Inspection on 27/08/09 for Chesterfield Gardens 80

This is the latest available inspection report for this service, carried out on 27th August 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chesterfield Gardens 80 20/06/06

Chesterfield Gardens 80 26/01/06

Chesterfield Gardens 80 30/06/05

Chesterfield Gardens 80 02/11/04

Chesterfield Gardens 80 22/04/04

Chesterfield Gardens 80 23/02/04

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Edenvale

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Chatsworth Care - Dawson House

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Townley Road, 2-3

Chatsworth Care - Tudor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chesterfield Gardens 80 Chesterfield Gardens 80 London N4 1LR     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: Susan Shamash     Date: 2 7 0 8 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 30 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 30 Information about the care home Name of care home: Address: Chesterfield Gardens 80 Chesterfield Gardens 80 London N4 1LR 02083506468 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Phivos Joannides care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home This home is registered for four people who have a learning disability or mental health needs. The house is situated close to Green Lanes, with easy access to public transport and local amenities. There are four single bedrooms, and an office on the ground floor, which is also used as a staff sleeping-in room. The home is one of a number locally, owned and managed by the Joannides family. This home is owned by Mr. Phivos Joannides who is also the registered manager. Weekly fees as of September 2009 are 650 - 764 GBP depending on care needs. CQC inspection reports are available to residents from the office in the home and from the CQC website: www.cqc.org.uk Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 4 4 4 4 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 30 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: This inspection took place on an unannounced basis, over approximately seven hours on two days, and was completed on 15th September 2009. I was assisted by an expert by experience, for part of the inspection. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The registered manager was not available during the inspection, however we were assisted by a staff member and the registered manager of another home owned by the provider on the first day of the inspection. I was assisted by two managers of different neighbouring homes on the second day of the inspection. Care Homes for Adults (18-65 years) Page 6 of 30 The expert by experience and I spoke with three people living at the home, the fourth person (still new to the home) did not wish to be interviewed. We spoke with the staff member on duty and members of the management team, and conducted a tour of the premises. I also inspected various records and policies relating to the home including staff and residents files, care plans, medication records, and health and safety documentation. Two residents had moved onto a more independent living setting since the previous inspection, and one had been admitted to hospital due to a deterioration in their physical health. The registered manager and his family continue to visit this resident in hospital although they are no longer a resident at the home, and the home is commended for this. Three new residents had been admitted to the home since the previous inspection visit. What the care home does well: What has improved since the last inspection? Various areas of the home had been redecorated and refurnished since the previous inspection, and improvements had also been made to the rear garden area. Care plans had been further developed to include more detail reflecting peoples preferences, abilities and goals, more fully. Improvements had also been made in the level of support provided to people living at the home in developing independent daily living skills, such as doing their own laundry and cooking meals. Safe provision had been arranged for the storage of medicines that need to be refrigerated, to ensure the safety of people living at the home including a dedicated refrigerator provided in the staff office for this purpose. Further information regarding diabetes had been made available to staff at the home, so that the identified people living at the home are supported appropriately. Staff at the home were very proactive in arranging for one resident to undertake tests leading to a diagnosis of diabetes, for which the home is commended. Care Homes for Adults (18-65 years) Page 8 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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. An appropriate system is in place to assess residents needs and goals effectively and ensure that these can be met. Prospective residents are able to visit the home prior to admission in order to make an informed decision about where they wish to live, and the rights of people living at the home are protected by contractual agreements. Evidence: Since the previous inspection, three new residents had been admitted to the home following two previous residents moving into accommodation for people with more independent living skills, and one person requiring hospital care for deteriorating physical health. At the start of the inspection the majority of residents were still in bed, but all got up during the day in order to attend opticians appointments later that morning. Both myself and the expert by experience had the opportunity to talk with three residents during the visit. The most recently admitted resident did not speak to either of us during the visit, but others spoken to indicated that their needs were being met Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: appropriately and according to their wishes. All spoke highly of the support provided and one person particularly valued the family atmosphere that is apparent within the home, feeling comfortable and safe. Records indicated that each resident including those most recently admitted, had been assessed and placed appropriately at the home. Multi-disciplinary assessments were undertaken in addition to the homes own assessments, undertaken in consultation with the new resident and relevant representatives. Records indicated that each new resident had the opportunity to visit and stay at the home prior to making a decision about whether to move in. This was confirmed by the two new residents spoken