Care Home: Whistley Dene

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Whistley Dene Whistley Road Potterne Devizes Wiltshire SN10 5TD two star good service The quality rating for this care home is: 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: Pauline Lintern Date: 2 8 0 4 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. They reflect the things that people have said are important to them: 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. 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 Information about the care home Name of care home: Address: Whistley Dene Whistley Road Potterne Devizes Wiltshire SN10 5TD 01380721913 01380721913 whistleymanager@whct.co.uk 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) : White Horse Care Trust care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The registered person may provide the following category of care only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability- Code LD The maximum number of service users who can be accommodated is 5. A bit about the care home Whistley Dene provides care and accommodation to men and women who have a learning disability and who may also have a sensory loss or associated physical disability. The house is located in a hamlet on the edge of the village of Potterne, which is located 3 miles from Devizes town centre. The home provides high standards of spacious accommodation with extensive and well-maintained grounds. Each service user has their own bedroom. Typically three support workers throughout the waking day staff the home. At nighttime one member of staff sleeps in and is expected to respond to any emergencies or night time care needs as they arise. The home has its own vehicle, which is used to access a range of day services and to ensure community presence. Whistley Dene is one of a number of homes operated by the White Horse Care Trust. Fees are between £1,037.66 - £1,806.44 per week 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 & Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct and Management of the Home Poor Adequate Good Excellent How we did our inspection: This is what the inspector did when they were at the care home This service was last inspected 4th May 2006. The unannounced inspection took place on Tuesday 28th April 2009 between the hours of 9:30 and 3:00 pm. The manager Mrs Shaw, was on leave on the day of our visit, however we were able to discuss the inspection with her over the telephone. Three members of staff were available to assist us with our inspection, throughout the day. During the morning one person using the service remained at home, whilst the other people were at day services. They returned to the home at lunch time and we then had the opportunity to meet people. Due to communication difficulties we were unable to obtain their views on the service provision, however we were able to observe body language and staff interactions. We sent Mrs Shaw an Annual Quality Assurance Assessment (AQAA) to complete. This was her own assessment of how well they are performing and it gave us information about their future plans. Information from the AQAA is detailed within this report. As part of the inspection process, we sent surveys to the home for people to complete, if they wanted to. We also sent surveys; to be distributed by the home to people using the service and staff members, care managers, GPs and other health care professionals. Six staff members, two healthcare professionals and three people using the service responded. The feedback received, is reported upon within this report. Surveys were completed on behalf of people living in the home, where they were unable to do so themselves. We reviewed the information that we had received about the home since the last inspection. We looked around the home and saw a number of records, including care plans, risk assessments, health and safety procedures, staff files and training records. Our pharmacy inspector visited the service on 14/10/2008. During this visit she made a requirement that alternative bolts must be fitted to the medication cabinet. This has now been actioned. The judgements contained in this report have been made from all the evidence gathered during the inspection; including the visit to the service and takes into account the views and experiences of people using the service. What has got better from the last inspection At our last visit to the service we made four requirements. These related to obtaining consent for the administration of medication, ensuring that a copy of the complaints procedure is available to each person living at the home and ensuring that all recruitment records are kept at the home. These have all now been met in full. The remaining requirement related to ensuring that all toxic materials were securely locked away. On the day of our visit we found that one cupboard was not locked, which contained cleaning materials. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Pauline Lintern 33 Colston 33 Colston Avenue Bristol BS1 4UA 0117 930 7110 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 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 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 is available in alternative formats to enable people to decide if they wish to move to the home. While there have been no new people to the service, the organisations admission policies would be adhered to, to ensure appropriate placements. Evidence: The home has a Statement of Purpose, which is available in alternative formats. It was noted that the contact details for CQC were incorrect. Within the AQAA it states, we offer a service users guide to the home in the form of a booklet with written and photo information. The guide is also on audio tape. The home have identified that this area could be further developed by introducing more photos into the Service User Guide and by producing a DVD tour of the home. Within our surveys we asked if people were provided with sufficient information before they decided to move to the home. One person commented, Yes, I was asked if I wanted to move to the home. I had day visits and overnight stays arranged, lots of discussion. I was given information and was able to ask questions to decide whether I liked the home etc. Since our last visit to the home there have been no new external admissions. One person has transferred to Whistley Dene from another Trust home. This was due to the home being more suitable following an injury to their ankle. Therefore the key standard which relates to the assessment process could not be fully addressed. 