Care Home: Valleyfield

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What the care home does well The service meets the needs of those who use the service through the care plans that have been used. The service ensures that those who live at the Valleyfield are given the opportunity to communicate their needs non verbally and are given time to respond to staff. Those who use the service are given the chance to make decisions on a basic level in line with their capabilities and have their interests maintained by transparent care practices and the involvement of their families. The risk involved with individuals pursuing their daily lives are acknowledged and reviewed therefore maintaining their health and safety. Those who use the service are able to participate in the local community and are able to maintain contact with their families. Individuals have their rights respected. The nutritional needs of all are met. Those who use the service are supported in an appropriate manner by the environment, care practices and the gender mix of the staff team. Those who use the service maintain their health through the practices of the agency. The health and safety of people is promoted through the safe management of the medication system. Individuals and their families are able to influence the support they receive through the presence of the service`s complaints procedure. Individuals are protected from abuse by the service`s policies, training given to staff and the manner in which staff are recruited. Individuals are provided with a hygienic and well maintained environment. The service ensures that the needs of those who use the service are met by the training received by staff. Individuals receive support form a service that is managed by an experienced and qualified individual. Individuals and their families are able to influence the running of the service by the way in which the service monitors its own practice. The health and safety of individuals is promoted through the practices of the agency. Comments received through surveys included: `we have meetings regularly to discuss everything regarding the way we work``I have been trained and I have experience` `The service is good at giving appropriate training to staff` `We provide a good service and aim to meet the needs of service users` `I am kept up to date with changes in the service` `I was given a full induction` `I feel supported by the staff and manager at Valleyfield and I feel comfortable in approaching the manager with any issues` `This service runs well` `We support service users to maintain a healthy and safe home while promoting their independence and personal choices` What has improved since the last inspection? No requirements were raised at the last inspection. What the care home could do better: No requirements are raised at this inspection. Two good practice recommendations are raised in relation to the protection of vulnerable adults and the recording of health appointments. Staff surveys made reference to issues in respect of pay and conditions. These are beyond the remit of the Commission For Social Care Inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Valleyfield 69 Grange Lane Gateacre Liverpool Merseyside L25 4SA     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: Paul Kenyon     Date: 0 7 0 1 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. 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 28 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Valleyfield 69 Grange Lane Gateacre Liverpool Merseyside L25 4SA 01514286388 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Sharon Slack Type of registration: Number of places registered: Community Integrated Care care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Valleyfield is a single storey three bed roomed detached property with a small garden to the front and a larger accessible enclosed garden to the rear. The property is situated in the Gateacre area of Liverpool and is close to shops, pubs, post office and other places of local interest. Maritime Housing Association owns the property and each of the service users has a tenancy agreement. Community Integrated Care provides care and support. Valleyfield accommodates three female residents with learning disabilities. All three have been tenants since the home opened in 1990. Fees are arranged through contracts between the placing authority and the care provider. Individual residents are advised of the financial contribution they will be expected to make. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 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: This was a key inspection of Valleyfield. The visit was unannounced. The visit took place during the morning and afternoon. The visit included the examining of records relating to the support provided to people living there as well as observing care practice, interviews with staff and touring the building. In addition to this, the service had submitted an Annual Quality Assurance Assessment prior to the inspection. This provided an account of the progress made by the service and the way in which the service was to develop in the future. One feature of this assessment was the recruitment of staff. Some staff had left since the last key inspection. This had meant that some consistency had been lost. New staff have been recruited and it is anticipated that as part of their induction, new staff will Care Homes for Adults (18-65 years) Page 5 of 28 shadow existing staff to ensure that this consistency of practice is re-established. The nature of the disability of those who use the service is such that they have limited verbal communication. As a result it was not always possible to gain an account of their experiences. The care practice in the service was observed with the result that a conclusion was made that those who use the service have their needs met by the staff team and that individuals appear comfortable and