Care Home: Victoria Court (Community Therapeutic Services Limited)

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What the care home does well Victoria Court provides a person centered service. The quality of assessments of potential service users and the involvement of people in planning their support is excellent. The service is run for the benefit of the people who live there this is shown by the selection and training of the support staff and the overall person centered ethos of the home. What has improved since the last inspection? Since the last inspection the complaints procedure has been reviewed and some of the windows in the home have been replaced What the care home could do better: There are no areas of improvement identified in this report. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria Court (Community Therapeutic Services Limited) 1 Victoria Park Weston-Super-Mare North Somerset BS23 2HZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jacqueline Sullivan     Date: 0 5 1 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Victoria Court (Community Therapeutic Services Limited) 1 Victoria Park Weston-Super-Mare North Somerset BS23 2HZ 08450943233 Telephone number: Fax number: Email address: Provider web address: d.wing@cts-homes.co.uk www.cts-homes.co.uk Name of registered provider(s): Community Therapeutic Services Ltd care home 6 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (Code MD) Learning Disability (Code LD) Date of last inspection Brief description of the care home Victoria Court is a two-storey Victorian property that is set above the town of WestonSuper-Mare offering views across the seafront and bay. It offers homely accommodation for up to six residents. In addition to provided therapeutic space, it is Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 6 6 Brief description of the care home in easy walking distance of all local amenities. The home is registered with the Commission for Social Care Inspection for people between the ages of 18 to 65 years old and registration category is for people with learning disabilities who may also have mental health difficulties. The service is available to both male and female resident; all rooms are single and have ensuite facilities. Service users needs are met through therapeutic interactions, which respect service users dignity, individuality , privacy and support their rights as individual citizens. There is an experienced staff team on duty over the 24-hour period and access to expert clinical support from consultant clinical psychologists. The aim of the home is to support service users through a therapeutic programme toward integrated social living and greater independence. Fees are negotiated on an individual basis according to presenting need. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The inspection of the home was undertaken with the directors of Community Therapeutic Services Ltd, Dr David Wing. We also spoke with three of the people living at the home, and the staff who were on duty. We looked at the records held at the home and used service users surveys to gather information about Victoria Court. An AQAA had been completed and sent to the Commission, this was discussed with the directors as part of the inspection process. The home has been assessed as having some excellent areas of practice, which have been highlighted in this report. The overall assessment is that Victoria Court provides an excellent level of service to the people who live there. Care Homes for Adults (18-65 years) Page 6 of 28 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have good information to make their own informed decisions and have the right to take risks in their daily lives. All new service users can be assured that they will receive a full comprehensive needs assessment before admission . Evidence: There are currently five service users living in the home. The manager told us that one person left last year. He described the work that they do as working with people with exceptional needs. People come to the home from a variety of routes. These routes include community treatment orders, guardianship orders and placement from the local authority. We looked at the statement of purpose and service users guide and saw that it contained detailed information to assist service users to make decisions about living at Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: the home and the care they would like to receive. It was seen to be in an easy read format with pictures so that it was accessible to every one who lived there. We spoke with three service users who told us that they had a copy of both the statement of purpose and the service user guide and that they understood what was in it. We spoke with two staff members who were able to describe how they assisted the service users access the information. Information in the AQAA ( Annual Quality Assurance Assessment) confirmed that transitions and admissions of service users are carefully planned by the staff team. Visits and overnight stays are arranged prior to admission and adapted service user information is made available to all those referred. The manager explained to us how Key staff are identified before admission to assist the transition process. We asked one person if he had met his key worker before he lived at the home, He confirmed that he had. One person told us, I didnt like it here at first but now I do. Another said, I chose this house and like it here. We looked at the care files for three service users and saw that they contained full and comprehensive assessments of need. We spoke with two service users who confirmed that the information was accurate and that they understood their plans. Two staff spoken with were able to confirm that understood each persons needs and how they were involved in the plan to meet them. In the AQAA it was stated that pre-admission assessments are carried out by Consultant Clinical Psychologists with full knowledge of care plans and risk assessments. Assessments are done in collaboration with service users, professionals, advocacy and family where suitable. When we asked how the service ensures that issues of equality and diversity are met we were told that, As a challenging behavior service we feel we very successfully promote social inclusion for people who have found this so difficult in the past that they have been placed in very restrictive environments previously. Our focus on social inclusion directly relates to the very philosophy of equality and diversity and underpins everything we strive to wards for our service users. We found many examples in this inspection where service users chose the care that would like to receive from the staff team. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from being able to to lead purposeful and fulfilling lives as independently as possible. They make their own informed decisions and have the right to take risks in their daily lives. The service users can be assured that their care plans include their aspiration and wishes and that they staff team will assist them to meet these. Evidence: Discussions with the manager and information in the AQAA explained to us how person centered outcomes for all the service users are arrived at. We saw that they are driven by government policy and by the service users goals, wishes and dreams for the future. From these outcomes, the staff team then create care plans in an accessible format for people so that they can fully understand them. They also include positive risk taking. The wishes and aspirations we saw on the care files were detailed and the three Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: service users that we spoke to were able to confirm that their aspirations were actioned by the staff team. For example, one person said that it was important to him that the staff respected his right to be a vegetarian and that he chose his own food. We saw on the inspection that this took place and when we asked staff about it they understood how important this was. Another person told us that they, Like to go swimming but they dont like it When there are lots of children in the pool. We saw that the staff listened to this person and take him swimming at times when there are adults in the pool. We saw risk assessments that supported the residents and the staff to assist people to lead a full life within the home and in the community. We looked at two peoples files in detail. We saw they have two files each.One is the data file and the other the current clinical file. We saw they contained person centred outcomes,careplans, risk assessments,contracts for self medication and saw that the house is run according to the service users needs and choices . For example, on the second day of inspection one person had their breakfast in the early afternoon. She said,Its alright when you have it as long as you have it. We noted that this person followed their own plan about how to start the day and when we spoke in the early afternoon she was well dressed in an outfit she said they had chosen. We noted that this information formed part of their care plan. One person told us it was important that they chose what information was written in the plan by the staff team and chose to have little written down. This person also chose not to have their photograph on the plan whilst others were happy to include one in the plan. This showed us that the staff team listen to peoples views and follow them. We looked at the staff rotas to see if there were enough staff on duty to ensure that the activities that people aspire to take place and we saw that there were. We also saw recording in the care files about the activities. As noted at the last inspection, the ethos at Victoria Court promotes service users taking decisions by supporting them with information to make an informed choice. Evidence of this was seen in the care plan for one person who is supported with making decisions about a specific need. This person is encouraged to take controlled risks and their are clear guidelines for staff about how they can support this person make positive choices and when their remit begins and ends if they choose less positive choices. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We saw that the work that is completed with this person is written in their files with a clear rationale. This plan of action is then evaluated for success and the control measures renegotiated to allow the service users to take more control. The manager explained how the staff team work within the mental capacity act and Deprivation of liberty safeguards. We saw an example of this. The care plans showed that this work took place. We saw that the care plans are accessible to the as it includes photos, pictures and is written in plain language. It is regularly updated and reviewed. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a strong commitment to enabling service users to develop their skills, including social, emotional, communication, and independent living skills. Service users can be assured that they will be I supported to identify their goals and work to achieve them. Evidence: We spoke with three service users about the activities they take part in to see if they felt they were doing enough. They were able to describe a wide range of activities that they were involved in. These included bowling,snooker, walk, shopping, acting and going to the cinema. Information in the AQAA explained to us what the staff team think about activities. It stated that . We promote independence through community inclusion and encourage Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: community skills on a daily basis. Community inclusion and participation however cannot be done without first enabling the person to have some control over their own behavior or for there to be a decrease in previously difficult behaviors that led to exclusion. They therefore work hard to minimize the behavioral difficulties of challenging behavior through good planning, communication, staff training, positive interventions, and good relational security. For one person we spoke to this meant that they stayed around the house and although they described themselves as bored we could see the work the staff had completed to engage this person. The ethos in the home is All service users are encouraged towards more independence and improvement of self esteem and confidence. Information in this document and discussions with the manager confirmed that, We promote independence through community inclusion and encourage community skills on a daily basis. Community