Inspection on 23/11/09 for Dale House

This is the latest available inspection report for this service, carried out on 23rd November 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

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Craigmore House

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Dale House Front Street Dipton Stanley Durham DH9 9DE     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: Kathy Bell     Date: 2 3 1 1 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Dale House Front Street Dipton Stanley Durham DH9 9DE 01207570652 01207570652 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Potensial Limited Name of registered manager (if applicable) Miss Claire Louise Carlyon Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category 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 category: Learning disability Code LD, maximum number of places 9 Date of last inspection Brief description of the care home Dale House is registered to provide care (but not nursing care) for nine people with learning disabilities. Most of the people who live there have been there for some years. The building is a large detached house, with a purpose-built extension on the ground floor. All the bedrooms are singles (one has an ensuite shower and toilet) and there is a large lounge and a separate dining room downstairs. The house is near the centre of the village of Dipton with local shops and doctors surgery nearby. There are bus Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 1 7 0 3 2 0 0 9 Brief description of the care home services to the local towns of Stanley and Consett. The fees for this home were not available at the time this report was written. 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: This inspection took place during one day in November 2009. During the visit, we looked around the building, we talked with most of the people who live there and with the manager and two of the staff. We looked at records kept in the home, including care plans. Before the inspection, staff had filled in surveys with people who live in the home. We also received three surveys filled in by relatives of people who live in the home, five filled in by staff and two by social workers. The manager sent us a report (the AQAA). This report gives their view of what the home is doing well and what it could do better. We used this information when we did the inspection. In the last report we may have told the home to improve what they do. We call this making Requirements or Recommendations. If the home hasnt done what we told them to, but this doesnt affect peoples safety, we may not tell them to do it again. In future, if we have to tell a home a second time, we will probably take action to make them do what we say. But Dale House has done what we told them to do to Care Homes for Adults (18-65 years) Page 6 of 29 make the home safe. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The manager should continue to see if residents want to do any other activities at weekends. She should use this information to look at what staffing levels are needed, to meet peoples needs in this area. When peoples needs change and they need intensive care and support in the future, the company which runs the home must provide sufficient staffing at once to make sure everyones needs are met. The garden should be improved so it is a pleasant place to sit out in and large enough and accessible for all the people who live in the home. The manager should continue working towards the qualifications recommended for care home managers. She should record who takes part in fire drills to make sure that all the staff take part in them regularly, so they are familiar with what to do if there is a fire. As part of the system are looking at the quality of care in the home, she should ask relatives and social workers what they think of it. Care Homes for Adults (18-65 years) Page 8 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides valuable information for people who might consider using it, in a form which is easy to read. No one new has moved into the home for some time but the home has systems to make sure they would get the information they need, to be sure they would be able to meet any new residents needs. Evidence: The home has changed its Statement of Purpose and Service User Guide. These are the documents which a home must provide to explain who is running the home and the kind of service it provides. The Statement of Purpose contains all the information which it has to do is include by law and is up-to-date. It has been written in plain English and describes the things someone might want to know if they were thinking of moving into this home. The Service User Guide has been provided in a pictorial format so it can be used with people who find this more useful. No new people have moved into the home for some time, but before each of the current people was admitted, a care manager assessed their needs. We saw from the Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: records in the home that the manager has asked care managers to look again at peoples needs when this has been necessary, for example, when they needed extra services. The company which runs the home has also provided its own assessment document, to be used when someone is considering moving in. This makes sure that the home itself would look at whether they would be able to meet the needs of the new person. This is good because it includes looking at whether staff would need extra training. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a care plan which explains the care and support they need. These contain a lot of useful detail so staff know exactly what people wanted and needed but do not include enough information on responding if people were angry or upset. People can make choices in their daily lives. Staff have recorded whether any activities put people at risk and described what they must do to keep people safe. Evidence: Each person has a care plan which explains the care and support they need from staff. There is a useful description of the help they need from getting up in the morning to going to bed at night. This includes explaining what people can do for themselves, so that staff do not take away their independence. The full care plans explain what staff are trying to achieve in each area of someones life. There are sections on how people communicate, if they need any special meals or help with eating, and their needs for leisure, employment or education. There is also a section which explains what may make people angry or upset, which could lead to behaviour problems. We looked at Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the care plan for a person who does become upset sometimes and the plan explained what things upset her. But it did not give detailed guidance on how staff should respond if she had become upset. In surveys, the residents who could be helped to fill in surveys said they could make decisions about what they did and do what they want at all times. We asked relatives if the home supports people to live the life they choose. Two said always and four said usually. The daily records mention people choosing when they go to bed etc. We saw the records of the residents meetings and in these people can say what meals they would like and where they would like to go on holiday. Staff have recorded when activities people take part in might create risks for them. These risk assessments explain what staff must do to keep them safe. For example, risk assessments describe how staff must supervise someone in the kitchen. Another gives detailed information on how to keep one person and staff safe when travelling by car. Staff were reviewing these risk assessments to make sure they were up to date. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most people take part in a range of activities outside the home and staff make sure that one person who doesnt go out, receives one-to-one staff attention at least once a day. But staffing levels mean it is difficult to take people out at weekends. People can maintain contact with their families. People are given a choice in the meals they have, are asked if they want any changes to the menu and special dietary needs are met. Evidence: Most people who live in the home go out during the week to activities arranged by their social workers. These range from visiting a local drop-in centre, to activities specially for people with learning disabilities and trips out and about in the local community. In the home, there is a keep fit session once a week and at weekends the records show staff entertain people in the home with music and keep fit activities, as well as cookery sessions. Some more independent residents go out to individual Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: activities in the evening, but mostly evenings are a time for relaxing in front of the TV. Staff time is arranged so that each resident has one-to-one attention from staff, every day in the case of the person who does not go to activities outside the home. But this time has been created out of existing staff hours, so while one person is receiving attention, only one member of staff is available for everyone else. Staff do record how people spend this one-to-one time and for some people, seem to provide activities individual to them. But often this is simply a time to spend with someones undivided attention, valuable in itself, but not necessarily a leisure activity. There are only two staff on duty at weekends. This severely restricts the ability of staff to take people out anywhere at weekends because sometimes it is not possible to leave only one person on duty in the home and a number of people need to be either pushed in a wheelchair or hold the arm of another person when they are out. We were told that sometimes staff come in on their own time if people want to go out. This should not be necessary. We recognise that people may be content to spend the evening quietly at home if they have been out all day but there was no clear record of how people had been asked if they wanted to do something at weekends. Residents did say where they wanted to go, in the residents meetings, but staff expected these wishes were going to be met by the day placements.The manager also explained that the cost of activities during the week takes up a lot of individuals personal allowances, so they do not have much spare for activities at weekends. When we spoke to people who live in the home, they seemed generally satisfied about how they spent their time. People may be used to the current pattern of activities and may need support to consider other choices. Care plans should include records of discussions about peoples interests and goals and these should be used to assess properly how many staff are needed to meet these needs. People can maintain contact with their families if this is possible. One person told us that she visited her mother regularly and another person goes home every weekend. When we asked in the surveys for relatives if the home helped them keep in touch, two people said always and two said usually. One relative said they were always kept up-to-date with important issues and five said they usually were. Care plans recognise peoples rights to personal relationships but also their rights to be protected from exploitation, as vulnerable adults. The records of the meals people eat show that people make individual choices. The care plans include information about special diets and if people need help with eating. The records showed that the home had asked for advice on how to stop someone losing weight. Care Homes for Adults (18-65 years) Page 16 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. Peoples personal and health care needs are well met. Medication is handled safely. Evidence: Each persons care plan gives staff clear guidance on the help and