content with the support they receive. Surveys have been made available to families. These have not been returned at the time of writing yet any received will be used as part of the ongoing regulation of this service. What the care home does well: The service meets the needs of those who use the service through the care plans that have been used. The service ensures that those who live at the Valleyfield are given the opportunity to communicate their needs non verbally and are given time to respond to staff. Those who use the service are given the chance to make decisions on a basic level in line with their capabilities and have their interests maintained by transparent care practices and the involvement of their families. The risk involved with individuals pursuing their daily lives are acknowledged and reviewed therefore maintaining their health and safety. Those who use the service are able to participate in the local community and are able to maintain contact with their families. Individuals have their rights respected. The nutritional needs of all are met. Those who use the service are supported in an appropriate manner by the environment, care practices and the gender mix of the staff team. Those who use the service maintain their health through the practices of the agency. The health and safety of people is promoted through the safe management of the medication system. Individuals and their families are able to influence the support they receive through the presence of the services complaints procedure. Individuals are protected from abuse by the services policies, training given to staff and the manner in which staff are recruited. Individuals are provided with a hygienic and well maintained environment. The service ensures that the needs of those who use the service are met by the training received by staff. Individuals receive support form a service that is managed by an experienced and qualified individual. Individuals and their families are able to influence the running of the service by the way in which the service monitors its own practice. The health and safety of individuals is promoted through the practices of the agency. Comments received through surveys included: we have meetings regularly to discuss everything regarding the way we work Care Homes for Adults (18-65 years) Page 7 of 28 I have been trained and I have experience The service is good at giving appropriate training to staff We provide a good service and aim to meet the needs of service users I am kept up to date with changes in the service I was given a full induction I feel supported by the staff and manager at Valleyfield and I feel comfortable in approaching the manager with any issues This service runs well We support service users to maintain a healthy and safe home while promoting their independence and personal choices 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 28 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 9 of 28 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. Although this standard cannot be measured on this occasion, the service has demonstrated through its policies and procedures the meeting of the needs of prospective individuals in the future. Evidence: All three individuals living at Valleyfield have lived there since the service was first opened. As a result, the standard examining the way in which their needs have been assessed is not applicable on this occasion. It was noted that the service has an admissions policy. This emphasises the considerations to be made when an individual comes to live at Valleyfield and also stresses the importance of obtaining assessments of their needs prior to them using the service. Care Homes for Adults (18-65 years) Page 10 of 28 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. Those who use the service have their needs met through the care planning process. Individuals benefit from being able to make some decisions about their daily lives and these are respected. Risks faced by individuals through their daily lives are taken into account through the practices of the service. Evidence: Care plans for all individuals were viewed. These include daily working documents that provide a reference for staff and these are backed up with detailed daily records about the progress of each individual. All care plans included information that is relevant to the needs of individuals and provide details of how each person can be best supported by staff. In addition to this care plans have been devised in an individualised format known as Essential Lifestyle Plans. These include reference to the preferences of individuals in relation to their daily lives as well as considerations to be made in supporting them. All care plans and the essential lifestyle plans have been reviewed within the past few months. Essential lifestyle plans showed evidence of relative Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: involvement . The disability of those who use the service is such that their verbal communication is limited. This has been recognised within care plans and information is present for staff suggesting the meaning of any communication of actions that are present. As a result, larger decisions are made by family members although contact information for a local advocacy service is available if needed. The service does encourage individuals to make decisions on a smaller level and this was witnessed during the visit. These decisions included what activities they wishes to pursue, what meals they wanted to have or whereabouts in the building they wished to be. These decisions were respected. One person is able to make some contribution to the monthly staff meetings and attends these. The organisation running the service operates as appointee for the financial affairs for individuals. A Financial Support Plan is available outlining the involvement the organisation has in financial affairs. All monies are accounted for through the records