to. Appropriate statements of terms and conditions with the home, were in place for all people living at the home. These included the room to be occupied, and the rights and responsibilities of both parties, and were signed by the resident and the registered manager as appropriate. In addition local authority contracts were available for each person. Care Homes for Adults (18-65 years) Page 12 of 30 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. Recording regarding peoples changing needs and support ensures that their needs are met appropriately. People are encouraged to make decisions regarding their lifestyles according to their preferences, and are supported to take informed risks in order to develop independence skills. Evidence: All residents spoken to indicated that their needs were being met at the home according to their choices. Care plans were available for each resident, and they had been reviewed within the last six months. Three peoples care files were inspected and these were found to be detailed and up to date including information about peoples care and support needs, alongside areas in which they were independent. Information recorded showed that residents are encouraged to make choices about their individual lifestyles. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Risk assessments were available for all residents specifying agreed actions to be taken to minimise risks whilst promoting their independence as far as possible. These included risk assessments regarding diabetes management, cooking, road safety, challenging behaviour, smoking and mental health. All of these risk assessments had been reviewed within the last six months, however during the inspection it emerged that there were further risks to residents relating to food being stored inappropriately in one persons bedroom, and window restrictors. Shortly following the visit, new risk assessments had been completed to address these issues as appropriate. As recommended at the previous inspection, care plans had been developed to reflect more fully peoples preferences, abilities and goals. However it remains recommended that more information be recorded regarding residents progress with individual goals, and the support that they are provided with e.g. in the form of keyworking notes, or goal progress tracking forms. Care Homes for Adults (18-65 years) Page 14 of 30 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. A range of age and culturally appropriate activities are available for residents both within and outside of the home. Freedom is provided for people to engage in personal relationships and maintain contact with family and friends. They are encouraged to be involved in most aspects of home life, and are provided with a varied selection of meals that meet their nutritional needs. Evidence: Residents living in the home continue to be fairly independent and able to say what they like and dont like, coming and going unaccompanied. Routine daily activities of residents include attending day centres, use of transport networks, going out in the local area, shopping, going out for walks, playing the Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: guitar, writing and reading about issues of interest. Newly admitted residents are still in the process of finding structured daily activities, one person advised that they are hoping to start a college course. Another showed off their certificates in IT competence obtained from a local college. Since the previous inspection two residents have moved out of the home into more independent accomodation, with continuing support from the provider organisation, for which the home is commended. Residents advised that they had enjoyed trips to Southend on Sea, Brighton, meals out, shopping trips and a barbeque in the last year. A holiday was also arranged for four residents in Clacton on Sea this year. Staff and residents spoken to confirmed that residents continue to be encouraged to maintain family links and friendships. One resident continues to visit their sister regularly and another is supported to keep in contact with family members, who visit the home periodically. The visitors book for the home also indicated that people living at the home receive regular visitors as appropriate. All residents make use of amenities within the local community and were seen to come and go from the home independently throughout the inspection, however few are currently involved in structured activities. The management advised that there was ongoing work between staff and residents to encourage them to consider routine structured activities including college classes, art therapy, voluntary work, and drop in centres. Although people living at the home take some responsibility for keeping their rooms tidy and bringing their laundry down, they generally choose not to be involved in cooking, other than making hot drinks, or other household tasks. Instead cooking is carried out by the staff member on duty, as was observed on the day of the inspection, and confirmed by staff and residents spoken to. Staff and management are aware of the need for people living at the home to further develop their independent daily living skills, including cooking meals. The three residents spoken to advised that they were satisfied with food served at the home. The menu indicated that a varied and balanced diet is provided. The staff member spoken to was aware of residents preferences in terms of lifestyle choices as well as meals. The minutes of residents meetings also indicated that people living at the home are consulted regarding the menu. Residents advised that their cultural preferences were being taken into account, and this was reflected within the menus seen. One person noted We dont get the same meals every day, and that there is plenty of fresh fruit available. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive appropriate physical and emotional support in accordance with their preferences. They are supported to take their prescribed medicines to ensure medication needs are met. Evidence: People living at the home are mainly independent with regard to their personal care. Those spoken to advised that they have appropriate access to healthcare services. Care plans included details of their preferences in terms of the support to be provided, and records of healthcare appointments attended. All residents had been offered regular appointments with dentists, opticians, their general practitioner, and other healthcare professionals according to their needs. Discussion with the management indicated that further information regarding diabetes had been made available to staff at the home, so that the identified people living at the home are supported appropriately. Staff at the home were very proactive in arranging for one resident to undertake tests leading to a diagnosis of diabetes, for which the home is commended. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Two residents had moved onto a more independent living setting since the previous inspection, and one had been admitted to hospital due to a deterioration in their physical health. The registered manager and his family continue to visit this resident in hospital although they are no longer a resident at the home, and the home is commended for this. All of the currrent residents have ambitions to move onto more independent settings in the future. The staff member spoken to advised that they encouraged self bathing, and housekeeping skills, as well as involvement within the local community. Prescribed medicines were stored appropriately, and specimen signatures were available for all staff involved in administering medicines to residents. Medicines that required refrigeration, were stored in a safety deposit box within the refrigerator as appropriate in order to safeguard people living at the home. A dedicated refrigerator had also been provided in the office for storage of such medicines. Records of receipt and disposal of medicines were complete and up to date. No residents were self medicating at the time of the inspection, although discussion with staff indicated that it was envisaged that some residents would be able to self medicate in the future, with appropriate support following risk assessment. The majority of medicines received at the home are dispensed into blister packs by the pharmacist, and signed for on administration by staff. However a small number of medicines cannot be stored in blister packs, and I was concerned to note that there were no clear records of the administration of these medicines, even though staff and residents confirmed that they were being administered appropriately. The medication administration records must include records of the administration of medicines that are not pre-dispensed into blister packs, to evidence that these are administered appropriately. On a second visit to the service shortly after the inspection, this issue had been addressed. Care Homes for Adults (18-65 years) Page 18 of 30 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 an appropriate complaints procedure to ensure that the concerns of residents are acted upon effectively. Procedures and training are in place to ensure that residents are protected from abuse. Evidence: There have been no complaints made to the Commission about the home. Records in the homes complaint book indicated that concerns and complaints regarding the home were taken seriously, and addressed promptly. Residents spoken to were clear about how to make a complaint and advised that they would feel able to speak up about issues of concern to them. Residents appeared to feel safe and comfortable around staff members and management. No safeguarding adults issues have been identified since the last inspection and the adult protection procedure for the home is of an acceptable standard. The local authoritys adult protection policy and procedure are also available at the home. Staff have undertaken training in adult protection and addressing challenging behaviour as appropriate. Care Homes for Adults (18-65 years) Page 19 of 30 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 living at the home have adequate private and communal space, and the home is furnished to meet their needs. The home is kept clean, safe and well decorated to ensure residents comfort and protection from harm. Evidence: Four bedrooms including one bedroom with en suite toilet, are provided. There are a bathroom and toilet, and a lounge/dining area and kitchen area on the ground floor. All areas of the house were found to be clean and hygienic, in a good state of repair and decoration, with bedrooms personalised as appropriate. The standard of housekeeping was very high. Residents spoken to advised that they were happy with their accommodation. All residents have a single bedroom, and those spoken to advised that they were happy with their accommodation. A smoking area is available outside in the rear garden and the garden was well maintained with fruit trees, garden furniture and flowers. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Various areas of the house had been redecorated with new carpets put in place, and the home had a warm and inviting atmosphere. During the inspection it was noted that the television available in the lounge was a little bit small for the number of residents using it. The management advised that a new and larger digital television set had already been ordered for the home. This was already installed in the home on the second day of the inspection. However there was still some work to be undertaken in connecting it to an appropriate aerial to ensure good picture reception. It is also recommended that consideration be given to providing Sky TV and internet access within the home for the intellectual stimulation of identified residents, and that a new hi fid system be made available to residents in the lounge area. Care Homes for Adults (18-65 years) Page 21 of 30 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. Staff are sufficiently competent, experienced and trained to meet the needs of residents effectively. Suitable recruitment procedures are generally in place for all staff, however there is room for improvement in this area for further protection of residents. Regular supervision is provided to staff members to ensure that they support people in line with best practice. Evidence: The rota showed one staff on duty throughout the day and one sleeping-in staff member on duty at night. Discussion with staff and residents indicated that this staffing level was satisfactory to meet peoples current needs. All residents were satisfied with the support provided by staff, with one person describing a particular staff member as excellent and particularly easy to speak to about any issues of concern. Another person also advised that the staff were easy to talk to, describing the staff as very good. It was clear that the staff member on duty played a vital role in creating and maintaining the homely and caring environment at the home. Inspection of staff records, showed that each contained evidence of satisfactory enhanced Criminal Records Bureau (CRB) disclosures, references, identity documents and application forms. However I was concerned that the CRB disclosures for two staff members were undertaken by their previous employers/college rather than the home. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Discussion with the management indicated that there had been some confusion over the new arrangements for obtaining CRB checks now that smaller providers cannot form their own umbrella bodies. I clarified the situation to the management staff on duty and advised that more information could be provided from the Criminal Records Bureau itself. A requirement is made accordingly. Records indicated that staff receive an adequate induction before working unsupervised within the home, in addition to general mandatory training. Training courses undertaken included fire safety, adult protection, first aid, challenging behaviour, control of substances hazardous to health, diet and nutrition, and dying and bereavement. Since the previous inspection, staff had also undertaken training in the Mental Capacity Act 2005, Equality and Diversity and Mental Health Awareness, although some of these certificates had not yet been received. The registered persons are aware of the requirement for fifty percent of staff to be trained to the equivalent of NVQ level two in care, and have sufficient staff members undertaking or who have already completed this qualification to meet this national minimum standard. Records of staff supervision sessions and appraisals indicated that one-to-one sessions are being held for staff regularly and that these cover a range of relevant topics as appropriate. Staff spoken to confirmed that this was the case. Two people living at the home have diabetes, and staff were generally aware of the support they needed to manage this condition. The management advised that inhouse training had been provided to staff in this area, as well as in an accessible format for the residents involved. Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from accountable management and quality assurance systems. Appropriate health and safety procedures protect them from harm within the home. Evidence: The registered manager has completed the Registered Managers Award at National Vocational Qualification level 4, and a certificate was available to verify this. He hadundertaken a range of relevant training including training in the Mental Capacity Act 2005, and training in equalities and diversity. He is supported in managing the home by the two managers of the other residential homes owned by the family. Minutes of regular residents meetings were seen, indicating consultation regarding the running of the home. Residents satisfaction questionnaires had been completed by the residents of the home as part of the quality assurance procedure. They indicated that they were satisfied with the support they received within the home. These included feedback forms completed by those who had more recently moved into the home, providing feedback about the admissions process. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The manager is due to complete the Annual Quality Assurance Assessment shortly, and had completed one last year as required. This identified areas to be addressed over the forthcoming year, including further consultation, training and activities provision. Evidence was provided that the appropriate level of liability insurance was available for the home. Accidents and incidents were recorded appropriately, with relevant incidents notified to the CQC. Health and safety records for the home were inspected and included appropriate gas, and portable appliance testing certificates and fire safety records. Detailed records were available for all fire drills and fridge/freezer temperatures. However the electrical installation certificate for the home had expired, and therefore a new certificate needs to be obtained for the home to ensure the safety of people living and working within the home. The records of weekly fire alarm checks were complete however it was unclear as to the order in which each call point was tested, and it is recommended that this should be clearer to ensure that no point is missed out. Care Homes for Adults (18-65 years) Page 25 of 30 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 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must 23/10/2009 ensure that risk assessments are undertaken regarding all relevant areas of risk relating to people living at the home including storage of food within one persons room, and the need for window restrictors, and that these are reviewed regularly, to ensure that people are supported to increase their independence skills, by taking informed risks, with appropriate staff support. . 2 20 13 The registered person must 09/10/2009 ensure that all medicines administered to people living at the home, including those not dispensed in blister packs, are clearly signed for at the time that they are administered, to ensure that peoples medication needs Page 27 of 30 Care Homes for Adults (18-65 years) 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 are met safely. This requirement had been met by the time of the second visit to the home. . 3 34 19 The registered person must 30/10/2009 ensure that new Criminal Records Bureau enhanced disclosures are undertaken for the identified staff members, to ensure that residents are safeguarded as far as possible. . 4 41 13 The registered person must 13/11/2009 ensure that a current satisfactory electrical installation certificate is obtained for the home to ensure the safety of people living and working within the home. . Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 It is recommended that more detail be recorded in care files regarding progress made by individuals with regard to their goals and support needs. It is recommended that consideration be given to providing Sky TV and internet access within the home for the Page 28 of 30 2 24 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations intellectual stimulation of identified residents. The new televisions reception should be improved, and a new hi fi system should be provided in the lounge area. 3 42 It is recommended that a clearer system be put in place to monitor weekly fire alarm checks whereby each call point is tested in a set order, to ensure that no point is missed out. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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