Care Home: Vicarage Road

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What the care home does well Care plans and risk assessments are very comprehensive and person centred and there was evidence that service users are involved in the drawing up of the care plans and subsequent reviews. An advocate is available to service users, if they so wish. Decisions within the home are made by the people who live there as much as possible and staff have the ability and skills to support the poeple to be as independant as possible and to have as much control over their lives as possible. A key worker system allows the service users to build up a relationship with a particular member of staff which is to their benefit. Equalty and diversity issues are given a high profile within the service and there is a very strong commitment to enabling people to develop and maintain their skills. People are encouraged to maintain personal and family relationships. Complaints and safeguarding issues are well managed and staff undertake training in these important areas. Feedback from people who live at Vicarage Road was very positive "I really like living here, "the staff are very nice", "I don`t want to live anywhere else". What has improved since the last inspection? The home has continued to provide a very high quality service which is based on the rights and aspirations of the poeple who live there. What the care home could do better: There were no requirements or recommendations mad at this inspection however the manager and staff team are committed to continue to look at ways of improving the service. Key inspection report Care homes for adults (18-65 years) Name: Address: Vicarage Road 28 Vicarage Road Dagenham RM10 9SD     The quality rating for this care home is:   three star excellent 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: Julie Legg     Date: 1 0 1 1 2 0 0 9 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 27 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Vicarage Road 28 Vicarage Road Dagenham RM10 9SD 02085921257 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): graceo@outlookcare.org.uk Outlook Care Name of registered manager (if applicable) Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Vicarage Road is a purpose built home in a residential area of Dagenham. It is in walking distance of local amenities. The home accommodates 7 adults with learning disabilities in single bedrooms. The aims and objectives of the home are to promote independence, to offer choice in all daily activities and to promote rights along with an understanding of the responsibilities that accompany this further participate in the running of the home undertaking household tasks and to use the services in the local community. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 7 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection took place on 10th November 2009 and was carried out by Mrs Julie Legg. We arrived at the home at 10:00 hours and was met by the acting deputy manager who was available throughtout the inspection. We spoke to service users and staff, lookedat service user files, staff files including training records as well as other records and documentation. We also took information from notifications which had been sent to the Commission. Care Homes for Adults (18-65 years) Page 5 of 27 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 6 of 27 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 7 of 27 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. The service understands the importance of prospective service users having sufficient information to enable them to make an informed choice as to whether the home is right for them Evidence: The home provides a Statement of Purpose that is specific to the individual home and the service group they care for. it clearly sets out the objectives and philosophy of the service supported by a service users guide. Service users know what to expect when they move into the home, it gives a clear account of the service provided, quality of the accommodation, how to make a complaint and a copy of the most recent inspection report is also available to them. There have been no new admissions since the last key inspection (2006). However admissions would not take place until a full needs assessment had been undertaken. The assessment would be carried out involving the prospective service users, social and health care professionals as well as families where appropriate. An admission would only take place once the service was confident that the staff had the skills, Care Homes for Adults (18-65 years) Page 8 of 27 Evidence: ability and qualifications to meet the assessed needs of the prospective service user. The assessment focuses on achieving positive outcomes for people and this includes ensuring that the facilities, staffing and other services provided by the home meets the ethnic and diverse needs of the individual. The home operates a key worker system and all prospective service users would be given the opportunity to spend time at the home including overnight stays. A member of staff would be allocated to them to give them information about the home; how the home is organised and run, together with the facilities available. New service users are provided with a Statement of Purpose and conditions and these set out in detail what is included in the fee, the role and responsibility of the provider and the rights and obligations of the service user. Care Homes for Adults (18-65 years) Page 9 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are involved in decisions about thei lives and are encouraged to play an active role in planning the care and support they need and receive Evidence: The service is very clear that service users are in control of their lives and that they direct the service, as far as possible. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as is possible. we spoke to service users and staff who all told us that service users are encouraged and supported to make their own informed decisions and that they also have the right to take risk in their daily lives within the bounds of a risk management framework. Care plans are very person centred and comprehensive and are being used as working documents. All relevant areas of equality and diversity are also covered within the care plans. They are in a pictorial format as well as a written format which ensures they are easily understood by service users, staff and to others who may not be as familiar with the individual service users. The service operates a key worker system Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: who ensure that care plans are being kept up to date through regular evaluation and review. All service users are actively encouraged and supported to be involved in the development of their care plan. Plans are highly individualised and they include evidence that the service values improving outcomes for service users; one service user until this year had not been able to spend a night away from the home but due to the work carried out by the staff with the service user, they were able to enjoy a two night break at the seaside. Photographs that were seen indicated that they had thoroughly enjoyed themselves. One service user told us I helped to do my plan and the staff help me with writing birthday cards and choosing presents for my family. Care plans include comprehensive risk assessments which are regularly reviewed. It was very apparent during the inspection from observation and from talking to service users and staff and from looking at documentation, the service has a can do attitude and risks are managed positively to assist people using the service to lead the life they want. Each service user has a service agreement which states any restrictions or infringements of rights for the safety of all who live in the home and the reasons why the need for restrictions are given and agreed by the individual. The attitude and practice of the service and that of the staff team promotes opportunities for service users to remain independent, exercise choice and express their wishes and needs. There was evidence that regular review meetings are taking place. These reviews include the service user who can invite others to attend such as a family member, key worker, social worker or advocate. reviews focus on finding out what has worked, where progress has been made, achievements, concerns and plans for the future. Where appropriate service users are supported in developing skills on budgeting and they have financial records and where able are encouraged to actively take control of their finances. Service users who require more support and assistance in managing their own finances are given this; on the day of the inspection a support worker was accompanying a service user to the bank as he wanted to take out some money. The service works closely with with other agencies to ensure that the service users whole life needs are met and goals addressed. When needed support is sought from other professionals to meet the individual needs of each service user. An advocacy service is available to every service user and the advocate is well known to the service users and the staff. They attend regular meetings with the residents which ensures they are involved in decisions as to the day to day life of the home; menu planning, activities and its future development. From viewing documentation and in discussions with staff it was evident that they Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: were aware of the need to respect the confidentiality of service users and to handle information about service suers in accordance with the homes written policies and procedures, the Data Protection Act 1998, Freedom of Information Act and in the best interest of the service users. Care Homes for Adults (18-65 years) Page 12 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and are supported to develop thier life skills. Evidence: Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life ninth home and in the community. central to the care and support provided is the importance of respect for the human rights of people in the areas of fairness, equality, dignity, respect and autonomy. The service has a strong commitment to enabling people to develop or maintain their skills, including social, emotional, communication and independent living skills. Individuals are supported to to identify their goals and aspirations and are encouraged to work to achieve them. Service users are encouraged and supported to enjoy a full and stimulating lifestyle with a variety of option to choose from. Two service users Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: benefit from one to one support, which allows those service users access to the community. Service users are able to access a variety of options in the community; the local college, day services and evening clubs. Trips to the cinema, theatre, shops, local cafes and pubs and are also enjoyed as well as trips further afield; Leeds castle, Hever castle, trips on canal boats, museums and Duxford airfield. Service users have enjoyed holidays this year; holiday camp at Hayling Island, Hotel in Brighton and another party went to Blackpool. Two of the service users also attend a local church. Some of the service users are able to access the community independently whilst other need support from the staff. On the day of the inspection two of the service went to get food shopping for the house, another went to see their GP and another went to the Bank. One of the service users told us I enjoy going shopping and I can buy things for myself The service seeks the views of the service users and consider their varied interests when planning the routines of daily living. Routines are very flexible and service users can make choices. The service actively encourages and provides opportunities for people to develop and maintain social and independent living skills where appropriate. This includes developing and maintaining family relationships; all have contact with members of their family, some family