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Inspection on 10/09/09 for New Wokingham Road 95

Also see our care home review for New Wokingham Road 95 for more information

This is the latest available inspection report for this service, carried out on 10th September 2009.

CQC found this care home to be providing an Good 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

The manager has recognised the importance of providing relevant and up to date information about the home, both for people who may be interested in living there in the future and for the people who currently live at 95 New Wokingham Road. Individuals are well supported to make choices about how their individual needs are met. They enjoy the lifestyle of the home and there have been many changes since the last inspection including progress in encouraging people to go out more. The personal and healthcare needs of individuals are appropriately met in a way that improves and enhances their quality of lives. People are encouraged and supported to express any concerns or complaints they may have. The ethos of the home and the manager`s attitude is very supportive of individual rights and people are safeguarded from possible abuse. People living at the home enjoy the comfortable environment it provides. The home is clean and steps are being taken to ensure all staff are fully trained in infection control. People are supported by appropriately recruited staff who are generally appropriately trained. Gaps in training have been identified and steps are being put in place to address these gaps. The people who live at the home benefit from the leadership and style of the manager. Their views are sought and acted upon and their health and safety is promoted and protected. The manager knows what further improvements need to be made in the written records of the home and is addressing this.

What has improved since the last inspection?

Several requirements were made following the last inspection two years ago. These were all subsequently met. The ethos of the current manager and staff team is enthusiastic and positive about encouraging and supporting individuals to make choices. This has resulted in improvements in the health and lifestyles enjoyed by the people who live there.

What the care home could do better:

No requirements have been made as a result of this inspection. Whilst there are some gaps in training and not all written records are up to date, these were inherited problems and we could see, from the evidence gathered during our inspection, that these are being addressed.

