Care Home: Wheatlands - Baschurch

What the care home does well The three people currently living at Wheatlands have settled into their new home well. They were supported to visit to home during the build and were provided with lots of information about the service so that they were certain this was the right home for them. One person told us `I like living here and I like visiting my friends`. People receive a good standard of care and are encouraged to lead an active and fulfilling lifestyle. Staff ensure that they plan each person`s care with their needs, preferences, choices and goals in mind. The home is welcoming, tastefully decorated, well equipped and is a comfortable and homely place to live, ensuring individuals feel safe and secure. People are supported by trained and experienced staff who have the skills and knowledge to meet their individual needs. People can be confident that their health needs are closely monitored and kept under review. This ensures their health and wellbeing is promoted. Individuals are encouraged to develop their life skills by assisting with household tasks such as shopping, cooking and cleaning. This helps to promote their independence. People are encouraged and supported to maintain relationships that are important to them. People told us the home does the following well: `Staff help me be more independent and support me to cook the tea` `I love working here` `There seems a varied choice of things to do` `I like my bedroom. I have a DVD and DS. They help me with makaton` `The Wheatlands allows the residents to live a happy and healthy lifestyle...the home has a lovely atmosphere and is in a great rural location. The manager has always given me a high level of support and works to high standards` `Looks after all the needs and welfare of the students who live here` What has improved since the last inspection? This is the first inspection of the home since it was registered in October 2009. What the care home could do better: As this is the first key inspection following registration an overall rating of "excellent" cannot be given as it is considered that the service needs to demonstrate a sustained level of performance over a period of time. However we are confident that the service currently provides positive outcomes for the individuals who live at The Wheatlands, therefore no requirements have been made for improvement. People told us the service could improve by: `I would like a television and some music` `Improvements in staffing` All support plans could be written as if the individual is telling others about themselves. This would make them more personal to the individuals. The shared areas of the home could be further developed to ensure they reflect people`s culture, religion and ethnicity. Key inspection report Care homes for adults (18-65 years) Name: Address: Wheatlands - Baschurch 77 The Wheatlands Baschurch Shrewsbury Shropshire SY4 2DW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Becky Harrison     Date: 0 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Wheatlands - Baschurch 77 The Wheatlands Baschurch Shrewsbury Shropshire SY4 2DW 01743872250 01743874815 condover@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Condover College Ltd Name of registered manager (if applicable) Ms Sandra Julie Crump Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 3. The registered person may provide the following categories of service only: Care Home only (Code PC). To service users of the following gender: Both. Whose primary care needs on admission to the home are within the following categories: Learning Disability (Code LD Max 3 persons). Physical Disability (Code PD Max 3 persons). Sensory Impairment (Code SI Max 3 persons). Date of last inspection Brief description of the care home Wheatlands is registered with the Care Quality Commission as a care home currently providing personal care and accommodation for three adults with a learning disability, physical disability and sensory impairment. The registered provider is Condover Care Homes for Adults (18-65 years) Page 4 of 29 3 3 3 Over 65 0 0 0 Brief description of the care home College Ltd who also operate another three local care homes. The property was formerly a childrens home and extensive renovation and refurbishment has been carried out to provide Phase 1 of the development and it is envisaged Phase 2 will be completed shortly providing a total of 9 places, subject to registration. The home is within walking distance of local shops and facilities available in Baschurch and just a short distance from Telford and Shrewsbury Town Centres. People are provided with their own bedroom with en-suite facilities to include a wash hand basin, toilet and shower. Shared areas include a lounge and domestic style kitchen/diner. The garden area is enclosed and will eventually be landscaped once Phase 2 has been completed. Some car parking space is currently provided however this will be extended when Phase 2 is completed. People are able to gain information about the service from the Statement of Purpose. Fees charged were not available in the service user guide at the time of the inspection therefore readers are advised to contact the provider direct for more information. Inspection reports produced by CQC can be obtained direct from the provider or are available on our website at www.cqc.org.uk 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: The visit to the service was undertaken by one inspector over 6 hours. People who live and work at the home did not know that we were coming. A range of evidence was used to make judgements about this service. The care received by two people was looked at in detail. This included looking at their personal records to include their care and health records and discussing their care with them. This forms part of a key inspection and helps us gain information and understand the experiences of people who use the service and the quality of care they receive. Upon arrival all three people were at the home. One person actively contributed to the inspection process and shared their own experiences of living at the Wheatlands. The other two people went out to college for the day but completed surveys for us. We received surveys from two members of staff and spoke with the manager, a senior manager and a member of staff on duty. We looked at parts of the home, reviewed the homes quality assurance processes and sampled a number of records to include Care Homes for Adults (18-65 years) Page 6 of 29 complaints and protection, staff training, recruitment and health and safety records. All three people who live at the home were supported by an independent advocacy to complete surveys for us and we have included some of their views about the service in our report. The manager completed an Annual Quality Assurance Assessment (AQAA) document for us, as requested. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. The AQAA provided us with lots of information about the service, how its developed and areas for continued development. 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: As this is the first key inspection following registration an overall rating of excellent cannot be given as it is considered that the service needs to demonstrate a sustained level of performance over a period of time. However we are confident that the service currently provides positive outcomes for the individuals who live at The Wheatlands, Care Homes for Adults (18-65 years) Page 8 of 29 therefore no requirements have been made for improvement. People told us the service could improve by: I would like a television and some music Improvements in staffing All support plans could be written as if the individual is telling others about themselves. This would make them more personal to the individuals. The shared areas of the home could be further developed to ensure they reflect peoples culture, religion and ethnicity. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 10 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. Information about the Wheatlands is made available to help people make an informed choice about whether the service is able to meet their individual needs. A complete assessment of their needs is undertaken with them and others close to them to ensure the service is right for them. Evidence: The three people living at the home were supported by an independent advocacy service to complete surveys for us. They told us that they were asked if they wanted to move into this home and that they received enough information about the Wheatlands before they moved in so that they could decide if it was the right place for them to live. We saw a statement of purpose, service user guide, a book containing lots of photographs of all areas of the home and an agreement on the files sampled. This information helps them and their representatives understand the service provided. One person told us he visited the home when it was being built and that he likes living at the home. Two of the three people who currently live at the Wheatlands have previously lived in Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: other homes managed by the organisation and therefore their needs were known. The managers of the organisation visited the person whose relatives expressed an interest in their son receiving a service to undertake an assessment of his needs. Managers also obtained lots of additional information from the people close to him to ensure they were confident in meeting his needs before he was offered a service. The person also met the two other people before he moved to make sure they got on well before sharing their home. Observations made and discussions held evidence that people have settled into their new home well. Care Homes for Adults (18-65 years) Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their assessed care needs are met. They are enabled to make decisions and take risks as part of their everyday lives because staff actively promote their rights, choices and independence enabling them to lead the lives they choose. Evidence: We looked at the care received by two people in detail. This included meeting them, talking with one person in detail and looking at the information held about their care needs. Both care plans seen were very detailed with evidence of review. Both people had attended a meeting with people close to them such as relatives, professionals and staff to review their needs and placement. We also saw person planning books, dream books and life stories ensuring their wishes and aspirations are known and acted upon. We spoke with a member of staff on duty who told us that staff have enough information to effectively support individuals and observations made evidenced that she was well tuned into the needs of the individuals in her care. Staff who completed surveys for us told us that they are always given up to date information about the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: needs of the people they support. Preferred communication styles are clearly recorded in peoples care plans so that staff are aware of how individuals make their needs known for example through verbal communication, physical gestures and facial expressions. In addition to these pictorial communication books, menu planning books, signs and symbols have been developed to help promote choice and assist individuals to express their needs and preferences and maximise their communication skills. Families, designated key workers and an independent advocacy service also represent peoples best interests and residents meetings are regularly held that enable individuals to voice their opinions and make decisions. Risks are managed positively, which enables people to lead the life they want based on an assessment. For example one person told us that he enjoys horse riding, helping with the cooking and making drinks and assessments to support him carrying out these activities safely were available on his file. He also told us that he is going on holiday to France and staff have recently visited the accommodation, looked at routes and transport to ensure the trip is appropriate and that all risks are minimised. The AQAA states Comprehensive risk assessments systems which are designed to encourage choice and spontaneity, so that the residents have the opportunity to participate in spur-of-the-moment activities. All risk assessments are agreed and reviewed by a committee of trained staff. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the Wheatlands are supported to maintain contact with people close to them and are provided with good opportunities for personal development, so that they can lead their life in a chosen way. People are provided with a choice of meals in accordance with their own preferences, cultural and dietary needs. Evidence: We sampled all of the records held on behalf of the two people whose care we looked at in detail. These evidence that people are provided with a variety of opportunities to develop their social and independent living skills. The member of staff spoken with considered people lead active lifestyles. Records seen and observations made clearly evidence that individuals are encouraged and enabled to partake in daily living tasks and also access the community. We saw that programmes have been developed to Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: increase peoples independent living skills and include specific targets and long term goals. One of these goals was for an individual to spread butter on his bread with limited support and we observed the person being supported with this task when preparing his own lunch. During our visit two people left to attend college and the other person was supported to visit a friend, go shopping and later attended an art session. This person also told us that he enjoys horse riding, massage, gym and going shopping which was an accurate reflection to the information recorded in his daily records. People are supported to maintain relationships that are important to them for example family are invited to attend any meetings held and regular contact is maintained through telephone, letters and visits. The manager is keen to develop positive relations with the neighbours and residents attended a local bonfire and exchanged Christmas cards. One person told us hed been home to stay with his family and during the inspection he visited a friend. Records sampled evidence that individuals are provided with lots of opportunities to see their friends and family. The AQAA states Cultural needs are identified and met, addressing dietary, personal care routines and celebration of festivals. This was a clear reflection of our findings however the manager must action a recommendation made in an individuals review for the purchase of prayer mat, which the manager commited to address at the earliest opportunity. Peoples preferences in relation to choices, routines, likes and dislikes are very well documented so staff are aware and act on these. Discussions indicate routines are flexible and observations made evidence that people have access to all areas of the home and can choose when to spend time on their own or in the company of others. People living at the Wheatlands are provided with a choice of food which is balanced and caters for their dietary and cultural needs. One person told us he enjoys going shopping and is supported to purchase and eat halal meat and provided with meals that reflect his culture. A pictorial recipe book has been developed to assist choice. One person has been assessed by a dietician and the speech and language team to provide assistance with eating and staff are working very hard supporting the individual with a specific eating programme to ensure his nutritional needs are being met. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical and emotional health needs are met because there is good evidence of multi agency working promoting their health and welfare. Evidence: The health and personal care needs of individuals living at the Wheatlands are clearly identified and recorded in their care plans and health action plans. Records evidence that individuals are supported to access healthcare facilities and all appointments and outcomes are clearly recorded. People receive annual health checks and any identified concerns regarding their health are swiftly referred to the relevant health professional ensuring their health and wellbeing. For example staff raised concerns about the weight loss of one individual and the person has since been assessed by a GP, speech and language team and a dietician and staff are adhering to the recommendations made. The cultural needs of one person are detailed in relation to attending to his personal care needs and how staff are to follow these. We looked at how medicines are managed and found all records to be up-to-date and accurate. The manager demonstrated a good understanding of the system in place to ensure people receive their medication as prescribed. The home uses the monitored Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: dosage system supplied by well-known chemist and has a medication policy in place, although this was not examined on this occasion. An audit has recently been undertaken by the supplying pharmacist and the one recommendation made actioned. People keep their own medication in their own rooms but need help to manage their medication based on an assessment of capacity to administer medication. The home has experienced one medication error which was investigated and the necessary safeguards put in place. Those responsible for administering medication receive the necessary training and their on-going competency is assessed. 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. People have access to a complaints procedure, which is accessible to people who live at the home and their representatives if they wish to make a complaint or express their concerns. The home has procedures in place to safeguard people from potential abuse and most staff have received training in adult protection, ensuring people who live at the home are protected. Evidence: The AQAA states We discuss the complaints procedure in house meetings with the Residents at a level appropriate to individual needs. A user friendly procedure is in the information pack sent prior to admissions and is displayed in their rooms. The complaints procedure is also shared with families so that they may use it on behalf of their relatives if needed. This is an accurate reflection of our findings and feedback gained in surveys evidence that people know who to speak to if they are not happy with the service provided at the Wheatlands. No formal complaints have been received by the home or CQC since registration. The home has a copy of the local safeguarding procedure and all but one member of staff have received training in the protection of adults. The member of staff on duty confirmed that she had received this training and had no concerns. Staff also receive information about protection of adults and the referral process, as evidenced in staff Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: meeting minutes seen. One referral under safeguarding adult procedures was made and recently investigated and the necessary action taken to safeguard people. No further incidents have taken place. We looked at how peoples monies are managed. We found that the system in place is robust and easily auditable. Currently people do not have their own bank accounts and therefore families are responsible for the safekeeping of finances and provide money to the home as and when requested. The manager confirmed that people receive enough money that matches their lifestyles and preferences. The AQAA states All expenditure of the Residents personal monies is accounted for, signed for and checked on a regular basis which reflected our findings. 