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Care Home: Winray Care Home

  • 17 Clarendon Road Leytonstone London E11 1BZ
  • Tel: 02082797884
  • Fax: 02082796812

4Winray Care Home is a privately operated care home, registered to provide personal care and support to four younger adults who have learning disabilities. The homes statement of purpose confirms that the home is currently offering a service to young adults who fall within the autistic spectrum and/ or have severe learning disability. The home is a converted semi-detached property with accommodation on three floors. The ground floor contains one resident`s bedroom, toilet, bathroom, a lounge, a kitchen/ dining room and adjoining utility room. This leads to a garden that contains a large trampoline and an outbuilding that has been adapted to be a sensory room. The first floor contains three further residents` bedrooms, staff office, toilet and bathroom. The second floor contains the main office and a second room that is used as a staff sleeping in room. The corridors in the home are narrow, there is no lift and there is a step on the first floor so the accommodation is not suitable for residents or visitors with significant mobility problems. The home is located in a residential area in the London Borough of Waltham Forest and is close to public transport. A stated aim of the home is: to provide a home to four people and to develop the concepts of Community Presence, Relationships, Choice, Competence and Respect and Dignity, for people living in the house. Information about the service is displayed in the home, including inspection reports, and is also available on request to interested people. The weekly fees charged at the home are from £800 per week, depending on people`s assessed needs.

  • Latitude: 51.568000793457
    Longitude: 0.0010000000474975
  • Manager: Manager post vacant
  • Price p/w: £800
  • UK
  • Total Capacity: 4
  • Type: Care home only
  • Provider: Winray Care Home
  • Ownership: Private
  • Care Home ID: 18107
Residents Needs:
Learning disability

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Winray Care Home.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Winray Care Home 17 Clarendon Road Leytonstone London E11 1BZ     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: Peter Illes     Date: 2 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Winray Care Home 17 Clarendon Road Leytonstone London E11 1BZ 02082797884 02082796812 Winraycare@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Winray Care Home care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 4 Winray Care Home is a privately operated care home, registered to provide personal care and support to four younger adults who have learning disabilities. The homes statement of purpose confirms that the home is currently offering a service to young adults who fall within the autistic spectrum and/ or have severe learning disability. The home is a converted semi-detached property with accommodation on three floors. The ground floor contains one residents bedroom, toilet, bathroom, a lounge, a kitchen/ dining room and adjoining utility room. This leads to a garden that contains a large trampoline and an outbuilding that has been adapted to be a sensory room. The first floor contains three further residents bedrooms, staff office, toilet and bathroom. The second floor contains the main office and a second room that is used as a staff sleeping in room. The corridors in the home are narrow, there is no lift and there is a step on the first floor so the accommodation is not suitable for residents or visitors with significant mobility problems. The home is located in a residential area in the London Borough of Waltham Forest and is close to public transport. A stated aim of the home is: to provide a home to four people and to develop the concepts of Community Presence, Relationships, Choice, Competence and Respect and Dignity, for people Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home living in the house. Information about the service is displayed in the home, including inspection reports, and is also available on request to interested people. The weekly fees charged at the home are from £800 per week, depending on peoples assessed needs. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of this service took place on 9th May 2009. This key inspection took approximately 6 hours and was undertaken by the lead inspector. However, terms such as we, our and us are used where appropriate within this report to indicate that the inspection activity was undertaken by the Commission. The registered manager had recently left the service but the provider organisations operations manager was available to assist throughout this inspection. There were 4 residents living at the home at the time and no vacancies. The inspection activity included: meeting and speaking to two of the residents although conversation was very limited due to their communication needs; detailed discussion Care Homes for Adults (18-65 years) Page 6 of 31 with the operations manager; independent discussion with two care staff; independent discussion by telephone with a care manager from L.B. of Newham, a care manager from L.B. Barking and Dagenham and a National Autistic Society accreditation adviser. Further information was obtained from a tour of the building, documentation kept in the home, from a survey form sent to us by 1 resident and from an Annual Quality Assurance Assessment (AQAA) that the home sent us prior to this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has up to date information about the service it provides to assist prospective residents and their representatives to make informed decisions about living at the home. Peoples needs are properly assessed before they move into the home to ensure those needs can be met. Once admitted peoples needs continued to be reviewed to assist staff be aware of any changes in these. Evidence: The homes Annual Quality Assurance