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 . Each person living at the home has a care plan which details how their needs should be met. With staff support people are able to make decisions within their daily life. However, this may be further enhanced with the development of person centred planning and communication tools. Mechanisms are in place to minimise any potential risk, whilst promoting independence. This judgement has been made using available evidence including a visit to the service. Evidence: As part of the inspection process we examined two case files in detail. We found that care plans reflect peoples assessed needs. The plan covers all aspects of the persons life such as, communication, choice, consent, culture, education, health, leisure, personal care, relationships, mobility, private space and safety. We noted that care plans have been updated as a persons needs have changed. Some entries to support plans have been added in pencil. We suggest that these be typed up or written in ink and are dated and signed by the key worker or the person making the entry. During feedback the deputy manager told us that the additions to the care plan were currently in the process of being typed up and this is the reason that they were in pencil. Judgement: Records demonstrate that the people living at the home have the opportunity to attend their review meetings if they choose to do so. Family members, care managers, health care professionals and day services managers are also invited to attend if appropriate. Within care plans peoples spiritual needs are documented. One persons file records that they are Roman Catholic and enjoy attending church regularly. Another persons file reports that they are Church of England, however they have not indicated that they wish to attend a regular church service. Within the AQAA it states that the home is currently developing communication passports for the people they support. We saw little evidence to support this. We discussed person centred planning with two members of staff but their understanding of this appeared limited. They confirmed that they had not yet received training in this area. We discussed this further during feedback with the deputy manager. She reported that the organisation are providing training called making it real, which all staff will be attending. She added that communication passports are currently being developed. There is scope to further develop a person centred approach within the home and we suggest training be arranged for all staff members. Files record how a person may make a choice in their day to day life. One file states X is able to make choices by pointing, nodding, shaking their head and grasping objects. One comment received in our survey was I always make decisions about going shopping, Gateway club and can make choices about whether to go to day services. I choose to go back to bed for a nap at weekends. I have to sometimes remember that others have needs/choices too. The home may wish to consider how they can further empower people to make decisions by using communications tools and converting documents into pictorial formats. Risk assessments are in place, which relate to specific activities. Evidence indicates that these have been reviewed and updated. 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 . People are supported and encouraged to take part in appropriate activities if they wish to do so. Peoples rights and responsibilities are respected. Links with families and friends are maintained if they person living at the home chooses. People are supported to take their meals in a relaxed environment. Meals appear varied and healthy. This judgement has been made using available evidence including a visit to the service. Evidence: The files of the two people we looked at demonstrated that they have access to various educational and leisure activities. Plans are in place for the people living at the home to take an annual holiday. Staff members told us that people were provided with leaflets and brochures to choose from. Mrs Shaw told us that two people chose to go to Centre Parcs, one is going to Mudeford and the remaining two have chosen Butlins holiday camp for their holiday. People access the Devizes Community Resource centre during the week. Activities undertaken at the centre include music, flower arranging and arts and crafts. Other activities available to the people living at the home are the hydrotherapy pool, the Gateway club and a local social club in Potterne. Massage sessions are offered every two weeks. One persons file states that at the Gateway club they enjoy playing skittles, bingo, dancing and themed evenings such as Halloween. Within our surveys people told us, sometimes I make decisions what I do each day. I will decide what to wear, what activities to do in house, go for a walk, have a cup of tea etc. I choose when to go to bed and have an afternoon nap. I will ask to go out in the car, I will ask to go out, however if no driver or vehicle already in use this may not be possible. Also other service users needs also have to be addressed and I like living at Whistley Dene with Tina (manager), going out in the car, looking out of the window sat in my chair, going for a haircut, shopping, clubs and Gateway club. One persons file records that they enjoy going to the local library and purchasing a lottery ticket at the weekends. Diary entries show that the person is regularly supported to undertake these activities. Within the Trust regular crafty clubs are run, where people using the service have the opportunity to meet up with friends from other local Trust homes. The home has introduced opportunity files. These highlight certain tasks, which the person living at the home may wish to participate in and the support required for this activity to take place. Activities sampled included, preparing a lunch box and making a sandwich, making a hot drink, cleaning the bedroom, social outings, daily walks and visits to the hydrotherapy pool. At the previous inspection we recommended that the homes vehicle be assessed to ensure it was meeting the needs