support they need with personal care. They describe what people can do for themselves, so they can be as independent as possible. The new member of staff told us that she had read the care plans when she started. We asked in the surveys for relatives if they felt the home met peoples needs. Three said usually and three said always. We asked if the home responds to the different needs of individual people and four people said always and two said usually. One relative said, The service at Dale House is first-class. I am very happy and content that X is well looked after. His needs are met in every way. We asked social workers what the home does well. They mentioned, individualised care, promote physical health, regular checks, caring through ill-health episodes. Excellent communication and support/liaison with health services. Meeting changing needs in a timely way. Both the social workers who responded to the survey said that the home always asked for advice and acted on it to meet peoples social and health care needs and always respected their privacy and dignity. The records showed that Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: staff arrange healthcare appointments and ask for advice from specialists when this is needed. They had asked for advice from an occupational therapist about how to move someone safely and had received training in how to do this. Staff have received training in how to handle medication safely and we saw the records of how the manager has checked people do this competently. The arrangements for storage, giving out and recording medication was satisfactory. The home had acted on the advice from the last inspection and asked the prescribing doctor to give clearer advice on the use of some as required medication. This was clearly available in the medication cabinet although was not recorded in full on the record of administration. The records showed that staff did not often feel the need to use this medication if people were agitated. The home has arranged for the pharmacy to fill separate packs with the medication people will need if they go home for visits. This means that whoever gives out the medication when someone is away from Dale House can be sure they are giving the correct medication at the right time. 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. The home encourages people to say if they are unhappy about anything and responds properly if people do raise concerns. People are protected from harm as far as possible. Evidence: The home has a complaints procedure in different forms, with pictures or with simple English. This helps people understand it. No complaints have been recorded in the last year. In surveys, the people who live in the home said they knew how to complain. When we talked to them, those who commented agreed that they would feel ok about telling staff if something was wrong. Most relatives said they knew how to complain. We asked relatives if the home had responded appropriately if anyone had raised concerns.Two said they always had, one said they usually had and one said they had never had to complain. When we asked social workers the same question, one said the home had always responded appropriately and the other said they usually did. The records of the weekly residents meetings show that staff continue to remind people that they can and should speak up if they are not happy about something. Staff have had training in safeguarding adults and refresher training is planned. There is a satisfactory procedure available in the home and the manager knew who she should contact if there were concerns. She followed correct procedures when a resident believed a small sum of money had gone missing. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable place to live which generally meet peoples needs. But the garden should be changed so it provides a place to sit out which everybody can use. Evidence: The home is a detached house with a ground floor extension, which provides three single bedrooms, bathroom and laundry. There is one other bedroom on the ground floor, with an ensuite bathroom. All the bedrooms are single, and decorated and furnished in a domestic style and often reflect the interests of the person they belong to. There are enough bathrooms and toilets around the building. There is a large lounge and a separate dining room. A small lounge is also used as a staff sleep-in room. This year the sofas in the living room have been replaced and there are plans to replace some carpets. Although the Handyman has been able to tidy the garden, the company which runs the home has not made money available to make the garden area a pleasant place to sit out in. The home seemed clean on the day of inspection. They have a cleaner who works two days a week and the care staff look after the building on the other days. We saw a schedule of cleaning to be carried out, to make sure that nothing was missed. All the staff have had training in the prevention and control of infection. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: 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. There are enough qualified and trained staff to meet peoples care needs. But more staff hours may be needed in the future if care needs change. The home carries out checks when recruiting new staff, to make sure they only employ people who are suitable to work in care homes. Evidence: The National Minimum Standards recommend that at least half of the care staff in each home achieve the National Vocational Qualification in care at level 2. Four of the five care staff have achieved this, two of these already have this qualification at level 3 and a third is working towards this. This is a particularly good achievement for a small home. When we asked people who live in the home about the staff, they said, Staff are lovely with us, very nice. In the surveys from relatives, they said, Very happy about the staff and his care., Staff appear to care for all the