Assessment, AQAA, states, A summarised copy of the service users guide is available with pictorial information that is easy to follow and understand by service users. The homes statement of purpose has also been reviewed and put in a pictorial format so that people with a learning disability can understand it. A copy of both documents were seen displayed in the home for people to look at as they wished. No new residents have been admitted to the home since the last key inspection. The files of the four current residents were inspected and these showed a range of Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: assessment information about the person, both for when they were first admitted to the home and also ongoing information about peoples needs and progress in meeting these. Each person has an allocated key worker who write monthly reports on the person they key work, which helps to keep information up to date about the persons needs and any changes in these. It was also noted that assessment information was received from other professionals, including specialist health care professionals, to assist the home be aware of any changing health needs a person may have. The home also liaises with placing authorities although it was noted that annual reviews due to be undertaken by identified placing authorities were over due and that the home had agreed new dates for these to be undertaken. We spoke independently by phone to a Community Psychiatric Nurse from LB of Newham, who is a care manager or one of the residents. He stated that his resident had complex needs although had been making good progress at the home over the past months. He went on to say that the home will contact him to discuss any issues or difficulties they may be facing. We also spoke to a care manager for another 2 residents, placed by L.B. of Barking and Dagenham. She stated that her clients were receiving satisfactory support and confirmed that these 2 residents had relatives who were also satisfied with those peoples care at the current time. Care Homes for Adults (18-65 years) Page 11 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from their needs and preferences being recorded in their care plans with guidance to staff on how to assist the person meet these. People are supported to make as many decisions for themselves as they can to maximise their independence. However, residents may benefit further from staff having more access to more timely and detailed information on how residents are progressing over time and how decisions are to made to support them in their daily lives. Residents are supported to take appropriate risks to help them safely enjoy as many everyday experiences as they can, although records of how this should be achieved need to be kept up to date to protect both the resident and the staff working at the home. Evidence: The homes Annual Quality Assurance Assessment, AQAA, states,Individual service users needs and choices are clearly identified through assessment and evaluation and consultation meetings with service users key workers. This enables us to develop a service users care plan. We looked at the four residents files including their care Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: plans. These had sufficient detail, were generally up to date, included peoples assessed needs and preferences and gave guidance to staff on how to meet these. Each care plan had sections relating to the persons individual needs including personal care, medical and health care, eating and drinking, social relationships and sexuality, life skills and employment/ learning. We were told that the home is in the process of moving to an electronic recording system whereby records, including care plans, are to be kept on computer and staff training is underway to facilitate this. The operations manager told us that he was aware of the implications for data protection of this and would ensure that data protection legislation and guidance is adhered to. A hard copy of peoples latest care plan and risk assessment were seen readily available to staff so that they did not have to log on to the computer to access these during their day to day interactions with residents. We also saw evidence that key workers wrote monthly reports of their work with individuals including areas of progress and any specific issues that were currently being worked on. Those monthly key worker reports seen were up to date and detailed. Evidence was also gathered, from the records seen and from discussion with a key worker, that these monthly updates were used to inform the 6 monthly review of the persons care plan. However, these key worker reports were kept electronically and were not so easy for staff to access as the hard copy of the latest care plan. A good practice recommendation is made that a hard copy of the latest key worker report is also kept with the hard copy of the latest care plan, to further assist staff keep up to date with any changing needs the person may have. The daily records for residents were also sampled at random. The printed format for recording these was good and included sections for describing an activity, how the decision was made to undertake the activity and what the person got out of it. However, some of the recording on the forms for individual residents was minimal, e.g. went to church. Residents have a range of complex needs and the home should be able to demonstrate that residents are being supported to make informed choices under the Mental Capacity Act 2005. In addition the home is currently offering a specialist service to people with a diagnosis of autism. As a result of this a good practice recommendation is made that more detailed information should be recorded in residents daily activity sheets to assist the home demonstrate that residents are being properly supported to make informed choices about what they do and dont do during each day. At the last inspection a requirement was made that the home ensures that robust systems