Care Home: Ventura

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What the care home does well Residents feel happy, safe and secure at the home. This means the home is achieving a fundamental objective for the residents really well. The new style format for residents care plans is very suitable for writing in a person centered way about the care and support people will need. Residents enjoy the choices of meals that they are provided with. There is now an effective complaints procedure in place to help residents to make complaints formally if they need too. The staff we met were kind and patient in manner. One resident told us the staff,`don`t pressure you too much`. Mrs Arshi is demonstrating a real commitment to improving overall standards of care in the home as well as the environment. One resident told us,`all the changes are a really good thing`. What has improved since the last inspection? This is not applicable as this was the first inspection of the service since Kismet Care Limited took over the ownership and running of the home in February 2010. What the care home could do better: Ensure that residents care plans are reviewed, updated and adjusted regularly,this is to show that residents can still be provided with the care and support that they need. Complete the planned progamme of maintenance and repair of the building, this is to ensure the home is fit to live in. For the protection of the residents, there must be two references taken up for all newly employed staff before they start work at the home. Cleaning substances used in the home that can be hazardous to health, must be stored in a secure place to protect people. To keep residents and staff safe, a comprehensive risk assessment of the risks from people smoking in the home must be undertaken. Any risks identified must be addressed or sufficiently minimized. Key inspection report Care homes for adults (18-65 years) Name: Address: Ventura 16 Swiss Road Weston-Super-Mare Avon BS23 3AX     The quality rating for this care home is:   one star adequate 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: Melanie Edwards     Date: 0 8 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 32 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Ventura 16 Swiss Road Weston-Super-Mare Avon BS23 3AX 01934629919 01934629919 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kismet House Care Home Ltd Name of registered manager (if applicable) Mrs Sheema Arshi Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 7. The registered person may provide the following category of service only: care home only-Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Mental Disorder (MD). Date of last inspection Brief description of the care home Ventura Care home is a registered care home that provides support for up to seven people who have long term mental health needs. The aim of the home is to offer a supportive and homely environment in a community setting. There are five bedrooms in the main house and two bedrooms in an annexe part of the home. People who live in the annexe live a more independant lifestyle then those in the main home. 7 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home Fees are arranged in consultation with the owner of the home, Mrs Sheema Arshi. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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: We met all of the residents who are living at the home. We spent time observing residents and staff together. We observed a small group of residents have lunch. We met the registered manager and owner, Mrs Sheema Arshi and a senior support worker. We looked at a selection of records relating to the day-to-day running and management of the home. The records we saw included two care plans, two assessment records, medication records, staff duty records, supervision records, accident records, fire records, and menus. We saw the majority of the environment. The only areas that we did not see were a Care Homes for Adults (18-65 years) Page 6 of 32 small number of bedrooms. The aqaa (an annual quality assessment document) that all homes are required to complete, has been used to help form the judgments in the report. We found that the home was operating within the required conditions of registration set down by us. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the home. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are assessed and are met. People are able to get hold of the necessary information to help them to understand the service provided. Evidence: To help us to find out more what sort of information there is available for residents about the home we looked at a copy of the service users guide and the statement of purpose. Kismet Care Limited, the company who have very recently taken over the running of the home have put in place a new statement of purpose and service users guide. We saw that the service users guide and the statement of purpose explain what sort of care and service is provided. There are going to be copies of the services users guide and the statement of purpose available for people so they can have the information about life in the home. The statement of purpose and the service users guide contain information about the service. There is also information about the qualifications of the staff employed and the accommodation. The philosophy of the home and how the service aim to meet residents needs is also included. The Care Homes for Adults (18-65 years) Page 10 of 32 Evidence: complaints procedure is in each service users guide so people know how to complain. We read two peoples assessment information to see how their needs had been assessed by the home. We saw information about the persons range of mental health needs. We also saw that one of the residents has been involved in the assessment process and signed care plans and assessment records in agreement with care that is provided. We read some useful information in the aqaa document about how residents are supported to make choices in the home and we have quoted this extract : Ventura has clear Policies and Procedures to ensure that all service users have a choice in where they would like to reside. The management and the home ensure that service users are assessed by a