Inspection on 09/04/09 for Camden Park House

This is the latest available inspection report for this service, carried out on 9th April 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Camden Park House 01/08/07

Camden Park House 22/11/06

Camden Park House 09/12/05

Camden Park House 21/07/05

Camden Park House 12/03/05

Camden Park House 25/10/04

Camden Park House 20/06/03

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Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Camden Park House 57-59 Camden Park Road London NW1 9BH     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: Pearlet Storrod     Date: 1 4 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 29 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 29 Information about the care home Name of care home: Address: Camden Park House 57-59 Camden Park Road London NW1 9BH 02072677503 02074858182 camden_park@umbrellacare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Umbrella care home 11 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 11 The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding Learning Disability or Dementia - Code MD The maximum number if service users who may be accommodated is: 11 Date of last inspection Brief description of the care home Camden Park House provides twenty-four hour support for up to eleven people with complex mental healthcare needs. The home does not automatically provide personal care i.e. physical intimate care is not within the admission criteria; however the potential is there if required. The service is operated by Umbrella, which is a mental health charity, which provides a full range of care and support services in North London. The building is owned and maintained by Community Housing Association and service users have license agreements. The house is situated approximately 10-15 minutes from Camden Town Tube station and there is access is the 253, C10 and 29 bus routes. Within the local area are a variety of local shops including a supermarket, hairdressers, newsagent, florist, chemist as well as cafes and public houses. A post office is sited within walking distance. The home is spread over three floors. It Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home comprises of two houses adjacent to each other, which have been adapted to provide registered accommodation for ten people. On the ground floor there is a main office, managers office, staff toilet, a single bedroom, a kitchen-cum-dining area, a main lounge and a non-smoking lounge. There is also a single toilet. The laundry is located in the courtyard, which is formed by the two properties and has been developed into a communal outdoor space. The average fee charged to service users is £619.69 per week 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: 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 quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This inspection took place on 9 April 2009, in a timescale of 8 hours. Time was spend talking with the deputy manager, a few staff members and some of the people who use the service. Examination of the records and scrutiny of records and files held in respect to people who use the service and staff. I toured the building to ascertain that the requirements relating to repairs and other matters outlined in the previous reports were appropriately addressed. To assist me with the inspection I used a sample of the information recorded in the Care Homes for Adults (18-65 years) Page 6 of 29 surveys returned from people who use the service, of which there were 7, including the three received from staff, one from a G.P and another from a Care coordinator. The information sent to use were positive and helpful. I also took into consideration information set out in the (AQAA) Annual Quality Assurance Assessment together with the views of people using the service with whom I spoke during the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: The manager is concerned that the landlords have been slow to address the refurbishment of the kitchen, deal with the damaged walls within the premises and redecorate the communal areas to brighten and make the house more homely and comfortable. The provider is currently pursuing this matter with the landlord. There was no evidence that the provider had conducted the monthly monitoring visits for the last 3 months of 2008 and there is no record to demonstrate that a visit was Care Homes for Adults (18-65 years) Page 8 of 29 undertaken in March of this year. They are also asked to develop a quality assurance system to enable people using the service to provide feedback independently on the quality of services offered to people living at the home. The provider is also reminded to attend to the two outstanding recommendations in the previous report. 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 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. People using the 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 people who use services and people living at the service continue to have their individual aspirations and needs fully assessed. People who use services have individual license agreements though the name of their actual landlord is not clearly defined at present. Evidence: There is evidence of comprehensive needs assessments of people who use services and staff are pro-actively working to ensure that a consistent approach is applied for current and prospective people who use services. As stated, an individual self esteem and confidence has grown since another individual had their license to occupy terminated, allowing a much calmer and relaxed presence among the other people using the service. Care Homes for Adults (18-65 years) Page 11 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. People using the 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 using the service know that their individual needs are assessed and that their goals and planned, prospective changes are reflected in their individual plans of care. Evidence: The deputy manager and I had a general discussion about the support plans and evaluation process and three files observed, showed good examples of the way in which the assessed needs of people using the service are conducted. The holistic needs of people are taken into consideration during the assessment process. Changing needs are taken into consideration and progress made are noted. Consistency of staff, in their approach to the care needs