are in place to check that the records of expenditure of each residents money matches the amount of cash held for each resident, to ensure that residents financial interests were properly protected. We were pleased to see at this inspection that the Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: requirement was being complied with. We sampled the records of peoples money that is kept by the home and inspected the cash and record of this for one person picked at random. The records showed that the cash and the record were now being checked at each staff hand over and the persons cash and the record of this that was inspected was accurate. Cash was seen to be securely stored in individual envelopes for each resident. A range of detailed risk assessments were seen for all four residents. these identified areas of risk and gave clear guidance to staff on how to minimise these. In addition there were ABC monitoring charts to assist staff in understanding peoples behaviour after an incident or occurrence. These monitoring charts listed what the circumstances were before an identified behaviour happened, what the behaviour was and what happened afterwards. It was also noted that identified sections on a persons care plan reminded staff to also refer to the risk assessment and a hard copy of the risk assessments are kept with the hard copy of the care plan to assist with this. However, we were therefore disappointed to see that the risk assessment for one resident, with regard to them travelling in the community, had not been properly updated and showed significantly incorrect information. The operations manager and staff spoken to independently were aware of the current needs of the resident when travelling in the community, and were clear the person was being properly supported. The persons care manager also stated that he felt the resident was making good progress. However, especially given the complex needs of the residents at the home, a requirement is made regarding keeping risk assessments up to date, including current guidance to staff on how to minimise identified risks, to maximise protection for both residents and staff. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home encourages and supports residents to enjoy a range of relevant activities, both within the home and in the community. Residents are also supported to maintain contact with relatives and friends to the extent that they wish. They also are encouraged to have as much control over their lives as possible, including by make decisions and choices for themselves wherever they can. Residents are supported to enjoy healthy and nutritious meals that they enjoy. Evidence: The homes Annual Quality Assurance Assessment, AQAA, states,Service users have planned activities every week to facilitate inclusion and accessing services in the community. Family contact and development of friendships is encouraged and supported through service user involvement. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: One resident is able to travel independently in the local community and has a travel pass to assist with this. This persons care manager from their placing authority was spoken independently and told us, Staff are really doing a lot to ensure (the person) is engaged in useful activities. Another resident is currently supported to attend an external day service one day a week. Records were seen of daily activities undertaken by residents. These included activities within the home and in the community. Activities within the home include a range of crafts and indoor games, use of a sensory area in a separate building in the rear garden and a large trampoline in the rear garden that we were told was very popular when the weather was fine. Activities within the community include visiting the local park, visiting a city farm, going to the cinema and to places of worship where residents wish to do so. On the morning of the inspection three of the residents went out to the city farm and another resident was out in the community on a planned activity. One resident spoken to on their return from the farm indicated that they had enjoyed this. Although our ability to communicate with this resident verbally was limited they were able to express in a variety of additional ways, including body language and an appearance of well-being, that they had enjoyed their trip. The four residents are from different ethnic backgrounds and records seen and staff spoken to indicated that the home was working hard to meet peoples differing needs, including their cultural and religious needs and preferences. Two people are supported to attend their place of worship and peoples cultural needs and preferences are clearly recorded on their files. This included areas relating to their sexuality, including issues of potential vulnerability. Residents are supported to maintain contact with relatives and friends to the extent that they wish and which meets their needs and preferences. Records seen and staff spoken to confirmed this. It was also noted that family members were invited to attend reviews at the home and ongoing dialogue took place with residents where this was appropriate. From discussion with staff, feedback from residents and records seen it was clear that the home is working hard to involve residents in the day to day running of the home and to make decisions for themselves where ever they can. Residents can get up and go to bed when they wish and his is recorded in their care plans. They are also encouraged to get involved in the daily routines of the home where appropriate, including such things as helping keep their rooms clean. It was also noted that residents have been included on the electoral role. The home has a specimen four week menu that was seen and showed an appropriate Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: choice of healthy meals. However, we were told that the menu is adapted at a meeting on a Sunday for the following week and records to evidence this were also seen. Records of meals eaten showed that peoples cultural needs and preferences were being addressed, one resident enjoys West Indian food and the menu that week included rice and chicken with calaloo. None of the residents need a special diet although healthy eating is encouraged. Care staff are responsible for ensuring that meals are properly cooked and served with assistance from residents where appropriate. Staff have undertaken training in food hygiene and this was evidenced by records seen and by staff spoken to. The kitchen/ dining room was clean and up to date health and safety records relating to the kitchen were seen. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive appropriate personal support in accordance with their needs and preferences. However, identified recording of how this is agreed and by whom needs to be improved to maximise protection for all involved. People are supported in meeting their healthcare needs including by accessing an appropriate range of healthcare professionals. People are also protected by the homes medication procedures that are being properly implemented. Evidence: The homes Annual Quality Assurance Assessment (AQAA) states, We support service users in meeting their personal needs in a manner that respects their dignity, privacy and independence. All service users are helped to access health services by having them registered with the GP, dentist and opticians, community nurse and chiropodist. The amount of assistance with personal care that people receive varies according to their needs and how this care is to be provided was generally seen to be properly recorded on their care plan. Some people need a lot of assistance with their intimate personal care, and, where appropriate this was supported by a risk assessment. However, for one person there had been a recent change in how one aspect of their Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: personal care is provided to them but it was not clearly recorded why this change had been agreed and who it had been agreed by. Given the persons complex needs and the nature of the identified personal care that is being given a requirement is made that these details are clearly recorded to maximise protection to both the person and to the staff assisting with this personal care. Staff spoken to were knowledgeable about individual residents personal care needs and one resident, who was able to give some verbal feedback, indicated that they were happy with the support they received with their personal care. Evidence was seen from the files inspected that residents are properly supported to meet their physical, mental and emotional health needs. The records showed evidence of appointments, including with the persons GP, mental health specialists, general hospital outpatient appointments, optician and dentist. It was noted that one person had specialist needs regarding dental treatment and a good practice recommendation is made that this should be further explored, including involving the persons placing authority regarding how consent is obtained regarding any treatment. The homes Annual Quality Assurance Assessment (AQAA) states, Service users are supported in administering medication ensuring that the prescribed medication is given at the correct time and in the right quantity. We were informed that two people were currently receiving prescribed medication and the medication and medication administration record (MAR) sheets for these two people were inspected. These were found to be accurate and up to date, indicating that the medication was being safely administered. Medication was also properly stored and evidence gathered from both records seen and staff spoken to indicated that staff that administered medication were properly trained to do so. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home, and other interested parties, can raise complaints and concerns and have these acted upon appropriately. The home has clear policies and procedures for protecting people from abuse, which staff are aware of. Evidence: At the last inspection a requirement was made that the home ensures that all complaints are robustly investigated and responded to in accordance with the homes complaints procedure. This was in response to a recorded complaint that did not have a record that it had been properly responded to. The homes Annual Quality Assurance Assessment (AQAA) states, Concerns and complaints raised by service users, neighbours, family members and other agencies are addressed appropriately in accordance with the homes policy on complaints. Evidence was seen at this inspection that the requirement was being complied with. Six complaints/ concerns had been recorded at the home since the last inspection and documentation seen regarding these indicated that they had all been addressed and responded to appropriately. At the last inspection a good practice recommendation was made that the homes complaints policy should be displayed in a communal area of the home so that it was more accessible to people. This had been acted on and a pictorial complaints procedure was seen displayed in the entrance hall. A questionnaire returned from one resident indicated that the home listens to Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: complaints or concerns raised and staff spoken to were clear about the importance of dealing with any issues or concerns raised. No complaints have been received by the Commission since the last inspection. The home had a copy of the latest LB of Waltham Forest Safeguarding Adults (adult protection) policy and procedures and a satisfactory in-house policy. It was also noted that information about safeguarding people from abuse and what to do if people had concerns about this, was also displayed in the entrance hall to the home. Staff spoken to and records seen indicated that staff had received training in safeguarding adults and knew what action to take should an allegation or disclosure of abuse