competent person and that the process is smooth and as little disruption or distress as possible. The management ensures that all necessary information and documentation is received from care co ordinators or social workers and is in place prior to potential service users over night stay. Care Plan and Risk Assessments are completed when the service user moves in. These would be done within a realistic time frame within five days. This is in place to ensure that service users needs are identified and met and that all staff are aware of their needs and implement care and support documented. All potential service users are invited to view Ventura prior to making any decision of residing here. They are also invited back for lunch or dinner with an opportunity for an over night stay if they choose. This enables all service users currently living at Ventura to meet the potential service user and have their say on how they feel and their wishes taken into account. The potential service user can also make an informed decision of their choice of home. The management will also discuss with the potential service user and their representatives any limitations that may occur. Ventura is transparent and will openly discuss what the service has to offers to ensure the service and staff can meet the needs of all individuals. Care Homes for Adults (18-65 years) Page 11 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are assessed, however care plans do not fully show how their needs are being met. Residents are being supported to make decisions and to take risks in their daily lives. Evidence: The residents we met were very positive in their views of the staff and the care they provide. Examples of comments made by residents included,Im happy here, they care for us well and the staff here leave you alone, but they talk to you if you need them. These comments help to demonstrate residents feel satisfied with the care and service. We saw some information in the care plans that we read about the potential risks the person may face and any risks from particular activities that they do. The care plans had some guidance information about what approaches staff should take and were Care Homes for Adults (18-65 years) Page 12 of 32 Evidence: reasonably informative. We saw some information in the care plans about the persons life history and what matters to them including important family and friends. One care plan had been newly written. However the second care plan had not been reviewed for twelve months and was far less detailed in the information that it contained. Care plans need to be reviewed regularly to demonstrates residents needs are monitored and can be met. We saw the new format for writing care plans that is being introduced into the home. We also read two peoples care plans. One persons care plans was up to date and person centered and set out what their needs are. The care plan also showed what sort of support and help the person needs. However the second care plan had not been reviewed for over twelve months and was not a full reflection of the persons range of needs. We read some useful information in the aqaa document about how residents individual needs and choices are promoted and we have quoted this extract :Each service user has an individual care and Support plan in place with clear documentation of risk assessments. Each care and support plan is very much person centred and all discussion and any changes the individual service user is included and agreed with all decisions relating to their care and support. All service users are present at their Care Plan Reviews and any Medication reviews, where their choice and wishes are taken into account and documented clearly. All service users have a central role in their development and planning and with all aspects of their daily living. Staff and Management encourage and support service users to freely express their wishes and desires and to fully participate with all decision making with their lives. The management ensures that all service users information, desires and wishes are not shared with families or friends without the service users wishes. That information is on a need to know basis and the home complies with the Data Protection Act and Confidentiality. Care Homes for Adults (18-65 years) Page 13 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being helped to take part in a some suitable activities. Residents are supported to be a part of the community and to have personal relationships. Residents eat well cooked meals. Evidence: We saw residents go out for a walk. This is evidence of how residents are able to take risks in their daily lives. There are now regular house meetings for residents and staff to discuss what they feel matters about the day to day running of the home. This is a really good way for residents to make their views known in the home. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: The residents who we met told us that they go to leisure and social facilities including local community based facilities such as shops, the gym and Western sea front. We noticed staff knock on bedroom doors before being invited. Residents can have their own key to their bedrooms if they want to, to give them more privacy. The residents we met told us that yes staff are helpful and are,on the whole polite. We saw in the home photos of holidays and social events that residents had taken part in. We were told by staff and by residents that the home encourages contact with family and friends. Some residents see their relatives regularly. We looked at a copy of the current records of meals that residents have eaten over the last four weeks. We saw there were a variety of dishes recorded as available for each day. Residents told us they can sometimes chose what they like to eat. We saw staff offering a varied choice of meal options available for the evening meal that night. Meal choices included a range of traditional nutritional meals. The lunchtime meal of boiled egg on toast looked appetising. All the residents we met told us they thought the food they eat at the home is ,good. We read some useful information in the aqaa document about how residents can live a meaningful lifestyle and we have quoted this extract :The staff