Inspection on 23/02/10 for Mountview

This is the latest available inspection report for this service, carried out on 23rd February 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mountview 25/06/07

Mountview 06/02/06

Mountview 19/10/05

Mountview 27/01/05

Mountview 04/08/04

Mountview 04/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 25/04/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Mountview 118 Upton Road Bexleyheath Kent DA6 8LX     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: Peter stanley     Date: 2 4 0 2 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: Mountview 118 Upton Road Bexleyheath Kent DA6 8LX 02083060269 F/P02083060269 frank.peet@ntlworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Frank Peet,Mrs J Peet care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The maximum number of service users who may be accommodated is 7 The registered person may provide the following category of service only Care Home with personal care only - Code PC to service users of the following gender Either 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 categories: Learning disability - Code LD Whose primary care needs on admission are in the following category Learning Disability - Code LD Date of last inspection Brief description of the care home Mountview is registered to provide personal care and accommodation for five adults with a learning disability. The home is within walking distance of Bexleyheath Broadway and local bus routes. The building was demolished in 2001/2 and rebuilt to Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 5 7 Brief description of the care home high standards with the needs of service users taken into consideration. The ground floor consists of four single bedrooms; two with separate en suite facilities and two with a shared en suite space, an open plan kitchen and dining area, lounge, toilet, group bathroom and office. At the rear of the property there is a large well laid out garden. Visitors can park on the driveway or in the surrounding residential roads subject to parking restrictions. 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: We visited the service and completed a site inspection. We met with one service user and received a number of completed questionnaires from residents and relatives. As most service users attend local day centres throughout the day, it was not possible to meet any other service users. We case-tracked the admission of a new service user who has been admitted within the last 12 months, looking in particular at the assessment and care planning process. We examined a number of service user files, and inspected staff recruitment records, staff supervision records, health and safety records, and other documentation relating to the day to day management of the home. We met with the manager, and observed the interaction of the manager and a staff member with the one service user who was present. We discussed issues relating to the day-to-day running and management of the home, and regarding the relevant standards and regulations that apply. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 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 8 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 is providing the information required with which to enable potential residents, and their relatives, to make an informed decision as to the suitability of the home. Assessments are carried out prior to admission, with residents and their families being fully involved in this process. The home issues a contract, stating the terms and conditions, for each resident who lives in the home. Evidence: The home has a Statement of Purpose and a Service User Guide. These provide detailed information regarding trhe home and includes all the required information. Both documents have been reviewed in November 2009. The home has a contract which outlines the terms and conditions that apply. This is signed by the provider and by the service user or their nearest relative. Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: The home has admitted one service user within the last 12 months. Inspection of the service users file evidenced that full referral and assessment information had been obtained from the referring agency, and that the needs of the individual had been appropriately assessed by the home. Assessments are carried out prior to the individual moving in, and he/she and their family are encouraged to visit the home,and for the person to have some overnight stays, before deciding whether the home feels right for him/her. The home was able to evidence that it is able to meet the needs of the new service user, a care plan outlining his care needs having been drawn up. Collectively, the home has the level of staffing, experience and expertise in place with which to meet the needs of the resident group. Feedback from questionnaires, and from a service user, who was present at the time of the inspection, was generally positive in this regard. A statutory 12 monthly care management review is arranged with each resident, at which the suitability of the placement in meeting the individual residents needs is discussed. The resident, the care manager and the nearest relative are invited to attend this review. Care Homes for Adults (18-65 years) Page 10 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. The assessed care and support needs of residents, and how these are met, are being detailed in individual care plans. These are being reviewed on a regular basis. Residents are encouraged to participate fully in the day-to-day life and routines of the home, and to develop an independent lifestyle. Residents are being supported to take risks in their day-to-day living. Whilst there is ongoing assessment of risk, the home needs to develop a more structured and generic assessment of risk. Evidence: A sample of care plans was inspected. Care plans are drawn up using the extensive