorations to put around the home. During the last year the people living there have built up a relationship with some of the local police officers. This has helped to develop some peoples confidence when going out on their own in the local community and increased their connections with the community. During the day one person living there had a call on their mobile phone from one of the police officers asking if it was alright to visit. They visited and had a drink with the people living there and spent time talking to them. Staff said that they often visit and recently when it was one persons birthday bought round a cake for them. Records sampled showed and people said that they are supported to keep in touch with their family and friends if this is appropriate. Some people have little or no family contact so visits from other people such as the local police are important to make them feel valued and accepted within the community. Records sampled showed and it was observed during the day that people are encouraged to be as independent as possible and take part in jobs around the home. Food records sampled did not show that people are being offered a healthy diet. One persons records showed in one week that they had chips three times and in another week had chips four times. Some records had not been completed so it was not possible to know what the person had eaten on some days. One persons weight has to be monitored as they are under weight and another person is overweight so it is important that food records are completed. The manager said they have tried offering people All Day breakfasts where most of it is grilled but people choose not to eat it. They have also offered foods from different cultures to try and change peoples tastes and records sampled showed this. The Dietician is involved with two of the people Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: living there and records show that staff follow their advice. Weight records sampled showed that peoples weight is stable. At lunch time staff sat with people to eat making it a social occasion. Lunch was pasta bake and salad. The salad was in a bowl so that people could help themselves to what they wanted. Some people chose not to have any salad but just pasta. People knew what was for lunch and said they are involved in choosing the meals. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that the personal care and health needs of individuals are met so ensuring their well being. Evidence: Care plans stated how staff are to support people with their personal care. They showed that people are encouraged to do as much as they can to increase their independence. People had been well supported with their personal care. They were dressed in individual styles that reflected their gender, age, cultural background, the weather and what activities they were doing. Care plans stated how staff are to support the individual to meet their health needs. Where appropriate people are referred to health professionals and records showed that staff follow their advice. One person had recently been assessed as having autism. Changes had been made to their care plan so that staff could support them in a way that would promote their health and well being. They had been referred to other health professionals for their advice in how to support the person. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: Records sampled included an individual Health Action Plan. This is a personal plan about what a person needs to stay healthy and what healthcare services they need to access. It was produced using pictures making it easier to understand. One persons plan included their record of the health appointments they had attended so all this information was together and it was clear how their health needs were being met. The other persons plan did not include this and this information was in different parts of their records. This made it more difficult to ensure that the persons health needs were met and when they needed to attend a follow up or check up appointment. Medication is kept in a locked cabinet in the laundry room. The temperature is monitored to ensure that medication is not kept at too high a temperature which could affect how efffective it is. Boots supply the medication to the home in pre prepared blister packs so that it is easier for staff to know who has what medication and when. The pharmacist from Boots had visited recently to do an audit of how the medication was being stored and given. They stated that there were no issues that needed addressing. They returned the following week to train new staff in giving medication to the people living there. At the front of each persons Medication Administration record (MAR) there was a photograph of the person so that unfamiliar staff would know who to give it to. Staff had signed the persons MAR appropriately indicating that medication had been given to the person as prescribed. Some people are prescribed PRN (as required) medication. A protocol was in place for each of these so that staff know when, why and how much of the medication should be given. This helps to ensure that the medication is not misused, which could impact on the persons health and well being. Audits of medication showed that PRN medication is rarely given. The manager said it is only given as a last resort when all other ways of helping the person to calm down have been tried. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that the people living there feel their views are listened to and acted on. The people living there are protected from abuse, neglect and self harm. Evidence: The home has not received any complaints about the service provided there since our last visit and we have not received any. People who live there said they knew how to make a complaint if they were unhappy. Complaints forms are available and staff said they would support people who needed help to complete these. Some people used to go to college but said they no longer wanted to go. Staff explored the reasons why this may be with the college and found that the course no longer interested them. One person had signed to say this was their decision after discussion about it with staff. They no longer go to college showing that their views are listened to. An inventory of peoples belongings is kept so that it is clear what possessions each person has. This makes it easier to track if things should go missing. However, records sampled showed the inventories had not been updated since April and June last year. They should be updated when people buy new things so their possessions can be as safe as possible. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Individuals money is kept securely in the home. Where people are unable to manage their own money staff support them with this. Records sampled showed that money is spent on things for the person not on things that should be paid for from the homes budget. Receipts are kept of all purchases and these cross referenced with the records showing that staff had recorded correctly what peoples money was spent on. The manager had received training in the Mental Capacity Act and all staff are booked to attend this training. This Act came into force in April 2007 and requires an assessment of a persons capacity to be done if there is any doubt that the person does not have the capacity to make a decision about a specific issue. An Independent Mental Capacity Advocate can be appointed to help the person if there is any doubt as to their capacity. There was also information for staff about this so they are aware of the implications of this legislation for the people living there. The manager and two staff attended a conference on the Deprivation of Liberty Safeguards. This legislation ensures that people who live in a care home who do not have the capacity to make decisions about their care are not being cared for in a way that deprives them of their liberty. This includes not being allowed to go out or have contact with their family or friends. It is important that staff know about this so they can ensure they are not depriving people of their liberty. Information about this was available for all staff to read and the manager said they would be discussing this with all staff. Staff have training in abuse and how to safeguard the people living there. Staff have regular updated training in how to use CPI (a non restrictive approved method of physical intervention). This ensures that they can help people calm down and be as safe as possible when they behave in a way that can put themselves and others at risk of harm. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, safe, clean and comfortable home that meets their individual needs. Evidence: Since we last visited several rooms have been redecorated making the home brighter and more comfortable to live in. The kitchen had been refurbished with new cupboards so it was cleaner and more hygienic to use. The manager said that there are plans to redecorate other rooms and the exterior of the building in the next few months. The day before our visit new leather sofas and chairs had been delivered for the lounge. This meant that people who did not want to sit on the sofa with others could sit on a chair by themselves so giving them the privacy they wanted. One person was proud to show us the new chairs and said they liked them. Since we last visited two bedrooms have been provided with en suite facilities. One bedroom already had an en suite bathroom. In the next year it is planned that all bedrooms will have en suite facilities provided. Following this the office will be moved downstairs. There will be a separate entrance at the side of the house so that people do not have to go through the home to get to the office. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: Bedrooms were personalised to individual tastes and interests and people who had en suites were pleased with them. One person had recently had a new double bed for their bedroom which was more suitable to their needs making them more comfortable. At our last visit there were plans to make part of the garden into an allotment area. The manager said that there is still the money allocated to improve that part of the garden but they are not sure whether this will benefit the people living there. They plan to buy a small plastic greenhouse and if people are interested then develop the area further. The home was clean and free from offensive odours. The people who live there are involved in cleaning the house and staff support them as needed. Hand wash and hand towels were provided in all bathrooms and toilets to help to reduce the risk of cross infection. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for staffing, their recruitment and support are variable, which could affect the quality of life of the people living there. Evidence: The AQAA stated that over 50 per cent of staff have NVQ (National Vocational Qualification)level 2 or above in Care and other staff are working towards achieving this qualification. This exceeds the standard so ensuring that staff have the skills to meet the needs of the people living there. Rotas showed that there are three staff on an early and three on a late shift each day with an additional member of staff doing a middle shift. The manager has three days where they do not work as part of the rota and two days when they work a middle shift. They said this is sufficient for them to do their management tasks. The manager said that two staff were on maternity leave. There was also a vacancy for one full time and one part time staff. There have been five staff recruited to work there since the last inspection. One of these had worked for the agency before so already knew the people living there well. Agency staff are still used to cover vacancies where needed. The manager said and rotas showed that these were the same staff so they knew the people living there. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Staff meeting minutes showed that there had been three meetings in the last year. There should be at least six meetings a year so that staff are updated with best practice and know how to met the needs of the people who live there. The manager said that the people living there are now involved in the interview process. Two people meet prospective staff and ask them questions. A senior staff is present and monitors the staff interaction with the people living there. They then feed this back to the manager and team leader who conduct the formal interview. This helps to ensure that the people who live there have some say in who works with them. The records of four of the staff who work there were looked at. This included the records about how they were recruited. They included a completed application form, written references and evidence that a Criminal Records Bureau (CRB) check had been done to ensure that suitable people are employed. Two of the four records did not include evidence of the persons identity or a photograph of the person. This makes it clear that the person stated on the other recruitment records is the person who is working with the vulnerable people who live there. The manager said that these records were available but were not yet filed. Records sampled showed that when staff start working at the home they have an induction so they know how to meet the needs of the people who live there. Records showed that staff have the training they need so they know how to support the people who live there. Records showed that staff do not have regular supervision with their manager so to show they are supported in their role. The manager said that often informal on the job supervisions are done but these are not recorded. Staff should have at least six recorded supervisions a year so they are supported and their training and development needs can be identified. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure that the home is safe and well run so ensuring the safety and well being of the people living there. Evidence: Since our last visit the registered manager had left. The previous deputy manager had recently been appointed as the manager and was applying to be registered with us. The manager has NVQ level 3 but will be doing NVQ 4 in management to ensure they have the skills and knowledge to manage the home. The team leader is currently doing NVQ 4 and supports the manager in running the home. The outcome of this inspection shows that the combined skills and knowledge of the manager and team leader ensure that the home is well managed in the interests of the people who live there. Staff said and records showed that a representative of the provider visits monthly to audit how the home is meeting the National Minimum Standards and the needs of the people living there. Reports of monthly visits were not all available. The manager said that they had been received but needed to be filed in the right place. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: In January this year surveys had been sent to the relatives of the people who live there and professionals who are involved in their care. Positive responses about the home and staff were received. One professional said, Good communication. Very professional staff, trustworthy and conscientious. Fire records showed that staff regularly test the fire equipment to make sure it is working. An engineer regularly services the equipment to ensure it is well maintained. Regular drills are held so that staff and the people living there would know what to do if there was a fire. Each person who lives there has a personal emergency evacuation plan so that staff know how to support the individual. Staff said that they invited the local fire officer to talk to the people who live there on fire safety. This has helped to make people aware of the risks of smoking in their bedroom and how to help prevent fires from starting. Hazardous products and cleaning materials were kept in a locked cupboard so that people were not at risk of drinking things that could harm them. Staff test the fridge and freezer temperatures daily. This helps to ensure that food is stored at the correct temperature so to reduce the risks of food poisoning. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 1 1 The service users guide should state the fees charged to live there so that people have all the information they need about the home. The statement of purpose and service users guide should be updated so that people have the information they need to make a choice as to whether or not they want to live there. Key worker progress reports should be completed more often so that people can be more involved in choices and decisions about the support they need. There should be more regular meetings with the people who live there so they can make more choices about the running of the home. Staff should continue to offer people healthy meal choices so to ensure their well being. Records about the persons health should be kept together so it is clear that the persons health needs are being met and staff have the information together about how to support the person. 2 1 3 7 4 8 5 6 17 19 Care Homes for Adults (18-65 years) Page 29 of 31 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 7 8 23 33 Inventories of belongings should be regularly updated so that peoples belongings can be as safe as possible. There should be more staff meetings so that staff are updated with best practice and know how to meet the needs of the people living there. Staff records should include all the required recruitment records so it is clear that suitable people are employed to work with the people living there. Staff should have regular, recorded supervision sessions with their manager so they are supported to meet the needs of the people living there. Reports of monthly visits from a representative of the provider should be available so it is clear that their audits seek the views of the people living there. 9 34 10 36 11 39 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: 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 © (2009) 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. 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