Care Home: Woodlands

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What the care home does well The needs of people are assessed before they move in so they know that their needs can be met there. People told us they know how to make a complaint and that staff listen to them. People get the opportunity to take part in activities that they enjoy. People are supported to maintain relationships that are important to them. People are supported to make decisions about their life and to maintain and develop their independence. People are involved and their views are sought on recruiting suitable staff. The home is decorated and maintained to a good standard and is homely and comfortable for people to live in. Health and safety is well managed to ensure people`s safety. Detailed reports with action points are completed by the homes senior managers so the home continues to be well run for the benefit of the people living there. What has improved since the last inspection? We made no requirements or recommendations at the previous visit to the home. Staff have had ongoing training so they know how to meet peoples needs. Care planning systems have continued to be developed so staff have the information they need to know to meet people`s needs. Opportunities for people to take part in activities has improved so people do things that they enjoy. What the care home could do better: Medication security and storage must be improved so people receive their medication safely. Key inspection report Care homes for adults (18-65 years) Name: Address: Woodlands 435 Shirley Road Acocks Green Birmingham B27 7NX     The quality rating for this care home is:   two star good 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: Donna Ahern     Date: 0 7 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Woodlands 435 Shirley Road Acocks Green Birmingham B27 7NX 01217785718 01217785718 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: suehullin@tracscare.co.uk TRACS LTD care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category PC Care Home Only to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Mental Disorder MD 6 Date of last inspection Brief description of the care home Woodlands Care Home is registered to provide accommodation and personal care for a maximum of six adults with mental health issues. The home is located in the Acocks Green area of Birmingham. It is close to bus and rail links and a public leisure centre. There are several shopping areas within walking distance. The house is a large detached property; it is set out over three floors. The accommodation consists of six single occupancy bedrooms all with en-suite facilities, which include a walk in shower. One bedroom is on the second floor, four on the first floor and one on the ground floor. A passenger lift is not provided so the home is not suitable for people with mobility difficulties. There are two lounges one is used as a quiet room. There is a kitchen with an adequate dining area for up to eight people. The home is a non smoking Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home environment an ouside covered patio area is provided for people who choose to smoke. There is a garden to the rear and to the front of the home there is a private drive offering parking for three to four cars. Details of fees charged is available from the home. In the reception area there is information on display including the complaints procedure and a copy of the last inspection report was available for people to read. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 visit to the home was undertaken by one inspector over one day. We, the commission were assisted throughout the day by the deputy manager. The manager of the home was present for feedback at the end of the visit. The home did not know that we were visiting that day. There were five people living there. Information was gathered from speaking to two people who live at the home and observing care and support. Three staff were spoken to. Two peoples care was case tracked. Case tracking involves discovering individual experiences of living at the home by meeting or observing them, discussing their care with staff, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files and health and safety records were also looked at. Care Homes for Adults (18-65 years) Page 6 of 28 Before our visit we reviewed any notifications received about the home, these are reports about things that have happened in the home that they must tell us about. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home think they are doing well and where they need to improve. It also gives us some numerical information about the staff and people who live at the home. Prior to our visit we sent out surveys to the five people who live at the home and six staff. At the time of writing this report we had not received any completed surveys. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need about the home and their needs are assessed prior to admission so they know they can be met. Evidence: At the time of the visit five people were living at the home. The manager was involved with reviewing referrals for the vacancy. We saw that a detailed pre assessment and referral procedure is established. The organisation has staff employed who specifically complete the assessments. The manager told us he is also involved in this process as he is best placed for ensuring that any potential new people are compatible with the needs of the people who already live there. We looked at the care records for two of the people. Detailed assessments were completed prior to admission and these involved other relevant people including the individual, professionals and peoples family. Other reports to support the assessments were available so ensuring comprehensive information is gathered prior to a place being offered. The statement of purpose and service user guide provide people with the information they need to know and have been produced in an easy read style. The home is Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: planning to support people living there to add their comments to the service users guide so it is more meaningful to prospective people. CQCs Newcastle address details needed updating so people would know how to contact us if they wanted to. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support to make choices and decisions about their day to day lives. Staff have detailed information so they know how to support people well. Evidence: We looked at two peoples care plans. Care plans explain what each person needs are and the care and support they require to make sure these needs are met. The two plans looked at gave detailed information about how staff should support the person in order to meet their individual needs in relation to personal care, health care, social activities and personal development. Care plans recorded details of peoples culural needs and how these needs will be met. We saw that people sign their care plan ensuring their involvement. There was evidence that when needs change the plan was updated so people received consistent support from staff. A number of risk assessments were looked at. These detail the support people need to be kept safe while still being enabled to be independent. These included assessments about community access, smoking, medication, use of the kitchen, laundry and fire Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: safety. These had been kept under review so that the control factors in place remain relevant and any unnecessary restrictions are removed . The AQAA told us that the homes clinical support nurse is involved with the review of risk assessments. People told us Staff talk to me about my care plan. Sometimes I want to see it and sometimes I dont and The manager shows me my care plan and prints me my own copy. We spoke to staff who were able to demonstrate a good understanding of peoples needs and of the risk assessments in place and how they should support people to minimise any potential risks to their safety. Reviews are held with the person and other relevant people so their care plans are kept under review and to ensure the home continues to meet their needs. Daily records were very detailed and are directly related to peoples care plan so identified needs are continually monitored ensuring the care plan is an active document. The AQAA told us that care plan documentation has been improved and care plan training has been provided for all staff. There was a notice board for people living there. We saw a range of information was displayed including a summary of the complaints procedure, menu information, activity information and house meeting details which keeps people up to date with what is happening in the home. We saw that minutes are kept of house meetings however these are not always monthly. From observations on the day we saw that people are supported in a respectful manner. Interactions between people living there and staff were good. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to make choices about their lifestyles, to develop their independence and live fulfilling lives. Evidence: We looked at care plans and daily records to establish that people are leading meaningful lifestyles. People told us that staff support them to look for suitable day time occupation. One of the people told us I go to a local gym three times a week and I am also involved with the local church and go there twice a week. On the day of the visit people went food shopping for the house and went to a bingo session at a local club. People have been supported to attend college courses or vocational skills. We saw an activity planner on peoples care files and information about their likes and interests. The AQAA told us activity planning has been improved over the last twelve months Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: and the activities that people are involved in are now reviewed more throughly alongside the care plan so ensuring that opportunities for people are beneficial. Independent living skills assessments are completed and used as a base line so that people can then be supported to develop their independent living skills.One of the people told us they are hoping to move to a more independent living arrangement soon. We saw that they manage their medication independently and are involved with day to day tasks in the home including laundry, cooking and domestic tasks so they can maintain and develop their skills in these areas. One of the people said Staff try and get us to do things for ourselves. Risk assessments are completed for peoples ability to manage a front door key. We saw people freely access all areas of the home. There was no evidence of rigid routines. We saw people get up, go out and eat meals at different times. We saw on peoples care files that they are supported to maintain links with family and friends so that important relationships are maintained. Staff told us that significant support is given to people so relationships with people important to them is maintained. On the day of the visits one of the staff supported one of the people to visit their friend in hospital.All contact is recorded and also details of any important events such as family birthdays. People told us that staff support them to visit their family and friends and when their family visit them at the home, they are made welcome by staff. The AQAA told us that all staff take part in sexuality training annually and there is a policy on sexuality which sets out guidelines for staff on the legal aspect of non discriminatory practice. We saw a range of tinned, frozen and supplies of fresh food. Menus looked at identified a variety of meals. Staff said menus are planned with peoples involvement and they are supported to go to the local shops to buy the food. We saw records of tests in place for food and storage safety checks, which means food is stored and prepared in a hygienic and safe manner.People told us I help cook a meal sometimes The food is good we are asked what we want to eat and I can go to the kitchen anytime and have a drink or snack. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements in place ensure peoples health and personal care needs are met. Evidence: The majority of people required minimal assistance from staff to meet their personal care needs. We saw people were wearing clothing appropriate to their age, gender, culture and the time of year. Care plans had information about how much support people require to meet their personal care and health needs. We saw that other professionals are involved with peoples care and details of any appointments and the outcome were detailed on their care plan. This should ensure their health care needs are monitored and any follow up action is taken. Mental health assessments are completed by the home manager so these needs are well planned for. Relapse prevention plans are in place so staff know what to look for and how to support people promptly should there be deterioration in their wellbeing. Behaviour management plans are in place and inform staff about how they can support people. Positive interactions are included so the safety and wellbeing of people is promoted. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We saw that systems are in place to weigh people regularly. This is good practice as weight gain or loss can be an indicator of other health problems. Medication is stored in a locked cabinet. The cupboard was found to be tidy and well ordered but the base of the cupboards had not been kept clean after spillages. The medication administration records (MAR) had not been signed on a few occasions, or a code entered which may mean people did not get their medication as required. Copies of prescriptions are retained so staff can check the right medication has been received from the chemist. Staff signatures and initials used to identify who had given medication had not been kept up to date making it difficult to have an audit trail of medication administration. Staff training records indicated that staff have received this training so they have the skills and knowledge to support people with their medication. The room that the medication is stored in was warm. We were told a window is left open to regulate the temperature so the room is not to warm for the medication.The fridge used for storing medication had a built in fan which came on at very regular intervals. There was no work area for staff to prepare and sign for medication which could lead to errors being made.There was a metal cupboard placed on the floor and not secured to a wall. We were told that this was the storage for controlled drugs. None were being stored at the time of the visit. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are arrangements in place to listen to peoples views. Systems in place should ensure people are safeguarded from the risk of harm. Evidence: The complaints procedure was in the statement of purpose. A summary version in an easy read format was on display on the notice board in the hallway so people would know what to do if they had a concern. People told us they would speak to the manager, deputy or any of the staff if they were not happy about something. They said I know how to make a complaint and The staff are good I can talk to them. We looked at the complaints log and register and saw that complaints and their outcome are logged in full so we could read what action the manager had taken to resolve complaints raised with him. A former client did raise some concerns with CQC which were passed onto the home to investigate. These concerns included too many staff on duty, an activity being cancelled and some concerns about the behaviour of other people living there. We were satisfied with the action taken to address these concerns. The AQAA told us the organisations has systems in place for analysing complaints to establish any patterns for future prevention. We saw that safeguarding and whistle blowing procedures were available for staff to Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: refer to. Staff who we spoke with demonstrated a general understanding of their duty to safeguard people and how to report concerns on to senior managers. We looked at training records to determine that training in safeguarding vulnerable adults had been provided.The Manager and senior staff have completed Mental Capacity and Deprivation Of Liberty Safeguards training so they have the knowledge of this important legislation and the impact for people living there. There have been some incidents in the home that have required reporting to CQC and other authorities. The home has made appropriate referrals to Adults and Communities under safeguarding procedures and where necessary further investigations have taken place. We saw that a copy is kept of all reportable incidents however there was no log of these kept which may mean there is not a full audit trail of information. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is safe, comfortable, homely and meets their needs. Evidence: The home is situated in a residential area in Acocks Green. There are a range of shops, public transport links and leisure facilities close by. This is important to the people who live there as they make regular use of these amenities. The home is a large detached property set out over three floors. There are two lounges one is used as a quiet room, the larger lounge has doors leading to a raised patio area with a cover over and is used as a smoking area. We saw lots of lovely paintings well displayed around the home. We were told staff and people living there had produced the work. The stairway leading to the first and second floor is steep and not suitable for people with limited mobility. There is no lift. A laundry room is provided on the ground floor with relevant domestic style equipment for people to use. An office with adequate storage space is provided on the first floor. All bedrooms are single and have ensuite shower facilities which ensures the privacy and dignity of people. One of the people showed us their bedroom. It was personalised Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: and reflected the persons individual tastes, gender and preferences. They told us they were happy with their room and liked to spend time in there. Additional communal toilet and bathroom facilities are provided on the first floor so people have the choice of having a bath. The home was clean , fresh and organised indicating good systems are in place for maintaining a hygienic environment. Staff and people living there are responsible for all domestic tasks and rotas are in place so tasks are shared. The kitchen cupboards and work surfaces have become worn and need replacing so a safe environment for the preparation and storage of food can be maintained. The heating system radiators within the home can be thermostatically controlled and are of a low surface temperature type minimizing the risk of injury to people. We saw items assessed as hazardous to health were kept in a locked cupboard so reducing any risks to people. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure people are supported by an effective staff team. Evidence: The home has three staff on duty during the day. At night there is one staff on duty and one sleeping in on-call. There are currently no staff vacancies and a very low use of agency with only one shift in the last three months covered by agency. The deputy manager told us there is flexibility to raise staffing levels to four if any of the people living there are unwell or unsettled. People told us The staff are good they try to get us to do things for ourselves. There is always someone to talk to you. You can speak to the staff anytime and There is always staff around if you need them. Interactions between people and the staff supporting them were entirely positive. Staff spoke respectfully to people and they knocked peoples bedrooms doors and waited to be told to come in, before entering. Staff told us there is enough staff on duty to meet peoples needs. Staff rotas seen reflected what we were told and indicated that staffing levels are adequate to meet the needs of people. The majority of staff have completed a National Vocational Qualification (NVQ) level 2 in care. This should ensure that staff have the knowledge Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and skills to support people individually and collectively. We saw certificates of training on staff files covering various topics such as first aid , studio three (recognised training for supporting people with challenging behaviour), fire and food hygiene. The manager is working on producing a matrix identifying when updates are due. We were told that manual handling training and specific mental health training is in the process of being scheduled so staff have the required knowledge and skills they need to support people effectively. We saw that a 12 week induction package is in place this was seen to be comprehensive and should ensure that staff are knowledgeable about their role. We looked at two staff files and these contained all the required information to ensure that people were safe from harm. We saw evidence that Criminal Records Bureau (CRB) checks had been completed ensuring only staff suitable to work with vulnerable people are employed. The AQAA told us people living in the home are involved in the homes recruitment process and have been involved in a training day. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements in place ensure the health, wellbeing and safety of people is promoted. Evidence: The manager has a number of years experience and completes training courses to keep his knowledge up to date. This should ensure that he has the knowledge to support staff and ensure the home is run well for the people living there. The manager is supported by a deputy and a senior worker which ensures there is always a manager on duty to support the staff team. The home has systems in place to monitor the quality of the service provided. The views of people living there and their representatives are sought through surveys so improvements can be made. Monthly visits are completed by the owners representative as required. We saw copies of comprehensive reports with clear action points for follow up by the manager. In preparation for our visit the manager completed an Annual Quality Assurance Assessment (AQAA) which identifies the strengths of the home and areas for improvement. This was completed to a good standard and returned to us within the timescales given. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The previous inspection raised no requirements or recommendations. At this visit it was identified that improvements were needed to the arrangements in place for medication storage and some aspects of medication administration so people continue to receive their medication safely. The manager responded very positively to our feedback and assured us that improvements would be made in this area. Comprehensive health and safety procedures are in place. We looked at some of the safety checks and saw that gas, electric and fire checks have been completed so that a safe environment is provided for people to live in. Regular fire drills take place so people know what to do if the alarm is activated. All accidents are analysed by the organisation on a monthly basis and a report kept so ensuring any action to minimise occurrence is taken. The manager told us training for staff in manual handling has been identified as a training need for the team. None of the people require lifting but sometimes people need some guiding. This training will ensure that staff have the knowledge to support people safely. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 Arrangements for the 20/02/2010 storage of medication should be reviewed. So that medication is stored safely and meets current legislation requirements. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 1 20 CQC contact details should be updated so if people need to, they know how to contact us. Medication records should always be signed or a code entered so ensuring people have received their medication as prescribed. The kitchen cupboards and work surfaces should be replaced so a safe and hygienic environment is maintained. 3 30 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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