Care Home: Whiteoak

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What the care home does well We saw good interactions by the staff with people using the service. Staff were polite and discreet in their work. People staying at the home looked happy and cared for, and the comments they made about the service were positive. People`s care and support needs are assessed before a decision is made as whether they can move in. People who had previously lived at Whiteoak for a considerable length of time have either moved on, or about to move on. People`s individual needs are met, and people are given opportunities to express choices. People`s social needs are well met, and the meals on offer to people meet their dietary needs. People`s health and personal care needs are well met. People`s concerns and complaints are dealt with effectively and there is good awareness by staff in relation to safeguarding issues. People live in a clean and tidy home that suits their needs. People`s needs are consistently met by a well trained staff team. People are protected by the staff recruitment procedures, which ensure people are suitable for employment before they start work. The service is well run by a management team that are approachable, and fully aware of the need to keep people safe. What has improved since the last inspection? Some people were living at the home on a long-term basis have now moved on. One person is about to move. Activities and outings have improved, and the staff organize a good and varied amount of activities based at the service. This has been enhanced by better access to transport. Bedrooms have been refurbished, and so has most the building leaving it comfortable and homely. What the care home could do better: The contracts that people have with the service should be updated so that people are made fully aware of their rights. Care planning with people who use Whiteoak could be further improved by the use of recognized person centered planning methods. The use of positive terminology to describe people`s personal requirements would enhance the care plans. The use of non-NHS branded signage, or alternative signage could be used to show that that Whiteoak is not a medical facility, but a short term care service. The use of a satisfaction questionnaire following each visit to the home could further enhance the systems the service has in relation to obtaining feedback from people about the quality of service provided. Key inspection report Care homes for adults (18-65 years) Name: Address: Whiteoak 2 Foston Close Fagley Bradford BD2 3QF     The quality rating for this care home is:   three star excellent 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: Tony Brindle-Wills     Date: 2 5 0 9 2 0 0 9 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 28 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) 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. The material should be acknowledged as CQC 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 28 Information about the care home Name of care home: Address: Whiteoak 2 Foston Close Fagley Bradford BD2 3QF 01274323778 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bradford District NHS Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Whiteoak is a Bradford District Care Trust home situated in the Fagley area of Bradford. The home is registered to provide respite care for up to 15 adults with learning disabilities. It has recently re-opened after a major refurbishment and extension project. The respite service is divided into three units. Charges for an overnight stay begin from #8.76. 15 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 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: three star excellent 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: We visited the service and looked at the following records; care assessments and care plan files, care reviews, personnel and training records, staff meeting minutes, health and safety records. We talked to three members of staff who work at the home along with a senior manager who oversees the operation of Whiteoak. We sent surveys to people who use the service, their relatives, and professionals with an interest in Whiteoak. The comments we received were positive, with relatives stating that they believed the care and support being given by the home was very good. Below is a summary of the comments we received: I am satisfied with what Whiteoak has been doing. I am very happy with the service that my relative is receiving. I am quite happy with the staff. Overall they are wonderful. We made a request for an Annual Quality Assurance Assessment (AQAA) prior to out Care Homes for Adults (18-65 years) Page 5 of 28 visit, which the manager completed and sent back to us in time for our visit. We used this document to to cross reference a variety in information and evidence we had gathered while visiting the agency. We have reviewed our practice when making requirements to improve national consistency Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 28 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 8 of 28 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. Peoples care and support needs are assessed before a decision is made as whether they can move in. The contracts that people have with the service should be updated so that people are made fully aware of their rights. People who had previously lived at Whiteoak for a considerable length of time have either moved on, or about to move on. Evidence: Staff at the home explained in detail the admission process at the home which involves obtaining a local authority care needs assessment if one is available; meeting with the potential new person and their family; completion of the services own detailed assessment document; visits to the service by the prospective new person and over night stays if appropriate. Staff also spoke about how they undertake observations of, and discussions with the person when they visit in order to obtain further information about their needs and interests which is used to support the admission assessment. Feedback from people who completed our survey showed that they were very satisfied Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: by the way they were introduced to service, and the way they started using it. One relative said the way we started using Whiteoak went well, and as a family we were really happy. We got alot of information about the home, and were able to visit it and see it for ourselves. The detailed records belonging to two people who use the service were looked at, and the information within them confirmed that the staff had undertaken a comprehensive