Key inspection report Care homes for adults (18-65 years) Name: Address: New Wokingham Road 95 Crowthorne Bracknell Berkshire RG45 6JN     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: Amanda Longman     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: New Wokingham Road 95 Crowthorne Bracknell Berkshire RG45 6JN 01344771369 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.new-support.org.uk Dimensions (NSO) Ltd The registered provider is responsible for running the service care home 4 Name of registered manager (if applicable): Type of registration: Number of places registered: 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: 4 The registered person may provide the following category/ies of service only: Care home only - 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 - LD Date of last inspection Brief description of the care home The home can provide care and accommodation for up to four people who have learning disabilities. The home is situated within a short distance from Wokingham and Bracknell town centres. A range of local amenities and shops are easily accessible within walking distance. The home has its own vehicle and there is good access to public transport. The property is detached and accommodation is provided on two floors. Windsor and Maidenhead Housing Association own the property and the care is provided by Dimensions. Care Homes for Adults (18-65 years) Page 4 of 26 4 Over 65 0 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the service was an unannounced key inspection. It was a thorough look at how well the service is doing. We, the commission, received detailed information from the service in the form of an annual quality assurance assessment, the AQAA. This gave us details of current care provided, as well as plans for the future, details of staff and resident numbers, qualifications and training of staff, and information about the health and safety of the home. A site visit was undertaken by Amanda Longman, regulatory inspector on 10 September 2009. During this site visit we looked around the home, observed care practices and chatted with people living at 95 New Wokingham Road and staff working there. We examined care records and staff records. The manager was able to join us for the last part of our site visit. The service has in place policies and procedures relating to equality and diversity and there was evidence that they could meet a range of different needs and choices. Care Homes for Adults (18-65 years) Page 6 of 26 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 26 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 26 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 manager has recognised the importance of providing relevant and up to date information about the home, both for the people who live there and for those people who may be interested in living there in the future. Evidence: The new manager is in the process of reviewing The Statement of Purpose and Service User Guide as they had not been reviewed for some time. The new manager does not believe they accurately reflect the ethos and atmosphere of the home and is keen that they should do so. There have been no new people moving in to the home since the previous key inspection, so there were no new assessments to review. The manager is reviewing the assessment procedure in conjunction with their review of all the home procedures. Care Homes for Adults (18-65 years) Page 9 of 26 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 people who live at 95 New Wokingham Road are well supported to make choices about how their individual needs are met. Evidence: We looked at the plans for care for two of the people who live in the home. Many of the records stored on the files were out of date and, in addition, many contained duplicated information. The current manager who has been overseeing the home for some time is aware of this situation. The out of date records were inheritted by the current manager. This situation is now being tackled and a full review of each person was undertaken with them in June of this year. Documentary evidence of this was available. This covered their personal profile, their personal care, healthcare and medication needs. It also reviewed their social and communication skills, their contacts, their activites and their financial arrangements. Further work will be undertaken to devise individual support plans, using this information, with each person. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Staff we spoke with commented on an improvement in how people are supported to make choices, for example with their clothes and hairstyles and we saw photographic evidence of such changes. We spent a lot of time interacting with the people who live at 95 New Wokingham Road and this confirmed that people are well supported to make choices about how they are supported to ensure their needs are met. Through discussion with staff, and discussions and interactions with individuals living at the home we established that people can get up and go to bed when they like and can spend their time as they wish. They can go out if they like and one person who was previously assessed as not wishing to go out is now supported, on a one to one basis, to go out. Accurate records are maintained regarding the involvement of individuals with health professionals, for example doctors, nurses, speech therapists and physciatrists. One person has been supported through a major health difficulty and operation, and is now enjoying a much improved lifestyle. We saw that staff interact with individuals all the time and that they are supported to participate in the life of the home. For example preparing meals, laying the table, doing the gardening and housework, and choosing the furnishing for their bedrooms. Risk assessments are still to be updated and the manager plans to tackle this urgently. Care Homes for Adults (18-65 years) Page 11 of 26 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. The people who live at 95 New Wokingham Road enjoy the lifestyle of the home. There have been many changes since the last inspection and some progress is being made in encouraging people to go out more. Evidence: On the day of our visit we saw that activities within the home are those of normal daily living and we saw people sorting washing and planning for shopping trips. We saw that people can choose how they spend their time. One person particularly likes to colour and one likes to do the gardening and is supported in that. Staff we spoke with explained that people are encouraged to spend time in the community and recent progress has been made in this area. However, they are keen to ensure that personal choice is respected. One person who did not previously go out now does go out accompanied by a particular individual. One persons mobilbiy limits Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: their access to the community and the home arranged for an assessment of their wheelchair needs. The home is supporting the person to purchase an appropriate wheelchair, in line with the assessment, as they have been advised it could take up to a year for one to be provided. The home has access to a shared vehicle. The home welcomes visitors and this was confirmed by