and management encourage and fully support service users to access facilities within the community to ensure that as individuals they are living as full a life as possible. The service users access a variety of activities, social events college therapeutic groups and training centres. All activities and social events are the choice of the service users and are encouraged and supported to maintain these and access new ventures. Service users have an opportunity to go out as a home with staff for a meal, live band or theatre. This is discussed prior to the event arranged and agreed with by all service users. Day trips are regular and are individual to the needs and wishes of the service users. Whether it is going into town shopping, to the super market car boot sales and local shops beach walking down the canal walking in the woods or simply going out for a drive and stopping off somewhere. Service users are encouraged and supported to maintain friendships within the home and wider community and with families. Service users have a choice to have their own mobile phone or use the pay phone available in the vestibule. Whereby they can contact friends and family when they choose. Families are encouraged to come to Ventura to visit and are invited to in house events Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: like barbeques and other special occasions birthdays Christmas and Easter. All service users have the freedom to choose whether of not they wish to attend agreed events, day trips or night outs. They also have a choice to spend time alone and in private where staff will respect this, though having a balance to ensure isolation does not occur to maintain mental and emotional wellbeing. Service users have free access and exit to the premises during the day and up until 11pm. Due to safeguards staff lock the back door to prevent intruders and ensure the safety of the service users and home. Service users have access to go out, night staff are to be aware they have left and what time they are back. The home offers a wide variety of meals three times a day that are healthy and a menu that all service users are encouraged to put suggestions and their views forward. Meal times are based round the service users daily activities and can be put back if service users are out socialising or attending activities. Snacks and drinks are available at all times and service users can help themselves to hot or cold drinks throughout the day and night. Ventura provides a takeaway evening, whereby service users can choose what take away meal they would like. Ventura encourages a healthy eating plan that meets the service users needs. Service users are encouraged to participate with the homes daily running, help setting the tables, making drinks etc . The management recognises the importance of learning independent living skills and are encouraged to plan, prepare and serve meals if they choose. The home recognises the impact that alcohol has and encourages service users not to drink excessive amounts. Service users are encouraged to drink in the evenings rather than during the day as this will impact on their lifestyle and attending chosen actives or therapeutic groups. As a policy the home has a no alcohol policy in house and service users if they choose are to go out to have a drink. Care Homes for Adults (18-65 years) Page 16 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to meet their physical and emotional needs. Residents medication is looked after safely. Evidence: We met all of the residents who live at the home. Everyone we met said they are really happy living at the home. We were told by residents that they had been anxious about a new owner taking over the home, but they now felt very comfortable with her and that Mrs Arshi is, really nice. One resident told us that the staff, help and support them. This tells us that residents feel settled and relaxed living at the home . We saw some information written in residents care records about the preferred daily routine of the residents and particular likes and dislikes in their daily lives. This helps staff to be able to meet residents needs in the way that they like. To support residents with their health needs they use local GP practices. There is also specialist support provided from other outside professionals including the psychiatrist, dietician and the community mental health nurses. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: We saw information in the residents daily records that showed us staff monitor residents and observe their overall health. Staff will call the doctor if they are concerned about the person. We looked at the procedures for giving out, storing and disposal of medication to see if residents medication is handled safely. We looked at four peoples medication administration charts. The stock of medication we saw was being looked after safely. The medication administration charts were legible, up to date and contained the signature of the dispensing member of staff. This demonstrates medication is given to residents safely. Mrs Arshi has arranged for the staff who administer medication to do regular training to enable them to do this safely. We read some useful information in the aqaa document about how residents physical and emotional needs are met and we have quoted this extract :The staff and manager ensure that all service users using our service receives a high level of care and support that meets their individual needs on a daily basis. Each service user has an individual care and support plan with up to date risk assessments and daily records. Each service user has full participation and included in all aspects of their care plan and risk assessments. The setting up and reviewing of care plan and risk assessments is a collaborative relationship and service users sign when in agreement with them. All service users participate with care plan meetings and medication reviews their views and wishes are first and foremost. Giving them control over their daily living and own development and programme. All service users have an in house named key worker and or a social worker community care worker care co ordinator or placement officer. This is to ensure each service user is receiving the level and type of