assessment of this persons needs. We found evidence to show that that this had been undertaken in a person centered manner, with the person themselves leading much of the work carried out by the staff team. Each person is given a written contract with the home. We looked at the terms and conditions of residency of the home, and found that they needed to be updated as they were not in an accessible format, and did not contain all the information recommended by the National Minimum Standards, and should be reviewed in the light of recent guidance on contracts from the Office of Fair Trading. It was explained that despite this, outcomes for people were seen to be good. At a previous inspection it had been noted that a number of people had been living at Whiteoak for a considerable length of time, and that it was necessary for alternative placements to be found for these individuals. Action has been taken to find placements, and all but one of the people have now moved on. The records held at the home should that the last remaining person was about to move out from Whiteoak into a place of their own. Care Homes for Adults (18-65 years) Page 10 of 28 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. Peoples individual needs are met, and people are given opportunities to express choices. This could be further improved by the use of recognized person centered planning methods. The use of positive terminology to describe peoples personal requirements would enhance the care plans. Evidence: Staff at the home explained how the plans are put together in relation to the care and support people receive. This involves consideration of the full assessment and risk assessment carried out before people start to use the service; discussion with the person about their social, personal and healthcare needs; and identification of peoples short and long term goals. We discussed the use of recognized person centered planning methods for the people who use the service, and staff at the service agreed that in some circumstances, the use of these techniques would be of benefit to the person and the staff. The three care plan files that we looked at were found to be very detailed and up to Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: date. We found that the staff have an excellent written record of the care and support needs of the people they are working with. The information was written in a person centered manner; individualized and from the persons perspective. We found information about how the staff promote choice and independence in relation to the activities people are involved in such as dressing, bathing, eating, socialising etc. We found up to date and detailed risk assessments that related to various tasks and activities that people take part in. Information about risks is given to people so that informed choices can be made. When a person is unable to fully understand the information or risks presented to them, then the records show that appropriate considerations are made and discussions take place with the relevant third parties, regarding any support plans that are devised, or restrictions that are placed upon individuals so as to promote their health and welfare. Feedback supplied by people who completed our survey showed that they were satisfied with the way peoples health and person care needs were met. One relative said, The staff are very good at helping my relative with their personal care, and always make sure they do the right thing for them. People at the service confirmed that the staff talk to them them about how they would like to be cared for and supported. One person said, the staff talk to me about how I liked to be helped, and make sure that they do what I say. The daily records of the care and support provided to people, and the activities they have been involved with were found to contain factual and detailed information. However, we noted that in one persons care plan, reference was made to the person having time out. It was pointed out that this type of terminology was inappropriate, and that alternative wording should be used to describe a persons need to either be alone or their need to have some space to themselves. Care Homes for Adults (18-65 years) Page 12 of 28 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. Peoples social needs are met, and the meals on offer to people meet their dietary needs. Evidence: Staff at the home told us that people take part in a variety of activities both inside and outside of the house. These include craft work, cooking, meals out and leisure pursuits. The records relating to the activities that people take p[art in were accurate and detailed and gave information about how these activities were linked to peoples individual needs and interests. The menus were seen to offer people a variety of meals, with a good nutritional balance. Staff confirmed that people do take part in small meal preparation if they are able, but that the catering staff do most of the cooking. The catering staff explained that if required they can cater for people with an individualized diet e.g. diabetic or Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: halal diet. Records held at the home home confirmed this. Some gaps in the records of cooked food temperatures were found, and it was explained that temperatures need to be recorded at all meals, so that there is a clear record that the food was served at the correct temperature. The records show that any restrictions placed on people in relation to access to the kitchen is well documented and all relevant third parties have been informed. Feedback from people our survey showed that they believed there to be a wide range of activities on offer to people, with one saying, My relative gets to go out and do so much. People told us that they take part in activities that are based on their personal interests and needs, with one person saying, I go out and do the things i want to do. Staff at the home confirmed that people have access to transport, but that people do make use of regular transport such as buses and taxis. The records show that people do spend time outside of the home attending day centres, and other facilities such as college. Care staff staff do have a key role to play in supporting people to live fulfilling lives outside the home by supporting people to shopping, bowling occasionally, and trips to places like Blackpool to see the lights. Other events that are organize externally usually coincide with local and national festivals such as Christmas or Diwali. People were observed to be engaged in activities such as making their own cups of tea, and watching TV. One person said that they were looking