Inspection on 03/12/09 for Noble Lodge

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

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Noble Lodge 14/06/07

Noble Lodge 11/12/06

Noble Lodge 05/09/05

Noble Lodge 03/05/05

Noble Lodge 09/09/04

Noble Lodge 10/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Noble Lodge 143 Bounds Green Road London N11 2ED     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: Susan Shamash     Date: 0 3 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Noble Lodge 143 Bounds Green Road London N11 2ED 02082457560 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Shaukatally Hossenally care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: One specified service user who is over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as the specified service user vacates the home. Date of last inspection Brief description of the care home Noble Lodge is a private care home providing personal care for up to 6 adults who have mental health needs. The home, which opened in 1990, is in Bounds Green, close to the underground station and local shops and services. There are six single bedrooms on the ground, first and second floor. There is a small dining room and lounge as well as a small paved garden to the rear. The home is not accessible for wheelchair users. The aim of the home is to provide a quality service for people who have mental health needs and to promote their independence. Noble Lodge aims to achieve this by providing support to help residents maximise their potential, physically, intellectually, emotionally and socially, within a homely atmosphere. At the time of this inspection there were three women living at the home. The fees charged range from 500-700 GBP a week. Noble Lodge makes inspection reports available to residents, their families and professionals from the office at the home. Reports can also be viewed on Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 1 7 1 2 2 0 0 8 Brief description of the care home www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and lasted approximately six hours. I spent time talking with the manager, a staff member and two residents during the visit, meeting the third resident as I was leaving the home, on their return from a visit to family members. I observed residents interactions with staff, and conducted a tour of the premises. I also inspected residents care files, staff files, medication and health and safety records alongside other records relating to the running of the home, and checked on the requirements made at the last inspection. Information provided in the most recent Annual Quality Assurance Assessment for the home was also taken into account as part of this inspection. Two completed CQC feedback surveys were received from residents, two from relatives and one from a staff member. They provided positive feedback regarding the home. 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. Care Homes for Adults (18-65 years) Page 7 of 29 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 8 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 9 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can generally be assured that their needs have been assessed before being offered a place at this home, however detailed assessments must also be obtained for emergency admissions to ensure that their needs can be met safely. Evidence: I inspected the files for all three residents living at the home, and these provided evidence that their needs and wishes had been assessed and recorded before they moved into Noble Lodge. Staff and residents confirmed that each resident had been assessed prior to their placement at this home, and the assessments were in their files and used as a basis for their care plans. However one resident had been admitted for a short time for an emergency placement, since the previous inspection. The registred manager advised that despite requests from the home, the placing authority had not provided all the information specified in the admission procedure for the home. The registered manger advised that she had obtained all relevant information from the resident and their relatives verbally, however this was not clearly recorded, and a requirement is made Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: accordingly. Care Homes for Adults (18-65 years) Page 11 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. Residents are satisfied with the care they receive at this home and are supported to take risks to develop their independence. Evidence: I inspected the care plans for all three residents, and discussed their care with two residents during the inspection. The manager advised that she had attended a training course in person centred planning and updated the care plan formats accordingly. Inspection of care plans showed that they included detailed information about peoples needs and how these were being met. Care plans covered a wide range of residents needs including areas such as medication, domestic skills, personal hygiene, budgeting, cultural needs and relationships. The plans were seen to be reviewed on a three monthly basis. However they did not included goals for each person although discussion with residents indicated that they had goals that they wished to work towards e.g. learning cooking skills, or going on holiday. A recommendation is made accordingly. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Risk assessments were in place and had also been reviewed regularly and updated. However there was only one risk assessment for each person, covering all relevant areas of risk, and therefore these assessments did not include much detail about how individual risks were supported. A requirement is therefore made that more detailed risk assessments be recorded for each resident, and these specify details of any restrictions placed on them, alongside signatures to evidence their acceptance, and those of their care managers, to ensure that people are supported to take responsible risks. Both residents said they were happy with their care at the home, and one spoke particularly highly of the staff support provided to them when they had been unwell. Both residents also said that they were listened to by staff and were able to make decisions for themselves on a day to day basis. Both residents told me that they were able to go and lie down, have meals, and go out when they wanted to, and observation of routines within the home confirmed that this was the case. Two of the three residents can travel independently. The other resident is encouraged to go out with staff whenever they wish to. Care Homes for Adults (18-65 years) Page 13 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 say they enjoy living in this home and are happy with their current lifestyle there. They are given support to maintain relationships with their families and are encouraged to be as independent as they are able. They are provided with a varied and balanced diet that meets their nutritional needs. Evidence: One person was at home at the start of the inspection, and I was able to spend some time with them. Another resident returned from their day centre towards the end of the visit, and I was able to speak to them also. The third resident was visiting family members during the inspection, and I only met them as they returned to the home just as I was leaving. One resident said that they attended a daycentre regularly and spent the rest of the week at home, by choice. Another person advised that they were hoping to attend Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: more structured activities in the future, but had been ill for sometime, receiving support from the home. All residents advised that they were happy at the home, enjoyed their meals and were well supported by the staff team. They advised that they were able to use the kitchen to make drinks whenever they wanted and staff cooked the majority of their food although they were encouraged to help out. All felt that staff encouraged them to be independent. One resident attends church regularly, and another has their cultural needs addressed by a carer from the same cultural background visiting twice a week to spend time with them. All three residents indicated that their religious needs were met . Staff advised that one resident is encouraged to go out for short walks alone and enjoyed this independence. Residents are also encouraged to go out on supported shopping trips, and to local eateries periodically. One resident told us that they had enjoyed a restaurant meal out over the last weekend, and records of activities indicated that residents enjoyed reading newspapers, going out to the pub and on shopping trips, and for meals out, and reading newspapers, watching TV and films, and playing various board games within the home. Food records showed a varied diet, which included some convenience foods, but these were enjoyed by people spoken to within the home. All residents advised that they enjoyd the snacks available to them including fizzy drinks, crisps and sandwiches, and one person noted that the food provided was lovely. They all confirmed that the manager supported them to maintain contact with their families, including taking one resident to Sussex to visit family members. All residents said they had a good relationship with the manager and one said, she is like a mother to me. Residents also said that another female staff member supported them well on a day to day basis. Care Homes for Adults (18-65 years) Page 15 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. People receive the support they need with their personal care and are encouraged to look after their appearance. Their health needs are supported, and improvements in recording of medication administration protects them from mistakes being made. Evidence: Two of the three residents need and receive support with personal care. One told me that staff help them with having a shower or bath and washing their hair, and keeping their room clean. I observed that staff encouraged residents to look after their appearance and one person showed me their recently painted nails, advising that a staff member had assisted them with this in the morning. Health records for all three residents indicated that they were supported to attend regular appointments with their GP, psychiatrist, dentist, optician etc. One resident receives regular visits by a district nurse and another had regular visits from a Community Mental Health Nurse. One person advised that their mental health had been very poor for an extended period prior to the inspection visit, and that staff staff had provided strong support Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: when this was needed. The manager confirmed that following concerns that this persons medication had not been helping, this was changed by the relevant medical professionals after intervention by the home. A relative completing a feedback survey advised that care is excellent, in sometimes trying conditions due to my relatives mental health. One resident is diabetic and continues to self medicate. This medication was stored safely. A new medication cabinet had been provided in the home, as required, with each persons medication stored in separate lockable storage units. A monitored dosage system was now provided to the home by the pharmacy, as recommended at the previous inspection. All staff had been trained in administering medication, and inspection of a sample of medication charts indicated that medication was recorded accurately. Improvements had been made to the recording of instructions on peoples medication charts, so that these were clearer, as required at the previous inspection, and there were clear records of medicines signed in and out of the home. The manager advised that one resident was allergic to Penicillin, and it is recommended that allergy information should be provided on all the medication administration records. Care Homes for Adults (18-65 years) Page 17 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. Residents feel their views are listened to and acted on in this home. They know how to complain if they are not happy and their wellbeing is safeguarded. Evidence: No complaints have been made to the home in the last year. The manager said there have also been no safeguarding issues. The complaints procedure is included in the service user guide which is given to all new residents. Both residents were asked if they had ever made a complaint, but advised that they did not need to, as they could speak to the manager or staff members about any issues of concern. One residents advised they are very good to me. Both advised that they would tell the manager if they were not happy. The manager advised that staff have all attended training in safeguarding vulnerable adults. Inspection of staff files, confirmed that certificates were available to verify this. There is a safeguarding policy in the home, with details of action to be taken by the manager if a safeguarding alert needs to be made in respect of any resident. The manager advised that she had attended training regarding the Deprivation of Liberty (DOL)Standards relating to the Mental Capacity Act 2005, and a poster regarding the DOL safeguards was posted within the home. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are satisfied with the facilities and live in a homely environment, improvements have been made, however further attention to the physical environment would improve the appearance of the home. Evidence: I inspected all the rooms in the home and the front and back garden areas. A requirement made last year to tidy up the front and back of the premises has been partly met, with significant improvements to the back garden, but the front garden still not accessible due to the accumulation of rubble. This also looks unsightly on entry to the home, which infringes on the comfort and dignity of residents living at the home. The laundry facilities are in an outhouse in the rear garden and were maintained to a satisfactory standard of cleanliness, and the rear garden area had a new fence fitted, and looked tidy. As a result of requirements made at the last inspection there has been some improvement to the physical condition of the house. Rooms have been redecorated alongside some corridors, making the home look cleaner and more homely. There was no broken furniture found within the home, and new dining room chairs had been purchased for the dining area. As required at the previous inspection, the local fire prevention team had been consulted regarding fire safety in the home, Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: following which the kitchen fire door had been fitted with a magnetic closing device, and new fire doors had been fitted on either side of the kitchen. Bedrooms were in a satisfactory condition. All three occupied bedrooms were clean and suitably furnished and decorated. The unoccupied rooms were in need of more work, including cleaning and refurbishment before future use, and one vacant room had a cracked window which must be repaired. All residents spoken to, were satisfied with their rooms, and advised that they were adequately heated and comfortable. Rooms had been personalised, and one person had been helped to decorate their room according to their wishes, and had plans to redecorate their room again with support from staff. Most areas of the home were clean, however there were some crumbs and stains in the kitchen and dining room areas. The manager advised that these areas were cleaned regularly, however it was difficult to keep these areas clean at all times, as they were used by residents to prepare snacks and drinks on a regular basis. It is recommended that a cleaning schedule be prepared for the home, with records of when each area is cleaned, with particular reference to the kitchen and dining room areas. Two residents keep their own rooms clean with assistance from staff. The lid of the chest freezer in the kitchen was broken, so that it did not shut securely, and the fridge freezer had some broken handles and trays. It is therefore required that a refrigerator and freezer be provided for the home. All residents should also be provided with keys to their rooms, and the home, to further promote their independence. It is recommended that the armchairs in the lounge area, be replaced and that a bigger flat screen television be provided for residents use, that consideration be given to fitting a magnetic doorguard to the lounge room door, and that the old certificates on the corridor walls be replaced, for the comfort and safety of people living and working at the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by staff who are trained and supervised in their duties. They benefit from a stable staff team who know their needs well. Evidence: At the time of this inspection the staff team remains small, due to low occupancy levels within the home. The team consists of the manager, the provider, one full time member of staff and one part time staff member. I inspected two staff files and saw that appropriate recruitment documents were maintained on file. Most of the mandatory training courses had been undertaken, however there was a need for updated training in first aid and food hygiene. It is also recommended that mental health awareness training be provided for all members of the team, to update their skills in this area. Supervision records indicated that staff are regularly supervised on a one to one basis, and there are also regular appraisals. This was confirmed by the staff member spoken to during the visit. The manager works alongside the staff team, and is therefore able to provide support and informal supervision on a daily basis. One full time staff member had completed NVQ level 3, and the other had completed NVQ level 2 but was hoping to undertake level 3 this year. The staff team is stable and no new staff have been employed since the last inspection. Care Homes for Adults (18-65 years) Page 21 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. Residents benefit form a home where their best interests are taken into account and where they have confidence in the manager to meet their needs. Their safety is protected by health and safety procedures and quality assurance systems in place. Evidence: The manager has managed this home for many years and has thus become experienced. She advised that she has completing the registered managers award training and is awaiting her certificates following internal verification. She advised that she also attends other relevant training to keep up to date with improvements in care practice. I discussed the management of the home with two of the residents. Both indicated that they considered the manager to be like a family member and had formed close relationships. They said they were happy with the way the home was run and that their views were listened to. I was able to witness staff giving a resident choices of their own meals and activities. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Regular staff meetings and resident meetings are held within the home, and I inspected the mintes of these meetings indicating that a wide range of topics relevant to residents lives within the home were discussed including swine flu precautions, day trips to the sea side, and the ground works being undertaken. The manager showed me the results of the most recent quality assurance surveys completed by residents and their representatives. These showed general satisfaction with the home. We discussed improvements made to the building in the last year and future improvements needed. The manager showed a commitment to continue to improve the home. However it is recommended that the quality assurance systems be further developed to include feedback from all stakeholders and include audits of all relevant areas. All residents are independent with their finances, and the home does not look after any of their monies for safekeeping. The manager advised that the only items kept on behalf of residents were bus passes for residents who were worried that they might lose them. A record should be kept of all items kept on their behalf, for the protection of staff and residents in the event of an item going missing. I examined a range of health and safety records in the home including fire and gas safety certificates, portable appliances testing, records of weekly fire alarm tests and fire drills. It is recommended that more detailed records be kept of fire drills, to ensure that the times are varied and all staff and residents attend at least one of these over each year. Staff are trained in health and safety topics such as food hygiene, medication and first aid and these certificates were seen, although a requirement was made in the previous section regarding updated training in first aid and food hygiene. Records were kept of fridge and freezer temperatures to ensure foods were stored safely. However although a certificate indicated that all appropriate checks had been undertaken in gas and electrical installations, a copy of the most recent electrical installation certificate must be available within the home. Care Homes for Adults (18-65 years) Page 23 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 24 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 2 14 The registered persons must 08/01/2010 ensure that no residents are admitted to the home without undertaking and recording a detailed assessment of their needs to ensure that these can be met effectively. . 2 9 13 The registered persons must 26/02/2010 ensure that more detailed risk assessments are recorded for each resident including separate assessments for each relevant area, and specifying details of any restrictions placed on them, alongside signatures to evidence their acceptance, and those of their care managers, to ensure that people are supported to take responsible risks. . Care Homes for Adults (18-65 years) Page 25 of 29 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 3 24 23 The registered persons must 26/02/2010 ensure that the front garden is cleared of rubble, and made fit for residents and their visitors to use, to improve the safety and appearance of this area. . 4 24 23 The registered persons must 29/01/2010 ensure that a new refrigerator and freezer are provided for the home, all residents are provided with keys to their rooms and the home, and that the cracked window in a vacant bedroom in the home is repaired, for the comfort and safety of people living at the home. . 5 35 18 The registered persons must 26/03/2010 ensure that all staff have up to date training in first aid and food hygiene, and updated mental health awareness training should also be considered for the staff team, to ensure that peoples needs are met safely and effectively. . 6 41 17 The registered person must 29/01/2010 ensure that records are kept of any items kept for Care Homes for Adults (18-65 years) Page 26 of 29 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 safekeeping in the homes office e.g. residents bus passes, and that these be signed in and out of safekeeping. A copy of the most recent electrical installation certificate must also be obtained from the supplier and maintained at the home, for the protection of staff and residents. . 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 It is recommended that care plans be further developed to include goals for each person e.g. learning cooking skills, going on holiday, with detailed progress records indicating the support provided to each person to assist them in achieving their goals. It is recommended that stocks of a greater variety of fresh fruit and vegetables should be kept within the home, and that these should not be allowed to run out. It is recommended that known allergies for each person should be recorded on each of their Medication Administration Records, including no known allergies if this is the case. It is recommended that the armchairs in the lounge area, be replaced and that a bigger flat screen television be provided for residents use, that consideration be given to fitting a magnetic doorguard to the lounge room door, and that the old certificates on the corridor walls be replaced, for the comfort and safety of people living and working at the home. 2 17 3 20 4 24 Care Homes for Adults (18-65 years) Page 27 of 29 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 5 30 It is recommended that a cleaning schedule be prepared for the home, with records of when each area is cleaned, with particular reference to the kitchen and dining room areas. It is recommended that the results of the quality assurance surveys undertaken for the home be collated and used to inform the homes business plan, and that regular audits be undertaken of each area relating to the homes functioning e.g. medication, food hygiene, activities etc. and that these be recorded. It is recommended that records of fire drills in the home should be more detailed to include the time of each drill, which should be varied, and that names of all staff and residents involved should be recorded, to evidence their participation. 6 39 7 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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