care to enable them to lead a fulfilling life style and have the necessary care and support in place to maintain their mental and emotional well being. Service users within Ventura have a choice to which GP they have and make their own decisions with regards to their medical treatment. Service users are encouraged and supported by staff to attend medical appointments and health checks and Ventura provides the transport to and from appointments if the service users needed or wishes. Ventura has a robust medication Policy, whereby staff adheres to. Training is given to all staff to ensure they are competent to administer medication. All Staff receives regular update training to comply with current up to date legislations and policies. Ventura has close links with Lloyds Pharmacy who provide Blister Packed Medication. All medication is prescribed by the service users GP or Psychiatrists. Regular medication reviews are arranged by the manager and the community mental health team. Care Homes for Adults (18-65 years) Page 18 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can make complaints if they need to and Mrs Arshi will properly investigate them. The home has procedures in place to try and keep residents safe from abuse. Evidence: We read the complaints records find out how complaints are responded to by the home. There had been no complaints since Mrs Arshi took over the running and managing of the home in February of this year. The residents who we met said they could talk to the Mrs Arshi and that she is,very nice. We saw a copy of the homes complaints procedure this has our contact information as well if people need to get in touch with us. We saw the minutes of the first residents meetings since Mrs Arshi took over the home. The meetings are a way that residents can make known any complaints they have. This helps residents take control in their daily lives. We saw a copy of the homes policy relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: action if they ever have to respond to an allegation of abuse. Mrs Arshi is in the process of booking all staff who have not recently done training on a course to help them understand the principles of keeping residents safe from abuse. The staff member on duty was warm and polite to the residents. This helps show that staff treat residents with respect We read some useful information in the aqaa document about how complaints are dealt with and how residents are kept safe. We have quoted this extract :The management has an open and transparent approach to all persons within Ventura. Ensuring that she is approachable and willing to listen so persons feel they have a voice within the system and service provided. The management at Ventura ensures that all Service Users, their families staff and outside professional bodies views and opinions are listened to. That they have an opportunity to express their opinion and are able to freely and openly comment on the service provided. Ventura has an easy to follow complaints procedure and a whistle blowing policy. All persons within the home have a clear understanding of who to go to if a complaint arises. The management ensures that all complaints are followed through within a set time frame in 28 days and ensures that it complies with current legislation and the homes policies and procedures, documenting clearly and concisely. The management ensures that all staff and volunteers employed are checked and are suitable to work with vulnerable adults. All staff are POVA checked and has an Enhanced Criminal Records Certificate. an Enhanced Disclosure. The manager ensures that all service users are safeguarded from all forms of abuse or inhuman or degrading treatment and will challenge any persons suspected or known to be doing so. The manager has a robust system in place and in depth Policies and Procedures, which all persons are to comply with. All staff are aware of these Procedures and Policies and training is given to ensure they are up to date with current legislative laws and procedures. The manager ensures that all staff attends regular training to meet the needs of the service users and to ensure the safety and protection of service users. The home has a no restraint policy and the manager is trained in the use of physical intervention and minimal force. The home and managers aim is to have a holistic approach to care intervention and support having in place clear guidelines of triggers early warning signs and indicators of potential challenging behaviour. Each service user has clear written risk assessments and triggers early warning signs and potential challenging behaviour is documented. Emergency procedures are set out in the policies and procedure file and all staff are aware of who to contact in the event of an emergency. Care Homes for Adults (18-65 years) Page 20 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an adequately suitable home that they find relaxing and suitable for their needs. The home needs a programme of maintenance and repair to be completed to ensure it is safe and suitable residents. Evidence: Ventura care home is in a residential area of the town of Weston super mare. The home is a short distance from the main shopping part of Weston. There are bus stops near to the home, shops, pubs and a supermarket. This means residents can be part of the community where the home is located. All of the residents we met kindly showed us around their bedrooms. We found the bedrooms looked adequately clean. Each bedroom in the home is for one person to live in. We saw residents sitting in the dining room and in the garden. We noticed that residents looked settled and relaxed. There is a patio area that we saw residents use, we noticed how relaxed people looked Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: sitting outside. We saw bathrooms near to communal areas and bedrooms. We saw that the bathrooms and toilets were clean and had towels and soap to help minimize risk from cross infection. The home is a three storey building and people use the first all floors of the building. There is no lift so the home would not be suitable for someone with reduced mobility. We found the home looked clean in the parts that we saw. The environment looked to be just adequatly