Inspection on 19/02/09 for Hyde Park House

This is the latest available inspection report for this service, carried out on 19th February 2009.

CSCI found this care home to be providing an Excellent 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hyde Park House 10 -12 Hyde Park Road Harrogate North Yorkshire HG1 5NR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jean Dobbin     Date: 1 9 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Hyde Park House 10 -12 Hyde Park Road Harrogate North Yorkshire HG1 5NR 01423509267 01423547624 dand@integracare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: IntegraCare Limited care home 10 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: 10 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 Date of last inspection Brief description of the care home Hyde Park House is registered to provide personal and social care support to ten younger adults, both men and women, with a learning disability. The home was originally two large Victorian terraced houses, which have now been joined internally on the ground floor. It is located within walking distance of the centre of Harrogate, with its main transport links. The home has small gardens at the front and back and there is disc parking on the street. The main accommodation is on three floors, though there are offices and the laundry room in the basement. There is a large communal Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 10 Brief description of the care home lounge, separate dining room and a well equipped kitchen on the ground floor. Peoples private rooms are on all three floors and six of the rooms have an en suite facility. One part of the home has been adapted to provide a self contained flat for three people. This allows some people to have a more independent lifestyle, whilst being kept safe within the main house. An information pack is used to tell people thinking of moving there about the home, and the facilities and services it provides. The latest report by the Commission for Social Care Inspection is also available at the home for people to read. The weekly fees to live at Hyde Park House on 19th February 2009 are between 528 pounds and 1190 pounds. People pay for additional items, such as hairdressing, personal items like specific toiletries and newspapers, and some activities, out of their weekly allowance. 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: 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 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 Commission for Social Care Inspection. 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 5.5 hours, from about 9.30am to 2.30pm. This visit included talking to people who live there, and to staff and the manager 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 Care Homes for Adults (18-65 years) Page 6 of 30 like to live at Hyde Park House. And some people showed us their private room and their possessions kept there. People were not asked to complete surveys as a report by the Commission for Social Care Inspection was written less than six months ago, and people were asked for their views then. Some of those comments though, are included in this report. Information about what was found during the inspection was given to the registered manager at the end of the visit. We have reviewed our practice 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. What the care home does well: What has improved since the last inspection? What they could do better: When an individuals support plan identifies potential risk, because of their healthcare needs, then the home could provide a more accurate record to show that those needs Care Homes for Adults (18-65 years) Page 8 of 30 are being met. The registered person could take advice about the frequency of the need to check water storage systems for the risk of legionella. Carrying out these checks at recommended intervals contributes to keeping 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed properly to make sure enough information is gathered to know that staff at the home can meet their needs if they decide to move there. Evidence: The manager explained that people are not admitted to the home without a full assessment of their care needs. This also includes speaking to other health and social care professionals who are involved in the persons care, in order to make sure the admission would be right, both for the individual and for the people already living at the home. Then the new person would visit the home on a number of occasions, spending increasing periods of time there, whilst they got to know the other people already living there, and they got to know the new person. These visits would include overnight stays. This would also enable the manager and staff to get to know the new person so that they could be sure they could support the person properly, if they chose to move there. One person had moved to the home in the last year and they described a process where they visited the home with their care worker and spoke at length with the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: manager. They said they found out a lot about the home by talking with her, and were confident that the move would be right for them. The manager explained that this persons admission did not follow the ideal process because of their particular circumstances, however their records contained comprehensive written information relating to their support needs, and how these were to be met. The last inspection report, written eighteen months ago, states that a person who moved to the home around that time said they had been able to test out the home during a number of visits, before they actually moved there. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans explore individuals strengths and personal preferences in good detail and staff are committed to helping people to maintain choice and control in their lives as much as possible. Evidence: People living at Hyde Park House have comprehensive individual plans and two of these were looked at as part of the inspection process. These contained a lot of information about peoples abilities and their individual goals. They included, for example, wanting to go to car shows and buying a camera and putting together a photograph album. Social interests were recorded and one person said they now played for a football team and had started scuba diving since they moved to the home. Peoples ways of communicating were looked at. For example what an individuals body language may mean and whether they need help to use the telephone or to read Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: information. There were assessments of peoples abilities to use kitchen appliances, and these were written in a positive way, describing the support individuals need to promote and maintain their independence. One support plan described how an individual now asks a staff member to pour the boiling water from the kettle. This shows that staff are alert to changes in peoples needs and are reviewing and updating the records accordingly. The support plans also describe the help people need when out in the community. For example one person gets nervous when needing to cross the road and doesnt like using escalators. This sort of written information is important so that staff recognise and understand peoples anxieties and can then help them appropriately. There are also comprehensive risk assessments in the support 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 include daily risks like those associated with simply showering or using the microwave, as well as assessments for outside, like when crossing the road. The support plans contain a number of assessments of risk of harm to the individual, or to others, by behaviour that challenges the service. For example these include risk associated with someone absconding, losing their temper or being verbally abusive. These assessments describe the support needed to deal with these behaviours. This helps to ensure a consistent approach by staff, when managing these incidents. One person spoken with said they knew they had a support file and that staff go through it with me sometimes. People spoken with said they were happy at the home. Ive lived here for a long time. The staff are absolutely brilliant. They are a really nice set of staff. Another said. The staff are nice to you. I go out very often and the staff help me. I go out in the car too. 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 excellent 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 to make choices so that they can live meaningful and interesting lives. Evidence: People living at Hyde Park House are supported to live ordinary yet fulfilling lives, by being actively involved in the community and in the day to day running of the home. On the day of the visit some people were out in the community with support from staff, others were cleaning, or tidying their rooms, one was watching television and another was looking at books with a support worker. One person made their lunch baked beans on toasted French bread. People were getting on with their lives, but were also keen to talk about what made their lives satisfying. One person said that they attended computer training at the local college. Another Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: said that they helped out at a cafe each week, which involved food preparation and also handling money. Others work on an animal farm/organic garden not far from Harrogate. Although they dont get paid they can bring home produce to use at the home. People enjoy going shopping, to the pub or out for a meal. A few people have families away from Harrogate and they travel regularly in a people carrier to visit their homes and families. Visitors are welcomed anytime, so that people can keep in contact with the people that matter to them. One person has recently had to move to another care home from Hyde Park House and people from the home are still in touch with them. Another person generally requires a lot of support when they go out, but are now able to have planned short trips out, when they are unsupervised. They are clearly pleased to now be able to do this. People have interests which they are supported to maintain. Two men have rooms which are filled with items about their favourite football team. Football is a popular subject in the home. Some people enjoy playing and others support the local team. One person said that he plays in a national team, which will be playing in a tournament in Europe later this year. Another person is very interested in cars and they also have many items in their room relating to this interest. When questioned one person was hoping to travel abroad for a holiday later this year, although this isnt firmly arranged as yet. They said that they went abroad three years ago, which they had enjoyed. The owners of the home provide an activities week each year and people are given extra money to try things theyve never done before. These have included camping, paint balling and (dry-slope) skiing. One person said they liked living at the home. They said you ask if you can go out. You can usually go out whenever you want, and someone will go with you. And I keep my bedroom clean and tidy. If I want something to eat then Ill just look in the fridge and see whats there. Ill make a drink if I want one. I help with the washing up and every week I cook for everybody else. People are supported to attend church if this is their choice. One person said that this was something they enjoyed. The home has a four week menu, but it is very flexible and as people often cook for themselves as part of promoting independent living skills it is more difficult to maintain an accurate record of what people are eating. One persons support plan Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: looked at identified that the individual needed a high calorie diet. The home must be able to demonstrate in their record-keeping that those people with nutritional care needs are being supported appropriately. Care Homes for Adults (18-65 years) Page 17 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 excellent 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 met in an appropriate and sensitive way and the records underpinning that support are written in good detail and reviewed regularly. Evidence: The support workers at the home help people to maintain their independence and make their own decisions about their health care. They ensure that help is given in a sensitive way and at the pace and understanding of the individual. One person said they would use the house phone to make their own appointment with their doctor, whilst another said they would ask a member of staff to do this for them. The individual support plans document how much