forward to the weekend when their were going shopping, and another said that even though they were staying at Whiteoak for a short period of time, they were going going to the day center which they really enjoyed. Care Homes for Adults (18-65 years) Page 14 of 28 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 health and personal care needs are well met. Evidence: Staff at the home told us that peoples individual personal and healthcare needs are well documented within the care plan records and risk assessments. A look at a selection of these confirmed this. Staff said that people are supported to attend healthcare appointments with their local GP, or other healthcare professionals. One person staying at the home conformed this. The staff said that people are supported with their individual medication requirements, by way of ordering medication on their behalf, keeping it safely on the premises and dispensing it appropriately. The detailed training records show that staff who work with medication have had relevant training. At check of the medication system at the home found no discrepancies, and the system was found to be safe. One staff member explained that peoples personal preferences are incorporated into the care plans to ensure there is a continuity of care. The care plan files of two people showed there is a comprehensive record of peoples personal and healthcare needs, that is clearly presented, in a person centered, positive and detailed way. We talked to Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: the staff about peoples needs, and they showed a thorough awareness of peoples individual needs and requirements. We saw that the staff respond to people in a sensitive and responsive manner, showing them respect and enabling them to take the lead in the care and support they receive. Examples of this were, staff sitting with people once they had returned from a day centre, chatting about their day; staff supporting people with their personal hygiene in a discreet manner; staff helping people with complex needs to get around the building safety, and making them feel comfortable. Staff at the home said that the service provided at Whiteoak gives home based carers the opportunity to take scheduled holidays or breaks throughout the year. People who responded to our survey supported this saying,We can relax with peace of mind knowing that our relative is in a safe and homely environment with 24-hour care available if they need it . People who completed our survey said that they are very satisfied with the way people are supported with their healthcare needs. One person said, The staff are very good at helping me to go to the doctors. They always help me with my tablets so that I get them at the right time. Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns and complaints are dealt with effectively and there is good awareness by staff in relation to safeguarding issues. Evidence: People who completed our survey said that they fully understood the complaints procedure. A relative who was spoken with gave details of how they would complain and to whom. Staff at the home told us that the procedure for complaining is displayed in the home, and is given to people within the homes Service User Guide. They added that efforts are being made to put the procedure into an easy read format, and that if people made a request, it could quite easily be put on an audio tape. The complaints records were seen and were in good order. Staff at the home explained that for some people, complaining may be difficult due to either a reluctance to do so, or a lack of capability. They told us that the staff are trained to look for signs of when people are feeling uncomfortable or worried, unsettled or upset. They added that that they would try and discuss issues with people and deal with their problems. They would also make efforts to access relevant agencies such as advocacy services, or the persons social worker. The detailed adult safeguarding procedures were found to be satisfactory, and the staff training records show that staff have had training in safeguarding, and other training training such as de-escalation techniques when dealing with people who Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: challenge the service. One staff member gave a clear and detailed explanation of what to do if they suspected abuse or if it were alleged that someone had been abused. People at the home said that felt safe there. We had not had any complaints about this service, and small number of minor complaints that have been received by the service have been dealt with appropriately eg Clothing lost and new clothing bought; tooth brush not returned, and sent later. Care Homes for Adults (18-65 years) Page 18 of 28 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 live in a clean and tidy home that suits their needs. The use of NHS branded signage gives the impression that Whiteoak is a medical facility. Evidence: People living at the home said that it was comfortable, clean and tidy. A look around the building confirmed this. The registered manager explained that there is a programme of refurbishment and redecoration that is followed through the course of the year. Some areas have been renewed and look pleasant and comfortable. One lounge needed further work to make it feel warm and homely, and the staff were aware of this, but the dimensions of the room will always make this problematic. We had a brief discussion with the staff about how the external part of the home, contrasts with the internal. The internal is homely and welcoming, but the external feels very clinical due to the use of NHS branded signage. It was explained that this issue could be sign to be a minor point, but the message given to the public is that Whiteoak is a clinical or medical facility, when in actual fact it is quite clearly not. We found appropriate infection control measures in place such as hand-washing and laundry facilities. One person let us have a look in their bedroom which was found to be personalized. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: Staff explained that explained that people can access the kitchen, and get involved in meal preparation. This was confirmed by people living at the home who said that they enjoyed making tea and sometimes sandwiches. Care Homes for Adults (18-65 years) Page 20 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are consistently met by a well trained staff team. People are protected by the staff recruitment procedures, which ensure people are suitable for employment before they start work. Evidence: The detailed, accurate and up to date recruitment files of 3 staff working at the home were seen to be satisfactory. A senior manager explained the recruitment procedure in detail, which again was seen to be satisfactory. Information contained within the detailed personnel records confirmed that people undertake an induction when they start work, and are on probation for 6 months to access their suitability for the job. Prior to starting work, employment checks are undertaken such as a criminal records bureau check and a check against the Protection of Vulnerable Adults List. Records relating these were seen and found to be satisfactory. The staff rotas showed that the staffing levels are very good, and this was confirmed through observations made on the day, with enough staff being on duty to meet peoples needs and requests for care and support. People who completed our survey said that they believed there to be a very high ratio of staff to people living at the home. Relatives and social workers see this as positive as it means that a number of opportunities can be created to support people with activities. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: The detailed personnel files show that the staff have been involved in a number of training courses specific to the work they do. The staff who were spoken with confirmed that they received formal supervision on a two monthly basis, and this was confirmed with information contained within peoples personnel records. The records show that more than half the staff staff have a relevant NVQ II qualification in care, and that several staff members have started work on achieving this award. People living at the home had nothing but praise for the staff team. This was supported with comments made by people who completed our survey. These included: the staff are great the staff always want to do their best for people the staff are always doing training there are always enough staff on duty. Care Homes for Adults (18-65 years) Page 22 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well run by a management team that are approachable, and fully aware of the need to keep people safe. The use of a satisfaction questionnaire following each visit to the home could further enhance the systems the service has in relation to obtaining feedback from people about the quality of service provided. Evidence: There has recently been a change in the manager of Whiteoak. This person has alot of experience, and is currently putting together an application to be considered for registration with the Commission. She has only been in post for a short period of time. The previous registered manager has now taken on a senior management role, and is overseeing all the short term care services run by the trust. Staff working at the home explained that the manager gives effectively leadership to the team by her example and what she says. This is done through training, supervision and one to one work where she shows people in what direction she would like to service move. People said that she does work with them on values and visions, such as promoting peoples rights and encouraging their involvement in decision making about their lives and life in the home. Information contained within the staff meeting minutes, training records and Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: supervision records confirmed this. Staff have had training in the Mental Capacity Act, and area fully aware of how their actions and the actions can have an impact on peoples liberty. Good records are kept of any restrictions placed on people due to risks that face them, and the senior manager overssing the service explained that when restrictions are placed on peoples movements, then all relevant parties are consulted including the person, their relatives, advocates and any relevant professionals. Records were found to support this. The detailed and up to date records shows that there are effective quality assurance systems in place for auditing and monitoring the work undertaken at the home by the staff. Staff explained that alongside these, the management team undertakes spot checks on medication, care plans, money and the food prepared in the home. Staff also explained that the management team often undertaken observations of care practice in order to give feedback on the work they are doing. Satisfaction questionnaires about the quality of the care provided are sent out to people on an annual basis, and consideration is currently being made into the idea of asking people to complete a satisfaction questionnaire following each visit to the home. The Annual Quality Assurance Assessment document we received from the home was detailed and contained good levels of information that we able to cross reference with evidence in the home. The accurate and up to date records showed us that appropriate health and safety checks are undertaken by staff at the home, and any issues that arise as a result of these are dealt with appropriately. The personnel and training records showed us that staff undertake relevant health and safety, and fire training. People who completed our survey said that the service was well run, with one relative saying, the management team are good, and they are always ready to help you out if theres a problem. A social worker said,this service is well run, and the management team are very approachable. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 5 The terms and conditions of residency at Whiteoak should be reviewed in order that it can be produced in an accessible format, and so that the documents contains all the information recommended by the National Minimum Standards, and takes account of the guidance on contracts from the Office of Fair Trading. The use of recognized person centered planning methods could further develop the care planning process, and enhance the care and support people receive. The use of positive terminology to describe peoples personal requirements would enhance the care plans. Gaps in the records of cooked food temperatures should not occur as there needs to be a clear record that food is served at the correct temperature. The use of non NHS branded signage could help to indicate that Whiteoak is not a medical, but a short term care facility. The use of a satisfaction questionnaire following each visit to the home could further enhance the systems the service has in relation to obtaining feedback from people about the Page 26 of 28 2 6 3 4 6 17 5 24 6 39 Care Homes for Adults (18-65 years) 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 quality of service provided. Care Homes for Adults (18-65 years) Page 27 of 28 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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