and systems adopted by the agency. Risk assessments for all individuals were viewed. These included the acknowledgment of risks faced by individuals in their daily lives. The risks included risks inside the building, in the wider community and risks faced by health conditions and behaviours displayed by individuals. All risk assessments had been updated and reviewed within a twelve month period. Care Homes for Adults (18-65 years) Page 12 of 28 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. Those who use the service benefit from being able to pursue activities with staff support both in house and in the wider community. All benefit from being able to maintain contact with their families. Those who use the service benefit from having their rights respected through the practices of the service. The nutritional needs of individuals are met. Evidence: All three individuals do not pursue any formal occupation or education. Activities during the week tend to be based on the perceived preferences of individuals. All activities are recorded on a weekly basis and these records were viewed during the inspection. Activities include a mix of in house individual activities as well as trips into the wider community. During the visit, one person was out using a local facility offering access to sensory activities. Later in the visit, one person was asked what they Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: wanted to do during the afternoon. While the individual did not have any verbal communication, the individual was able to respond to suggestions from staff and as a result the preferred activity was undertaken. Records suggested that in house activities involved listening to music, watching films and aromatherapy massage. The service has its own transport and records noted that this was used on a regular basis. In addition to this there was evidence that all individuals have bus passes and that dial a bus services from a local transport provider were also used. Records also suggested that individuals tended to access the community individually rather than as a group. The disability of individuals is such that they are reliant on staff to assist when going out. Records suggested that all individuals continue to have links with their families. Activity records include when visits are received or when families are contacted. One individual was able to indicate that she was able to receive phone calls from their family. The communication needs of individuals is such that it is not possible for staff to gain direct permission to enter rooms, however, care practice noted that the privacy of individuals is taken into account. This practice included the respecting of one persons privacy to remain in their room during the visit. While the individual was in their room, staff communicated with the person without going into their room and as a result their wish to enjoy their own company was preserved. Another person also prefers time in their room. A note is placed on the door when the person is in their room and requests that they are not disturbed. During the visit, one person received a letter addressed to them. The person was told that it for them and was asked if they wanted it to be opened. The letter remained unopened during the rest of the visit. The individual term of address is included within each care plan and these terms were used throughout the visit. Staff interaction with those who use the service was significant through the visit. Staff interacted with individuals in a positive and friendly manner and gave individuals the opportunity and time to respond. Evidence was available that individuals are encouraged to participate to a degree in housework or domestic tasks such as cooking in line with their abilities. A menu is available yet this serves as a broad guide and the menu is devised on a weekly basis. The menu provided evidence of the food provided but also indicated whether alternative meals were provided and the amount of food individuals were accepting. Care plans indicated the extent to which individuals could independently eat their meals, any nutritional needs they had as well as any meal supplements that were available. Risk assessments indicated the manner in which meals should be presented to enable individuals to eat without the risk of choking. Individuals do not plan menus Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: yet these are based on the preferences of individuals that have been gained over the years that people have lived at Valleyfield. Records suggested that individuals are able to be involved in the preparation of meals.A dining room is available with one person noted to use this area to eat breakfast and lunch during the visit. Drinks are available and are provided on a regular basis. The nutritional needs of individuals are included in care plans. A speech therapist is involved with one person in respect of their swallowing of food. Weight is monitored periodically. No individuals have any cultural needs in respect of food. Care Homes for Adults (18-65 years) Page 15 of 28 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. Those who use the service receive the personal support they require and benefit from this. The health needs of all people are met through the practices of the service. The health and safety of all individuals is promoted through the safe management of medication. Evidence: All individuals living at Valleyfield require transferring and support in their mobility. The communication abilities of individuals are limited and therefore it has not been possible to gain the views of people about their satisfaction or otherwise of how they are transferred. Methods of mobility is outlined in care plans. Two are reliant on the use of hoists and the service was noted to have sufficient equipment to assist in this. Records suggested that these are serviced regularly. One person has limited mobility and has been given the