and support of an individual has enabled the person using the service to move on to more independent living accommodation within the community. One other person that was due to have their license terminated was moved on to live elsewhere. Another person who use the service is recovering in Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: hospital. The risk management plans were noted to accord with the needs and services of individuals and reviews are carried out at appropriate intervals in conjunction with care planning. Care Homes for Adults (18-65 years) Page 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the 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 who use services follow their preferred lifestyle as far as they are able and individuals cultural needs are taken into consideration in planned activities. Evidence: The (AQAA) Annual Quality Assurance Assessment indicates the ethos of the house is to encourage people who use services to have as much independence as possible. Group participation as well as individual activities are facilitated by staff according to individuals needs and choice, to enhance their life skills and self determination on an individual basis. The inherent and eccentric lifestyles of some individuals are embraced by staff, which ensures respect for the rights of individuals and encouragement for people to take personal responsibilities on board. It was pleasing to note that an Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: individual who was disappointed in not moving on to alternative accommodation last year, has now resettled to live more independently elsewhere in the community. A person who use the service told me that they are happy living at the home and two other people took pride in showing me their individual rooms; one person said the following in their survey returned to us, we have a key worker - a care plan and we make a plan for the month ahead, my key worker is very helpful. The staff listen to your problems and help with my physical health, I am very well supported here. This individual was very much supported to contact their mother, whose birthday was due in a couple of days. A cook is employed to prepare and cook lunch and the evening meals for people who use the service are decided at the weekly house meetings by the individuals themselves. A menu is on display which appears to be sufficiently nutritious. People who use services are supported to cook according to their individual needs. It was noted though that an individual raised a concern that they had asked for mixed grill for two weeks without success, an outcome was not observed from the records. Staff will need to demonstrate clear outcomes for issues such as this, supporting the individual to cook such a meal is an example of this. The home could also consider inviting the cook to the house meetings occasionally since the menus are discussed there. Further, individuals who attend a day centre usually have lunch at the day centre, information could be sought from the day centre for those who attend which can be then be integrated into the support plans ti ascertain the progress being made. A similar example should be used for those attending work experience as seen from information held at the home. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Efforts are made to promote and protect the dignity and independence of people who use the service. Evidence: Domiciliary care workers continue to provide personal care services to an individual living at this home. Improvements have been made in relation to the continence management of an individual following a previous requirement. Staff sought advice from the continence nurse adviser and are working consistently with the individual concerned in this area. Progress were noted in with regard to the individuals personal appearance and growth in their self-confidence. It should be said though that the number of people residing at the home with continence problems have increased, there is indication that additional support with personal care needs may be required. It is acknowledged that staff at the home received input from a continence nurse; the manager was previously asked to develop Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: a policy and procedure in respect to continence management for staff guidance and they asserted that they were advised to just seek advise from the continence nurse as they do not provide personal care. Each person has a different level of needs and support staff are not trained to provide personal care in the physical sense and these needs are increasing for people living at the home. Practical support will be needed on occasions when the needs of individuals with continence problems requires such. The home is asked to review the decision regarding the development of a policy and procedure for continence management for staff guidance. More support is needed to be given to another individual regarding their personal appearance when going out into the community. The individual wore a coat that was notably soiled to go shopping on the inspection day, presenting a poor personal appearance. Also noted was the ankle strap on the individuals left shoe, which was broken and tightly strapped around her ankle. After returning from the shops the individual visited the office bare footed, with swelling to her left foot, toes and instep; they then changed into a soiled dressing gown. Evidently this individual needs more practical one to one support regularly and consistently; the emphasis is to support the individual to enhance their personal appearance to command respect within the community. This was discussed with the deputy manager who asserted that they are trying to encourage the individual to take personal responsibility in various aspects, including the cleaning of their room. The physical and emotional health needs of people using the service are generally met and comments outlined in a survey returned from a care co-coordinator said, the service manages my clients mental and physical health in harmony. A G.P commented, I have always found the staff helpful, respectful and their use/contact with our service appropriate. Credible comments were made from a person who use the service who said, I am very pleased with things here. I come and go as I please and get staff support to go out, I had very good support when I had cancer. Some individuals were noted to be supported by