staff and people who live there. One person told us their sister and niece visit and another persons parents visit. One person also has a befriender who visits and takes that person out. We saw evidence form the daily diary which showed that the people who live there and staff had held a menu planning meeting the day before our visit. Shopping is usually undertaken by a member of staff as the people who live there have not previously been keen to go, but this is something that staff are encouraging. There are no menus for breakfast or lunch as people can have what they want. For breakfast this includes cereal, porridge. bacon, eggs and beans for example. People we spoke with confirmed they can choose what they like and we saw evidence of this at lunch time when people could choose what they wanted for lunch. Pictorial menu options were used to assist in communication where it helped. There is a dining area off the lounge but people can choose where they eat their meal. There is a small table in the kitchen which one person likes to sit at. We sat with one person why they had their lunch who confirmed there was always plenty of good food. Care Homes for Adults (18-65 years) Page 13 of 26 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 personal and healthcare needs of the people who live at 95 New Wokingham Road are appropriately met in a way that improves and enhances their quality of lives. Evidence: As stated in section two of this report, The manager has identified the need for all the personal support plans for the people who live at 95 New Wokingham Road to be rewritten An annual review of peoples needs were conducted in June 2009. This included a review of peoples personal, healthcare and medication needs, so there is up to date information on these needs. Healthcare records include involvement with other pratitioners for example, outpatient appointments and appointments wih doctors or therapists. We saw a particualr example of how one persons health care needs have been met. This involved the identification of a mojor helath problem, which seemed to have been present for some time and was impacting majorly on this persons health and quality of life. The manager and staff supported this person to attend hospital appointments, undergo tests and have a major operation. The manager and staff informed us this has had a very positive effect on this persons life in terms of their general health and well being and they are now able to undertake activites they previously enjoyed, such as gardenning. We also saw, through staff Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: interactions with people and through records that the home is currently actively addressing a possible choking issue one person is having with swallowing food. A new medication cabinet for the secure storage of all medication has been installed since the previous inspection and the home has changed its medication procedures to those of the Boots pharmacy. We were able to confirm that staff received training from the Boots pharmacist following this change over. The manager and one senior member of staff have now been trained as medication trainers and we saw evidence that staff receive a six monthly refresher on medication administration. During our visit we observed medication being administered and saw that the correct procedures were followed and that medication records were accurate and include a photograph of each individual. Care Homes for Adults (18-65 years) Page 15 of 26 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 who live at 95 New Wokingham Road are encouraged and supported to express any concerns or complaints they may have. The ethos of the home and the managers attitude is very supportive of individual rights and people are safeguarded from possible abuse. Evidence: The home has a complaints procedure in place and has previously produced an easy read version of this. However, staff we spoke with felt that none of the current people who live there would be able to make a formal complaint without support. However we observed that two of the people who currently live at the home were able to speak up if they were not happy about anything and this was confirmed by the staff we spoke with and by the manager. All the people are very well known by the staff, and the manager confirmed that all three people can express dissasisfaction or unhappiness. Monthly meetings are held and the people who live at the home are encouraged to express their views about all aspects of home life. These meetings are minuted. No formal complaints have been received by the service since our last inspection. The home has in place an appropriate policy and procedure for safeguarding the people who live there. The manager spoke passionately about the rights of the people who live there to respect, choice and dignity. All the permanent members of staff were undertaking the training Our Approach (see staffing section of this report) in September 2009 which includes training on the protection of vulnerable adults. Staff Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: we spoke with were aware of how to deal with potential abuse. Dimensions also provides a specific training course in the protection of vulnerable adults, which six of the permanent staff had previously undertaken, although three were due for renewal, which would be covered by the Our Approach training course. The home holds money on behalf of the peole living there. This is stored securely. All expenditure is documented and cross referenced to receipts. The money is checked at each staff handover and two people sign to verify the ammounts. Care Homes for Adults (18-65 years) Page 17 of 26 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 living at the home enjoy the comfortable environment it provides. The home is clean and steps are being taken to ensure all staff are fully trained in infection control. Evidence: 95 New Wokingham Road is a detached house in a residential area. The building belongs to Maidenhead and District Housing Association and the care is provided by Dimensions. We were informed that the housing association are suppossed to visit monthly to undertake any maintenance but that this does not always happen. The house appeared to be reasonably well maintained and suitable for those people who live there. Each person has their own comfortable bedroom which is individually furnished and decorated. There are two suitable bathrooms. There is a large communal lounge as well as a small reception room. The dining room follows on from the lounge and has quite a large step down to access it. This did not appear to be problematic at present for the people who live there. There is also a small eating table in the kitchen, where one person prefers to eat. The home appears to be comfortably decorated and is homely in style. The people who live there appear to be comfortable and the home currently seems to physically meet their needs. There is a large garden to the rear of the property, which one of the people who lives there likes to help maintain. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: The home has policies and procedures in place to manage infection control. However, at the time of our visit only two of the permanent staff had received training in infection control, although the subject is covered generally at the induction stage. As part of the training audit (see staffing section), arrangements are being made for staff to receive infection control training. The home has a seperate laundry room where the people who live there are supported to do their washing. Care Homes for Adults (18-65 years) Page 19 of 26 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 supported by appropriately recruited staff who are generally appropriately trained. Gaps in training have been identified and steps are being put in place to address these gaps. Evidence: Information we received prior to our site visit stated the home has three full time care staff and 9 part time staff. Seven of these staff are permanent care workers, four of these have NVQ level 2 or above. The home also receives support from staff who are permanent staff in other Dimensions homes. For example on the day of our site visit a member of staff was working who is based at another home. However, they obviously knew the individuals in the home well, and is qualified. We discussed staffing with the manager at the end of our site visit. She confirmed that there has been some turn over in staff in recent months, as the ethos of the home has been re-developed. Staff are also being offered training, to ensure their approach is consistent with the current ethos of the home to provide person centred care. The home has in place policies and procedures to ensure that staff are recruited appropriately. This procedure includes obtaining a full employment history, two appropriate references and a clearance form the Criminal Records Bureau (CRB). Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Recruitment records are not currently stored in the home but at Dimensions Head Office. However, we saw evidence that staff files held in the home are currently being re-organised to include evidence of appropriate checks being undertaken including the CRB reference number, the application forms and that appropriate references have been obtained. The home has recently undertaken a full audit of the training undertaken by staff and outstanding within the home. All staff receive an in-house initial induction. They then attend a four day training course called Our Approach. This covers The Principles of Care, including values, confidentiality and person centred approaches; Understanding The Organisation and the Role of The Worker, including policies and procedures; Effective Communication, including verbal and non verbal communication techniques; and Recognising and Responding to Abuse and Neglect. All current staff commenced this course in September 2009. In addition, all staff attend mandatory training in First Aid, Food Hygiene, Health and Safety, The Protection of Vulnerable Adults and Manual Handling. The current audit has shown where refreshers for these courses were overdue and arrangements are being made to provide this training. The manager and a senior member of staff are qualified to provide medication training and we saw evidence that updates to this training are provided every six months. 95 New Wokingham Road is a small home and we therefore did not see many staff on the day of our visit. However, from our observations staff appeared well trained and demonstrated appropriate knowledge, for example in regard to how they communicated and interacted with the individuals, and in the administration of medication and in food and hygiene procedures. Care Homes for Adults (18-65 years) Page 21 of 26 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 people who live at the home benefit from the leadership and style of the manager. Their views are sought and acted upon and their health and safety is promoted and protected. The manager knows what further improvements need to be made in the written records of the home and is addressing this. Evidence: The home has undergone a change in management since the previous inspection. At the time of our site visit the current manager had not formally accepted the post of manager and was operating in a covering role. Since our site visit she has formally been appointed and has commenced her application to register with us as the manager of the home. She is an experienced and suitably qualified person and is already registered with us to manage a different Dimensions home. The manager was not able to be present for most of our site visit but we spent some time speaking with her at the end of the site visit. Through talking to her and other staff, and from our observations of the historical records within the home, we saw that the home has changed under her leadership. The support provided to the people who Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: live there has become more person centred. For example one persons long term health problem has been resolved and one person has been supported to buy new clothes, have their hair cut and go out. Through observation, interacting with these people and talking to staff, we could see that these people were enjoying an improved quality of life. The home has previously been described as providing support for people who may demonstrate behaviour which challenges the service. The manager stated she has not found this to be the case and that she has put together a staff group who interact and communicate effectively with the people who live at the home. Our observations during our visit confirmed that staff communicate and interact effectively with the people who live there. The home keeps in touch with us and notifies us of any incidents that we need to know about. A previous requirement was made to obtain the views of the people who live at the home as part of a quality assurance process. This has not been done in the form of a formal survey as this would not be the most effective way to enable the individuals who live there to participate. However, we saw evidence that peoples preferences were sought in the running of the home. For example in menu planning, the furnishing of their rooms, the activities individuals participate in and how the home operates on a day to day basis to enable them to spend their time as they wish. The manager plans to incorporate peoples views in to the homes development plan. This will formalise the recording of their involvement and demonstrate how their views are taken on board. The manager explained that whilst she has been working to change the ethos of the home, the updating of paperwork has taken second place. It is now her plan to begin to ensure the written records in the home are all updated. Policies and procedures are provided by Dimensions and have been reviewed in November 2007 or April 2009. These include policies to ensure the health and safety of individuals is protected. However, as stated earlier in this report individual risk assessments need to be updated. General risk assessments are in place, for example covering fire and pandemic flu outbreaks. Electrical and other equipment is maintained in line with manufacturers guidelines. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 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 25 of 26 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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