opportunity to use this mobility to move around the building. The service submitted its Annual Quality Assurance Assessment. This suggested that all staff were female and this reflects the gender of those who live at Valleyfield. All individuals rely on the use of wheelchairs. One person has a specialist mould fitted into the aid in order to assist with posture. Another person has the input of a speech Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: therapist in order to assess the persons abilities with eating. All families maintain contact with individuals and have given the opportunity to comment about the support provided to their relations. The preferred routines of people have been determined and are outlined in care plans. A key worker system is also in operation with the role of the key worker outlined in documentation. Records are available outlining the health appointments attended by individuals. These are included within the care plans known as essential lifestyle plans. A statement of the health needs of individuals is outlined in this plan and then accompanied by a list of health appointments that have been attended. Individuals are reliant on staff to arrange health appointments. Records were available to suggest that individuals are referred to Doctors, chiropodists, dentists and opticians. Records suggested that one person had not received dental support for a number of years. It is considered that this is a lapse in record keeping. It is recommended that these are updated. District Nurse are involved with two individuals and visit periodically. One person has been referred to a speech therapist in relation to eating. Assessments have also been carried out by physiotherapists in relation to mobility and mobility aids. Medication is stored in individual purpose built cabinets which are located in each persons bedroom. Medication records are available and these were noted to include signatures of staff once medication has been received. Signatures are also in place once medication is administered. No controlled medication is prescribed at present. Medication is mainly in liquid form to reflect the needs of individuals. Training records and interviews with staff noted that medication awareness training had been received by staff. Care Homes for Adults (18-65 years) Page 17 of 28 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. Those who use the service and their families are able to influence the running of the service through the information they are given on making complaints. Those who use the service are protected from abuse. Evidence: A complaints procedure is available for families. This contains details of how complaints will be investigated and contains the contact details of the Commission for Social Care Inspection. The service has complaints records but no complaints have been received about the service since the last key inspection. A complaints procedure is available in the service user guide. This is presented with symbols and is designed to offer information to individuals who use the service in as appropriate format as possible about the action they can take if they are not happy with the service provided. No allegations of abuse have been raised in relation to the service since the last key inspection. The service has its own policies and procedures relating to the referral of abuse but does not have a copy of the local authority procedure. This is raised as a recommendation in this report. Staff interviews revealed that they had received training in abuse awareness and were aware of the whistle blowing procedure. Examination of training records also noted that training in abuse awareness had extended to all staff. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Care plans noted that two individuals do demonstrate some aggression which mainly involves self harm. Discussions with staff concerning one person noted that they believed that such behaviours had decreased and that this was due to consistency in the past with respect of the staff team. Another person was noted to be demonstrating some challenging behaviour during the inspection. It was noted that staff intervened to reduce this. Care plans outlined ways in which staff should intervene to reduce such instances of these behaviours. Care Homes for Adults (18-65 years) Page 19 of 28 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. Those who use the service benefit from living in a clean, well maintained and pleasant environment. Evidence: A tour of the premises was undertaken. The Annual Quality Assurance Assessment submitted by the service prior to the inspection stated that the whole building had been decorated. The tour of the premises confirmed this with all areas being bright and decorated to an acceptable fashion. All furnishings throughout the building were noted to be of good quality and suited the needs of those who use the service. Bedrooms are large enough for the use of hoisting equipment and doorways again are wide to enable hoists to be moved through the building. The building is located in a residential area and is indistinguishable as a care service. The building is also close to local facilities and amenities. The last report from the environmental health department of the local authority are available as well as recorded details of the last visit by the Fire Authorities. No CCTV is in use. The building is secure and ramps are available to the front and rear of the building to enable access to and from the building. Records are available suggesting that ongoing repairs are dealt with as appropriate. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The same tour of the building noted that there was no offensive odours noted in the building at any time during the visit. A laundry area is available containing washing and drying appliances. The laundry is separate from all food storage and preparation areas with the exception of a drier located in the kitchen. The laundry area has an impermeable floor and protective clothing is available for staff. The building remained clean and hygienic at all times. This is assisted by the use of cleaning schedules in the kitchen and other areas. Care Homes for Adults (18-65 years) Page 21 of 28 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. Those who use the service are protected by the way in which the service recruits new staff. Those who use the service have their needs met by a well trained staff team. Evidence: One person has commenced work at Valleyfield since the last key inspection. The personnel file for this person was examined. This file showed that a number of checks had been done to ensure the persons fitness to work at the service including a criminal records check, initial check against the protection of vulnerable adults register (known as a POVA First) and two references. Other information confirmed the persons medical fitness as well as copies of their application form, interview notes and proof of their identity. As a result the recruitment of this person was in line with care home regulations. Training records were viewed for all staff. These suggested that staff had received training in health and safety topics such as first aid and manual handling as well as training in the protection of vulnerable adults and medication. This was reinforced through interviews with staff. The induction for one member of staff was examined. This included a general induction of the layout of the building as well as an induction workbook relating to care practice know as common induction standards. Comments Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: from staff in staff surveys confirmed that the induction had covered all they needed and that this had been done very very well. One comment stated I was given a full induction into this service and its service users on my first shift. Another commented The service is good at giving appropriate training to staff Care Homes for Adults (18-65 years) Page 23 of 28 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. Those who use the service benefit from receiving support from a service that is managed by a qualified and experienced individual. Individuals and their families are able to influence the running of the service. Those who use the service have their health and safety promoted by the practices of the service. Evidence: The Manager is now registered with the Commission for Social Care Inspection having undergone the registration process in November 2008. The Manager has worked in the service for a few years and has experience in the support of individuals with a learning disability. Training records suggested that the Manager has received mandatory training in health and safety topics as well as obtaining a National Vocational Qualification at Level 4. manager foundation training and becoming a manual handling facilitator.Staff interviews noted a positive view about the manner in which the service is managed. No requirements were raised at the last inspection so a judgment cannot be made in Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: relation to the responsiveness of the service to any requirements raised, however, the agency returned its Annual Quality Assurance Assessment within the time required and this contained information which summarised the manner in which the service is operated. The Manager demonstrated her awareness of the standards and regulations relating to the support of younger adults and the Inspector was able to view all records relating to the support of individuals and to talk with individuals and staff in private. Staff surveys were also returned when requested. There was evidence that questionnaires had been provided to families offering the opportunity for them to express their views about the quality of support provided. This had been done in September 2008. Any comments raised are then compiled by the organisation that manages the service and then published. In addition to this, a responsible individual visits the service on a monthly basis to determine the quality of support provided. The Manager confirmed that she received copies of reports relating to this. Staff training records confirmed that staff had received training in health and safety topics such as manual handling, first aid and infection control. This training was also confirmed through staff interviews. Documents suggested that health and safety checks are made on the building each month and any remedial action identified. Hoists are checked every six months, portable appliances have been tested annually and the annual quality assurance assessment suggested that electrical and gas systems have been tested. A health and safety policy is in place and this includes reference to the notification of any adverse incidents under reporting of incident legislation (RIDDOR). The service has low surface temperature radiators and water temperatures are checked regularly. Risk assessments relating to individuals identify the hazards faced by each person in the environment and actions are in place to protect them. Records suggested that fire detection and fire fighting equipment is tested regularly and that fire drills take place every six months. The service is aware of the reporting of adverse incidents to the Commission for Social Care Inspection and this has been done since the last key inspection. Certificates of Registration and insurance are in place. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 19 The dental appointment of the person identified at the inspection should be updated to ensure that their health needs are met. The service should obtain a copy of the Local Authority abuse reporting procedure so that any allegations raised are dealt with in a manner which serves the interests of those who use the service. 2 23 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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