Inspection on 22/11/08 for Queensdown Road, 1

This is the latest available inspection report for this service, carried out on 22nd November 2008.

CSCI 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

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 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Queensdown Road, 1 1 Queensdown Road Hackney London E5 8NN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Robert Cole     Date: 2 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Queensdown Road, 1 1 Queensdown Road Hackney London E5 8NN 02089856908 Telephone number: Fax number: Email address: Provider web address: EObayoriade@outward.org.uk Name of registered provider(s): Type of registration: Number of places registered: Outward care home 6 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: 6 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 Date of last inspection Brief description of the care home Outward Housing Association owns the home. This care provision is a care home for six adults with moderate to severe learning disabilities. The home is located in a quite residential road overlooking Hackney Downs. It is in close proximity to Mare Street shopping areas, local amenities and there are good transport links. Permit parking is in operation. The nearest British Rail stations are Hackney Downs and Hackney Central. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 took place over one day on the 22/11/08 and was unannounced. The inspector had the opportunity of speaking with service users, staff from the home, and the homes manager was present for much of the inspection. The inspection also included a tour of the premises, and an examination of records and other documents. Some of the service users have limited verbal communication, and in order to help gain an insight in to their experiences of the home, the inspection included observations of staff as they carried out their duties. Care Homes for Adults (18-65 years) Page 5 of 30 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 7 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the view of the inspector that prospective service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. Evidence: The home has a Statement of Purpose in place. This lists the aims and objectives of the home, which include Respond to individual needs by providing a needs led service based on individual care plans and assessment within and equal opportunities framework. and Support and encourage service users to develop and maintain as much independence as they are able to. The Statement also includes details of the services and facilities provided by the home and of the staff and management. The home also has a Service User Guide. This has been produced in plain English, and also pictorial form, helping to make it more accessible to service users and meeting needs around equality and diversity issues. The Guide includes a summary of the Care Homes for Adults (18-65 years) Page 8 of 30 Evidence: Statement of Purpose and details of the homes physical environment. Individual contracts are in place for all service users. These include details of the fees payable, and the rights and responsibilities of both parties. Contracts have been signed by service users and a representative of the home. Although there have been no new admissions to the home since the last inspection, the home does however have an admissions procedure in place. This states that pre admission assessments would be carried out, and that any prospective service users would be given the opportunity of visiting the home before making a decision as to move in or not. Records indicated that service users had indeed been given this opportunity, and that they would initially move in to the home on a three month trial basis, after which a placement review meeting would be held. Care Homes for Adults (18-65 years) Page 9 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors view that service users have a large measure of control over their daily lives, and are able to be involved in the day to day running of the home. Evidence: Individual care plans are in place for all service users. These are drawn up with the involvement of the service user and their keyworker. Care plans are person centered and drawn up from the point of view of the service user, for instance one plan states I like relaxing in the garden during summer and I also enjoy watching horse racing, music and love cars. Plans cover needs around personal care, communication and social and leisure needs. On the subjects that they cover, care plans are of a good standard, clear and comprehensive, setting out in sufficient detail how the home is able to meet the needs of service users. However, care plans provide little information around some equality and diversity needs, for instance plans examined contained no information around sexuality and relationships or cultural and ethnic needs. In order to help ensure that the home is meeting all the needs of service users in a Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: comprehensive and consistent manner, individual care plans must be in place covering all areas of assessed need. Care plans are subject to regular review, and service users have an annual review in conjunction with their placing authority which feeds in to the care planning process. Individual risk assessments are in place for all service users, these are subject to regular review and of a satisfactory standard. Assessments identify any risks, and include strategies to manage and reduce those risks. Assessments make clear that that service users are supported to take reasonable risks, for instance one service user visits the local shops without staff support, which helps to develop their independence. The risk assessment states that if they are gone for more then half an hour the missing persons procedure will be implemented. Assessments also cover traveling on public transport and using kitchen utensils. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. Service users were seen to be ale to get up at a time of their choosing, and informed the inspector that they chose what clothes to wear, what to have for breakfast etc. Service users are involved in the daily routines of the home, such as making beds and keeping bedrooms tidy, and service users were observed to be doing the washing up. Service users have complex communication needs, and some have very limited verbal communication. The inspector was impressed by work done in the home to support service users to communicate, and thus giving them more control and choice over their daily lives. For example, the home has worked with speech and language therapists to develop individual communication passports for service users, which sets out the various ways service users are communicating, and what particular gestures and sounds are likely to mean. The home has also developed picture books which enable service users to be involved in planning menus and actives, helping to meet needs around equality and diversity issues. There was evidence that service users are given the opportunity of being involved in the day to day running of the home. The home holds service user meetings fortnightly, which are minuted. Minutes evidenced discussions around menu planning, activities and maintenance issues. The most recent meeting held discussions around plans for Christmas. Service users also have regular one to one meetings with their keyworkers, giving them the opportunity to discuss issues of interest or concern to them. The home has recently ordered a new sofa, and service users were given the opportunity of being involved in choosing this. Confidential records in the home are stored securely in locked cabinet. The manager Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: informed the inspector that staff and service users can access their records as appropriate. The home has a confidentiality policy in place. Care Homes for Adults (18-65 years) Page 12 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that service users are supported to live valued and fulfilling lives. Service users have regular access to the community, and food is of a good standard. Evidence: Although no service users are currently involved in any employment, it has been identified that one service user would like some work involving gardening, and the home is actively pursuing this. One service user attends college where they study cookery, and have the opportunity to further develop these skills at home. Outward, the organization that runs the home, provides training to service users, and there are plans for service users to attend training on IT skills, assertiveness, budgeting and travel awareness. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Service users attend various day services. One attends the Hoffman Center, which is specifically for adults with autism, thus helping to meet their needs around equality and diversity issues. They are involved in various activities through this center, including carpentry, drawing and painting, and the inspector was pleased to note that examples of their artwork were on display within the home. Another service user attends the Daylight day services, where they are involved in music, craft and dance groups. Another service user attends First Start day services, where they are involved in arts and cooking. Service users have regular access to the community. This in part helps to meet their needs around equality and diversity issues, for example one service user visits a Caribbean hairdressers, while another visits a swimming club that is specifically for adults who have autism. Three service users attend church, helping to meet needs around religion. Service users access public transport, and the home has its own unmarked vehicle which service users are able to access the community in. One service user has their own car. Service users access community facilities, including shops, markets, banks, libraries and parks. Two service users were supported to go for a hair cut on the day of inspection. Service users have access to a variety of social and leisure activities, both in house and in the community. In house service users have access to television, DVDs and music, the home has a piano which service users play. The home holds occasional parties, for example to celebrate birthdays, and BBQs. In the community service users visit cinemas, pubs, restaurants and go on day trips, such as to Margate and Bluewater shopping center. On the day of inspection one service user was on a day trip to Paris with their mother, supported by staff from the home. All service users are offered a weeks holiday away from the home as part of their basic contract price. This year service users have visited Bognor Regis, and other recent holidays have included to the USA and Jamaica. Visitors are welcome to visit at any reasonable time, and service users can see visitors in private if they so wish. Service users are able to visit their families at their homes, and maintain contact by telephone. One service user has their own mobile phone, and informed the inspector that they are able to phone their relative every day, which they very much value. Records are maintained of menus, which indicated that service users are provided with individual choices, and that they are offered a varied, balanced and nutritious diet. The home has worked with a dietitian to try to develop and encourage healthy eating. The home provides traditional English and Zimbabwean food to help meet service users Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: cultural needs. Service users are able to help themselves to drinks and snacks, and mealtimes were observed to be unhurried and relaxed. Fresh fruit was available. The home has had a new kitchen fitted since the previous inspection. This was found to be clean and tidy, and food was stored appropriately. Fridge and freezer temperatures are checked daily. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that the home is able to meet the personal and health care needs of service users. Service users are able to manage their own personal care, and have access to relevant health care professionals as appropriate. Evidence: Care plans make clear that service users are supported to manage their own personal care as much as possible, and the home provides a choice of bath or shower. Service users are able to choose their own clothes to wear, and were all appropriately dressed on the day of inspection. All service users are registered with a GP, dentist and optician. It has been identified that the needs of one service user are changing around their mobility, and a referral has been made to occupational therapy. The Autism Spectrum Disorder Service visit the home for seven hours a week, to provide specialist support to service users. All service users have a Health Action Plan in place, which forms part of their care plan.This sets out how the home is able to meet health needs, for instance around Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: healthy eating, eye care and skin care. Records are maintained of medical appointments, including details of any follow up action required. These indicated that service users have access to health care professionals as appropriate, including chiropodists and opticians. The home has a policy in place on medication, and all staff undertake training before they are able to administer medications. Medications are stored in individual locked cabinets inside service users bedrooms. No service users currently self medicate, or are on any controlled drugs. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. Medication Administration Records were maintained, these were generally up to date, although they did contain some inconsistencies in the form of gaps, which the home must take steps to address. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that the home has taken reasonable steps to help protect service users from the risk of abuse. Appropriate policies are in place, and staff undertake training in adult protection. Evidence: The home has a complaints procedure in place, a copy of which was on display within the home. The policy includes timescales for responding to any complaints received, and service users are also able to raise issues of concern to them through the regular service user meetings. The home also has a complaints log, although the manager informed the inspector that the home has not received any complaints since the last inspection. The home has a copy of the Local Authorities adult protection procedures, and also its own policy on adult protection, which was clear and comprehensive. All but two staff who work at the home have undertaken training on safeguarding adults, and the manager informed the inspector that the remaining two staff were booked to attend such training before the end of this year. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection issues. All service users have their own bank accounts. The home holds money on behalf of service users in a locked safe. Records and receipts are maintained of financial Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: transactions involving service users monies. Those checked by the inspector were accurate and up to date. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the view of the inspector that the home is generally suitable to meet its stated purpose with regard to its physical environment. The home was generally well maintained, and service users are provided with adequate communal and private space. However, the home must ensure that any maintenance issues are addressed in a timely fashion. Evidence: The home is a three story town house overlooking a public park, located in the London Borough of Hackney. The home is in keeping with other homes in the area, and is close to shops, transport links and other local amenities. The home was generally well maintained, both internally and externally. Communal areas consist of a kitchen, dining room, sitting room, activity room and rear garden. A considerable amount of work has been carried out on the environment since the previous inspection. This includes the new activity room, and an extra shower and toilet room. The kitchen has also been refurbished. Service users were able to be involved in choosing the new kitchen. At the time of inspection, the activity room did not yet have any equipment, but the manager informed the inspector that they expected this room would be operational in the near future. The garden was well Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: maintained, and included garden furniture. Furniture and fittings within the home were well maintained and domestic in character. Toilets and bathing facilities have improved since the last inspection, in addition to the new toilet/shower room, an existing shower room has been extended with improved bathing facilities. Showers and baths are adapted to make them accessible to all service users, thus helping to meet needs around equality and diversity issues. Bathrooms were clean, tidy and free from offensive odour, and all had a working lock fitted which included an emergency override device. The home is registered for six service users. Recent development work has added an extra bedroom, and the manager informed the inspector that the home was in the process of applying to be registered for seven service users instead of its current registration for six. All service users have their own bedrooms. Those seen by the inspector were clean and tidy. Service users have been able to personalize bedrooms to their own taste, for example with televisions and family photographs. Bedrooms meet National Minimum Standards on size requirements. Bedrooms contained adequate natural light and ventilation, and all had central heating fitted. Bedding, curtains and carpets were well maintained and domestic in character. Bedrooms contained adequate furniture, including table, chairs, chest of draws and a wardrobe. The home has taken reasonable steps to help prevent the spread of infection within the home. Laundry facilities were of a suitable scale for the home, and hand washing facilities are situated around the home. Protective clothing such as gloves and aprons are available to staff. COSHH products are stored securely. There was evidence that minor maintenance issues within the home were not dealt with in a timely manner. For example, one service user showed the inspector their bedroom, and pointed out that the wardrobe door had come off. They said they would like it repaired. Records indicated that this issue was first brought to the attention of Outwards maintenance department on the 27/5/08. The service user subsequently raised the issue during service user meetings on both the 28/10/08 and the 11/11/08. yet at the time of the inspection, not only had this issue not being dealt with, their were no plans in place to deal with it in the near future. The homes manager informed the inspector that there were several other maintenance issues that they have being trying to resolve, without success. These include a broken bed in one of the service users bedrooms and a