Care Home: White Barn

Similar services:

• Hillview Farm
• Dalewood Respite Care
• Orchard,The
• REACH Upton Court Road
• Fairways
• Treloar College
• Kestrel House, St Anne`s Opportunity Centre,
• Pinta

What the care home does well The needs, wishes and preferences of residents are reflected in their individual care plans, and residents are encouraged to make day-to-day decisions where possible and to take appropriate risks subject to risk assessment. Residents have opportunities to take part in appropriate activities in the home and within the community and are encouraged to take part in household tasks and make decisions and choices in their daily lives. Relationships with family are supported by the home. Residents are offered an appropriate diet and have some input into choosing the menu. The home provides support to residents to meet their needs and with reference to any individual wishes and preferences. The physical and emotional health needs of residents are met by the home and appropriate systems are in place to manage medication on their behalf. An appropriate complaints procedure is in place and the home has appropriate systems in place to safeguard residents from abuse. The home provides a spacious and comfortable environment for residents, and standards of hygiene are satisfactory Levels of NVQ attainment in the team are good.Page 8 of 32Care Homes for Adults (18-65 years) What has improved since the last inspection? The previous requirements have all been addressed or are in the process of being addressed. The care plans and activities provision have improved. Staff recruitment and motivation has improved following the decision that the home will continue for at least three years while its ongoing future is decided. What the care home could do better: Information needs to be available to prospective residents/their representatives which is directed specifically at the residential service provided by the home. The pre-admission assessment format could be improved by greater emphasis on the individual`s skills, aspirations and goals. The homeliness of the building will be improved as the refurbishment is undertaken. The identified training shortfalls need to be addressed. The recruitment system operated by the provider supports and protects residents, though some further improvements in the associated records are still needed.The quality assurance system needs further development to maximise the range of sources of feedback on the home`s performance. The health, safety and welfare of residents are promoted by the homes systems. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: White Barn 45 Cressingham Road Reading Berkshire RG2 7RU 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: Stephen Webb Date: 1 9 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. 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 Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 32 Information about the care home Name of care home: Address: White Barn 45 Cressingham Road Reading Berkshire RG2 7RU 01189873190 01189864415 paula.cox@kingwood.org.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) : The Kingwood 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/ies of service only: Care home only - (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 (LD). The maximum number of service users to be accommodated is 5. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home White Barn provides twenty-four hour residential care to five service users, of both sexes, who have learning and associated behavioural difficulties. The home is a large two-storey building with all the individual accommodation on the first floor. The building is owned and the care provided by the Kingwood Trust, a charitable organisation. White Barn is situated a few miles from Reading Town Centre and there are local facilities within walking distance. The home has its own vehicle and it is on a main public transport route. At the time of this inspection, the charges as range between # 1448.13 and #1921.82 per week. There are no additional charges. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home This inspection included an unannounced site visit from 9.30am until 4.45pm on the 19th of May 2009. This report also includes reference to documents completed and supplied by the home, and those examined during the course of the site visit. The report also draws from conversation with the manager. Residents were unable to provide verbal feedback but the inspector also observed the interactions between residents and staff at various points during the inspection. An inspection survey was completed by each of the residents next of kin on their behalf. The recorded responses were mostly positive, with regard to the care and support provided. The inspector also examined the majority of the premises. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well The needs, wishes and preferences of residents are reflected in their individual care plans, and residents are encouraged to make day-to-day decisions where possible and to take appropriate risks subject to risk assessment. Residents have opportunities to take part in appropriate activities in the home and within the community and are encouraged to take part in household tasks and make decisions and choices in their daily lives. Relationships with family are supported by the home. Residents are offered an appropriate diet and have some input into choosing the menu. The home provides support to residents to meet their needs and with reference to any individual wishes and preferences. The physical and emotional health needs of residents are met by the home and appropriate systems are in place to manage medication on their behalf. An appropriate complaints procedure is in place and the home has appropriate systems in place to safeguard residents from abuse. The home provides a spacious and comfortable environment for residents, and standards of hygiene are satisfactory Levels of NVQ attainment in the team are good. Page 8 of 32 Care Homes for Adults (18-65 years) What has got better from the last inspection What the care home could do better Information needs to be available to prospective residents/their representatives which is directed specifically at the residential service provided by the home. The pre-admission assessment format could be improved by greater emphasis on the individuals skills, aspirations and goals. The homeliness of the building will be improved as the refurbishment is undertaken. The identified training shortfalls need to be addressed. The recruitment system operated by the provider supports and protects residents, though some further improvements in the associated records are still needed. Care Homes for Adults (18-65 years) Page 9 of 32 The quality assurance system needs further development to maximise the range of sources of feedback on the homes performance. The health, safety and welfare of residents are promoted by the homes systems. 