inclusion and participation however cannot be done without first enabling the person to have some control over their own behavior or for there to be a decrease in previously difficult behaviors that led to exclusion. We therefore work hard to minimize the behavioral difficulties of challenging behavior through good planning, communication, staff training, positive interventions, and good relational security include voluntary jobs in the community. Activities for the service users include jobs in the community, one person took part in a community play and one person went to see Manchester United football club. We were told by the staff team that one of their wishes was too see this football match. We saw he asked for it to happen in his list of aspirations. We spoke to this person about this trip and he told us, It was fantastic. To assist service users move around the community they are given a free bus pass and free entry to the cinema. One person told us, I really like shopping. We saw that the staff encourage this person to make choices about buying relatively inexpensive items so she can save for outings as she has a limited income. This person said, I like going out with the staff. When we met with two staff members we asked if they felt they had time to do the activities with the residents and they confirmed that this was the case. One person said, I really enjoy doing them. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All the service users can be assured that they will be encouraged and supported by the staff team to manage their own health care. The service users are protected as there is an efficient medication policy, procedure and practice guidance. Evidence: Discussions with the staff team and service users and evidence in the health action plans seen at the inspection confirmed that the staff team both encourage and support people to manage their own health care. We saw that each person has not only a health action plan but also a traffic light form in case they require hospital admission. We spoke with staff members and saw the staff rotas which confirmed that there is a high staffing ratio to service users. This means that same gender staff can be chosen by people for personal and health care. We spoke to three service users who told us they could choose the staff member they wish to support them. This was recorded in their care plans. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: In the health action plan we saw that capacity assessments and risk assessments are carried out for all people about personal and health care support. Information in the AQAA stated that We provide psychological support to service users and specific interventions where necessary to support good mental health and positive behaviours. Each individual has a positive behaviour support plan. Each individual has an allocated keyworker team to facilitate consistency with health and health appointments. We read the health action plans and spoke with three residents whch confirmed this took place. As noted at the last inspection the home continues to benefit from the support of the local mental health and learning disabilities teams as well as the consultant psychiatrists who are accessed for expert advice. There is a unit dosage medication system in use at the home, the records and stock levels of medication were checked and found to be correct. There is a robust system in place for audit of medication. and training of staff.In the last twelve months they have improved their training for staff on medication awareness and administration. They have also decided to have two staff signing for medication. In order to ensure quality control the service has created a role of medication co-coordinator. We spoke to three service users about whether they felt their health needs were being met by the staff team and each was positive. We spoke to three staff members and looked at the medication training in the staff files which showed us that staff members have regular training in all aspects of health care. this includes specific training on neglect and self harm. Each service user has an annual medical and discussions with service users and evidence in their care documents showed us that the staff team assist people attend medicalappointments. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be confident that their views are listened to by the staff team. Service users are protected by sound safeguarding procedures. Evidence: Discussions with the staff team and the service users confirmed that service users are supplied with a complaints procedure that they can understand. It is in pictorial form and each of the three service users we spoke to understood the complaints procedure and had used it. The manager said that they audit the complaints to improve practice. We spoke with one person who had made a complaint to us and they felt that it had been dealt with appropriately. There is a rolling program of safeguarding training for staff and we spoke to two staff members who were able to describe the procedures. We saw comprehensive policies and procedures were in place . We spoke with three people about whether they felt safe in the house. they all confirmed that they did. One person said It sometimes kicks off in here but I feel safe. He went onto say that if there was a problem he felt confident that the staff would sort it out. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Discussions with the manager and information in the AQAA told us that We often have to process a vast number of complaints. This can sometimes be related to the clinical difficulties service users present with rather than the quality of the home. We feel that as a service we are able to strike the balance between acknowledging each complaint, empowering and validating the service user during this process while also recognizing that there may be some clinically relevant information to be gained from the complaint. There is a sound audit system in place which the service users to improve their service. We looked at the staff files and saw that safeguarding adults training has been provided for all the staff at the home. The recruitment process ensures the protection of the vulnerable adults at the home. There have been incidents that have occurred outside the home where it has been necessary to contact external agencies; these incidents are fully documented onservice users files. We looked at the recording in the complaints log and noted that complaints from service users are always recorded. At the last inspection it was noted that the records were incomplete with outcomes and actions not being properly logged. At this inspection we saw that this issue had been resolved. All the staff we spoke with understood what constitutes a restraint. They try to use alternatives to restraint when possible. Individual assessments are always completed which involve the individual where possible their representatives and any other professionals such as the care manager or GP. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users enjoy a comfortable environment which is well maintained by the staff team. Evidence: Victoria Court is a two-storey Victorian property that is set above the town of WestonSuper-Mare offering views across the seafront and bay. It offers homely accommodation for up to six residents. It has two comfortable lounges.One is used for quiet time. There is large dining room which is warm and inviting and a kitchen just off this room. One staff office is upstairs and the other next to the kitchen. This is a separate space with its own small corridor. We saw that all service users have their own en-suite bedrooms that they have personalised to their own tastes. One person has pets in his room which he looks after.Some service users have bells on their doors. We saw that there is a cleaning rota for the staff team and all service users are encouraged to get involved in this. Discussions with the manager and information in AQAA confirmed that there regular health and safety walk around are completed monthly and any health and safety Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: problems are identified and logged from this.All staff are trained on infection control and food hygiene. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users can be assured that the staff team are appropriately trained and supported to meet their needs. The service users are protected by sound recruitment practices. Evidence: We met with staff members to ask them what it was like to work for the management team and if they were supported and received regular training. One person was a shift leader and the other a relatively new staff member. The shift leader told us he was the physical response trainer and explained to us how he trains the staff to ensure the safety of the service users. The newest staff member said My induction was really helpful.They are absolutely superb to work for . The shift leader said,I get one hundred per cent support.I cant fault it. They both confirmed that they had training in safeguarding, health and safety, COSHH, manual handling and first aid. We saw evidence of this in the staff files. When we asked about the strongest feature of the home one person said,Good communication is very important.We hit massive goals for people . We looked at five staff files to make sure they contained the required information . We Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: saw that the home has a recruitment procedure for all new staff, which ensures that the interests of service users are safeguarded. We were able to have access to and read the personal staff files for five staff. There were no documents missing from the files and the home was able to demonstrate a clear pathway of staff recruitment, induction and training. We saw a detailed organisational structure that showed us how the operations manager and the clinical manager supervise the nine shift leaders who then supervise the support workers. We looked at the supervision records and saw that staff are regularly supervised and the records are person centered. The manager said,We value supervision as a vehicle to deliver care. The staff team complete the Skills for Care training for effective supervision. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from being supported by a manager is person centered in their approach and leads and supports a strong staff team who have been recruited and trained to a high standard. Evidence: The registered manager is a qualified Clinical Psychologist and Registered Nurse (General and Learning Disabilities) with many years experience of working in learning disability services and with safeguarding issues. He was able to demonstrate strong leadership and a commitment to ensuring that service users receive the best possible service. We discussed how the day to day running of the home was achieved, and the management structures in place. The manager told us that the management team consists of a finance manager, two Consultant Clinical Psychologists and a Senior Social Worker. There is also a trainee manager who we met at the inspection. We were told that once trained this manager will complete the day to day managerial tasks freeing the current manager to work at the two homes as a clinical psychologist. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: There are many ways that the staff team communicate with each other to ensure that they are working consistently to care for the service users. These include key worker meetings, handover meetings, service review meetings, staff meetings and shift leader meetings. One staff member said,the meetings ensure that I am up to date about the service users. The service is also involved in several other groups.These include the challenging behavior strategy group for developing good practice guidelines for the South West and a group focusing on personality disorder and learning disability. They are also involved in the steering group for challenging behavior in North Somerset and provide training for North Somerset. The regulation 37 notifications received by the Commission and follow up action to prevent any re occurrence demonstrate that the wellbeing of the people using the service is the priority for the service. The service has a detailed quality assurance system in place which includes service users views. They are encouraged to complete the View of the week which can be about any aspect of their care. The findings of the quality assurance are analysed to improve practice. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!