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Inspection on 03/12/09 for Hamstead Hall Road, 43

Also see our care home review for Hamstead Hall Road, 43 for more information

This is the latest available inspection report for this service, carried out on 3rd December 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Staff look at the information about what people can do and how well they are every year to check this is still the same.People have care plans. People have plans that tell staff about risks to the person. People have plans that say what is important to them.People are helped to make choices. People have help with activities and to go on outings.The home asks people`s relatives what they think about the home. They thought the home was good and looked after people well.There are enough staff and they have training to help people in the home.

What has improved since the last inspection?

People get money towards the cost of meals taken outside of the home.Information about the home, care plans and some procedures are available on a CD so people can listen to them.People are reminded how they can make a complaint.There are photographs of holidays and outings that people have had through out the year.Staff that give medication are checked to make sure they do this well.Accident records were checked to make sure that the same accident doesn`t happen again.The manager has time given to be the manager of the home as well as help people.

What the care home could do better:

Some changes were needed to procedures so a new law called the Mental Capacity Act is thought about before people live in the home.The temperature of the medication fridge needs to be written down better so the home can tell if the medication is still safe.On one occasion an incident should have been talked through with a social worker so that the home could be sure that they have done everything they need to do to keep people safe.At residents` meetings it is helpful to write down whether the things such as food and outings people wanted at the last meeting have happened.