personal help people need and how this is to be provided. Both male and female staff work at the home so that people can express their preferences when receiving personal care. Those care plans looked at were written in a way that promoted peoples dignity and privacy and emphasised healthy living as a way of maintaining good health. The personal care plans stressed the need for people to be supported in the way they Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: choose, as much as possible. One persons care plan described the need for them to receive high calorie foods and how this was to be encouraged. Another described the support an individual needs in their efforts to lose weight. Aids have been provided for one person to enable them to maintain their independence. The care plans also showed that good links were established with the district nurses and chiropodist, with records to show that advice had been sought from them. People have their own specialist health and social care professionals who provide good support to individuals and offer guidance to staff at the home. This helps to ensure that people receive the most appropriate and individualised support, according to their needs. Medicines are securely stored at the home. The manager says that nobody currently looks after their medicines, but people have done so in the past. The manager explained that the decision for somebody to self-medicate is only taken following discussion with other professionals who are involved in a persons care. Medication records looked at were completed appropriately. All staff attend accredited training so that they understand their responsibilities when administering medicines. Each persons support file contains a list of an individuals prescribed drugs, why they are taking them and what side effects to look out for. This helps to make sure staff are well informed. Care Homes for Adults (18-65 years) Page 19 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 their complaints will be taken seriously and looked into properly and staff are alert for any abusive behaviour, which may mean people are not being kept safe. Evidence: The complaints process is written in the service user guide and people spoken with all said that they felt safe living at Hyde Park House and would tell the manager if they had any concerns about the home. All were confident that the manager would listen to what they had to say and sort any problems out. Neither the home nor the Commission have received any complaints in the past year. Staff receive training in abuse awareness as part of their induction programme and National Vocational Qualification study. Care staff spoken with confirmed that they had also attended refresher training in abuse awareness in the past year. When questioned one worker was very clear about promptly reporting any incident they suspected may be abusive behaviour, even if the person had asked them not to tell anyone. This is good practise as it shows that staff recognise that this information must always be shared as a way of helping to keep people safe. The manager also understood her responsibilities about sharing information with other professionals, in line with national and local guidelines, and had this information easily available to refer to. There has been one incident where abusive behaviour was Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: suspected in the past year. The manager referred promptly to the Commission and the local authority, who take the lead in any investigations that need to be done. The manager worked well with the local authority and the incident was dealt with properly. Peoples monies and allowances are stored securely in the home and records and receipts are kept to show that peoples finances are being managed properly. A number of people choose to be responsible for their finances and they sign when they receive the money each week. The home though looks after one persons allowance on their behalf. Whilst records and receipts are kept, only one staff member signs for each transaction. It would be good practise for two people to sign for money coming and going out of this account as a way of protecting everyones interests. Care Homes for Adults (18-65 years) Page 21 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 clean and comfortable home, which has been adapted, decorated and furnished to meet the needs of the people living there. Evidence: Hyde Park House is two joined and adapted terraced houses on three floors. It was seen to be clean, tidily decorated and well maintained. A plumber was at the home on the day of the visit. The service has a self contained flat for three people on the upper floors of one of the houses. Here people live a more independent lifestyle, whilst still being able to get the support and help from care staff if needed. The manager told us that people generally move into the flat from the main home, if they choose to, as the next stage in promoting and enabling a more independent way of life. And people have moved on from the flat into supportive living in the community. The three people living in the flat were out in the community on the day of the visit. People in the main home have their own bedrooms, which are on all three floors. Some of these have en suite toilet and shower. Two people spoken with didnt have those facilities but were quite satisfied with the communal bathrooms close to their rooms. One person said that they had their own door key but didnt use it, saying I dont need to. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Those rooms looked at were very individualised, reflecting peoples different interests. They were decorated, furnished and personalised in keeping with the age of the person living there. On the ground floor there is a large lounge, dining room and kitchen. These communal rooms are domestic in design and decor. The dining room particularly had a lot of homely clutter that you would expect to see in many peoples houses. There is a house computer though one person spoken with said it was very slow. People use the kitchen as they wish. One person cooked their lunch during the visit and explained that they cook for everyone in the house once each week. The laundry room is also domestic in design and some people look after their own laundry. Most people living at Hyde Park House need little hands-on care however the manager ensures equipment is available for use, when necessary to minimise the risk of spread of infection. Care Homes for Adults (18-65 years) Page 23 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 sufficient numbers of staff who are well trained, well recruited and well supported by senior managers. Evidence: The staff rota showed that there are five or six support workers during the day, two or three in the evening and two sleep at the home every night. There is also an on-call rota of senior staff who support workers can contact if necessary. Both male and female staff are employed, of differing ages and backgrounds, and all staff share the catering and domestic duties within the house. Some of the people living there also take some responsibilities for the cleaning and cooking. Most people living at Hyde Park House require supportive care only and these people have a written care programme where support workers help to promote their independent living skills and decision-making, both in the home and in the local community. Staff are supported to attend training sessions, both locally and regionally, if appropriate, to help to make sure they are knowledgeable and well informed about meeting peoples individual needs. Staff records confirmed that training sessions are attended, and two support workers spoken with also confirmed that they received Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: training relevant to the type of work they do. More than half the staff have achieved a minimum Level 2 National Vocational Qualification award in Care. This helps provide good up to date training, which meets recognised standards. It also help staff to work in a safe, consistent way when providing people with care. Two recruitment records were looked at, which confirmed that all checks were completed before an individual starts working at the home. One person started work before their police check was available to look at. A PoVAFirst check had been completed to show that they were not barred from working in a care setting because of previous offence. The manager said the individual was supervised at all time by one of two senior workers, until their police check was returned. The support worker also confirmed that they had always shadowed staff during this time and had not gone out unsupervised with a client. The manager should consider how this period of supervision could be evidenced, as this would help to demonstrate that recruitment processes at the home are robust and contributing to keeping people safe. New staff follow a planned induction programme, which the manager tells us is in line with the Learning Disabilities Award Framework and appropriate for staff who work with people with learning disabilities. One support worker spoken with said they had received a lot of support and help from other staff when they started working at the home. Records are kept to show that support workers receive regular supervision and annual appraisals, where their work, training needs and career plans can be discussed. Regular staff meetings are held. A support worker confirmed this, and minutes from the last two meetings, held in November and January were available to read. Care Homes for Adults (18-65 years) Page 25 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 manager and staff ensure that the home is run in the best interests of the people who live there. Evidence: The registered manager has worked with people with learning disabilities for a number of years and has completed extra training, to help her in her role. She encourages an open and inclusive culture in the home, where people are consulted at every opportunity about how the home operates. She showed in discussion that she had a good understanding of the needs of the people living there and the responsibilities of staff at the home to provide person centred support to enable people to live meaningful lives. One support worker commented. I feel very comfortable going to her. She is the best. The manager carries out her own checks to make sure the home continues to run well and records and processes required to demonstrate this are maintained properly. The self assessment sent to the Commission by the manager prior to the visit could be completed in more detail to show that good quality support is provided and this was Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: discussed at the visit. The manager consults about the way the home runs more formally with people living there by using surveys, however these were not available to look at as one of the owners was putting together a report from their results. The last inspection in 2007 says that people are surveyed to get their views about the home. This includes staff and professionals who have an interest in how the home operates. The home has good systems in place to make sure that the health and safety of both the people living there, and staff are protected. Staff are supported in attending regular health and safety training to make sure their knowledge is up to date. A small number of service safety certificates were looked at and all were in date. Fire safety checks are carried out regularly. Although fire drills are completed the manager should record who was present to make sure all the staff and all the clients undertake this practise periodically. Hot water temperature checks are carried out regularly however the check of the water tank to rule out the risk of legionella has not been done for over two years. The manager should get advice about the timescale for monitoring the homes hot water system to control the risk of this infection in order to protect people from harm. Care Homes for Adults (18-65 years) Page 27 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 28 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 17 16 There must be a dietary record kept for people assessed as needing dietary support to ensure their well being is maintained So that the home can evidence that people assessed as at risk are receiving a good balanced diet. 10/04/2009 2 42 13 The registered person must 10/04/2009 seek guidance with regard to checking water storage for legionella and act on that guidance if necessary. This will contribute to protecting the welfare of people living there and staff. 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 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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