Inspection on 12/05/09 for Croft House

This is the latest available inspection report for this service, carried out on 12th May 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Croft House 15/11/06

Croft House 07/02/06

Croft House 27/10/05

Croft House 30/11/04

Croft House 11/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Croft House 155 Town Street Horsforth Leeds West Yorkshire LS18 5BL     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: Jean Dobbin     Date: 1 2 0 5 2 0 0 9 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 30 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 30 Information about the care home Name of care home: Address: Croft House 155 Town Street Horsforth Leeds West Yorkshire LS18 5BL 01132580131 01132580131 crofthouseFLM@stannes.org.uk www.st-annes.org.uk St Anne`s Community Services care home 7 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Croft House provides accommodation and care, without nursing, for up to seven people with a severe learning disability. It is a listed building situated in a pleasant residential area in Horsforth, very close to shops, pubs, a library, a health clinic, GPs, a pharmacy and churches. The home is accessed easily by public transport and has parking for two cars, one of which is a designated disabled space. The home is spacious, providing accommodation over two floors, with one bedroom on the ground floor and six on the first floor. There are gardens to the front and rear of the building, with outdoor seating. The service is run by St Annes Community Services, a large voluntary organisation. Each person is provided with information about the home when they move in and they are given a copy of the service user guide and details of how much their placement costs. The latest inspection report about the service is available at the home for people Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 1 0 Brief description of the care home to read. The scale of charges per week are between 890 and 976 pounds. An additional charge is made each month for the use of the homes transport. This amount varies according to peoples benefits. The manager can provide more details about this. 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 is what was used to write this report. Information about the home kept by the Care Quality Commission. Information asked for, before the inspection, which the manager provides. This is called an Annual Quality Assurance Assessment or AQAA. A visit to the home by one inspector, which lasted about 4.5 hours. This visit included talking to people who live there and to staff and the senior support worker about their work and training they had completed. It also included checking some of the records, policies and procedures that the home has to keep. Some time was also spent watching the general activity to get an idea about what it is like to live at Croft House. Care Homes for Adults (18-65 years) Page 6 of 30 Information about what was found during the inspection was given to the senior person at the end of the visit, and briefly by telephone to the registered manager a few days later. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: A hand written prescription on the medication record, could be signed and dated by the person who wrote it. This could then be checked and countersigned by a second person, as this would help to minimise the risk of an error being made. Care Homes for Adults (18-65 years) Page 8 of 30 Although staff know that they must report abuse they may witness, they could be reminded about the role of the local authority, in leading any investigations about these incidents. This would ensure that their concerns are always passed on to the right people quickly. Fire practises and drills could be organised in such a way as to make sure that all staff and people living there are aware of the procedures to be followed in the event of a fire. This could add value to the fire safety training that staff already attend. The services risk assessment describing how people are being kept safe from the risk of legionella in the water supply could be forwarded to the commission. This would help to confirm that the home is doing all it can to keep people safe. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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. Information about a prospective person moving to the home is obtained from different sources to make sure that the move is in their best interests and their total needs can be met. Evidence: One person has moved to the home in the past year and their records were looked at. They showed that a lot of information had been gathered, from a number of sources, to identify the persons physical, emotional and social needs, and whether these could be met if they moved to Croft House. These included detailed information from a care manager, from their previous care home, from an independent advocate and from healthcare professionals. This information enabled the manager to create a support plan, which could be used for when the person moved to the home. The senior person explained that the individual had visited the home the first time with their independent advocate so they had someone with them who they felt Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: comfortable with. They had several more visits including some overnight stays. This enabled them to meet the other people living there as well as the staff. A support worker spoken with confirmed this process and said that support staff felt they knew the person well by the time they moved to the home. People have a copy of the Statement of Purpose and service user guide in their room. Although it contains some photograph and signs, it is not very user friendly for people with a learning disability. The home could consider producing their service user guide as a video or DVD, which people could look at both before they visit the home and on their own, after they move to the home. 