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 Stephen Webb 33 Greycoat Street London SW1P 2QF 02079792000 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 Care Homes for Adults (18-65 years) Page 10 of 32 line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 32 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 12 of 32 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 information available to prospective residents/their representatives will be improved through developing additional documents directed specifically at the residential service provided by the home. The provider has a system in place for the assessment of a service users needs and wishes, but this could be improved by greater emphasis on the individuals skills, aspirations and goals. Evidence: The provider has recently reviewed and revised their Statement of Purpose and Service User Guide, and these documents are very detailed and informative. The Service User Guide is enhanced by the inclusion of pictures and images to support its explanation to service users, where possible. However, both documents are focused on the providers supported living services and do not really address the residential home in sufficient detail. The manager indicated that local versions, focused on the residential home were going to be produced to compliment the organisational documents. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: All of the residents have been at White Barn for an extended period so original assessment documents had been archived. Reassessments had been undertaken more recently for two residents, with regard to moves, when there were plans for the service to close, though when this proposal was been deferred for at least three years, the plans were not pursued. Ongoing review of residents changing needs is via regular review of the care plans. The manager supplied a copy of the pre-admission assessment format used in the past, which would benefit from greater emphasis on the prospective residents positive abilities, goals and aspirations. Care Homes for Adults (18-65 years) Page 14 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The needs, wishes and preferences of residents are reflected in their individual care plans, and residents are encouraged to make day-to-day decisions where possible. Residents are enabled to take appropriate risks subject to risk assessment. Evidence: The care plans and related documents have been revised and developed since the last inspection, and are now focused around a person-centred approach. The files contain useful detail within various formats about the needs, wishes and preferences of individuals regarding how they are supported, and their preferred routines. Information is provided on significant family and other contacts and how these links may be supported. The plans also include preferred communication methods and how the individual may express their choices and display their moods and feelings nonverbally, together with some guidance for staff on appropriate responses to support consistency of approach. Records include individual support guidelines in detail about relevant aspects of care and support. In one example there was clear guidance about the residents gender preference with regard to their carer, and how to address Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: situations where this could not be met, which is evidence of the home seeking to address the rights and dignity of the resident. The plans also identify aspects of care which the individual is able to manage themselves, and where they may benefit from prompts or encouragement, which also respects the individuals dignity. The plans do include a record of the setting of individual goals for residents, though there remains room for further development in this area to enhance personal skills, development and independence. The plans also refer to other aspects of self-image and dignity and any identified spiritual or cultural needs, and in one case note the changeable views of the individual so that staff do not make an assumed judgement, but instead seek their particular views on-the-day. Plans also include an individual schedule of planned activities throughout the week, showing a range of activities both within the service, in the community and at a local day-services provider. A record is also maintained of the individuals participation or whether they have declined to take part in the planned activity. Individual daily notes are maintained within a diary format summarising any significant activity, contacts and events. The home manages their personal allowance on behalf of the residents and maintains appropriate records of monies in and out as well retaining receipts for any expenditure. Information on residents monies was held within their care records, together with copies of bank statements. There are also records of the individuals understanding of money and their support needs around this. The expenditure records seen indicate that residents funds are spent appropriately, and the manager explained how the service tries to maximise the effectiveness of use of these funds on behalf of the residents. One resident is given small amounts of his allowance