Care Home: Westwood Avenue, 20

Similar services:

• Ashlong House
• Norbury Crescent (30)
• Edenvale
• Wadham Avenue
• Chatsworth Care - Dawson House
• Cowden Road, 52 - 54
• Chatsworth Care - Tudor Lodge
• Foxley Lane (121a)

What the care home does well `I visited the home several times before I moved in. This gave me a chance to meet everybody`. Comment from a resident`s survey. `I talk to the staff about what I want to do every morning. Some things I do by myself and staff help me with other things`. Comment from a resident. `The staff all try to work out why, if I`m unhappy. They all try to make things right`. Comment from a resident`s survey. `The on going training and support for the clients and the staff in my opinion is the best I have had in the years I have been working in social care`. Comment from a staff survey. `Support is always available from the manager and management. If needs be I can always approach my manager for advice, so I feel at ease`. Comment from a staff survey. During these visits we found that managers and staff working in the home supported residents to make positive choices about their daily lives. Residents were involved as much as possible in planning and directing the care and support they received. Staff made sure that each resident took part regularly in activities they chose. The home also provided good standards of accommodation. Residents` bedrooms were bright, spacious and very individual. What has improved since the last inspection? When we last visited the home we made six requirements to improve the management of complaints and safeguarding adults issues. During this inspection we found that all six requirements had been met. The manager tells us about significant incidents affecting residents, staff have received safeguarding adults training and fire safety arrangements in the home have been agreed with the Fire Service. What the care home could do better: Following this visit we have asked the provider to review the shifts worked by staff to make sure that they have sufficient breaks to enable them to support and care effectively for residents at all times. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Westwood Avenue, 20 Westwood Avenue, 20 South Harrow Middlesex HA2 8NS     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: Tony Lawrence     Date: 1 8 0 5 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: Westwood Avenue, 20 Westwood Avenue, 20 South Harrow Middlesex HA2 8NS 02084224176 02084224176 monpeksoncare@aol.com 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) : Monpekson Care Limited care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users who can be accommodated is: 3 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 20 Westwood Avenue is a registered care home providing care and accommodation for 3 people with learning disabilities. When we visited, two men were living in the home and there was one vacancy. The home is owned by Monpekson Care Limited and was opened in 2000. The home is located in South Harrow and is a three bedroom semidetached house, in a quiet residential street. The home is located within a few minutes walk from a variety of shops, pubs, cafes, post office, local bus and train services and other amenities and facilities. All the bedrooms are single. One bedroom is on the ground floor, and two bedrooms are located on the first floor. There are bathing and toilet facilities on both the ground and first floor. There is accessible street parking and limited off street parking. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The home has an enclosed, accessible garden. Details of the fees charged for the service may be obtained, on request, from the provider. Care Homes for Adults (18-65 years) Page 5 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 unannounced key inspection of the home took place on Thursday 14th May 2009 from 09:00 - 10:30 and Monday 18th May 2009 from 09:15 - 14:30. During these visits we reviewed the outcomes for people living in the home against the National Minimum Standards for Care Homes for Adults. We did this by talking to residents, staff, the manager and proprietor and checking care records kept in the home. Two residents and three staff working in the home sent us confidential surveys and we have used their comments in this report. The manager also sent us the homes Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on outcomes for people living in the home and we have also used this information in our report. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. It has developed clear information to help people understand what services the home can provide. Evidence: All the documents mentioned, contracts, service user guide, statement of purpose, have been reviewed and updated, made user friendly and accessible to all who use the service. The home has available to each service user the GSCC Protection of Vulnerable Adults information in symbol format. Extract from the providers Annual Quality Assurance Assessment (AQAA). We talk about who we would like to come and live here. Comment from a resident. I visited the home several times before I moved in. This gave me a chance to meet everybody. Comment from a residents survey. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: When we visited the home, there were two people living there. There was one vacancy following the sudden death of a resident in November 2008. The manager told us that she had started to talk to local authorities about referrals, but no potential new residents had yet visited the home. The manager also confirmed that the home had procedures to make sure that people were supported to make a positive choice to move into the home. The procedures included an assessment of the persons care needs using a new form developed by the home, a series of visits to meet other residents and staff and overnight stays. One resident told us that they had talked to staff about people who might move into the home at a recent residents meeting. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home involves people in planning the care and support that affects their lifestyle and quality of life. Staff understand the importance of people being supported to take control of their own lives. People are supported to make their own choices and decisions. Evidence: We provide each service user with a person centred approach to their individual needs. Each month the service users meet with the staff team and voice their likes, dislikes, wishes and decisions. Extract from the providers Annual Quality Assurance Assessment (AQAA). I talk to (my key worker) about my plan and he makes sure I do what I want to do. Comment from a resident. We meet with the staff and talk about what we want to do, where we want to go and Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: what we want to eat. Comment from a resident. I find it hard to choose and make decisions but the staff all help me by showing me pictures and talking to me. They listen and try very hard to work out what I want. Comment from a residents survey. During this inspection we reviewed the homes care planning for both of the people living there. Both of the care plans we saw were very person centred and concentrated on maximising each persons independence. We saw that one person had been fully involved in planning the care and support he received and he told us that this had been very important to him. We also saw that staff had worked well with the second person and their representatives to make sure that their views were reflected fully in the care plan. Both of the care plans had been produced using pictures to make the information easier for residents to understand. The care plans that we saw were reviewed regularly, involving the residents and people important to them. One resident told us that they met regularly with staff to talk about the day to day running of the home. We saw a record of these meetings and this showed us that people living in the home were regularly consulted and supported to make decisions about their lives. Both of the care plan files we saw included risk assessments that had been completed by staff and reviewed regularly. These assessments clearly identified possible risks for each person and included clear guidelines for staff on how these should be managed. Care Homes for Adults (18-65 years) Page 13 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 home has a strong commitment to enabling residents to develop and maintain their skills, including social, emotional, communication and independent living skills. People are supported to identify their goals and work to achieve them. Evidence: There are charts for daily activities that suit each of the service users according to the things they prefer and what assists and enables them to participate in society in a meaningful manner. Extract from the providers Annual Quality Assurance Assessment (AQAA). I talk to the staff about what I want to do every morning. Some things I do by myself and staff help me with other things. Comment from a resident. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Sometimes they arrange activities at the weekend for the service users. Comment from a residents survey. I am very happy in my home. I have a very full life doing things which I enjoy. I do many things which I had not done before coming here. I am still learning new skills like cooking. I enjoy art sessions, trips to the cinema / theatre, discos, social clubs and outings to interesting places especially when they include meals out. I have had fantastic holidays due to the determination of managers to uphold my rights to access the outside world. Extract from a residents survey. The home provides the quality service that meets individual needs and works in partnership with family and friends. Comment from a staff survey. During this visit we checked the care plan files and daily care notes kept by staff. We saw from the care plans that people living in the home were asked regularly about their interests and activities they wanted to take part in. The daily care notes showed us that both people took part in activities outside the home each day. One person went to some community activities independently, while the second person needed staff support for all activities outside the home. When we arrived at the home on 14th May, staff were preparing to take both residents to the cinema, so we returned on 18th May to complete this inspection. On 18th May, one person living in the home went out independently, returning later in the day for a head massage provided by a sessional worker who visited the home. This person also worked with the second person living in the home, supporting him with an art session and then preparing his lunch. The daily care notes also showed us that people living in the home took part in a range of appropriate activities, including adult college classes, shopping, the cinema and trips to local parks. The two care plans we saw included the contact details of both residents family, friends and other significant people. The daily care notes also showed us that staff supported people to keep in touch with these people. The homes manager told us in the AQAA that both people living in the home were included on the electoral register and were supported to vote in local and general elections. The daily care notes also showed us that staff supported each of the people living in the home to choose and prepare the food they wanted at each meal time. We saw that staff were able to provide individual meals to each person, according to their likes and preferences. The daily care notes showed us that each person had a varied and nutritious diet. Staff kept a regular record of each persons weight and this showed us that there was no significant weight loss or gain. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Care Homes for Adults (18-65 years) Page 16 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. People receive personal and health care support using a person centred approach, with support provided based on the rights of dignity, equality, fairness, autonomy and respect. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Evidence: The principles of care are promoted by all members of staff who are trained to ensure that each service user, based on their individuality, is treated with dignity, diversity, respect and privacy. Health care plans have been devised to look at each service users individual health needs. Extract from the providers Annual Quality Assurance Assessment (AQAA). I can see the doctor when I need to and Ive been to the optician and the dentist. Comment from a resident. During this visit we checked the personal and health care plans for both people living in the home. Both of the care plans showed us that staff talked to residents about how Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: they preferred to be supported with their personal care and the routines in the home reflected this. We saw that the care and support provided to people was very individual and staff knew each persons needs and routines well. Both of the care plans we saw had been reviewed and updated in January 2009. We saw that the residents and other significant people had been involved in the reviews. The care plan files also included a Health Action Plan (HAP) that detailed each residents health care needs and how these would be met in the home. We saw that one plan had been reviewed and updated in August 2008 and the other in November 2008. Staff kept a record of each persons medical appointments and any actions needed following each visit. We saw that the home used a Monitored Dosage System (MDS) for each residents prescribed medication. The MDS was provided by a local pharmacist. We saw that all medication was securely stored in the home and there was good recording of the receipt, administration and disposal of all prescribed medication. We saw evidence that all staff working in the home had completed medication training in September 2008 and the pharmacist completed a medication audit in November 2008. Care Homes for Adults (18-65 years) Page 18 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 home has a complaints procedure that is clearly written and easy to understand. The home keeps a full record of complaints and tis includes details of the investigation and any actions taken. The policies and procedures for safeguarding adults are available and staff know when incidents need external input and who to report the incident to. Evidence: The home has an open door policy in regard to complaints, protection, concerns and compliments. We encourage all involved with the service offered to feel free to express their concerns, likes, dislikes in the way the home is run or the services that are provided. Extract from the providers Annual Quality Assurance Assessment (AQAA). If I was worried, Id talk to (my key worker) or the manager and they would sort it out for me. Comment from a resident. The staff all try to work out why, if Im unhappy. They all try to make things right. Comment from a residents survey. My mother would always make complaints on my behalf. Comment from a residents survey. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: When we last inspected the home we asked the provider to improve the recording of complaints, make sure staff followed the local safeguarding adults procedures consistently, review the use of residents personal money and tell us about significant incidents that affected people living in the home. During this visit we found that all of these 4 requirements had been met. The manager told us that residents money was no longer used to pay for items that should be provided by the home and that three staff working in the home had completed safeguarding adults training. The fourth person working in the home was booked to take part in safeguarding training provided by the local authority. We saw during this visit that staff had a copy of the local authoritys safeguarding adults policy and procedures. We also saw that the recording of formal complaints had improved and the manager audited the record of complaints regularly. The homes complaints procedure was displayed in the front hall, in a format that used pictures to make the information easier for some residents to understand. The provider had also made sure that we were told of significant incidents that affected people living in the home. We judged that the provider was informing other relevant agencies and managing incidents well, to make sure that people living in the home were cared for safely. Care Homes for Adults (18-65 years) Page 20 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 home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a very pleasant, safe place to live. Evidence: The home is person centred to each individual who lives in the home. They have the freedom to personalise their rooms and make choices about the colour schemes. Each service user has on the wall the things that they find interesting and like the most. Extract from the providers Annual Quality Assurance Assessment (AQAA). I like my room, Ive got all my things here. Comment from a resident. 20 Westwood Avenue is a registered care home providing care and accommodation for 3 people with learning disabilities. The home is owned by Monpekson Care Limited and was opened in 2000. The home is located in South Harrow and is a three bedroom semi-detached house, in a quiet residential street. The home is located within a few minutes walk from a variety of shops, pubs, cafes, post office, local bus and train services and other amenities and facilities. All the bedrooms are single. One bedroom is on the ground floor, and two bedrooms are located on the first floor. There are bathing and toilet facilities on both the ground and first floor. There is accessible street Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: parking and limited off street parking. The home has an enclosed, accessible garden. When we last visited the home we asked the provider to make sure that the fire safety arrangements were agreed with the fire service and a lock was provided on the first floor toilet door. During this visit we saw that the homes fire safety risk assessment had been reviewed and updated, recommendations made following a visit by the Fire Officer had been implemented and a lock had been fitted to the toilet door. We found that the home provides a very good standard of private and shared accommodation. Bedrooms are very individual, spacious, bright and well decorated. All parts of the home we saw during this visit were clean and hygienic. 