Key inspection report Care homes for adults (18-65 years) Name: Address: Hamstead Hall Road, 43 Hamstead Hall Road, 43 Handsworth Wood Birmingham West Midlands B20 1HT three star excellent service The quality rating for this care home is: 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: Jill Brown Date: 0 3 1 2 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 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 Information about the care home Name of care home: Address: Hamstead Hall Road, 43 Hamstead Hall Road, 43 Handsworth Wood Birmingham West Midlands B20 1HT 01215235472 F/P01215235472 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) : www.voyagecare.com Milbury Care Services Ltd care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: Date of last inspection 1 3 1 0 2 0 0 8 A bit about the care home 43 Hamstead Hall Road provides a place to live, care and support for three people who have learning disabilities. The home is in the Handsworth Wood area of Birmingham and there is a bus available to the city centre. TO BIRMINGHAM Downstairs there is a sitting room, a separate dining room, a kitchen, a laundry and a toilet. All of the bedrooms are upstairs, there is no lift. There is a bathroom upstairs. There is an enclosed garden at the back of the home. Fees charged for living at the home vary according to the help people need. 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: three star excellent 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on a day in December 2009 the staff did not know we were visiting. DECEMBER The home told us about what they do in an Annual Quality Assurance Assessment before we visited. ANNUAL QUALITY ASSURANCE ASSESSMENT We watched and listened to how people were helped during the day. We spoke to people about what interested them. We looked at peoples care plans. We also looked at other records about the building, accidents and medication records What the care home does well Staff look at the information about what people can do and how well they are every year to check this is still the same. People have care plans. People have plans that tell staff about risks to the person. People have plans that say what is important to them. People are helped to make choices. People have help with activities and to go on outings. The home asks peoples relatives what they think about the home. They thought the home was good and looked after people well. There are enough staff and they have training to help people in the home. What has got better from the last inspection People get money towards the cost of meals taken outside of the home. Information about the home, care plans and some procedures are available on a CD so people can listen to them. People are reminded how they can make a complaint. There are photographs of holidays and outings that people have had through out the year. Staff that give medication are checked to make sure they do this well. Accident records were checked to make sure that the same accident doesnt happen again. The manager has time given to be the manager of the home as well as help people. What the care home could do better Some changes were needed to procedures so a new law called the Mental Capacity Act is thought about before people live in the home. The temperature of the medication fridge needs to be written down better so the home can tell if the medication is still safe. On one occasion an incident should have been talked through with a social worker so that the home could be sure that they have done everything they need to do to keep people safe. At residents meetings it is helpful to write down whether the things such as food and outings people wanted at the last meeting have happened. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact: Jill Brown Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000 616161 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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. Peoples relatives are confident that the care home can support them. Information is available to people and their representatives to help them decide whether this home will suit them. People have their needs assessed before admission and this is reviewed regularly so the home can be sure they are continuing to meet the persons needs. Evidence: We did not look at the service user guide or statement of purpose at this inspection but noted that these were in peoples rooms. These have now been put on to a CD for people, or their representatives, that have difficulty with written information. We were told in the homes Annual Quality Assurance Assessment (AQAA) that the service is trying to explore other formats that will help people understand important parts of this information. There had been no new admissions to the home since the last inspection in October 2008. However information held about peoples needs (the assessment) are reviewed every year to see if the information is still correct. The assessment looks at peoples abilities and difficulties with for example their health, daily living, social, behaviour and communication. This helps staff look at ways the person can be supported in these areas. We were told that the assessment and admission procedure had not been changed since the last inspection and this would mean that people have opportunities to visit and experience the home before any admission. Consideration of the Mental Capacity Act should be part of the admission procedure to ensure that no person is admitted against their will. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have care and risk management plans that ensure that their needs are met safely. People can be assured that the home makes every effort to involve them in decisions that affect them and this helps them be included in day to day life. Evidence: Each person living in the home has detailed care plans that show how the needs identified in their assessment are going to be met. So for example where a person had communication difficulties it stated communication book in the bedroom to be taken to the day centre. Use the pictures on the picture board and use small sentences. During the inspection all these methods of communication were used by staff with the person. Where the person needed help with personal care there were good details about how much the person could do themselves with prompts and this helps to maintain independence. In addition to this goals are set in each area and this means that staff encourage people to gain skills. People living in the home have decision care plans. These detail the decisions that the person understands and how staff can assist people to make good choices for example explaining the weather and what they may need to wear to keep warm or cool. We observed the manager asking a person what they would like to wear to go out that evening. This included whether they wanted to get changed, what they would be doing and whether they would like to wear their new clothes. There were records of resident meetings where people were helped to make choices of activities. Decision making helps people be involved in their lives and feel valued. Evidence: The home has started person centred plans these plans help people say what they like, what their goals are and which people are important to them. These have pictures which people to choose to represent what they like and their goals for example one person had a picture of Blackpool, the sound of music and make up. This helps to demonstrate that people are involved in planning their care in a way that is meaningful to them. Where there are risks associated with peoples care these are assessed and risk management plans put in place. A person for example had risk management plans including being in the kitchen and the use of equipment and for the risk of choking to help them keep safe. The person was later heard saying when due to have a meal before going out for the evening, eat slow, careful eat slow. This indicated that the risk management plan was being acted upon and effective. 