to hold and spend as he wishes, which addresses his rights and dignity. A range of individual risk assessments is in place for each resident, and these were being reviewed and updated at the time of this inspection, to a new, more personcentred format. This process is ongoing. The new risk assessments are detailed and include information on how staff should address the identified issue, as well as cross-referencing to specific guidelines where applicable. Risk assessments seek to reduce risks appropriately, whilst enabling the activity in question, wherever possible, in order to facilitate a fulfilling lifestyle for residents. The new risk assessments each have an associated signature sheet for all staff to sign, though they had only just been established and most staff had yet to sign them. Care Homes for Adults (18-65 years) Page 16 of 32 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 . Residents have opportunities to take part in an appropriate range of activities in the home and within the community and are encouraged to take part in household tasks and make decisions and choices in their daily lives. Relationships with family are supported by the home. Residents are offered an appropriate diet and have some input into choosing the menu. Evidence: As noted above, each resident has an individual activity planner detailing their regular scheduled activities within and outside the building, together with a record of the reasons should they not have attended any of these. The activity planners now include target sheets, thought these have yet to be utilised. The care plans identify the likes and dislikes of individuals with regard to activities. One resident has part-time supported employment at a local stables. Residents also attend a local day services provider for a range of activities, and this provider visits the home to provide a service Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: for two residents. The home has its own vehicle to provide transport in the community and will also use taxis and buses when appropriate. Two residents attend specialist horse-riding sessions, some are able to visit the cinema at times, and small groups/individuals will go on day outings and walks. The cultural/spiritual needs of individuals are noted, where relevant, within the care plans, including aspects of personal appearance and other appropriate elements. One resident attends church when on home visits. Key relationships and friendships are also recorded and supported, though there is room for additional information on how to support social interaction by some residents. All of the residents have regular family contact through a range of visits, phone contact and stays with family. The directions to the parents house were present on one file to be used by staff when accompanying and supporting these visits. None of the residents went on holiday last year owing to the home closure plans which were in place at the time, but plans are being made for individual holidays chosen by residents this year. One of the residents will help with the house food shopping, but others prefer only to do personal shopping when they are able to manage this. Busy public places can present challenges for residents at times due to elements of their Autism. Involvement in household tasks such as cleaning and laundry is encouraged but variable. One of the residents holds a key to their bedroom, and three others have this available to them fixed to their door. This is reported to not present any problems at present. Residents choose their preferred breakfast daily and take turns to choose what they have for lunch, with alternatives being provided if the chosen meal is not to someones liking. Teatime meals are planned on a four-week rolling menu, and again an alternative is provided where necessary. Individual records of the meals eaten and any refusals are also maintained to monitor nutritional intake. Residents were seen to be offered choices at luch on the day of inspection. Care Homes for Adults (18-65 years) Page 18 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home provides support to residents to meet their needs and with reference to any individual wishes and preferences. The physical and emotional health needs of residents are met by the home and appropriate systems are in place to manage medication. Evidence: Individual support guidelines were in place where appropriate for residents and included evaluation records. The manager indicated that instances of particular behaviours covered by support guidelines, would be noted within daily logs or a specific chart as necessary. There were examples within these guidelines of instruction to staff to encourage participation in household routines etc. In one case appropriate guidelines were also in place on laundry management. The manager indicated that the in house behavioural practitioner had recently left the organisation. It was not clear whether they were to be replaced. Records of incidents were present to enable monitoring of the effectiveness of mangement strategies. Communication profiles also support effective communication with residents though as noted, there was potential for further development in some areas especially around supporting social interaction. Appropriate steps had been taken in response to the declining mental health of one resident and appropriate re-introduction plans are also in place. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: Healthcare records indicate regular routine appointments where necessary. Some residents receive regular support from external healthcare specialists. The care plans also include nutritional records to monitor this aspect of good health, and weight record charts which were in regular use. The home has an appropriate system in place to manage the medication on behalf of residents. Records include details of the quantities of medication received, administered and of any returns, providing the necessary audit trail. Examination of the medication administration record (MAR) sheets did however, highlight some gaps which the manager undertook to investigate. The medication file included a photgraph of each residents along with their administration record sheets. Care Homes for Adults (18-65 years) Page 20 of 32 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 degree to which any residents/relatives concerns are addressed is not clear in the absence of any recorded complaints, though an appropriate procedure is in place. The home has appropriate systems in place to safeguard residents from abuse. Evidence: The home has an appropriate complaints procedure which is also available in symbol format, though this would be of limited use in conveying the contents to the current residents. The manager felt that residents understanding of the concept of complaint is limited though she was considering developing a basic format to try to explore this. It is likely at present that residents would be reliant upon the advocacy of a relative or staff member to pursue a complaint. Examination of the complaints log indicated no recorded complaints, so it was not possible to verify the operation of the procedure in practice. The manager said that she had offered the option of making a complaint to the family of one resident recently, but they had declined. The current complaints procedure had been reviewed in May 2009. No complaints have been received by the Commission for referral to the home, over the past year. The home has an appropriate procedure for safeguarding vulnerable residents, though there have been no reported safeguarding incidents in the past year.Copies of the local Multi-Agency safeguarding protocol and DoH guidance were also present. Incident report forms are completed for any untoward events, which are also copied to head office for collation and review. The manager also said that they are reviewed Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: within the home to monitor the effectiveness of the interventions used. The home responded appropriately to the mental health needs of one resident to safeguard the resident and others. Appropriate safeguards are also in place where the home manages residents personal allowance monies. Staff had not received a training update on safeguarding within at least the last year, but four are booked to do this in June and the manager stated that others would be booked on courses as they became available. The provider should prioritise this training and arrange a dedicated course should places not be offered via the local authority within a reasonable timescale. Care Homes for Adults (18-65 years) Page 22 of 32 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 degree of homeliness will be improved as the refurbishment is undertaken, but the home provides a spacious and comfortable environment for residents, and standards of hygiene are satisfactory. Evidence: The home provides five single bedrooms, a separate lounge and dining room and a quiet room which also doubles as a sleep-in room when necessary. There is also a conservatory which is used as a sensory room. Most rooms are spacious though the decor throughout the building lacked the homeliness provided by pictures etc. Damage to some of the doors and frames needed to be repaired, and the stair carpets were very worn. The bedrooms had been personalised to reflect their occupant but again there was some damage to the decor. The floorboards and flooring had been replaced in the toilet to address the problems identified in the last inspection, though work to the panelling around the cistern was still outstanding. The home has two bathrooms, one of which also has a toliet, plus a further three toilets. The large garden was mostly turned over to lawn with some patio areas. The manager indicated that there are plans for a major refurbishment of the building as part of a three-year maintenance and repair plan now that the future of the home has been assured for at least that period. The identified priorities this year were said to be redecoration, replacement of the carpets in some areas and refurbishment of one of Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: the bathrooms and the sensory room. The kitchen and other bathroom are scheduled to be done next year. A copy of the written schedule of works was provided to the inspector on request. Laundry provision was satisfactory, and had been checked with the environmental health department as requested at the last inspection. Standards of hygiene were satisfactory. Care Homes for Adults (18-65 years) Page 24 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are supported by a well-qualified team of staff, though the remaining training shortfalls need to be addressed to ensure that current knowledge of best practice is maintained. The recruitment system operated by the provider supports and protects residents, though some improvements in the associated records are still needed. The existing training shortfalls could compromise the degree to which staff are able to maintain a consistent approach in line with current best practice. Evidence: The manager felt that the staff team were now more positive and motivated following the decision that the home shall remain open for at least a further three years while plans for its future direction are decided. This has also helped staff retention. The home has been able to recruit additional staff since the last inspection and now has a core of permanent staff supported by a small bank of casual staff, with reduced use of agency staff. Regular staffing was said to be either three or four carers throughout the waking day and one waking night and an additional sleep-in staff. The level of NVQ attainment is good with ten of the fifteen permanent staff reported to have achieved NVQ level two or above. Until recently there were monthly team meetings though there are some gaps in the recent minutes. Supervision is also provided regularly, with the aim being that this is provided bi-monthly. Appraisals have taken place previously Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: though as yet none have been done this year. Examination of a sample of recent