Care Home: Wisteria Lodge

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What the care home does well There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective service users and their representatives the information required to enable them to make an informed choice about where they live. This is also available in an specially formatted style if required. The homes` environment fully meets its stated purpose and provides a comfortable, clean and well maintained environment. There is specialised equipment in place to maximise service users independence and access to a stimulating lifestyle. Care plans reflect the health and personal care needs of the individual service users and are accessible to them and their representatives. Needs are met as fully as possible and staff encourage service users to be independent. Care is provided as consistently as possible by staff who have in depth awareness of needs. Service users have access to a varied programme of interesting and stimulating activities, making full use of their local community and attending a local college. There are robust admission processes to the home. A full needs assessment and transition document by a competent person is undertaken for all admissions to the home and they are assured in writing that their needs will be met before they move in. Families and representatives are fully involved during this process. The menus evidence a well thought out balanced diet with a varied choice of food in line with peoples` preferences. A comment received was ` The food is good and I enjoy it`. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. Comments received included: `The staff are great`. There is an open-house policy which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard service users finances. Staff provision is well maintained with a robust recruitment practice being followed and appropriate numbers of suitably qualified staff working in the home. The atmosphere of the home is pleasant with good interaction seen between service users and staff. What has improved since the last inspection? Care plans now include evidence that service users are consulted as regards gender preference in respect of their personal care. What the care home could do better: No requirements have been made as a result of this inspection. Some recommendations of good practice were made and these are referred to in the body of the report. The service users past lives could be used more pro-actively in the homes care documentation for each service user. Personal goals whilst identified are not followed through for all service users with a definite plan of how to achieve the goal and are not evaluated fully. This was acknowledged and will be introduced. It would be beneficial if a service users medication is listed and the reason explained of its reason for prescription, the possible side effects and contra indications. This will enable staff to monitor behavioral and physical traits. This is especially important for `as required medication`. Key inspection report Care homes for adults (18-65 years) Name: Address: Wisteria Lodge Horney Common Nutley Nr Uckfield East Sussex TN22 3EA     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: Deborah Calveley     Date: 2 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 29 Information about the care home Name of care home: Address: Wisteria Lodge Horney Common Nutley Nr Uckfield East Sussex TN22 3EA 01825714080 01825714081 wisterialodge@sussexhealthcare.org www.sussexhealthcare.org Sussex Health Care Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elmira Hossen Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Service users may also have a physical disability. Service users must be aged between eighteen (18) years and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated The maximum number of service users to be accommodated is ten (10). Date of last inspection Brief description of the care home Wisteria Lodge is a care home registered for ten service users who are between eighteen and sixty-five years of age and who have a learning and physical disability. The home is registered to provide nursing care. The home is located off the main A22 road, it is owned by Sussex Healthcare who own numerous care homes throughout the Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 10 10 Brief description of the care home South of England. Wisteria Lodge is located on the same site as another care home owned by Sussex Healthcare. These services are run independently from each other and both have their own communal facilities. The home is purpose built with wheelchair access throughout. All rooms are for single occupancy and ground floor. Staff accommodation is provided on the first floor. All rooms are provided with a toilet and shower en suite facilities. Overhead tracking hoists are located in some areas of the home. There is a good-sized lounge room, dining and activities area and a sensory room. An accessible garden area is located off the dining area. In addition to en suite facilities there is a wet room with shower and toilet facilities, an assisted bath and a large spa bath for service users to use. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over six hours on the 28 January 2010. There were 10 service users living in the home on that day. The purpose of the inspection was to inspect all the key standards and ensure that the home is continuing to provide an excellent service for those living in the home. Care Homes for Adults (18-65 years) Page 6 of 29 During the inspection visit, a range of documentation was viewed. These included the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of the care team were spoken with in addition to discussion with the registered manager, Mrs Hossen and a visiting health professional. The Annual Quality Assurance Assessment (AQAA) was used to provide a hypothesis of the expected outcomes prior to the site visit. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 8 of 29 No requirements have been made as a result of this inspection. Some recommendations of good practice were made and these are referred to in the body of the report. The service users past lives could be used more pro-actively in the homes care documentation for each service user. Personal goals whilst identified are not followed through for all service users with a definite plan of how to achieve the goal and are not evaluated fully. This was acknowledged and will be introduced. It would be beneficial if a service users medication is listed and the reason explained of its reason for prescription, the possible side effects and contra indications. This will enable staff to monitor behavioral and physical traits. This is especially important for as required medication. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users and their representatives receive the information they need in respect of the homes facilities in a format that is easily understood. Evidence: The home has a detailed Statement of Purpose and Service User Guide in place that gives prospective service users the information they require to make an informed choice of where to live. It was confirmed verbally that these documents are updated and reviewed regularly. They are also available in a pictorial format as well. All of the people who use the service have a copy of their terms and conditions of residence in their personal file. These evidenced that the room allocation and the fees charged are discussed and confirmed before admission to the home. These documents are signed by the individual or their representative confirming acceptance. There are ten people using the service at this time of both sexes and varying ages from 18 years to 60 years of age. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: All the people who choose to live in the home have a detailed transition document in place before admission. This document contains detailed information in respect of the persons individual needs to ensure a smooth transition in to the home and provides staff with pertinent information. As discussed this could be used more pro-actively in the homes care documentation for each service user. The service users and their families are involved in the admission process and this is includes the service users family or principal carer staying as well to ensure a smooth transition in to the home. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are encouraged and supported to be involved in all aspects of life in the home. They are offered opportunities to participate in the day to day running of the home. The service users each have a support plan with risk assessments in place that ensures that their changing needs and personal goals are monitored. Evidence: The inspection process included viewing the individual care plans of the people who use the service. They were found to be both specific to the individual and comprehensive in content. There was evidence of consultation with the service user and/or their representative. A pictorial format is in use to engage with the service users in respect of their personal care, wishes and aspirations. This also includes the preference of the gender of carer. The care plans are reviewed monthly and reviews Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: with families and health professionals undertaken regularly. It was discussed that personal goals whilst identified are not followed through for all service users with a definite plan of how to achieve the goal and are not evaluated fully. This was acknowledged and will be introduced. The needs of the people who use this service are complex and very individual and this is demonstrated in the care documentation. Wherever possible the service users are all supported in making choices and decisions on their day-to-day lives and longerterm plans. The relatives are involved on a regular basis and are kept informed of any events that take place. The care plans contain valuable information in respect of how to communicate with each service user. They identify service users likes and dislikes and their specific personality traits which ensure that they are understood and treated with respect and understanding at all times This information was invaluable during the site visit to enable the inspector to interact with the people who use the service. It was confirmed that regular service user meetings take place as well as monthly menu meetings. These give the people who use the service an opportunity to offer their views and these are then considered and if appropriate implemented. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported and enabled to participate in a wide range of varied and stimulating activities to meet their individual needs. Contact with relatives and friends is promoted and encouraged. Meals are healthy, varied and nutritious and planned with service user consultation. Evidence: The home staff ensure that each service user is treated as an individual and are responsive to their culture, religion, age, disability, gender and sexual orientation. All the service users have a busy and fulfilling lifestyle and attend a variety of activities inside and outside the home. There is a full time activity co ordinator that has produced a programme of varied activities that are devised to suit all the people who use the service. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Information in respect of daily and weekly activities is clearly displayed for service users on a pictureboard in the communal areas of the home. Activities at the home include art and crafts, a news group, story telling, cinema sessions, sensory sessions and in fair weather outdoor games and walks. There is also access to a computer that is in the communal area of the home. Some service users attend Crawley College or a local day centre, four were at college during the inspection. Other activities discussed are the Events Club when service users can attend an event such as a show concert or sporting event once a month at a venue in surrounding areas. Visits to a local church each Sunday are available for those who wish to attend. Service users can choose to spend time with others or on their own within the constraints of group living and some arranged activities. This ensures that the home is run as flexibly as is possible to accommodate their choices and wishes. Birthdays and other special events are celebrated and families and friends are invited. Each service user is offered an annual holiday and photographs of holidays and day trips are on display Contact with relatives is promoted and the home offers accommodation for relatives who may wish to stay. Discussion with the manager and staff showed that they involve relatives appropriately and there is good two way communication. The care plans evidence daily activities and these included exercise sessions, physiotherapy