be made to them. No safeguarding concerns had been recorded at the home or received by the Commission since the last inspection. Care Homes for Adults (18-65 years) Page 21 of 31 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 physical environment of the home is comfortable, homely and meets peoples current needs. People who live in the home, staff and visitors benefit from the building being kept clean and tidy. Evidence: The home is a converted semi-detached property with accommodation on three floors. The ground floor contains one residents bedroom, toilet, bathroom, a lounge, a kitchen-dining room and adjoining utility room. This leads to a garden that contains a large trampoline and an outbuilding that contains a sensory room. The first floor contains three further residents bedrooms, staff office, toilet and bathroom. The second floor contains the main office and a second room that is used as a staff sleep-in room. The corridors in the home are narrow, there is no lift and there is a step on the first floor so the accommodation is not suitable for residents or visitors with significant mobility problems. However, the physical lay out of the home meets he needs of the current residents. On a tour of the premises it was noted that residents bedrooms had been personalised to their taste, including the colour that rooms are decorated. All bedrooms have a wash hand basin and there are sufficient bath and toilet facilities to meet the current Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: residents needs. It was also noted that the home had a new wide screen television in the lounge and electronic computer games for residents to enjoy, including a Wii that allows residents to physically interact with the games through the television. At the last inspection a good practice recommendation was made that the home should explore further insulation/ sound proofing in key areas of the building following concerns being expressed about noise levels at that time. We were told that this had been acted on and the previous issues regarding noise were not problematic at this time. At the last inspection a requirement was made that dirty laundry is not taken to the laundry facilities through the kitchen-dining room in order to promote infection control. A good practice recommendation was also made that the home may wish to seek professional advice on options to address this. The requirement was being complied with. We had been informed following the last inspection that a new procedure had been implemented at the home with dirty laundry being taken to the homes laundry facilities by a different route. At this inspection this system was seen to be in operation and we were informed that this was working satisfactory. We also noted that the home had received a satisfactory report following an Environmental Health visit in February 2009. Evidence was also seen that staff receive training in infection control. The home was free from unpleasant smells and was clean and tidy during the inspection. Care Homes for Adults (18-65 years) Page 23 of 31 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. Residents benefit from a staff team that work in sufficient numbers to meet their needs and who are properly trained and supported. Residents are also protected by the homes recruitment procedure, which is being properly implemented. Evidence: The homes Annual Quality Assurance Assessment (AQAA) states that the home employs 13 permanent care staff, 4 of these as senior care workers. Of these 13 staff 5 have achieved the National Vocational Qualification (NVQ) level 2 or above in care and another 6 are working towards this. The AQAA also states that the home uses 5 bank staff of whom 2 have achieved the NVQ level 2 or above in care. Staffing records sampled and care staff spoken to supported this. The home currently deploys 3 care staff on the morning shift, 2 care staff on the afternoon shift and 1 waking staff and 1 sleeping-in staff at night. We saw a copy of the homes staffing rota which accurately recorded the staff on duty at the time of this inspection. The registered managers post is currently vacant and is being covered by the provider organisations operations manager. He is currently working in a day to day management capacity on a full time basis at the home while the registered managers post is being recruited to. He was shown on the rota in addition to the care Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: staff cover and confirmed that he was based full time at the home at the present time. The home does not employ separate domestic staff or a cook with care staff undertaking these duties and encouraging residents to be involved as much as they can. Care staff spoken to told us that this arrangement was satisfactory for them and indicated that the staffing levels in the home were adequate to meet the current needs of the residents. At the last inspection a requirement was made that the home must ensure the protection of residents and staff by the service completing robust recruitment checks before a new member of staff is employed. 3 new care staff have been employed at the home since the last inspection and the staff files for all 3 were inspected. These evidenced that the requirement was being complied with. All 3 files contained: a completed application form, proof of identity, proof of eligibility to work in the UK where appropriate, 2 satisfactory references and the proper Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks. Training records sampled confirmed that staff received proper induction training and a range of other training in key areas. This included recent training including in health and safety, infection control, food hygiene, safeguarding adults, fire safety and basic first aid. In addition the operations manager told us that staff had undertaken a range of specialist training last year provided by the National Autistic Society (NAS), as part of the homes ongoing programme to be accredited with the NAS. This was confirmed by a NAS accreditation adviser who was spoken to independently by phone. Staff spoken to confirmed that they received regular training and one member of staff, that had started work at the home since the last inspection, confirmed they had received a satisfactory induction at that time. Evidence was seen that staff receive formal supervision at least every two months and those spoken to said that this was useful and that they felt well supported by management. This included at the present time by the operations manager, while the registered managers post was in the process of being recruited to. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from it being effectively managed. People accommodated and other stakeholders are consulted to promote and monitor the quality of the service they receive. A range of effective health and safety procedures generally protect people living in the home although attention is required to identified fire doors to maximise safety in this area. Evidence: The registered managers post was vacant at the time of this inspection and we were told that the post was being actively recruited to. The provider organisations operations manager was taking day to day management responsibility for the home and was based at the home on a full time basis. The operations manager presented as being knowledgeable regarding the needs of the current residents, the needs of people with a diagnosis of learning disability and autism and also with regard to management issues within a residential care home. Feedback from two care staff spoken to independently about the operations manager was very positive. This included one staff member telling us that communication and staff morale were very good under the Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: operations manager. Feedback from one resident was also very positive about as well. The home has a number of ways of monitoring quality at the home. A key worker system is in operation and this is judged as being important for obtaining ongoing feedback from residents, especially those with complex communication needs. The home also sends out stakeholder surveys to care managers and relatives with the last surveys being sent out in May 2008. copies of these and the responses received were sampled. These showed a generally high level of satisfaction with the service and also that issues raised were appropriately responded to. Evidence was seen that surveys are also sent out to staff and responded to as appropriate and we were told that the exercise would be carried out again later in 2009. We also spoke to a National Autistic Society, (NAS), accreditation adviser independently by phone. He confirmed that the home was still working towards accreditation with the NAS although still had some way to go. At the last inspection a requirement was made that written reports of the required monthly monitoring visits by the provider organisation must be made available to the registered manager of the home and that these reports must give sufficient detail of any perceived shortfalls and that compliance is checked at those visits with any requirements made by the Commission. This requirement is being complied with. Since the last inspection copies of these reports have been forwarded to the Commission by the home on a regular basis to evidence this. A range of satisfactory health and safety documentation was seen. This included: a gas safety certificate, electrical installation certificate, a portable appliance certificate and a satisfactory Environmental Health report dated February 2009. Fire fighting equipment had been serviced, fire drills held regularly and a fire risk assessment was seen. However, the physical environment of the home is subject to heavy use given the needs of the residents and it was noted during the inspection that two identified fire doors were not closing properly on release. A requirement is made regarding this to maximise fire safety at the home. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure that activities that residents participate in are free from unnecessary risk. This must include ensuring that risk assessments are kept up to date, including the current guidance for staff on minimising any identified risk. This requirement is made to maximise protection for both residents and staff. 29/05/2009 2 18 12 The registered person must 29/05/2009 ensure that proper provision is made for meeting residents health and welfare needs. This must include recording how any intimate personal care is to be offered and, where a person is unable to give informed consent to this care, how agreement to this care has been obtained, when and by whom. Care Homes for Adults (18-65 years) Page 29 of 31 This requirement is made to maximise protection for the person and staff that provide the personal care. 3 42 23 The registered person must 29/05/2009 make adequate arrangements for detecting, containing and extinguishing fires. This must include ensuring that all fire doors close and remain closed when released. This requirement is made to maximise fire safety to all that use 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 6 The home should keep a hard copy of the latest key worker reports on residents accessible and available to all staff to help them keep up to date with any new information regarding that resident. More detailed information should be recorded in residents daily activity sheets to assist the home demonstrate that residents are being properly supported to make informed choices about what they do and dont do during each day. The home should explore further how an identified residents dental health may be further promoted, including by discussion with the residents placing authority. 2 7 3 19 Care Homes for Adults (18-65 years) Page 30 of 31 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 31 of 31 - 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!

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