staff recruitment records indicates that an appropriate recruitment process is in place and the manager is revising and improving the associated records on a rolling programme, though there remains some work to do on this. The provider should assist by supplying copies of any missing recruitment records for confidential filing in the home. Examination of the training records supplied suggests there are significant shortfalls in mandatory training and training updates across the team, though the manager is working to address this. It was reported that the provider had also recently recruited a new training coordinator to lead on the provision of training for the organisation. Courses are provided through a mix of in-house, external and local authority trainers. The provider must ensure that any shortfalls in mandatory training are addressed as a priority and that updates to the training are provided with appropriate regularity. In some cases the courses may need to be targeted to the needs of this residential care service rather than more generically across the providers full range of support services. Care Homes for Adults (18-65 years) Page 26 of 32 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 interests of residents by an appropriately experienced manager leading a consistent team of staff. In the absence of available feedback from residents there is room for development of the quality assurance system to maximise the diversity of sources of feedback on the homes performance. The health, safety and welfare of residents are promoted by the homes systems. Evidence: The manager is appropriately qualified and experienced to manage the home. She has attained her NVQ level 4 and Registered Managers Award and has a City & Guilds in Care Management. She has been manager for five years having previously been deputy manager. The manager has attended recent updates on key training in most areas. The culture of the provider organisation has reportedly improved following recent changes in key senior management positions. As already noted, the recent decision that the home will remain open for at least three years while its long-term future is decided, has enabled a more positive team spirit. It has also led to the development of a three-year maintenance and refurbishment plan to address the current shortfalls in the environment, which were at least partly due to the previous Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: uncertainty about the homes future. The provider has a quality assurance system in place and residents relatives have been surveyed on their opinions about the service previously. The manager felt that residents would be unable to respond to surveys. None of the current residents has an allocated care manager so this source of feedback is also unavailable, and at present staff views are not sought as part of the quality assurance process. However, the new trustees were reported to have met with the longer-term staff to seek their views. It is suggested that the views of staff are sought within the quality assurance system in the future to obtain a wider range of views on the performance of the home. The most recent QA surveys were at head office for analysis but a summary of the findings was made available immediatley after the inspection, which indicated a vast majority of positive comments from the parents. However the results related to the collective feedback about the Kingwood Trusts various services and did not relate solely to this service, which is not as useful as it might be in identifying any issues specific to this service. A summary of the quality assurance survey feedback specific to this service should be produced annually and made available to participants. The providers now undertake regular Regulation 26 monitoring visits since the changes in senior management, with copies of all monthly reports available since January 2009. The reports contain a good level of detail including feedback on any interactions with/observations of residents and staff during the visit. An annual development plan was in place for the home as part of the three-year plan now in place, comprising the redecoration and repairs plan, a Service Plan and the training spreadsheet, which identifies the current shortfalls. There was evidence of recorded progress against the goals set. Examination of a sample of health and safety-related service certification indicated servicing and testing within expected timescales. The five yearly testing of electrical wiring was being undertaken on the day of the inspection. Accident records are maintained in an appropriate format and held collectively for monitoring purposes. The records of monthly health and safety inspections were also seen. Care Homes for Adults (18-65 years) Page 28 of 32 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 Care Homes for Adults (18-65 years) Page 29 of 32 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 35 18 The provider / manager must 05/12/2009 ensure that the mandatory training for all staff is brought up-to-date and appropriately updated thereafter. In order to ensure that staff knowledge of best practice remains current. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 Consideration should be given to broadening the preadmission assessment format to include more information on the individuals skills, aspirations and goals. The provider should ensure that all staff receive an update to safeguarding training in timely fashion and regularly thereafter. The provider should ensure that any remaining omissions in 2 23 3 34 Care Homes for Adults (18-65 years) Page 30 of 32 staff recruitment records within the home are addressed. 4 39 Consideration should be given to broadening the quality assurance system to include seeking feedback from staff about the operation of the home, and to providing a summary report on the survey findings specific to the home, to participants. Care Homes for Adults (18-65 years) Page 31 of 32 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 32 of 32 - 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!