and hydrotherapy sessions. As discussed the activities are very important to the service users and their families and the documentation does not evidence the full participation and enjoyment expressed by the service users. Residents are supported and encouraged to develop friendships with people from colleges and external clubs. The home has a specially adapted people carrier that is used for transporting residents to and from activities in the community. The home ensures that residents dignity and rights are respected in their daily life and this was demonstrated by the interaction observed during the visit to the home. Menus are varied and there is always choice of meal service users contribute to meal planning and a photographic menu has been introduced so that choice can be as informed as possible. Meals are cooked at the larger service next door, only the Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: breakfast is prepared at the home. Drinks and snacks are available throughout the day and night from the kitchen. Service users were observed discretely at lunchtime and were seen to enjoy their meal, the meal was taken in a relaxed atmosphere with staff chatting to them whilst assisting them in a respectful matter. it was observed that staff however stand whilst assisting them and a recommendation of good practice is that they sit on a level with the service user. The diningroom, tables and equipment have been designed to encourage independence. Records are kept of residents dietary and fluid intake and where necessary supplements are prescribed and expert advice sought from appropriate health proffessionals. The menus viewed demonstrated that the residents have healthy well presented meals and snacks at a time and place to suit them individually Care Homes for Adults (18-65 years) Page 17 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected by the systems in place to manage their health care needs. Service users are treated with dignity and respect in all aspects of their lives. Evidence: The care plans are comprehensive and ensure that the people who use the service receive personal support from staff in the way that is individual. There is clear guidance for staff to follow in ensuring that the service users identified needs are met in a consistent manner. The organisation have provided care policies and procedures based on good practice guidelines and current legislation. It was confirmed that staff have easy access to these documents which ensure they can competently and safely meet service users physical and emotional health needs. Service users weights are monitored and recorded regularly as are their base line observations. This allows staff to monitor their physical well being especially at certain Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: times of the year when they receive inoculations. The home has a hydro spa and have the guidance of a Primary Care Trust physiotherapist. Structured care plans are in place for the staff to follow to ensure that they gain maximum advantages of this service to maintain their posture and muscle co ordination. The service users continue to maintain progress and are regularly monitored by the lead physiotherapist who also attends the reviews of individual service users. The care plans evidenced that the home staff support the service users to access health professionals as necessary which ensures that their health needs are appropriately met. The medication practices in the home are robust there are clear records kept of changes to the service users medication and also of the General Practitioners visits. There are clear procedures in place for dealing with medication that is provided when service users are away from the home. A recommendation of good practice is that the service users medication is listed and the reason explained of its reason for prescription, the possible side effects and contra indications. This will enable staff to monitor behavioral and physical traits. This is especially important for as required medication and the fact that the home do employ agency staff for covering holidays and sick leave. The management of medications was seen to be competent and safe at this time. There is evidence that the wishes of the service users in respect of terminal illness and death have been developed and this is being done by consulting with families and health practitioners. Care Homes for Adults (18-65 years) Page 19 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a formal complaints system with evidence that service users feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: There is a detailed procedure in place in relation to complaints. There is also a simplified version in place, a copy of which is included in the service user guide. The service users currently living in the home would need support to complain and relatives advocate on their behalf. An advocacy service is available should it be necessary. Records showed that the complaints received have been dealt with appropriately clearly recorded along with any action taken as a result. There is a detailed procedure in place in relation to the protection of vulnerable adults. All of the staff team receive training in safeguarding vulnerable adults. The staff members spoken with were clear about what types of issues would need to be reported and were fully aware of whom they should be reported to. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Wisteria Lodge provides a comfortable, clean and safe environment for those living in the home and visiting. The home has the space and facilities for service users to lead the life they choose and to meet their needs. The home has ensured that they have the right specialist equipment that encourages and promotes service users independence. Evidence: Wisteria Lodge is a purpose built home situated in a rural location in a village in East Sussex. It was designed specifically for its intended use and meets its stated purpose of meeting the needs of those with physical and learning disabilities. It is an extremely well equipped home ensuring that the service users have safe accessibility to all areas of the home and promoting maximum independence. All the people who use the service are wheelchair users. Wisteria Lodge provides a large dining room which is also used for activities, a large comfortable lounge, hydro spa room, sensory room and kitchen. The sensory room is Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: currently being decorated and therefore not in use. One service user was happy to invite the inspector to see his room. It was personalised, attractive and provides an en suite facility with overhead hoist tracking. The service user confirmed that he was able to choose the decor and that his family brought in personal items. There was plenty of space for him to manoeuvre in his wheel chair thus promoting his independence. There are service users in the home that are visually impaired and it was confirmed that their rooms include plenty of lights and tactile signs and that staff keep the areas as clear as possible. The communal bathrooms and the sensory room also have over head hoist tracking so that moving and handling is kept to a minimum. Each room leads onto an outside patio and path that surrounds the building, there are attractive views of surrounding countryside. Some service users have set up bird feeding tables and plants in their outside space. The communal garden is safe and accessible and the service users have small pets which they assist in caring for. The home is well maintained and decorated to a high standard. Communal areas as well as bedrooms evidence service users photographs on the walls enjoying activities and outings. There are picture boards showing which staff are on duty and which service users are in or out, these are helpful for service users, staff and visitors. The home has underfloor heating which contributes to the safety of the home and the AQAA confirmed that there are systems in place for monitoring safety issues such as fire checks, fire drills, PAT testing, electrical tests and gas and boiler checks. All the rooms are routinely checked for safety and maintenance issues. The kitchen is used by staff to prepare snacks and breakfast. The main meals are prepared in the adjacent home. Service users can access the kitchen with staff and cooking sessions are held. Mrs Hossen confirmed that the garden area is still being developed and will include a sensory area for people to enjoy. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of the people who use the service. Robust recruitment procedures and appropriate staff training ensure the safety and protection of service users. Evidence: From direct observation and from viewing the staffing rota, it evidenced that there were appropriate numbers of suitably trained and competent staff on duty over a 24 hour period to care for the people who live in the home. The fire safety risk assessments and service user dependency levels are taken into consideration when reviewing staffing levels at night. It was confirmed by Mrs Hossen that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the service users. from talking to the staff they felt that more staff at certain times would be beneficial to ensuring good outcomes for the service users. this was discussed with Mrs Hossen and this will be reviewed on a regular basis. A selection of staff recruitment files were viewed and demonstrated that there is a thorough and robust recruitment process in place to protect the people who use the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: service. The documentation in the files supported the information supplied in the Annual Quality Assurance Assessment (AQAA) that all staff receive a thorough induction to the home. All new staff complete a trial period to ensure that the job is suitable for them. Staff spoken with said that training opportunities are good and interesting. Mrs Hossen follows a training matrix which enables the management team to track the training needs. This ensures that all staff receive the training required to perform their job competently and therefore promoting the health and well being of the people living in the home. There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. The induction and foundation training is in line with the Skills for Care guidance. As previously stated all new staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of National Vocational Qualification (NVQ) training. The AQAA states that all care staff at this time have an NVQ in care. All staff working in the home have received training in learning difficulties and other health related illnesses. All staff receive supervision on a monthly to two monthly basis and a staff member spoken with stated that they are well supported. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefit from a managerial structure that provides leadership and support to the staff and promotes their health and safety. Evidence: Mrs Hossen the registered manager has been in post since September 2008. She is a registered nurse specialising in in learning disabilities. Mrs Hossen has worked in the home since it first opened in 2005 and was previously the deputy manager. She has the necessary qualifications and experience to run the home effectively and has completed the Registered Managers Award. The staff spoken with confirmed that they were well supported in fulfilling their role within the home. the atmosphere in the home was comfortable and friendly with a very positive ethos. the service users and staff were seen to interact very well with each other and There are systems in place to monitor the quality in the home and include the use of questionnaires. It was confirmed that these are audited, reported on and responded to. There are resident/relative meetings and staff meetings which are minuted and form part of the quality assurance system. The complaints received Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: are also audited and responded to. The home receives an unannounced visit each month from a member of the senior management team who then reports to the director on the running of the home. Record keeping was thorough and showed that a wide range of areas had been assessed and reported on. The arrangements in place for the management of residents finances were discussed and computerised records in relation to service users monies are kept. All records seen were in order and receipts kept. All policies and procedures are updated regularly. The home provided an annual quality assurance assessment in advance of the inspection and within the assessment there was evidence that the home is ensuring that all equipment is tested and serviced regularly. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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