staff to self medicate and risk assessments in this respect are taken into account in the risk management plans. Medication management was observed as satisfactory. It was noted from the information held that an individual who asserted that the food made them feel sick, purchased Immodium from the shops and shared this with another person using the service. People who uses the service should be encouraged to inform staff of any ailments that they may be experiencing and not share any medication they bring into the home with others. We also had a brief discussion about the cat who was recently put on a course of antibiotics by a Vet. Whilst examining the medication held in the cabinet I was Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: querying a medication when the deputy manager informed me that it was antibiotic prescribed for the cat. Whilst the medication for the cat has to be appropriately stored in a secured manner, it would be good practice to store the cats prescribed medication in the other medication cabinet to prevent any unforeseen circumstances that may potential arise. Care Homes for Adults (18-65 years) Page 18 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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff continues to encourage people who use services to raise concerns and complaints. Evidence: It was apparent from the complaints record and information included in the AQAA that complaints are generally managed well and within the 28 day timeframe. Seven complaints were made to the home over the last year all of which are said to meet compliance. There was one concern/complaint raised, which the manager attempted to address though the actions and outcome was not clearly defined. This was discussed with the manager who agreed to look at and review. All staff have received training in safeguarding and are proactive in their approach in dealing with such matters as they arise. The manager and her deputy were reminded to ensure that regulation 37 notification reports are forwarded to the commission within the timescale to ensure the maintenance of compliance. Care Homes for Adults (18-65 years) Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provide a clean and homely environment for people who use the service though further work is necessary to enhance the environment as a whole. Evidence: Some improvement have been made since the previous inspection and the AQAA confirms that the manager has enlisted the help from senior management to persuade the landlords to carry out their contractual obligations in respect to kitchen refurbishment, redecoration of the communal areas and to make strong attempt to deal with the large cracks to some internal walls in the house, some of which appears to have expanded since last inspected. For example a large elongated crack to a bathroom wall was very visible and such areas of the house cannot be redecorated until the situation has been dealt with. From observation of a shower cubicle in an upstairs shower room and discussion with an individual who uses the shower, they asserted that the cubicle is too small and is a problem for them to get in and out and to adequately wash themselves in it. This was confirmed to be the case by the deputy manager on duty who also asserted that another person who use the shower has also mentioned this. In view of this, a requirement is made for the shower cubicle to be Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: removed and replaced and a more appropriate bathing facility. Also observed were the improvements made to some of the rooms, the colour coordinates in the room of an individual and the cleanliness noted in the room of another individual were pleasing. The deputy manager shared the providers intention to seek an increase in their registration numbers from 11 to 12. For this to occur the design and layout of the room means that the existing radiator will need to moved and repositioned below the window for example, to ensure more space and to protect the prospective person using the room from potential harm. An individual is being supported to make their bed each day and from observation the individual also needs practical support/ guidance to clean the dusty shelves in their room also. A large vent observed to the external wall housing the laundry needs a mesh to be fitted to prevent the intrusion of vermins. A large dining table has been purchased for the house that now enables everyone living there to be seated together for their meals. New ceramic tiles have been fixed around the kitchen sink and worktop areas and the fire door leading from the kitchen to the hall has been repaired. The home continues to be clean and pleasant looking in the lounge areas and in two of the rooms of people who use the service that I was permitted to see. Care Homes for Adults (18-65 years) Page 21 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. People using the 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 people who use services benefit from an experienced staff team, appropriately trained to meet their needs. Evidence: Camden Park House has an enthusiastic staff team who works conscientiously to improve the quality of care and support services at the home for the people who use the service. Staff at all levels demonstrated a caring attitude and commitment in the work that they undertook. Staff members appear to have relevant qualifications for their supporting roles and managers alike. The manager and her deputy have started training for the Registered Managers Award. I made a request prior to the inspection for the manager to have a number of staff files available at the home for inspection in respect to the recruitment of staff. The manager agreed to do this initially prior to telephoning me later to say, the HR Manager would not allow any of the staff files to be removed from the office for security reasons. I explained that the files being made available for inspection at the service is a regulatory requirement and that I would have no alternative but to service Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: an Immediate Requirement Notice for compliance. She replied, the HR manager would need something in writing before the files are released. I explained that an Immediate Requirement Notice would have to be served in such a case; she asserted that the notice should be served if the files are to be inspected at the office. An Immediate Requirement