residents and communication between staff and residents appears to be good. When we asked relatives if they thought the care workers had the right skills and experience, they all said that the staff always did. The home has been very successful at retaining staff, so most of them have worked with the same residents for some years. Staffing levels take into account that most people go out through the day during most weekdays and evenings tend to be a time for relaxing at home. There are two people Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: on duty from 7-9 am, to help people get up and ready for the day. Then one person is on duty until 3pm. Two people are on duty from 3-8pm and one person is on duty for the rest of the evening and then does a sleep in shift. At weekends there are two staff on duty through the day. As well as this the manager is at work during the day on weekdays. These staffing levels seen sufficient to meet current care needs. But when someone who lives in the home needs much more care and attention, the company which runs the home must respond promptly to ensure there are enough staff to meet everyones needs. Only one person has been recruited since the last inspection. The records showed that the employer had asked the right questions about their previous experience and training and had obtained references. They had carried out a CRB/Protection of Vulnerable Adults List check, to make sure there was nothing in the persons background which would mean they were not suitable to work in a care home. This member of staff is still working through the training provided for new staff which gives a thorough grounding in good practice and the values which staff should understand. There is a training programme for all staff. Staff have completed training in key areas such as food hygiene, first aid, safeguarding adults. They also receive training in challenging behaviour, with refreshes every year and training in specific conditions residents may have, such as epilepsy. 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. The home is well managed and the manager is working towards the qualification she needs. There are systems to check on the quality of care in the home but these should include asking relatives and social workers for their views. The home is generally a safe place to live and work. Evidence: A new manager has been working in this home for about a year. She has been registered by the Care Quality Commission as the manager. She already has a BTEC National Diploma in care at level 3. When we were looking at registering her as manager, we said that she needed support from her manager to receive the training she needed to carry out her role and develop her skills and experience. She told us that the company which runs the home set out, in an induction programme, how she should gain these skills and knowledge, and her manager has been visiting twice a week and working with her on this. She, and the deputy, who has regularly covered the home in the absence of a manager, have started a qualification in leadership and management. The new manager and an established group of staff have worked well Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: together to improve the home, while maintaining continuity of care for the people who live there. The company which runs the home has to carry out monthly visits to check it is running properly. We saw the records of these visits and they are now being done as regularly as they should be. The records showed that the manager who does them looks in depth at how the home is running and identifies improvements needed. We saw that there is a development plan, which looks at how the home should improve in the future. Residents had been asked for comments, as part of looking at the quality of care in the home. But the home should also ask for comments from relatives and care managers, particularly because not all residents can say what they think easily. In the last inspection report we said that the home had failed to check radiator covers were safe. In fact work had been done to make them safe but this had happened before the new manager started work and she had not been aware of this. Thermostatic valves have been fitted to taps used by people who live in the home, to control the temperature of hot water to prevent accidental scalding. Staff record how they check the temperature every week and also when they help people in the bath or shower. Staff carry out regular checks of the fire safety system. They receive regular refresher training in fire safety. We saw the records of fire drills, held two or three times a month but these did not show who took part. This is important because the manager must make sure that each member of staff takes part in a fire drill regularly. 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 6 15 Care plans must include 31/12/2009 clear guidance on what to do if someone becomes angry or upset. This is to make sure staff know what to do and are consistent. 2 33 18 The company which runs the 30/12/2009 home must respond rapidly if if a residents needs change and more staffing hours are required. This is to ensure that there are enough staff to meet peoples needs at all times. 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 12 The manager should continue to try and find out if residents would like to do anything else at weekends and use these choices to assess staffing levels needed to make this possible. Page 27 of 29 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 2 3 4 24 37 39 The garden area should be improved so that it is a pleasant place to sit. The manager should continue to work towards the recommended qualifications for care home managers. As part of the system to check on the quality of care, the manager should ask relatives and social workers for their views. Records of fire drills should include who took part. 5 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!