Care Home: Victoria House

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What the care home does well The needs of the ladies who live in the home have been properly assessed, and are clearly recorded. Any risks are also carefully assessed. The ladies all attend college several times each week and are given choices as to which courses they do. They are also involved in their local community, using local shops and other facilities, and go out regularly in the evenings to the theatre, a club, and for meals. They have a wide range of activities in the home, and these are added to regularly, as their interests change. The ladies have regular contact with their families, where they choose this, and relatives and friends are made welcome when they visit, and can talk in private. All the ladies said that they enjoy living in the home, and said that staff listen to them and act on what they say. They have all been told how to complain if they are not happy. The ladies` health is carefully monitored, and any health problems are quickly referred to the necessary health professional. The home is kept clean and tidy, and is comfortable and safe. All the ladies have their own rooms which they are encouraged to personalise to their taste. The ladies enjoy a good diet, with plenty of choice. They all said they like the food, and get plenty to eat. Staff are well qualified and well trained, and have positive relationships with the ladies who live in the home. The home is well managed. What has improved since the last inspection? The home has a simpler and clearer system for reporting any `Safeguarding` issues. The recording of medications has improved, with staff now following the home`s medications policy more thoroughly. The ladies` range of choices continues to improve, and they are becoming increasingly independent. Staff have been given better training and guidance on how to deal with `challenging behaviours`, and are showing increasing skills in positively managing difficult situations. What the care home could do better: Although the daily records show that staff are sensitive and flexible to the needs of the the ladies, the care plans are still rigid and confrontational. Care plans also need to bemore measurable and to be evaluated more openly and sensitively. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria House 10 & 11 Victoria Terrace Bedlington Northumberland NE22 5QA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Baxter     Date: 0 8 0 6 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Victoria House 10 & 11 Victoria Terrace Bedlington Northumberland NE22 5QA 01670828396 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr F Haley,Mrs R Haley care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 A maximum of 1 place can be used to accommodate a named service user who has a mental disorder (excluding learning disability or dementia). Date of last inspection Brief description of the care home Victoria House was originally two terraced houses and work had been carried out to form one well-equipped house that can provide accommodation for up to six people. A conservatory has recently been built at the rear of the building. At the time of the inspection the Home accommodated five adults with learning disabilities. The accommodation was domestic in nature and was comfortably furnished and appointed. There is a small garden area/patio area to the rear of the property. Victoria House is situated within walking distance of Bedlington town centre and is therefore close to a range of local amenities. The fees charged are £456.43 per week. Information about the home, including inspection reports, is available on request. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during this inspection. The quality rating for this service is 2 star. This means that people using this service experience good quality outcomes. Before the visit we looked at information we have received since the last inspection on the 9th and 13th June 2008. We looked at how the service has handled any complaints or concerns since the last visit, and whether there have been any changes to how the service is run. We looked at the providers view of how well they care for people, and also the views of people who use the service, their care managers and the staff. Care Homes for Adults (18-65 years) Page 5 of 29 An unannounced visit was made to the service on 8th June 2009. This visit took eight hours in total. During the visit we talked with the ladies who live in the home, the staff and the proprietors. We looked at information about the people who use the service and how well their needs are met. We looked at other information that that must be kept. We checked that the staff have the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was safe, clean and comfortable. We checked what improvements have been made since the last inspection. We told the proprietors what we found. What the care home does well: What has improved since the last inspection? What they could do better: Although the daily records show that staff are sensitive and flexible to the needs of the the ladies, the care plans are still rigid and confrontational. Care plans also need to be Care Homes for Adults (18-65 years) Page 7 of 29 more measurable and to be evaluated more openly and sensitively. 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 8 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of all the ladies living in the home have been assessed, but these assessments are not always being kept up to date. Evidence: No new admissions have taken place in the past year. The registered manager is considering an application for admission of a new person, and has received an assessment from the referring social worker. The manager confirmed that she will carry out her own assessment of whether or not the home can meet all of this persons needs. As part of this process, the potential new service user is having some visits to spend time with the ladies who already live there. This is so that the dynamics can be assessed, and the views of the other ladies can be considered. In surveys, all four ladies who responded said that they were asked if they wanted to move into the home; and both staff who responded said that they are given up to date information about the needs of the ladies living there. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: At the last inspection, it was recommended that all assessments are evaluated at least every six months, and updated where necessary. Some assessments have been evaluated; some appeared not to have been. Where evaluations had taken place, they had not been done in a particularly thoughtful or sensitive manner. Indeed, some were quite judgemental of the service users in question, who appeared to be being blamed for the lack of success of some care plans. Care Homes for Adults (18-65 years) Page 11 of 29 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. Although care plans still need to be further developed, the ladies who live in the home have been given more space to make decisions for themselves, and are participating more in the running of the home and in the local community. Evidence: Care plans are in place for each lady, and cover all the significant areas of need identified in assessments. Since the last inspection, there has been progress in making the expected outcomes of the care plans a bit clearer, but they are still often not framed in a way that makes them easy to measure. An example was a care plan that aimed to reduce incidents of challenging behaviours that did not set a base line at the begining, nor a target to be achieved, nor record how many incidents had taken place, when the care plan was evaluated. The home was also asked to make its evaluations of its care plans more robust, and to change or improve the care plan, where the goals wasnt being met. However, Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: evaluations had not been done in a particularly thoughtful or sensitive manner. Indeed, some were quite judgemental of the service users in question, and appeared to direct blame for the lack of success of some care plans at the service user, rather than professionally re-assess whether the care plan itself was at fault or required improvement. Currently, the space for evaluation is shared with that for recording assessed needs and staff actions. This leads to confusion, and the three elements should be seperated. The need for the care plans to be used on a daily basis by staff was also highlighted in the last inspection report, with the advice that care plans should be the focus for daily recordings. This has not been fully put into practice, as the care plans still seem to be formal documents held apart from the daily recordings in the home. Improvements have been made in the quality of the daily recordings, which are now much more focussed on the identified needs of the ladies in the home, and are relevant and professional. They are also very positive, showing respect and sensitivity to the ladies and their wishes and needs. There has also been some improvement in the guidance given to staff in the care plans regarding challenging behaviours which, although still lacking detailed guidance, is much more professional in content and tone. There has certainly been a noticeable decrease in such behaviours, according to the care records, and there was a very positive atmosphere in the home, with the ladies seeming happy and relaxed, and expressing themselves confidently. The different component parts of the care plan (assessed need; goal or target; staff actions; and evaluation) should be separated out, to make care plans clearer and more easily evaluated. Discussions with manager, staff and the ladies who live in the home are increasingly being involved in making decisions about their lives and their activities. They are also taking an even more active part in the community. Examples include one resident who has increased her number of days at her voluntary work placement, and who is also considering starting a National Vocational Qualification (NVQ) level 2 in commerce. Two ladies are now traveling further afield, together on public transport. Another lady has chosen to spend slightly less time with her family, and to enjoy more independent activities. She also now has more confidence to express her views without family advocacy. One lady has joined a rambling club, which has improved her confidence and social skills. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: All the ladies are taking more responsibility for food preparation and cooking. All voted in recent elections. There are monthly meetings where the views and wishes of the ladies are asked for and recorded. They have a good degree of choice about activities, and recent choices have included trips to cinemas, the theatre, shopping trips, walks on the beach, and meals out. In a survey, all four ladies who responded said that they always make decisions about what they want to do each day. Appropriate risk assessments are in place, but these need to be re-assessed at the same time as each ladys care plans. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ladies have an enjoyable and stimulating lifestyle that reflects their wishes and needs, and enables them to take a full part in their local community. Evidence: One staff member commented, We encourage the clients to participate in as many life skills as their abilities allow. This includes accessing educational facilities, work placements, day services and social activities. This was confirmed by the ladies in conversation, and by the care records. One lady has a work placement, recently increased from one to two days each week at her request. This lady now travels independently to her work place, and this has increased her self esteem and social skills. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: All the ladies access Ashington College two or three times per a week and enjoy and benefit from a wide range of courses. These include drama, local history, citizenship, employment skills, I.T. skills, healthy living, and literacy and numeracy skills. They have choice as to which courses they go on, and were keen to tell the inspector their most recent choices. Other activities that the ladies enjoy include keep fit and excercise classes, shopping, and meals out (at least monthly). The ladies are taken to see shows at local theatres at least nine times a year, and also enjoy trips to cinemas and bowling alleys. In the home, there is a good range of activities for the ladies to enjoy, including the latest interactive technology Wiigames, arts and crafts, computer games, cards , dominos and board games, a sewing machine, bingo and jigsaws. The favourite activity at this inspection was the air hockey table, at which the ladies were able to show very good skills and seriously competitive spirits. The ladies are very much part of their local community, and they all make regular use of shops, library, post office, cafes, pubs and bank. Three of the ladies have their own bank cards. All four ladies who returned surveys said that they can choose what they want to do during the day, in the evenings and at weekends. One commented, The staff look after us and take us out to lots of places. Three of the ladies have support and contact with their families. They decide themselves what level of contact they have. Staff support them to keep these links, where approapriate, and will for example provide transport, and write letters as dictated by the ladies. The daily routines in the home now seem to promote their independence, freedom of choice and freedom of movement, and have become more relaxed over the past few years. Strict adherence to set bedtimes, for example, has given way to the ladies making their own decisions about when to retire, and some now choose to watch television when in bed. The ladies are encouraged to take responsibility for helping with the normal daily tasks involved in running a home. Each enters into clear, written agreement with the staff about what she will do. Examples include doing laundry, cleaning surfaces, food preparation, dish washing, vacuuming and dusting. The form used to record these agreements also stresses that these chores are not compulsory, and the individual may choose to opt out. Staff reported that the ladies normally join in with good grace Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: and enjoy helping out. Daily records also show that the ladies have choice as to their meals. All are involved in drawing up the three-week menu that the home uses to ensure variety. There is a choice of meals, plus alternatives, if wanted. Fruit is available at all times, and fruit smoothies are very popular at the moment. There is a cooked breakfast available, several times each week. No specific nutritional assessments are used at the moment, as there are no particular issues with food with the current resident group, all of whom enjoy their meals. A meal was taken with the ladies, with their agreement. It consisted of chicken or lasagne, plus a good range of salads, side dishes and sauces. This was followed by steamed pudding and custard or strawberries with cream (and with evaporated milk or custard, to meet the requests of individuals). The meal was well cooked and presented, and was enjoyed by all. Hot and cold drinks were available throughout the meal. The ladies all said that they enjoy their meals and that they get plenty to eat. Care Homes for Adults (18-65 years) Page 17 of 29 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. The ladies receive good individualised personal support and appropriate healthcare. Evidence: The ladies are encouraged and supported to do as much as possible for themselves. Care records confirm this and show a welcome emphasis on what the ladies can do. Records are also sensitive to the ladies personal histories and the emotional aspects of their lives. The ladies privacy and dignity are respected and protected. Clear and detailed instructions to staff as to how the ladies personal care needs are to be met are given in the care plans (but the instructions in the daily record, which is the guidance most frequently consulted by staff are less detailed). All staff have had training on Challenging Aspects within Mental Health. Team minutes show appropriate instructions to staff regarding incidents of challenging behaviour, with an emphasis on the need for amicable resolution, rather than punitive isolation. No formal re-assessment of health needs takes place, other than at the care plan evaluation stage, but staff know their residents very well, and examples were given Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: regarding staff having the skills, knowledge and experience to pick up subtle changes in individual ladies body language, clothing, facial expressions and social interactions that may be significant, and responding to such cues appropriately. Care plans in place to address the possibility of self-harm or challenging behaviours showed that staff have awareness of the appropriate responses to such behaviours, and showed awareness of previous professional advice. Records are kept of all visits to or from health professionals, including doctors, dentists, chiropodists, and opticians. Regular check ups are arranged, and feedback is recorded. The former care manager for three of the ladies said that he was very pleased with the support his clients get from the home, and felt that they receive very individualised care. He said he was always kept informed with significant issues, could always speak confidentially with the ladies, and had never had any concerns about the home. None of the ladies currently takes responsibility for her own medicines, and all have signed forms asking for staff assistance in this area. All staff have been given training in the safe handling of medicines. Staff complete a Medication Administration Record (MAR) for each lady. This is being done more thoroughly than at the last inspection, and no gaps were found. Handwritten entries are signed by the staff member (these entries should also always be dated). There is a photo of each lady on her section of the MAR to avoid the chance of giving medicine to the wrong person. Care Homes for Adults (18-65 years) Page 19 of 29 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. The ladies who live in the home have their views listened to and acted upon, and are protected from abuse. Evidence: The home has an appropriate complaints policy, and there was evidence in the house meeting records that the ladies are reminded of the policy on a regular basis. They are asked at each meeting if anyone has any complaints, and anything raised is welladdressed, even if its not strictly an issue about Victoria House. In surveys, all the ladies and both staff who responded said that they know what to do and who to speak to if they have any concerns. One complaint, only, has been recorded in the past year. This was a disagreement between two of the ladies. Staff intervened appropriately, and the matter was resolved. All staff have received Safeguarding training (formerly known as the protection of vulnerable adults, or POVA, training). A new plan is in place for reporting any allegations or suspicions of abuse. This is clear and simple. No such reporting has been necessary in the past year. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: All four ladies who returned surveys said that treat them well, and always listen to them and act on what they say. Care Homes for Adults (18-65 years) Page 21 of 29 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 ladies who live in the home are provided with a comfortable, clean and safe environment. Evidence: The building was partly toured. All areas seen were clean and hygienic, and no obvious safety hazards were noted. The home is well decorated and furnished, and provides a comfortable environment for the ladies who live there. Some of the ladies kindly allowed the inspector to see their rooms, and all of those seen were highly individualised by the ladies, who had their rooms just as they wanted them. Care Homes for Adults (18-65 years) Page 22 of 29 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. There are sufficient numbers of well qualified and well trained staff to meet the needs of the ladies who live in the home. Evidence: All staff hold an appropriate qualification. Both Proprietors hold the Registered Manager Award, and National Vocational Qualifications (NVQ) to level 4. All care staff hold NVQ level 2 in care. Two care staff also hold NVQ level 3; two others are studying for this level; and one hopes to start NVQ level 4. In addition, three staff hold the learning disability-specific training award known as LDAF, and two others are hoping to start this course. No new staff have been employed since the last inspection, but at that time (June 2008) the evidence showed that the homes recruitment and selection practices were robust and provided good protection to the people who live in the home. In surveys, staff said their employed had carried out the full range of proper checks when they were appointed. Both staff who responded also said that there are enough Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: staff to meet the needs of the ladies who live in the home. Training records showed that all staff have had the training which they are required to have by legislation (mandatory training). In addition, staff have also had training regarding their responsibilities under the Mental Capacity Act, and training in epilepsy awareness, equality and diversity, Challenging Aspects within Mental Health, and Deescalation techniques. The benefits of the training received are shown in the significant reduction in challenging behaviours seen from the ladies over the past couple of years, and in the skills currently being used by staff to defuse difficult situations in positive ways. Staff confirmed that their induction training covered everything they needed to know. All staff receive supervision at the recommended frequency of every two months, and this is recorded in good detail. Staff also receive annual appraisal of their work. This includes identifying individual training needs, and checking knowledge of key policies such as the whistle-blowing (exposing bad practice) policy. Both staff who returned surveys said that they get regular support from their manager. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ladies who live in Victoria House benefit from a safe, well maintained and well run home, in which their views are asked for and listened to. Evidence: The joint proprietors, Mr and Mrs Haley (who is also the registered manager) are appropriately qualified. There are systems in place for finding out the views of the ladies who live in the home, their relatives and involved professionals, the main one of which is an annual survey of views. The most recent survey had been sent out, but had yet to be returned. Previous inspections have shown that such surveys are carefully collated and considered, and that they are acted upon. Other methods of quality assurance include staff meetings and house meetings. Staff meetings are held every two months. The minutes showed a good quality of discussion of the needs of the ladies, and showed a flexible and sensitive approach by the staff. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: House meeting minutes also showed a good, positive and responsive approach by staff, and demonstrated that the ladies are fully consulted, and that their views are listened to and acted upon. In surveys, one lady commented, Everythings fine here; another said, Everythings great. The staff help me have a good life. The health, safety and welfare of the ladies who live in the home are taken seriously and systems are in place to keep them safe. The accident book showed a low number of accidents, mainly falls by one lady with a balance problem. The fire log book showed that all the necessary checks and tests of fire safety systems and equipment take place at the required intervals, and that in-house fire training is given to staff every three months. Staff have been given training in moving & handling, first aid, food hygiene, and infection control, as well as in health & safety. Maintenance and servicing documentation was up to date, and risk assessments are in place. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 Each persons needs should be re-assessed at least every six months, to make sure that the home is still meeting those needs, or if new needs can be identified. The registered manager should access training in the principles and practice of care planning. The different component parts of the care plan (assessed need; goal or target; staff actions; and evaluation) should be separated out, to make care plans clearer and more easily evaluated. All risk assessments should be regularly re-evaluated. 2 3 6 6 4 9 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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