Notice was served at the inspection and the files were brought to the office for inspection and returned. Feedback outlined in surveys from three members of staff have been positive. A staff member commented for example, I am very happy working at Camden Park House. It is a good team, supportive and allows clients to develop their skills. The team also works well with clients who may be experiencing some crisis. Having worked in most Umbrella projects, I feel that I have been happiest here at Camden Park House always plenty to do, a great team and wonderful client group. They further asserts that the service could do better if they, increase permanent staff so as to work closer with clients on a one to one basis to develop individual skills. Another support worker said, the service provide good training opportunities for staff hence promotes good practice. One other person asserts, good service offered to clients, good in-house training provided and the service encourages clients to promote independent living skills. The comments outlined in the staff surveys are re-echoed at this inspection, including the issue relating to the employment of more permanent staff at the service, we are increasing the number of residents to 12 here all of which have very high needs, it would be good to have more permanent staff. The necessary checks relating to the Criminal Records Bureau were in date and evidence of staff supervision and training were observed to be satisfactory and this is borne out in the staff surveys returned to us and information reflected in the self assessment tool. Care Homes for Adults (18-65 years) Page 23 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. People using the 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 continues to be managed well and staff are making strong efforts to ensure that the environmental standards do not compromise the quality of services offered to people living at the home. Evidence: Since the previous inspection the appointed managers registration has been approved by the commission and the home is appropriately managed as affirmed from this inspection, which accords with the information outlined in the surveys from people using the service and those with whom I spoke on the inspection day. This inspection showed that the provider had not conducted the necessary monthly visits at the service from 16/09/2008 to 31/12/2008 and there was no report available in the home to demonstrate that a visit was undertaken in March of this year. These monthly visits are to enable the provider to meet and speak with staff and people Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: using the service to ascertain their views and to monitor the quality of the services offered at the home and to recommend improvements as appropriate. Regular monthly monitoring of the service needs to be reintroduced to meet compliance. It should be noted that the self assessment document reflects that there is no quality assurance system in place as yet as the questionnaire is in the process of being devised. People who use the service are able to air their views at house meetings and key working sessions but as mentioned above, there is not yet a formal process for people to voice their concerns independently and anonymously according to their wishes. Requirements from the previous inspection report have been addressed with exception to two recommendations outlined in the previous report. The manager confirmed that work is currently being done in respect to the recruitment policy. She further asserts a willingness to develop a policy and procedure for promoting continence, in view of this, the recommendations are repeated. Overall, this inspection showed that staff do make strong efforts to ensure that the health, safety and welfare of service users are safeguarded; examination of the health and safety records demonstrated that the home continues to adhere to the National Minimum Standards to ensure compliance. The manager has solicited support from senior management to pursue the refurbishment of the kitchen, redecorate the communal areas of the house and above all, to address the disrepair and damaged walls in the house. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 34 19 The registered manager must ensure that the references for all staff employed are properly verified This would go toward ensuring that the people using the service are protected from harm 30/06/2009 2 39 26 The registered person must ensure that they visit the home at least once a month unannounced and to inspect and home and the services provided and to prepare a report on the conduct of the home. They must also have in place a quality assurance system Regular monitoring of the service would enable the provider to test the quality of the the services that are offered and to ascertain 21/07/2009 Care Homes for Adults (18-65 years) Page 27 of 29 whether the aims and objectives outlined in the statement of purpose are being met. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 5 The registered person should obtain in writing the name of the landlord responsible for maintenance and repairs of the property to enable individual people who use the service to know who to approach if they are dissatisfied about the environmental standards in the house. The registered manager should ensure that more one to one practical support and or guidance is given to an individual to dust the furniture in their room and to improve their personal appearance and wellbeing The registered manager should develop a policy and procedure for continence promotion for staff awareness and guidance. The registered manager should encourage people who use the service to inform staff of any ailments that they experience and that they are not to share any medication that they purchase, with other people who use the service. The registered manager should consider reviewing the storage of medication prescribed for the cat in the other medication cabinet as opposed to the medication cabinet where medication prescribed for people using the service are held. The registered person should ensure that the home develops a policy and procedure for promoting continence. They should also review the policy for recruitment of temporary and agency staff as the document held in the home was devised in 1999. 2 18 3 18 4 19 5 20 6 40 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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