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. People are encouraged and supported in expressing their views and in leading the life they choose. Evidence: People living at Croft House have comprehensive individual plans and two of these were looked at as part of the inspection process. These include peoples likes and dislikes, and what different gestures and behaviours mean. There is information for staff about what support people want and need, in order to have some control of their lives. Examples of individualised support include likes to go shopping and paying for goods them self, but needs staff with them because of poor road safety awareness. And likes to wear makeup when she goes out, and likes to push the supermarket trolley. This sort of detail helps to make sure people receive a consistent level of support and staff do not undertake tasks that the individual can do themselves. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: These plans of care demonstrate that although the people living there have disabilities the staff are committed in supporting them to lead purposeful and fulfilling lives as independently as possible. Staff were observed talking and laughing with the people there and showed in their responses that they understood what peoples behaviours meant and what needed to be done as a result. They were seen consulting with people about day-to-day routines and listening to peoples responses, although these were not necessarily verbal responses. Staff at the home review all the care records each year and looks at peoples short and long term goals and how these are to be met. These include goals such as buying an alarm clock, and using a camera when out for the day, as well as attending a variety of social events and a holiday. These reviews are looked at each month, to ensure that identified goals will be achieved over the year. Good daily records are kept and these help to show that people are being supported to maintain as much control of their lives as possible. There are also good individualised risk assessments in the service files. These show that people are not stopped from taking risks as part of everyday living, but systems are in place to minimise the risk of harm. These included risks associated with day to day living, as well as assessments of help needed in the event of a fire at the home. People are all allowed into the kitchen, and staff encourage people to be involved in the day to day household tasks. Nobody at the home is able to look after their own money. The home has a standard care plan for each person, which describes the safeguards in place to protect peoples monies. Written records kept at the home were sampled and found to be robust. The senior care worker explained that people did not normally accompany staff when money was withdrawn from their account. Some people though may have some understanding of money and it would be good practise for those people to visit the bank with a support worker, as part of promoting peoples awareness, independence and living skills. 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. People using the service are supported to live interesting and fulfilling lives. Evidence: None of the people currently at Croft House are able to undertake any sort of paid employment because of their level of disability however one person attends a sign assisted language class and several have joined social clubs, which are held weekly. The daily records help to show that people live ordinary lives, enjoying visits to the pub, the hairdresser or helping with shopping. Some people had been to Flamingoland the previous day. The home has its own transport and a record is now kept of the people who use this facility. This helps the manager to check that people who have to pay a monthly fixed amount to the organisation for transport fees, actually use the service. People have had holidays both in this country and abroad in the past year. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The routines of daily living in the home are arranged very flexibly, according to what people want. Support, for example with bathing, is provided at a time when people want it, whether this is morning or evening. Staff were observed interacting with people, both in speaking and in non-verbal communications. The atmosphere was calm and relaxed. People are encouraged to contribute to the running of the home. This can be helping to prepare the meals, helping with the laundry, or keeping their rooms clean and tidy. People have a day each week, when they are helped with this and this help varies according to peoples abilities. These skills are recorded in their plan of care, and these everyday tasks help to maintain life skills and ordinary living. Staff are alert to the need to support peoples religious needs. One person attends a church group and their support plan records the importance of this contact being maintained. People are encouraged and supported to keep in touch with friends and family. One person spends regular weekends with their family and another person who moved to Croft House from another care setting some distance away, has been back to their old home to visit some of the people with whom they used to live. Support staff share the catering at the home. Meals are provided according to whats available in the house. On the day of the site visit there was spaghetti on toast for lunch and spicy chicken wraps, with fresh vegetables, were being prepared for tea. Fresh fruit is always available for dessert. A record is kept of what people eat each day, to show that they are having a nutritious and balanced diet. Two weeks menus were looked at, which confirmed this. They also showed that in this two week period two meals were eaten out. 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. Peoples personal and health care needs are well met and the records underpinning that support are written in good detail. Evidence: The support files looked at were written in a way that stressed the importance of promoting independence and maintaining life skills. Such as can wash themselves with prompts and can clean gums with toothpaste on finger. This detail helps staff to encourage people to look after their own personal care rather than taking over, but also ensures people are not asked to complete tasks that they cannot manage. There are good records relating to seeking health care support and guidance and these included the family doctor, optician, chiropodist and specialist doctors. One person had been referred to a specialist doctor because of their changing mental health needs. Another persons needs relating to bathing had been assessed by an occupational therapist. Peoples weights are checked each month. Staff are alert to the