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 living in this home are supported to have the activities and relationships they want and this enhances their lives. People have good wholesome meals and are supported to make healthy food choices and this helps to keep them well. Evidence: People living in the home have the opportunity to be involved in several activities. For example 2 out of the 3 people attend different day placements for further education. People are encouraged to take part in daily living tasks within the home as much as they able. People are assisted to make choices of activities that they would like to do. One person on the day of the inspection was going to a Michael Jackson tribute concert and was very excited about the music and dancing. One person on the day didnt want to do their planned activity and other suggestions were made. There is an activity board in the dining area and this is used to show people what is happening through the day for each person. The home keeps a photographic record of the places that people have visited and this provides a visual record for people helping them to remember. We looked at these photographs and these showed that at least once a month people were taken on a day trip. Such as trips for Christmas shopping in Chester, trips to Blackpool, Nottingham, Cadbury World and as well as attending celebrations in Birmingham such as Eid Mela. All three people had a holiday in Edinburgh this year and there are plans to holiday in Cyprus. Evidence: People are assisted to keep in touch with their families for one person this means regular phone calls. People are assisted to spend times with their families. We were shown photographs of where extended family had been invited to the home for a celebration. We were shown the homes survey of relatives views of the service and found the following comments. I am pleased with the care and support that (my relative) receives from people within the home. They respond to their needs and communicate well with them and myself. Another relative said the personal care is excellent couldnt be better. (My relative) is consulted about places to visit leads a very fulfilling life. I am kept informed included and in (my relatives) life. People are given help to choose meals. There are picture representations of food to tell people what is available each day. Some people in the home are being assisted to loose weight and others to gain weight. Looking at the food supply we found that there were low fat and high fat options of food available and information from dieticians to help staff. We saw a person being assisted to choose what food to take to the day centre. We found that culturally appropriate food was available a number of times a week. Records looked at showed that people were attaining the changes in weight that were needed and these weights were being monitored. We looked at the menus and found that these had healthy options such as fresh fruit salads, vegetables and yoghurts were included and a good variety of food was available. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive health and personal care based on their individual needs and are supported to receive appropriate health care and this keeps them as well as possible. The arrangements for administering medication are safe and this helps to keep people well. Evidence: People appeared to be dressed appropriately for the activity and weather when we visited. There were good interactions between staff and people in the home throughout the inspection. We saw people displaying some of their known behaviours and this was handled calmly and well, despite the added pressure of an inspection being carried out. We saw choices such as activities being offered to people throughout the inspection. We observed that people were talked to about where they were going, things they needed to do,(such as to give their medication to a specific person at the day service) and on return what sort of day they had had. These interactions help people feel included in their day to day life and respect the persons opinions. Please see also Individual Needs and Choices Section. Each person has a Health Action Plan which shows the contacts the person has had with health professionals. This ensures that routine appointments with GPs about their medication, dental and chiropody and so on are made as well as appointments for new health problems. Each person has a passport. This passport is information about the person that can be taken to hospitals, day services or, community health care professionals. It tells professionals how the person communicates, choices they can make, their interests and what can upset them. This is very helpful to health professionals who may be seeing the person for the first time. Evidence: The home uses a monitored dosage system for the management of medication. The medication was stored securely. Copies of the current prescription are kept and this helps to ensure that the medication dispensed from the chemist is as prescribed. In front of the medication administration records (MAR) there is a photograph of the person and this is an extra check to ensure the right medication is administered. The medication was checked by the pharmacy that dispenses the medication and the report of this check said that medication administration was good. Earlier in the year all the staff that administer medication had a competency assessment which helps to ensure that staff skills remain good enough and their knowledge current. There were medication policies and procedures in place and these assist staff to act appropriately if for example a tablet was dropped on the floor. Each person has a written description of how they prefer to take their medication this is helps to ensure that people take their medication. We looked at the records of some administered medications and compared them to the drugs held and found these were correctly accounted for. The home records the medication cupboard temperatures but do not have a maximum, minimum and current thermometer. These temperatures should be recorded daily as the temperature of the cupboard may fluctuate outside the medications product licence which may mean they are not as effective. 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 in this home are helped to understand how to complain if they are not happy with the service and this gives them a voice. People in the home are safeguarded by staff that are well recruited and trained. Evidence: The home has had no complaints in the last 15 months and we have received no complaints or concerns about the service delivered in this home. We looked at a sample of records of resident meetings and found in each meeting some time was devoted to asking people if they had any concerns and reminding them how they can make a complaint. In one meeting there was a role play about this. We found that there was an audio version of the complaint procedure and this shows us that the home has appropriate systems to enable people to have a voice about their care. We asked the home to discuss with social services where a person had raised an issue and then retracted it. The manager has done this and social services were satisfied with the homes process however it is important on such occasions to get a view independent of the service. We looked at the homes systems for managing two of the three peoples money. We found that people spent money on items and activities that interested them. There were clear records and receipts for each amount spent. The records matched the amount held for people. We found evidence in the home of what people spent their money on, one person being keen to show us and another having presents wrapped up for their family. Arrangements for holding money are individual to each persons circumstances and how peoples representatives want this to be arranged. There are good systems in place to check the money held and to gain money from the bank if needed. These systems ensure that peoples money is safe. People that have meals out, have some of the cost of this reimbursed to account for the money they pay towards living expenses at the home. People contribute towards the homes transport. Evidence: Staff were recruited appropriately and had received training on safeguarding and this helps to keep people safe. 