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. People living at the Wheatlands are provided with a homely, clean and comfortable place to live where they feel safe and secure and is equipped to meet their individual needs. Evidence: One of the people whose care we looked at in detail told us that he likes his new home and was keen to show us his bedroom that he choose the decor and helped make it his own. His room contained lots of things important to him and reflected his culture although this is not currently extended to shared areas of the home and requires further input to ensure his culture, religion and ethnicity is represented. Other rooms seen were appropriately equipped and furnished to meet the needs of the individuals currently accommodated. Shared areas include a lounge and kitchen/diner. Two people require a wheelchair for outside use but can mobilise well indoors without a wheelchair and are able to negotiate stairs. A disabled toilet is available on the ground floor. The home is welcoming, clean and well equipped and people looked relaxed and comfortable in their surroundings. Future plans include purchasing garden furniture, landscaping the garden and completing Phase 2 of the building in preparation for registration. A part time cleaner is employed however people who live here are encouraged to keep Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: their home clean and tidy. Substances such as cleaning products that could cause harm to people are safely stored and some staff have received training in infection control procedures. The manager reported maintenance problems are dealt with promptly in the best interests of people living at the home. 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 at the Wheatlands are supported by a well trained, robustly recruited, caring staff team who enhance the quality of life they experience. Evidence: People living at the Wheatlands are supported by a well trained staff team. The AQAA states A comprehensive training package is available which has a balance of external and internal trainers, which all staff have access to. The management prioritises training and encourages all staff to undertake qualifications beyond the basic requirements. We saw evidence on staff files sampled that staff receive training in safe working practices such as manual handling, first aid, health and safety and fire safety in addition to service specific training such as visual impairment, cultural and religion and the management of actual and potential aggression (MAPA). Surveys received from staff confirmed that they are provided with training that is relevant to their role, helps them understand and meet the individual needs of the people they support, keeps them up to date with new ways of working and gives them enough information about health care and medication. Staff records were well presented and certificates supported the training undertaken. We sampled the files of the two staff most recently employed to ensure all they contain the information required and the necessary checks have been made to safeguard vulnerable adults. With the exception of a staff photograph on one file, all of Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: the checks had been undertaken prior to new staff commencing work which was also reflected in staff surveys. Staff also reported that their induction covered everything they needed to know to do the job very well. Future plans outlined in the AQAA include providing additional training for staff to enable them to communicate more effectively with the residents and providing residents with training in the recruitment process. 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. People benefit from a service that is effectively managed and enables them to live a lifestyle of their choice based on their views and wishes. The home is maintained in a manner, which ensures the safety of the people living and working at the home. Evidence: The manager has many years experience working with people with learning disabilities and complex needs and has attended numerous training courses relevant to her role. Observations made evidence the manager has developed good working relationships with the people living at the home and has a sound knowledge of their individual needs. She was able to describe a clear vision of the home based on the organisation values and demonstrated her knowledge and commitment to equality and diversity in the best interests of people using the service. Surveys received from staff indicate they receive regular support from the manager and this was also confirmed with the member of staff on duty. A member of staff stated Sandra has always given me a high level of support and works to high standards. The manager reported that she has attended training in the Mental Capacity Act and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Deprivation of Liberty Safeguards and advised that no individuals are currently restricted or subject to authorisation. Records sampled evidence that people are provided with choices and their rights promoted. There are systems in place to monitor and review the quality of care and support. For example staff receive regular supervision and performance appraisal of their work. Staff and residents meetings are held monthly to gain peoples views and surveys will be distributed within the next six months to assess how this new service is currently performing and evaluate outcomes for people and aid future planning. The AQAA reports future plans include Further input of the residents into staff meeting, management team and board of management meetings. We looked at the health and safety checks that staff do to prevent people from being placed at risk of harm and these were found satisfactory. Service certificates were assessed as part of registration so we did not review on this occasion. Staff receive training to keep them and the people they support safe such as manual handling, health and safety, infection control procedures however records show that some staff are due training in food hygiene. The manager advised that the maintenance team are quick to respond to any repairs ensuring a safe environment for people using the service. 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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