maintained. As was also applicable at the last inspection of the home when it was under a different ownership the general appearance of the building is tired and worn in bedrooms and communal areas. Mrs Arshi has already demonstrated her commitment to fully addressing the general environmental flaws in the building. When we carried out the inspection there was an electrician ensuring the electrics in the home are safe and fit for purpose. We also saw recent work that Mrs Arshi had commissioned to address damp problems in one lounge area and a bedroom. We read some useful information in the aqaa document about the plans for the improvement of the environment and we have quoted this extract : Ventura is going to be a warm safe open and friendly home where it would meet the ever changing needs of each service user in a supportive and encouraging environment. The home has a unique family atmosphere encouraging service users to access the community and maintain friendships and contact with families and friends. The manager and staff offer a wide variety of support and care that enables service users to develop their skills and abilities to enhance their own life and wellbeing. The home is working towards to meet the standard standard and is going to keep to a high decorative standard. Ensuring service users have their say on what colours and changes take place within the home. The home prides itself with having a wide range of facilities and amenities in the wider community and encouraging each service user to access these with staff support and guidance in order them to progress and develop and lead as full a life as possible. There is public transport available and on a main bus route into town or other towns and cities. The home has a clear statement of purpose and service users guide, which has clear written information about the service provided. The home improvements are agreed with the service users and discussed in their meetings for them to have their say and an opportunity to express their concerns or worries. The improvements to the home is done in such a way to minimise the impact and disruption to their daily living and done within a time frame that is realistic. The home is clean and hygienic and staff are encouraged to maintain a high standard at all times. There are clear readable Policies and Procedures in place for staff to read and Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: fully understand. Laundry is done on a daily basis and ensured all laundry is clean aired or dried and put away. All staff has protective equipment to minimise cross contamination and the spread of infection or diseases. Safety of the home is monitored regularly by the management and monitored via visits from external professional bodies. The home has a robust Fire and Emergency Procedures in place to ensure the safety of all persons who work and reside here. All persons are aware of the procedures and training is given on a regular basis. The home complies with the current Smoke Free Law and working towards encouraging the service users not to smoke in there rooms and smoking area is going to be provided. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures are only partly safe. More robust procedures must be followed to ensure suitable and safe staff are recruited to care for residents. There are enough staff on duty to support the residents with their needs. Mrs Arshi is working hard to ensure all staff have regular supervision of their work and performance. Mrs Arshi is putting in place a training progamme for all staff at the home. Evidence: We checked the number of staff on duty for the last four weeks. We saw that there is a support worker on duty for a day shift. There is one member of staff who works at night. Mrs Arshi works additional hours to the staff on duty each day in the week. She is also available on call outside of these times for support and advice if needed. Based on the evidence from the inspection the number of staff on duty at any time meet residents needs. We looked at staff employment files of three care staff. We saw written professional references taken up for new staff prior to offering work at the home. However for one Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: member of staff who has recently been recruited there was only one written reference. We advised that two references are needs as a protection measure to ensure that only suitable people are employed at the home. We saw that all staff have a criminal records bureau check carried out on them before starting employment. These checks also aim to make sure the home employees only suitable people to work with residents. We met one member of staff who told us they are working toward completing a national vocational qualification in care award. Mrs Arshi said a significant number of the team have either completed national vocational qualifications or are working towards them. We asked to see two staff recent supervision records. We saw some really good evidence that Mrs Arshi is working hard to motivate and supervise staff. We saw evidence to demonstrate that staff are now being regularly supervised in the work that they do. We read some useful information in the aqaa document about the staff team and the training they do , we have quoted this extract :Ventura has a robust staffing procedure in place to ensure the safety and well being of the service users. The management fully supports and encourages staff development and training which is essential for progress and providing a service that is up to date and of a high standard. Current Staff are undertaking their training in Health and Social Care. Accessing courses and training via Weston College, Primary Care Training and North Somerset training programme. The manager ensures that all staff employed has skills and qualities that meet the service users needs. All staff are have a criminal records bureau check completed and two references are obtained prior to being employed. All staff at Ventura has their own file that is kept separate and personal development programme. Staffing levels at Ventura meets the current needs of the service users and is reviewed when potential service users choose to reside ensuring the home and service provides the support