information that has been gathered during the assessment. Each care plan detail the persons care needs and preferences, and how these are to be met. The manager has provided an assurance that care plans are being reviewed and updated on a regular basis. So as to clearly evidence this, the date of each review, and the reviewers Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: signature, should be recorded on the care plan or on an attached sheet. A statutory review is held following the first 6 to 8 weeks of placement, and a decision made regarding the suitability of the placement. A 12 monthly care management review is then arranged with each resident, at which the suitability of the placement in meeting the individuals needs is reviewed. This is attended by the individuals keyworker, care manager and nearest relative. Residents are encouraged to make decisions for themselves, and when they could be vulnerable or at risk, assessments are carried out to identify ways of minimising the risk. As part of the risk assessment process, the home completes a manual handling risk assessment. Whilst reference is made to other risk factors within the care plan, the home does, however, need to ensure that all the various areas of risk have been fully identified at the assessment stage. It is, therefore, recommended that the home develops a generic risk assessment template, outlining all the various areas of risk, with indication, for each area, of the level of risk that applies for the person being assessed, and how each risk that is identified is to be managed. Residents are assisted to exercise choices in their day-to-day routines and activities, and are consulted both individually and at residents meetings. Residents have been consulted regarding the expansion of the home, and have been given the opportunity to express preferences regarding their choice of room. Personal information is stored securely within the office, and staff are made aware of the importance of maintaining confidentiality in their dealings with residents. Care Homes for Adults (18-65 years) Page 12 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. Residents are able to participate fully, and to exercise chouce in their daily routines and activities. Residents are encouraged to maintain contact with their family and friends, and to access the local community. Residents rights and responsibilities are being respected and recognised in their dayto-day lives. Residents are being offered a healthy diet, in pleasant surroundings, with choice and flexibility being provided. Evidence: Residents are given the opportunity to develop their interests and skills, and to Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: participate in a range of activities. 5 of the 6 residents choose to attend a local day centre 5 days a week where they are able to engage in activities such as painting, exercise, swimming, gardening and reminiscence. Residents are also able to access local adult education classes. The home offers opportunities to residents to access facilities in the community, to go shopping, play bowls or to go to a local pub or cafe. One resident, who works at a local supermarket one day a week, and has an individualised programme of activities, indicated that he was very settled and happy with his day-to-day life at this home. Residents are encouraged to maintain contact with their families, receiving visits at weekends and at other times when residents are around. Barbecues are held during the summer months, to which friends and relatives are invited to attend. The home does not organise group outings, but has encouraged individuals to attend outings arranged through their day centres, or to take individuals out in small groups of 2 or 3, using the homes minibus. The home has also arranged holiday breaks to Blackpool in 2008, and to the Isle of Wight in 2009. Residents are encouraged to assist with daily household chores that are within their capabilities, such as keeping their room clean and tidy, or helping to lay the table for meals. The emphasis in this home is on encouraging as independent a lifestyle as possible, within the persons capabilities, whilst endeavouring to ensure that residents are properly supported by staff and are not subject to any significant degree of risk. Residents are being offered a healthy diet which takes account of individual preferences.and choices. Views received from surveys indicate that residents enjoy the food that is being offered. Care Homes for Adults (18-65 years) Page 14 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. The health and personal care needs of residents are being met. Residents are being protected by the homes medication policy and procedures, and training. However, to ensure that safe practice is maintained, all staff who administer medication should receive updated medication training. The health and personal care needs of residents are being met, and their privacy respected. Evidence: Care plans are detailed and show that residents are being consulted regarding their wishes, and are being offered support in a way which meets their varying needs. Views expressed by a resident, during the inspection, indicated that he felt well supported by staff and that his needs were being well met. Staff are used to communicating with residents who have difficulties with verbal communication, having developed their skills in this area. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: All residents are registered with a local GP, with evidence that visits are being arranged as and when required.Specialist support, such as Occupational Therapy and Psychology, is accessed through the local Learning Disabilities Team. All residents receive regular three-monthly health checks, and are monitored in terms of their physical health and emotional/behavioural well-being. Dental and optician checks are arranged periodically, or as and when these are required. Notes on residents files indicate that where any concerns arise, action is taken to refer these to the local GP, or for specialist healthcare advice. Medication storage arrangements were inspected, and found to be satisfactory, with all medication being securely stored. The home keeps a MAR record for each resident, with a photo identifying each resident. A sample of these records were inspected, and found to be up-to-date and appropriately maintained. One resident is supported to manage his own medication. The home has arrangements with a number of local pharmacies in the area. To ensure that safe medication practice is being maintained, all staff who administer medication should receive updated medication training. Care Homes for Adults (18-65 years) Page 16 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 has a good complaints record, with residents and their relatives being encouraged to raise any concerns they may have. Residents are generally being protected by the homes safeguarding policies, procedures and practice. However, to ensure that staff are made fully aware of local safeguarding procedures, up to date statutory training in safeguarding is required. Evidence: The home has a complaints procedure in place, which is referred to in the Service User Guide. The home encourages anyone who may have a concern to raise this at an early stage. The home has had a good record with complaints, none having been recorded since the last inspection in June 2007. The home keeps a record of compliments, a number of which were evidenced during the inspection. The home has policies and procedures in place for protecting vulnerable adults. Whilst staff have in recent years undertaken Adult Protection training, there is a need for the registered manager, and all staff who work at the home, to update their knowledge in this area and to access statutory safeguarding training with Bexley council. A requirement applies. Discussion with one resident, who was present during the inspection, indicated that he feels safe and well cared for in this home. No concerns have been raised with the CQC Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: in this regard. Care Homes for Adults (18-65 years) Page 18 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, hygienic and well-maintained environment, with access to pleasant and spacious communal facilities. Residents rooms present as being safe, comfortable and pleasantly decorated, suited to individual needs, and reflecting the residents individual identities and preferences. Residents are being provided with all the necessary aids and adaptations with which to maximise their coping abilities and independence. The home presents as being clean, pleasant and hygienic. Evidence: The home is spacious and well-decorated, and furnished to a high standard. The home has been re-built to high standards throughout, and is wheelchair accessible throughout. Three of the homes residents are wheelchair users. The home is fitted with the necessary aids and adaptations throughout, and meets the needs of this client group. The home has ample communal facilities with a pleasant through lounge and dining area, and open-plan kitchen, on the ground floor. The lounge and dining area open up onto a large patio, and garden, where there is patio furniture, providing a pleasant place to spend time and receive visitors. Barbeques are arranged outside Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: during the summer months. There are presently six residents who live in the home, five of whom live on the ground floor, and one on the first floor. There are plans to convert the owners first floor living area to create another bedroom. Residents bedrooms are well furnished and decorated, and have been personalised, reflecting their occupants individual identities, interests and choices.. In addition to basic bedroom furnishings, residents have a sofa and large wardrobes for personal storage. Three of the residents have an en suite bathroom, while two residents share a large ensuite bathroom, and the other resident has the exclusive use of a bathroom next to his bedroom on the first floor. There is also a separate additional bathroom, for the use of residents, which is equipped with an appropriate hoist. Residents are consulted regarding any changes or improvements that take place, including the recent conversion to accomodate another resident. The home presents as being clean and hygienic throughout, and staff receive training in food hygiene, and health and safety. Residents play their part by helping to keep their rooms clean and tidy. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are generally being well met by a sufficiently qualified and experienced staff team. The home is, however, placing the safety of residents at risk through its failure to have completed the required recruitment criminal records and employment checks for recently recruited staff. The home is failing to protect the best interests of both residents and staff through its failure to provide regular, recorded supervision of staff. All staff must also receive a written annual appraisal. Evidence: The staff group comprises of the homes owner and manager, his wife, two part-time care staff, and a domestic worke.One of the care staff has worked in the home for nearly 20 years, while another has been recruited within the last 12 months. The home also has the services of two care workers who do an occasional day shift. The home uses the services of anl agency to provide additional staffing as and when this is required. All staff are required to have a minimum NVQ Level 2, with one recently recruited staff member currently undertaking studies leading to this qualification. One staff member has an NVQ Level 3. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home has a recruitment policy in place. All staff are CRB checked through an agency, though the two staff members who work occasional shifts had a CRB on file from their main employer, a care home providing organisation. It was pointed out to the manager that the home must complete its own enhanced CRB check, as the two staff are not being supplied by an agency or other employer. A requirement applies. Inspection of the staff file for a recently recruited staff member did evidence an enhanced CRB check. However, the file did not evidence the take-up of references or the necessary employment and identity checks. Given the previous good record of the home, as evidenced in the files of staff previously employed, enforcement action is not being taken on this occasion. However, it was made clear to the registered manager/ owner that all the required recruitment checks (as detailed in the care home regulations) must be completed for all future applications. A requirement applies. The home accesses an agency (Swiftcare) to provide all the necessary mandatory training for its staff. Inspection of staff files evidenced relevant qualifications and certificates that staff have acquired through their training and development. All care staff, apart from one recently recruited care worker (who has registered for NVQ 2) , possess a minimum of an NVQ Level 2, with 2 care staff possessing an NVQ Level 3. The registered manager is qualified to NVQ Level 4. As previously identified, all staff need to undertake updated statutory safeguarding training. The home is failing to evidence that staff are being supervised on the required basis of at least six times a year. Whilst the manager gave an assurance that staff are receiving regular supervision and support, it is essential that all care staff receive structured supervision sessions, and that each session ie recorded in a supervision record. A requirement applies. Care Homes for Adults (18-65 years) Page 22 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. Generally, residents are benefiting from from a caring, committed and enabling approach to the management of this home. The home must, however, address recently identified shortcomings in ensuring rigorous recruitment practice and the regular, structured supervision of staff. The health, safety and welfare of residents is being promoted and protected.by the promotion of relevant policies and procedures, and the completion of up-to-date health and safety checks. Evidence: The homes manager and owner has worked with the majority of this resident group for many years, having known them since they were children. He has stated that his aim is to offer a quality service that is inclusive and suited to the needs of each individual in a way that is as much like home as possible. The home is evidenced to be providing a caring and welcoming environment , and one in which individuals are encouraged to develop their capabilities and potential. The Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: manager is assisted by a long-serving and committed staff group, which has recently been supplemented by agency staff and by more recent staff appointments. The home must, however, ensure that it is maintaining rigorous recruitment practice, and the regular supervision and appraisal of staff, so as not to place residents safety and best interests at risk. The home is evidenced to be completing the necessary health and safety checks, these being found to be up-to-date. The home has the necessary risk assessments for Fire Safety, and Health and Safety, and completes periodic fire drills involving both residents and staff. The home was found to be well-maintained, and safe. The home maintains staff and service user records, and maintains files relating to health and safety checks, policies and procedures, and other documentation. Staff and service user files would, however, benefit from being made more structured so as to make the process of accessing and tracking information an easier and clearer one. Care Homes for Adults (18-65 years) Page 24 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 25 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 23 13 The registered manager, 30/09/2010 and all staff who work at the home, must update their knowledge of local safeguarding policies and procedures, and access statutory safeguarding training with Bexley council. To ensure the protection and safety of residents 2 34 19 The home must (as detailed in Regulation 19, Schedule 3) complete all the required identity and employment checks for all future staff appointments. To ensure the safety of residents. 05/03/2010 3 34 19 The home must obtain an 31/03/2010 enhanced CRB check for two care staff who work occasional shifts, as their present CRB certificates do not cover them for working Page 26 of 29 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action in this home. The two care workers must be supervised at all times (with no 1 to 1 contact with any residents) until such time as the CRB clearance has been received. To ensure the safety and protection of residents, 4 36 36 The home must ensure that 01/04/2011 all staff receive the required regularity of supervision of at least 2 monthly or six times a year. This must be evidenced with the necessary supervision records. To protect the safety and best interests of residents 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 1 6 The date of each care plan review, and the reviewers signature, should be recorded on the care plan or on an attached sheet. The home should develop a generic risk assessment template, outlining all the various areas of risk, with indication, for each area, of the level of risk that applies for the person being assessed, and how each risk that is identified is to be managed. Page 27 of 29 2 9 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 3 20 To ensure that safe medication practice is being maintained, all staff who administer medication should receive updated medication training. 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!