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 safe, well maintained and comfortable home that is homeley and meets all their needs. Evidence: We toured the premises of the home and found no health and safety concerns. The building matches others in the street and both inside and out presents as being homely. On the ground floor there is a spacious lounge and dining area large enough to accommodate all of the people living in the home and the staff. There is also a nicely fitted kitchen and laundry room. We looked in each persons bedroom; bedrooms are accommodated on the first floor. All of the people living in the home are able to use stairs safely. Each room has a picture of the person on the door and this helps them recognise their room. Bedrooms are decorated to the individuals taste and redecorated when needed or their tastes change. We found that people had the opportunity to collect items that interested them and where important to them had photographs, pictures and so on. We looked in the bathrooms of the home and found these were appropriate to the needs of people living there. All areas of the home were clean, odour free and staff had appropriate personal protective equipment to ensure good infection control. There is a good garden space to the rear of the home that is enclosed and safe. There is a paved area a lawn and some shrubs. We were told that one person assisted in choosing some scented plants. In the homes survey one relative described the home as the environment is pleasant. Another said Im satisfied much calmer and cleaner place than the last place. 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 can be assured that there are enough trained and skilled staff to meet their needs. Staff are recruited well and this safeguards people. Evidence: The staffing level in the home is set at 2 staff on duty in the mornings and afternoons and 1 member of staff during the night. Rotas showed that this was maintained except where one of the people went to stay with relatives. The manager stated and the rotas indicated that there was planned dedicated management time of up to 15 hours a week. Rotas for November 2009 indicated that extra staff cover had been needed to maintain this level of staffing but this was supplied by a person that had worked in the home before and was known to the people living there. The homes AQAA indicated that the home has male and female staff and has at least one member of staff from the ethnic backgrounds of the people living in the home. This gives people the opportunity to be with people they can identify with. One relative stated in the homes survey Staff are caring and helpful and efficient. We looked at the staff records for the newest person and appropriate checks had been undertaken to ensure that they were suitable to support people living in the home. Prospective staff complete an application form, references and checks with the criminal records bureau (CRB) are undertaken. We found that when the new staff member started work they were in addition to the staff on the rota. The staff person then also started training and has a set time to get their computer learning completed. These measures help to ensure people living in the home are safe. We looked at two further staff files to check their training and found that staff had not only completed the mandatory training but also had completed training specific to people living in the home such as autism, makaton (a communication system), epilepsy, non violent crisis intervention and diet and menus. Staff meeting minutes indicate that this training is valued one stating that the makaton training was very good. Evidence: In addition we were supplied with a training matrix covering each staff member for (Voyage the service provider) induction, care standards induction, food hygiene, health and safety, first aid fire drill, fire training, moving and handling, infection control, safeguarding, medication knowledge set and medication awareness. This showed that almost all staff had completed almost all of the training. The homes AQAA stated that 88 of staff have achieved an National Vocational Qualification level 2 in care which exceeds the standards. The above training indicates that staff receive suitable training to meet peoples needs. We looked at a matrix of supervision and sampled staff files and found that staff have supervision 6 times a year as recommended with some staff achieving more than this. Supervision of staff allows staff performance to be measured and allows staff a time to raise any concerns they may have and this helps to keep people safe. 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 staff and management of this home ensure that it is run in the best interests of the people that that live there and has a regard to peoples health and safety. Evidence: The home has a manager and he is in the process of being registered with us. He worked in the home previously as the deputy manager. He stated that he has completed the Registered Managers Award which we recognise as the most appropriate training for managers of care homes. He has also undertaken management development supplied by the service provider. In last year done mandatory courses such as fire, health and safety, in addition has undertaken service specific training such as Protection of Vulnerable Adults, Mental Capacity Act and Deprivation of Liberty, epilepsy, diet and makaton. This shows that he is keeping is training current and also undertaking specific courses in management. We found that requirements and recommendations made at the previous inspection in October 2008 had been acted upon informing us that this is an improving service. As stated previously the home surveys relatives and has meetings with people that live in the home and this helps to inform them how they can improve the service. We suggested that residents meetings should record what has happened to the suggestions people made at the previous meeting this will help ensure that peoples expectations are met. The representative of the service provider visits the home on regular basis to check the quality of the service and reports are written of these visits. There are a number of systems in place for monitoring the quality of the home including peoples finances, medication and health and safety. We found the records of this home to be well ordered and available on request. There had Evidence: been no best interest assessments under the Mental Capacity Act in this home and we did not see at any point where people were being deprived of their liberty. We have advised that the homes admission procedure needs to consider the implications of this legislation but accept that there is not a vacancy in this home at the present. We looked at health and safety certificates for the building including gas, electrical and fire safety and found these were in place. The home has appropriate accident and incident records and audits of these are undertaken on a six monthly basis. These indicated that appropriate action had been taken following accidents. Appropriate training had been given in Health and safety issues. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 The admission procedure needs to include a consideration of whether a deprivation of liberty may be taking place by admitting the person to the home. If so what steps the home must ensure are to be undertaken before admission. The temperature monitoring of the medication cupboard should include the minimum maximum and current temperature within 24 hours. This is to ensure that medication remains within the temperature range required for its product licence. If issues of concern are raised by a person it is advisable that a discussion is had with the persons social worker even if it is then retracted. This is to ensure that there is an independent view of the event. Where people have suggested activities food and so on in residents meetings these should be reviewed at the next meeting to check whether they have happened. 2 20 3 23 4 39 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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