members visit the service users and take them out for meals, other service users visit their families at their own homes and some service users are supported to visit the graves of their departed relatives. People are encouraged to be involved in all areas of daily living in the home and this includes taking responsibility for keeping their bedrooms clean and tidy, laundry, shopping, planning meal and meal preparation. Outcomes for people living at Vicarage Road are very positive and there is evidence that they enjoy the life opportunities they are able to experience. Some of the service users are able to make cups of tea/coffee and prepare light meals such as breakfast and sandwiches as well as assisting with the preparation of the main evening meal. All of the services users are encouraged to eat a healthy diet and one of the service users is receiving support from the Community Dietician. Care Homes for Adults (18-65 years) Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs with the principles of respect, dignity and privacy being practiced. Evidence: The personal support around personal and health care is very person centred with support based upon the rights of dignity, equality and respect. Individual care plans clearly record the personal and health care needs of the service users and also detail how these will be delivered. All support is flexible and consistent and is able to meet the changing needs of the service users. The use of a key worker system has meant that staff have in depth knowledge about the individual service users personal and health care needs. Staff were observed to respond appropriately and sensitively in various situations. records that were seen showed that service users have health action plans. All of the service users are supported to access dental care, opticians, chiropody, dietician, psychologist, psychiatrist, GP and any other health specialists as required. On the day of the inspection one of the service users was supported to access their GP. Service users that display behaviour that challenges receive the appropriate health Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: interventions and all necessary risk assessments are in place and regularly reviewed. staff are very alert to changes in mood an behaviour and general well being and fully understand how they should respond and what action to take. The service has developed efficient medication policies, procedures and practice guidance and this was evidenced during an inspection of the Medication Administration Records (MAR). Where staff are involved in the administration of medication they have undertaken the necessary training. Quality assurance systems are in place to ensure that the homes policy is put into practice and this is also confirmed in audits undertaken by the homes manager and pharmacist. We looked at MARs and found these to be in order and where PRN medication is prescribed there is a written protocol. There was some evidence when looking at the care plans that staff have commenced in looking at service users end of life wishes however the manager has recognised that this is an area that further work needs to be carried out, to ensure that the wishes of the service users at this difficult time are clearly recorded. Care Homes for Adults (18-65 years) Page 16 of 27 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. People who live at the home are listened to and acted upon and they are protected by the robust safeguarding systems of the service. Evidence: The home has a clear complaints procedure which is available in a pictorial format and the service users have been involved in the making of a complaints DVD. This very beneficial for service user who have communication difficulties. A copy of the procedure has been made available to all of the service users and their relatives and is displayed in a number of areas within the home. The service keeps a record of nay complaints and this includes details of any investigations and actions taken. the service views complaints in a positive manner and uses outcomes to improve the service for people living at the home. In discussion with some of the service users it was evident that they knew how to complain. The home has an open culture that allows people to express their views and concerns in a safe environment. All of the service users that we spoke to were happy with the service provided. One service user told us If I had a problem I would tell Grace (manager). There was evidence in the complaints book that service users had made complaints and that they were satisfied with the outcomes. The service has a whistle blowing policy staff know that if they speak out on poor practice they will be supported by the organisation. the service is clear when an Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: incident needs to be referred to the local authority as part of the local procedures for safeguarding. All staff working at the home have undertaken training in safeguarding adults. Staff are also trained to respond appropriately to physical and verbal aggression and fully understand the use of physical intervention as a last resort. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people to live in a safe, well maintained and comfortable environment. Evidence: We undertook a tour of the home including service users bedrooms (where permission was gained) and found the living environment to be appropriate for the lifestyle and needs of the service users. It is homely, well maintained, clean safe and comfortable and reflects the individuality of the people living there. The kitchen area was clean and food was being stored appropriately. There are sufficient toilets and bathrooms and these were also seen to be clean and in good order. All of the bedrooms are single and four of the service users invited us to view their bedrooms, it was apparent that service users have been able to personalise their bedrooms according to their wishes. There are two seperate lounge/dining rooms and both of these rooms were being used during the inspection. The garden is a pleasant area for the service users to use during the warmer months, some of the service users enjoy assisting with the gardening. The kitchen and laundry are designed to enable and promote the involvement of Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: service users in undertaking domestic tasks and as part of developing their indpenedance. Where necessary risk assessments are in place to ensure the health and safety of service users using the kitchen and laundry. Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pople who use the service can be confident that they are supported by staff who are trained, skilled and in sufficient numbers Evidence: The deputy manager confirmed that the home is fully staff and that mostly permanent and bank staff are used to cover for emergencies, sickness and annual leave. There is also good staff retention and some of the staff have worked at the home for a number of years; this affords the service users continuity of staff who are known to them. The staff team are culturally diverse and this reflects the local community in which the home is situated. Staff rotas were inspected and they correlated with the staff members on duty and on the day of the inspection there were sufficient staff on duty to meet the needs of the service users. We observed that staff had very good interactions with the service users and in discussion they demonstrated that they were very knowledgeable as to the needs of the service users. We looked at the files of the 2 most recently recruited members of staff and found that the selection and recruitment procedure were robust. All appropriate references, proof of identity and police checks were obtained prior to a member of staff Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: commencing work. The content of the induction and probationary period are robust and service specific. Training is focused on delivering improved outcomes for people and all staff are encouraged to undergo relevant training. Recent training has included safe handling of medication, Mental Capacity learning event, food hygiene, Autism awareness, self harm, positive response, safeguarding of vulnerable adults and person centred planning. The majority of the staff have achieved their NVQ 2/3 in care and the acting deputy manager will shortly be undertaking the NVQ 4 . Through talking to staff and viewing documentation it was evident that regular 1:1 supervision and staff meetings are taking place as well as yearly appraisals. it was also apparent that the staff team support each other and share their skills and knowledge. Service users spoke very positively about the staff and felt that they supported I enjoy living here, all of the staff are kind, the staff are good, they help me. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed by a qualified and competent manager and the management and adminstration of the home is based on openess and respect. There are effective quality assurance systems which ensures the home is run in the best interests of the servcie users. Evidence: On arrival we were greeted by the acting deputy manager who advised us that the registered manager was attending a managers meeting. The acting deputy manager was available for the inspection and feedback at the end. During discussion with him it was apparent that he was very knowledgeable as to the service users needs and he was also very aware of the need for confidentiality and also of the fire safety of the home. The acting deputy manager demonstrated a clear understanding of the key principles and focus of the service based on the organisational values and priorities. The service has a strong focus on person centred thinking, with service users shaping the service wherever possible. the management has a strong ethos of being open and transparent Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: in all areas of the running of the home. All work continuously to improve the service to provide an increased quality of life for the service users with a strong emphasis on promoting human rights. Staff that were spoken to during the visit spoke positively about how well supported they felt by the manager. Both staff and service users told us that the manager listens to them and that they felt valued. The manager ensures that staff follow the policies and procedures of the home and that they have access to relevant training and documentation. Practice and performance are discussed during supervisions and team meetings. Spot checks and quality monitoring systems provide evidence that practice reflects the homes policies and procedures. We looked at a wide range of records and other documents including fire safety, health and safety checks, gas, electric and found these to be detailed and up to date. Fire alarms are tested weekly and staff and service users regularly participate in fire evacuation procedures. The home has sufficient systems in place to ensure effective safeguarding and management of service users money and valuables. Wherever possible service users are supported to administer some of their own finances such as going to the bank to draw out money. The manager and her staff recognise the importance of good risk assessments being in place and these are regularly reviewed and updated where necessary. they also recognise that risk assessments must be underpinned by promoting independence, choice and autonomy. Working practices within the home are safe and the service pro actively monitors its health and safety performance. Regulation 37 notifications as required under the Care Home Regulations 2001 are sent to the Commission as necessary and Regulation 26 visits are also being undertaken. The manager ensures that she is up to date with current and new legislation and both she and the staff have undertaken training on the Mental Capacity Act 2005. Currently there been no referrals under the Deprivation of Liberties Safeguards. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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