need for people to remain active and have healthy diet so that they remain in good health. A recent staff Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: meeting recorded a discussion about peoples weight gains and the support they need to eat the right foods to maintain a stable weight. Support staff spoken with, clearly knew peoples needs very well, and what different behaviours may signify. The atmosphere in the home was very relaxed and staff were observed interacting with people, in a sensitive and respectful manner. The home uses a NOMAD cassette system, where the pharmacist dispenses the weeks supply into individual named cassettes and then staff administer these to people each day. These are securely stored in the kitchen. At the last inspection some shortfalls were identified, however at this time the medication systems and records were satisfactory. One person had a hand-written prescription on their medication record sheet. It would be good practise for hand-written prescriptions to be signed and dated, and a second person countersign to confirm that the prescription has been written down correctly. This would help to minimise the risk of error. 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. People can be confident that complaints will be addressed properly and staff are alert to the need to protect people from harm. Evidence: The last inspection two years ago, when relatives were surveyed, states that they know how to make a complaint and if they have raised concerns the response has always been appropriate. Neither the home nor the commission have received any complaints in the past year. Peoples service files detail how people are able to communicate their needs, particularly if they rely on non-verbal communication. Two support staff spoken with were able to describe how they would know if an individual was unhappy. They were also clear about individuals likes and dislikes. This suggests that staff are alert to changes in peoples behaviours which may signify that something is bothering them. Staff also said that most of the people living there would take and show a member of staff something they were concerned about. Staff attend safeguarding adults training and five are booked to attend refresher training in the next six months. One support worker spoken with was alert to the need to keep people safe. They said that if an incident occurred at the home that could be abusive then they would inform the manager immediately. The organisation also has a telephone helpline, which they would use if the manager was not at work. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The senior support worker on duty knew immediately where the local safeguarding guidance was located in the home. However they said that dependent on the severity of a potential incident, then they might carry out their own investigation into the incident. The local authority takes the lead in all safeguarding investigations and the manager must make sure that all staff know their responsibilities, should an allegation of abuse occur at the home. Care Homes for Adults (18-65 years) Page 20 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 live in a comfortable, safe and well-maintained home, which has been adapted to meet their needs. Evidence: Croft House was noted to be clean, warm and comfortable. The furniture and furnishings were like those to be found in a family home. There were no unpleasant smells. The house has secure access and a safe and well maintained garden at the back of the house, with seating areas. All except one of the private rooms, which are all for single use, are on the first floor. The downstairs room is sited next to a newly refurbished bathroom, with an assisted bath, so is suitable for people who are not as mobile. People need to be able to manage stairs to reach the other private rooms. Two private rooms were looked at, with peoples permission and these both contained items that reflected the individuals interests. Family photographs were displayed on the walls. The communal areas comprise a large kitchen, separate laundry room, and three sitting areas. These include a large lounge, with a dining table where people and staff eat together each evening, a quiet room, which contains the computer and a well equipped sensory/music room. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Health and safety visual checks are carried out each month. The organisation employs a maintenance team who visit the home routinely and can be called on if something more urgent needs addressing. This support helps to ensure that the home is well maintained. One support worker confirmed that appropriate aids are available and used to make sure that people living in the home are protected against infection. Care Homes for Adults (18-65 years) Page 22 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. People are helped by staff who are well trained and well supported. Whilst there is no evidence that new staff arent recruited properly, the records are not available to look at. Evidence: There is an established staff team at Croft House. Both male and female staff are employed, of differing ages and backgrounds and all staff share the catering and domestic duties within the house. There is generally a low turnover of staff at Croft House, and this stability helps people to feel secure and enables strong relationships to be formed between the support team and the people living there. The manager though says that eighty shifts have had to be covered by agency staff in the past three months, because of particular circumstances during that time. She also says that there has been a higher than usual turnover of staff employed in the past year. The home keeps a file containing a summary of peoples needs for unfamiliar staff to refer to, and this helps to ensure that those needs are easily identified. Staff spoken with were able to describe peoples individual ways of communicating and could say what was both important to those people, and what they didnt like. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The rota confirmed that there are always at least two members of staff working, although at night one of these is sleeping at the home, but can be called on if necessary. There are often three people on during the week each morning and this allows the manager to have some protected time or staff to spend 1 to 1 time with people away from the home. The rota is also drawn up to take into account peoples planned activities or health appointments. Nearly all the staff have a minimum National Vocational Qualification Level 2 in Care, or are working towards the award. On the day of the visit an assessor was visiting the home and working with one of the support workers. There is a planned timetable of compulsory refresher training, which includes emergency first aid, food hygiene and equality, diversity and rights. One person spoken with confirmed that they had attended training in Autism Awareness earlier this year. Staff meetings take place monthly and good records of the last two were seen. Staff spoken with confirmed that they had regular supervision meetings with the manager, where their work could be discussed. These records were not looked at during this visit. Recruitment records are stored centrally by the parent organisation and the recruitment process is managed by the companys Human Resources department. The senior support worker said that all applicants are invited to a pre-interview day at the home where they can meet people living there and their interactions can be informally assessed. They stressed the importance of employing someone with the right beliefs and attitudes about disability and this process helps to make sure that the most suitable person, who understands the aims and ambitions of the home, is chosen. Although recruitment documents are not stored at the home it would be good practise for the manager to keep a record at the home to confirm that she has seen all the documents and is satisfied that a new member has been recruited properly. The induction programme, used when new people start working at the home is an established training programme, which is equivalent to Learning Disability Foundation Award Standards. A standard induction process means that all new staff receive the same learning and support so that they learn about good practises and how these can be provided. Care Homes for Adults (18-65 years) Page 24 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. The home is well run and the people living there are at the centre of all decisions made. Evidence: The manager is registered with the Care Quality Commission and has been in post for several years. She has also completed extra qualifications to help her in her role. She was not working on the the day of the visit. However staff spoken with described her as approachable and available for them when needed. They felt the home was well managed. She has supernumerary hours each week to carry out her management duties, but also works closely with her team so that their work can be informally monitored and she can be satisfied that staff are providing the right support. It is difficult for the views of the people living there to be formally gathered, however family are asked for feedback at their relatives annual review and the home keeps records of comments made at other times through the year. Some of these were looked at and the comments were all complimentary. For example Im very pleased Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: with the care X gets at Croft House. All the staff are wonderful. And Id like to thank you for the lovely party you put on for our Y. Thank you so much for the care you give them. A senior manager makes an unannounced visit to the home each month to carry out their own checks. Records of these visits are kept at the home. There are a range of health and safety policies and procedures in place. The home has made proper provision to ensure that there are safe working practises by providing staff training in first aid, fire, food hygiene, infection control and safe moving and handling techniques. Fire drills are carried out twice a year, however one support worker spoken with said that they had never been at work when these had happened. The manager must make sure that drills take place at such a time to ensure that all staff are present for this exercise at least once a year. Portable appliance testing was up to date. Safety certificates for the home are stored centrally by the company and copies of the gas and electric certificates were sent to us in the days following the site visit. it would be good practise to have copies of these certificates at the home so that they are available for authorised people to look at. The company employ maintenance staff who visit the home routinely every few weeks, but can also visit on demand if a problem needs addressing more speedily. Currently the home monitors the water temperature monthly to rule out the risk of legionella in the water supply. The manager was asked to send a copy of the homes risk assessment for this. The senior support worker says that all the people need help with bathing, and so people are not at risk of getting scalded. Although all the hot water taps have valves the manager needs to be satisfied that the current level of water temperature monitoring is sufficient to minimise the risk of people coming to harm. Care Homes for Adults (18-65 years) Page 26 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 27 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 23 13 Staff must be reminded 30/06/2009 about the role of the local authority as lead investigators in safeguarding adults. This is so they are clear that the local authority need to always be informed of any incident that may be abusive behaviour. 2 42 23 Fire drills and practises must 31/08/2009 be carried out at the home at times to ensure all staff know the procedures to follow in the event of a fire at the home. This will contribute to helping to keep people safe. 3 42 13 The manager needs to 30/06/2009 provide their risk assessment which shows they are keeping people safe from the risk of legionella. Care Homes for Adults (18-65 years) Page 28 of 30 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 This will confirm that they are protecting the health and safety of the people living there. 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 20 It would be good practise for hand written prescriptions to be signed and dated by the person who wrote them, then countersigned by a second person. This would minimise the risk of error. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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