of all the people living at the home. This has been addressed and the home now has two vehicles available to them. We noted that each person has a front door key, which is attached to their purse or wallet, which is kept secure. Staff members told us that when they leave the building they are able to regain access using their own key if they choose to do so. Within the AQAA it states that one person now has a bus pass, which enables them, with staff support to use public transport. Evidence: Peoples chosen daily routines are respected where possible, however files state that one person needs to be encouraged to get up during the week to access their day services. However, they are able to return to bed for a nap at other times. One persons file records that their handbag is very important to them and staff are reminded to respect the persons privacy by not touching their handbag without permission. During our visit we observed staff interacting positively with the people they support. Staff members did not talk between themselves without including the person living at the home in the conversation. The AQAA confirms that people are supported to maintain links with their family and friends, if they choose to do so. Regular home visits and telephone calls are supported by staff members. Family and friends are also welcome at the home. The home has a large keypad telephone available to the people using the service. Staff members told us that there is a four week menu in place; however the menu is very flexible to suit the needs of the people using the service. Generally the main meal of the day is taken in the evening, except for Sundays when a roast dinner is served mid day. We noted that a large bowl of fresh fruit was available to the people living at the home. The arrangements for meal times have recently changed to accommodate changes in one persons behaviours. This has resulted in the person taking their meals separately from their peers, with staff supporting them. Records are being discretely kept to enable healthcare professionals and staff members to evaluate and monitor the activity. 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 . Records direct staff to provide personal care in a way that is preferred. The home is ensuring that peoples healthcare needs are being met. Medication is well managed by the home. This judgement has been made using available evidence including a visit to the service. Evidence: Care plans sampled provided clear details to the reader on how the person living at the home wishes to have their personal care delivered. Plans inform on how staff may offer support to the person, whilst promoting their independence. Plans are separated into morning and evening routines. One persons file records that staff should encourage and promote their privacy by reminding the person to close the bathroom door when getting dressed. Within our surveys we asked the question, what do you think the home does well? Comments received included treat individuals with respect they deserve and as individuals ensuring they have, where possible what they like, I very much like the way they communicate with the people living at Whistley Dene, respectfully and with an interest of that person shown and whenever I have visited Whistley Dene, I have always been made to feel welcome. I have been given information on a need to know basis. Clients needs have always been met. Evidence: Records take into account how a person may wish to present themselves. For example one person likes to wear perfume and paint their nails. Within our surveys one health care professional commented they always support individuals to live the life they choose. Again, I have observed staff trying to sort out specific issues as they have identified that a person likes or dislikes something. Care plans, diaries and daily notes confirm that people living at the home have access to healthcare professionals as and when required. These include staff support to attend appointments such as doctors, dentists, podiatrists and opticians. The home receives regular support and guidance from the local health team including the community nurse, physiotherapist and psychiatrist. It was noted that when one persons needs have recently changed and they have increased behaviours being displayed, the home has sought the advice from the relevant people to manage the situation appropriately and in the best interests of the person they support. Records demonstrate that interactions have been recorded and multi disciplinary meetings have been arranged to ensure the best way forward for the person. Any changes to risk assessments and care plans, as a result of the meetings have been actioned straight away. Each person living at the home has an OK health check and a holistic assessment in place. During feedback at the end of our inspection, Mrs Shaw confirmed that they are planning to develop the forms further to make them more person centred. Within our surveys we received the following comments they are very good at recognising when to involve other health professionals. Clients are enrolled on the national stepometer programme, with full support from staff. Improved general fitness and sense of well being and reaching agreed goals and staff training enables staff to be more aware of social and healthcare needs-valuing people now. Epilepsy intervention plans and risk assessments are in place for the people who may require them. Records show that one person with epilepsy has not had a seizure since 2008. As part of the inspection process we looked at the arrangements for managing medication and found them to be satisfactory. During our pharmacy inspectors last visit to the home she made a requirement that the bolts on the medication cabinet be replaced to comply with legislation. The manager confirmed that the new bolts have now been fitted. We noted that medication administration records (MAR) had been completed properly. There was one gap on the sheet, which we were able to discuss with the staff member on duty at the time. The gap was a human error and they confirmed that the medication had been administered. Evidence: Staff members are not allowed to administer medication until they have completed their training and are deemed competent. Medication stock checks are completed every Sunday by staff members. Each MAR sheet has a photograph of the person receiving the medication on the front, to enable easy identification. All as required (PRN) medication is recorded on a separate yellow sheet. Staff members told us that one person they support is able to request when they need PRN medication. Following a requirement at the last inspection, care plans now record whether a person is able to self administer their medication and whether they have been able to give their consent to medication being administered by staff. 