and care needed to meet their needs. Care Homes for Adults (18-65 years) Page 25 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mrs Arshis track record as a care home owner suggest that she will provide strong and effective leadership in running Ventura. There are some failings in the protection of peoples health and safety in the home. Evidence: Mrs Arshi has been the manager and owner of the home since the end of February of this year. She has a number of years of experience caring for people with a range of mental health needs. She is also registered with us as the owner of nearby Kismet House care home. This demonstrates she is fit and competent to be the manager. We saw residents approach Mrs Arshi and look relaxed in her company. All of the residents who we asked told us that Mrs Arshi was really nice. There are now residents house meetings taking place and residents can talk about what matters to them. We saw minutes of recent staff meetings. The minutes we read showed that staff are Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: consulted about the running of the home and can make their views known. We saw up to date evidence that Mrs Arshi is going to be carrying out a full quality audit of the care and the service in the home. This is a really good way to review overall standards in the home and to improve them even more. We found that the environment looked safe and generally was just adequately maintained in the areas that we saw. However,please refer to the comments that have been written in the environment section of this report. All of the staff are going to be doing regular training in food safety. This is a really good way for staff to help residents to prepare and cook food in a safe way. We saw records that showed staff check the temperatures of all high risk cooked food before it is served to people to make sure it is hot enough and safe to eat. We saw evidence that staff have done some training in health and safety matters including first aid, infection control and fire safety. This should help protect residents if staff are knowledgeable and well trained in health and safety principles and practices.Mrs Arshi is booking remaining staff on to general health and safety course as priority. We saw that the cupboard that is used to keep cleaning products in did not have a door on it. We reminded Mrs Arshi and the staff member on duty, that these products need to be stored securely for health and safety reasons. We checked the fire logbook record and it showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment are carried out and are up to date. We read some useful information in the aqaa document about Mrs Arhshi plans for the home and about her style of management . We have quoted this extract :The manager has gained a lot of experience over the last few years and her skills and ability has improved greatly. The manager has gained new qualifications in NVQ 4 in Management. As the manager it is my responsibility to ensure the smooth running and safety of the home. That the written Aims and Objectives are achieved and that all persons comply with the Policies and Procedures set out. That the home complies with all current Legislative Laws and Standards set out and challenge persons who do not comply with them. The safety and well being of service users is my top priority and ensure that all Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: staff maintain safe working practice and know their responsibilities and role. As the manager I have an open transparent and friendly approach that enables persons to approach without fear prejudice discrimination or difficulty. I ensure that all staff, service users, families and representatives has an opportunity to put in writing their concerns, worries, grievances, thoughts and wishes, as well as their praises and positives. I am committed to development and positive change that enhances the service and provides and high quality of care for the service users. Through enthusiasm commitment and positive outlook I motivate staff and service users alike to lead a more fulfilling life to grow and develop. Ensuring also that I encourage fresh new ideas and open to constructive criticism for change. As the manager I ensure that all files records and documentation are factual concise and clearly documented and up to date. Ensuring also all files are regularly reviewed and maintained when required. To also ensure that all persons are aware of any changes and inform all persons of any visits, inspections and opportunities to discuss changes that may take place. As the manager I ensure that all staff has regular supervision, reviews and personal development programmes. That staff are fully trained to do their tasks and job description in order to meet the needs of the service users. That I am up to date with any changes and implement those changes to ensure safety of all persons within the home. I also ensure that all persons are fully aware of fire and emergency procedures and training is given and updated recorded and signed. That all persons are competent to work and that the home is a safe environment to reside and work in. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 32 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 42 13 Cleaning substances that can 10/04/2010 be hazardous to health must be stored in a secure place. Health and Safety. 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 1 6 15 Care plans must be reviewed 09/05/2010 and updated regularly and must show how needs are met. Health and personal care of residents. 2 24 23 Complete the planned progamme of maintenance and repair of the building. Health,safety and wellbeing. 30/06/2010 3 34 19 There must be two references taken up for all newly employed staff before they start work at the home . The safeguarding of residents. 16/04/2010 4 42 13 There must be a be a comprehensive assessment of the risk from people 23/04/2010 Care Homes for Adults (18-65 years) Page 30 of 32 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 smoking in bedrooms. Any risks identified from the assessment must then be addressed or minimized. Health and Safety. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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