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. People living in the home have confidence in the staff who care for them. Staff members undertake external qualifications beyond the basic requirements. Managers encourage and enable this and recognise the benefits of a skilled, trained workforce. Staff meetings take place regularly and supervision sessions are regular. Evidence: Staff turnover is stable, this gives the service users consistency and the ability to form sound working relationships with those who provide them with care services. The shifts meet the needs of the service users and staff members. All staff have their references and CRB checks in place on their files. There is a policy in the home for probation and a clear focus on the competency of staff according to the Skills for Care knowledge set. Extract from the providers Annual Quality Assurance Assessment (AQAA). The staff are all good, they help me to do the things I want to do. Comment from a resident. The on going training and support for the clients and the staff in my opinion is the best I have had in the years I have been working in social care. Comment from a staff survey. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: During this visit we spoke with residents and staff and checked staffing records kept in the home. When we arrived, one member of staff was on duty, supporting two residents. As the residents had planned to go out for the day, we agreed to return at a later date. On our second visit we were able to meet with the homes Manager and one of the proprietors. We checked the staff rota for May 2009, as well as the personnel files for 2 staff working in the home, staff meeting records and staff training and supervisions records. We found that one member of the care staff team regularly worked long shifts, as well as sleeping in and being responsible for the welfare of people living in the home at night. We have asked the proprietor to review the shifts worked by staff in the home, to make sure that staff are able to work efficiently and effectively at all times. The proprietor must also make sure that staff are given sufficient breaks during long shifts. We saw that staff meetings were held every two weeks, giving staff and managers the opportunity to review the day to day running of the home and the welfare of people living there. The meetings were well recorded and we saw that the manager made sure actions agreed at the meetings were followed up. Staff training records showed us that a training needs analysis had been completed for each person, identifying the training they needed to complete to do their jobs effectively. The Manager told us that all of the staff had completed their National Vocational Qualification (NVQ) Level 2 training and 2 staff had recently started their Level 3 NVQ training. We saw from staff supervisions records that the manager met regularly with each person working in the home and staff told us that they found this support helpful. The staff personnel files we reviewed were all up to date and we saw clear evidence that all of the necessary pre-employment checks had been completed for each member of staff. 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 manager has the required qualifications and experience and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service and works to continuously improve the service. There is a focus on personcentred thinking, with residents shaping service delivery. Evidence: Staff training has developed over the past year. There has been a rise in NVQ qualified staff and this has improved staff knowledge and practice. Extract from the providers Annual Quality Assurance Assessment (AQAA). We meet with the staff and talk about what we want to do. Comment from a resident. Support is always available from the manager and management. If needs be I can always approach my manager for advice, so I feel at ease. Comment from a staff survey. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The homes manager told us she had completed the National Vocational Qualification (NVQ) Level 4 Registered Managers Award and her NVQ Level 4 in health and social care. We have registered the manager as a fit person to manage a care home for people with a learning disability. The manager demonstrated a good knowledge of current best practice and an awareness of recent changes in legislation, including the Mental Capacity Act. The manager sent us the homes Annual Quality Assurance Assessment (AQAA) when we asked for it in March 2009. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The AQAA was clear and gave us all the information we asked for. The manager told us that the providers quality assurance systems included monthly house meetings with all the residents, an annual survey that was sent to residents, their relatives and professionals involved in their care. The manager told us the survey results were used to produce an annual development plan for the home. We saw that staff had access to all of the policies and procedures they needed and the manager told us these were being reviewed and updated. During this visit we checked a selection of records kept in the home, including residents care plans, daily care notes, medication, health and safety and staff records. Standards of record keeping in the home were good. All of the records we checked were up to date and well completed, providing good evidence of the care and support given to people living in the home. The health and safety records we checked showed us that all of the necessary checks and tests were completed regularly by staff and managers. The manager confirmed that 2 recommendations made by the Fire Service in July 2008 had been met immediately by the provider. Fire equipment in the home was serviced in May 2009 and we saw current gas and electric safety certificates. We also saw that a representative of the provider carried out monthly monitoring visits to the home. A written report was sent to the home after each visit and the manager confirmed that any issues were dealt with after each visit. 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 1 33 18 The provider must review the shifts worked by staff in the home . This will help to make sure that staff are able to work effectively at all times. 31/07/2009 2 33 18 The provider must make sure that staff have sufficient breaks during long shifts. This will help to make sure that staff are able to work effectively at all times. 31/07/2009 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 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. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!