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 an established complaints policy and procedure in place. People using the service are protected where possible from any potential abuse. This judgement has been made using available evidence including a visit to the service. Evidence: In line with the Trusts procedures each person living at the home has a complaints postcard in their file that is already addressed for them to send to head office if they wish to raise a concern or make a complaint. The complaints policy is available in alternative formats including a DVD. As mentioned earlier in this report, it was noted that the contact details for CQC were in need of updating to ensure it is current. People told us in our surveys that they know how to make a complaint if necessary. Two comments received included I will communicate / gesture if I am unhappy and will make some indication to what the cause is. I have had the complaints procedure explained to me and I have on occasion sent the complaints postcard to WHCT and I have watched the DVD. Within the AQAA it states that the home has not received any complaints since the previous inspection. No complaints have been received by the Commission since the last inspection. The home keeps a complaints log at the home, to enable any complaints received to be recorded with timescales actions and outcomes. This enables the manager to monitor any trends or emerging patterns. Evidence: The AQAA states there has been one occasion where physical intervention was used over the last twelve months. Staff members we spoke to confirmed that they attend training in the use of non violent physical intervention and regular refresher courses. Staff explained that distraction techniques are generally used to defuse a situation that may occur. Staff members we spoke to were able to explain what procedures they would follow if they had any concerns that a person may be subject to any form of abuse. The home has a whistle blowing policy in place to protect staff. A copy of the local safeguarding protocols No Secrets was available in the home. Staff confirmed that they had read the document and attended training in safeguarding people. The system for looking after peoples money was checked and found to be in good order. Receipts are kept and two staff sign out all money and sign in money returned to the home. 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 interior of the home remains clean and tidy and provides a safe and homely environment for the people who live there. However it was noted that the exterior of the home is in need of some attention. The home was found to be clean and hygienic throughout. This judgement has been made using available evidence including a visit to the service. Evidence: The home is spacious and accessible for people with mobility needs. We found the grounds to be in very good order and maintained by a gardener. We noted that the exterior of the home was in need of some attention. Areas around the door frames and windows had cobwebs and the paint work was in need of redecorating. We discussed this with Mrs Shaw during feedback at the end of our visit. Mrs Shaw confirmed that this was in hand and many exterior maintenance jobs have been authorised to go ahead. The interior of the home was found to be comfortable and homely. Furniture and fittings are of a high standard. The home affords plenty of communal places, where people have the opportunity to sit quietly on their own if they choose, or mix with their peers. We looked at individual bedrooms, which again were decorated and furnished to a high standard. Rooms were personalised to suit individual needs. People had televisions and music centres in their rooms. One persons room was decorated in pink with matching accessories and a new carpet. Evidence: Within our surveys we asked if the home was always clean and fresh. One person commented yes, the home is always clean and fresh. I like a colourful bedroom, flowers in window. I help with some cleaning of my room. We found bathrooms and toilets to be both clean and hygienic. One bathroom houses a Parker bath for easy access. Anti bacterial hand wash was available throughout the home. Protective clothing was also available. The home has a laundry where both the washing machine and drier are sited. This area was found to be clean and tidy. 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 . Staff members told us that the home is sufficiently staffed to enable them to meet the needs of the people living at the home. We could not access recruitment records fully during our visit. However discussion with the Manager confirmed that correct procedures have been followed. The home has a comprehensive training programme in place; however care must be taken to ensure that refresher courses are offered in line with the Trusts timescales. Staff members are offered regular supervision with their line manager. This judgement has been made using available evidence including a visit to the service. Evidence: Staff members we spoke to confirmed that the home is currently fully staffed. Due to the closure of another local Trust home, some staff have transferred to Whistley Dene, which has enhanced the staffing levels. The home generally has three staff working on each shift and extra support is brought in as and when it is needed. During the night one member of staff sleeps in. Within our surveys people told us usually staff treat me well, I dont like being told what to do, or too much information as I get anxious and usually staff listen and act on what I say, sometimes I can repeat things over and over and staff may become impatient and what I was trying to say gets confused I sometimes need more time, which is then given. Evidence: Due to the manager and deputy being unavailable during our visit, we had limited access to recruitment records. We were able to see that staff have all had a satisfactory check with the Criminal Records Bureau and against the Protection of Vulnerable Adults (POVA) list prior to commencing their employment. We were unable to access application forms and references, however during feedback Mrs Shaw was able to check and confirm that these were in place for the staff members whose files were examined. We spoke with three members of staff, who confirmed that they had received an induction to the service. When new staff members have completed their induction, they commence the Learning Disability Qualification (LDQ). This qualification covers four units: The principles of learning, your role as a learning disabilities worker, health and safety in a learning disability service and protecting people with a learning disability from abuse. Once staff members have obtained this qualification they are able to commence their National Vocational Qualification in Social Care (NVQ). All mandatory training is provided to new staff. This includes health and safety, manual handling, fire safety, basic first aid and basic food hygiene. One member of staff told us all my training is up together, but I would like to do OBriens principles soon. Staff members take on responsibility for certain delegated tasks, such as infection control, fire or COSHH. One person told us that they are to become the COSHH representative for the home soon. Within our survey one staff member told us new training and different ways of working is encouraged. I highlight to the manager when I need training and what courses Id like to go on and what would be beneficial. We noted that the Trust state that refresher courses for manual handling are to be carried out annually. Records showed that two staff members were due to complete their refresher training by 19/3/09. We asked Mrs Shaw if arrangements had been made for this to take place and she confirmed that she was aware and that the staff members would be on the next available course. Staff members confirmed that they receive regular supervision from their line manager. Regular team meetings also take place in the home. One person commented I regularly meet with my manager and the sessions are very constructive on both sides. Another person added Support plans are always reviewed and updated regularly and items discussed at team meetings. Staff member told us that they receive an Individual Performance Review (IPR) annually, when their performance is discussed and their personal development goals are set for the next twelve months. 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 home is run in the best interests of the people living there, by a competent and qualified manager. People have the opportunity to input into the running of the home, where possible. Health and Safety policies and procedures are in place to protect both the people living at the home and staff members. However failure to store toxic materials securely could place people at risk. This judgement has been made using available evidence including a visit to the service. Evidence: Mrs Shaw is a registered nurse within the learning disability field. She has over 29 years experience and ensures that the home is run in the best interests of the people who live there. Staff members told us that they feel well supported by both Mrs Shaw and the deputy manager. One staff member told us I have 110 support from the management team. Mrs Shaw is the registered manager for two Trust homes and works across the two services. Evidence: Within our surveys one staff member told us My manager often gives support, my manager works here and at another home we rarely see each other. However I know I can discuss issues with the deputy and contact Mrs Shaw if and when necessary. The Trust carries out regular management audits of the service. These include finance and administration, care visits and unannounced management visits. Satisfaction surveys are also sent out to stakeholders to obtain their views on the service provision. The Trust holds regular Residents consultation meetings. This is an opportunity for people to get together with people from other Trust homes and to share their views. Minutes showed that one person living at Whistley Dene attended the last meeting, with staff support. We noted that within the laundry toxic materials were stored. We found that one cupboard was unlocked and the key was in the door. As this was subject of a requirement made at the last inspection we are carrying forward the requirement that all toxic materials must be securely locked away. Mrs Shaw confirmed that she will once again remind staff of the importance of this. It was noted on the most recent team meeting minutes that staff had been asked to complete a COSHH questionnaire to remind them of the procedures. Kennet District Council completed an inspection report on 18/11/08 relating to food safety within the home. The service was awarded 5 stars, excellent. All radiators within the home are guarded to ensure people do not have access to hot surfaces. We sampled the accident book and found that entries linked to care plans and daily notes. Environmental risk assessments are in place and kept under review. These cover safe systems at work and LegionElla. Are there any outstanding requirements from the last inspection? Yes  No  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 1 42 13(3) The registered manager must ensure that all toxic chemicals are securely locked away. 04/05/2006 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 Description 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 Description Timescale for action 1 42 13 You must ensure that all toxic materials are securely locked away at all times. 07/06/2009 To ensure the safety of people living at the home. 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 1 The Statement of Purpose and complaints policy should contain current contact details for CQC. 2 3 6 6 Staff to attend training in person centred planning. Development of communication tools, which may aid decision making. 4 22 The complaints policy should be updated to provide current contact details of the commission. 5 35 In accordance with company policy, refresher courses should be offered within agreed timescales. 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. 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