broken lock on another service users bedside cabinet. It is required that maintenance issues are addressed in a prompt and timely fashion, and that the particular issues mentioned within this report are addressed within the timescales given in the requirement made. Care Homes for Adults (18-65 years) Page 21 of 30 Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the view of the inspector that the home is staffed in sufficient numbers to meet the needs of service users, and that staff are suitably experienced and qualified to carry out their duties. Evidence: The home provides 24-hour support, including waking night staff and an emergency on-call procedure. The staffing levels have been reviewed since the previous inspection, and the inspector was pleased to note that the home now has a sleeping night staff in addition to the waking night staff on duty every night. The inspector considers that this provides a more comprehensive and safer level of staff support to service users. The home had a staffing rota on display, which accurately reflected the actual staffing situation on the day of inspection. Through observation and discussion there was evidence that staff have built up good relations with service users, and have a good understanding of their needs. For example, staff demonstrated a good ability to communicate with service users who have complex communication needs. Staff were seen to interact with service users in a respectful and friendly manner throughout the inspection. Instances of positive interactions were noted, for example supporting service users to make their breakfast, Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: and discussions over what activities to participate in. Service users spoken to expressed satisfaction with the staff, one commented that The staff help me. The home has all necessary employment related policies and procedures in place, including on equal opportunities and recruitment and selection. Pre employment checks are carried out on all staff prior to them working in the home. These are stored centrally by the organization that runs the home, with the agreement of the CSCI. The home keeps a pro forma for each member of staff, which details what checks have been carried out. These indicated that all staff have provided references, proof of ID and CRB checks as appropriate. All staff undertake a structured induction on commencing work at the home, this covers service users and health and safety issues, and includes shadowing more experienced members of the staff team for a period. Staff have access to regular training, recent training attended includes Person Centered Planning, challenging behavior, team building and adult protection. The inspector was pleased to note that since the previous inspection all but two of the care staff have attended training around autism, and that the remaining two staff are booked to attend such an event in February 2009. All care staff in the home have successfully achieved an NVQ Level 2 in Care or equivalent qualification. Staff receive regular supervision, minutes are maintained and staff have access to their supervision records. Those records seen by the inspector evidenced discussions on performance, training needs and service user issues. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgment of the inspector that this is a generally well run home. Records were generally well maintained, and appropriate quality assurance systems were in place. Evidence: The homes manager has seven years experience of working in social care, including nearly four years in a senior position. They have an Open University qualification in managing health and social care. The manager informed the inspector that they intend to commence working towards the Registered Managers Award and an NVQ in Management in February 2009. Staff and service users were seen to interact with the manager in a relaxed manner. The home has relevant policies and procedures in place which are in line with National Minimum Standards. Those examined by the inspector, including admissions, adult protection and medication were of a satisfactory standard. Record keeping was of a generally good standard, and confidential records were stored securely. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Service user meetings, care plan reviews and staff supervisions all contribute to the quality assurance process within the home. Copies of previous inspection reports were available to view in the home, and there was evidence that monthly Regulation 26 visits have taken place. The manager informed the inspector that they intend to hold relatives meetings in the near future to help gain their feedback on the running of the home. Fire extinguishers were situated around the home, these were last serviced in November 2007. Fire exits were clearly signed and free from obstruction. Fire alarms are tested weekly, and regular fire drills are held. At the time of inspection, the last time the fire alarms had been serviced was in July 2007. This was brought to the attention of the manager during the course of the inspection. Subsequent to the date of this inspection, the home was able to demonstrate that it had since arranged for the fire alarms to be serviced, therefore no requirement will be made around this in this report. Likewise, the homes landlords gas safety certificate was out of date at the time of inspection, but again, the home has arranged for this safety check to be carried out shortly after the date of the inspection. The home had in date safety certificates for PAT testing and electrical installation. The home had in date employers liability insurance cover in place. When the inspector arrived at the home for the inspection, it was noted that the fire door leading into the kitchen/dining room area was propped open with a stool, thus preventing it from closing in the event that the alarms sounded. Staff said that this was because on occasions the kitchen got humid, (although this was not the case at the time). It is required that fire doors are not left wedged or propped open. They must either be kept closed, or fitted with a device that allows them to close automatically in the event of the fire alarms sounding. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must 31/01/2009 ensure that comprehensive care plans are in place for all service users, covering all areas of assessed needs, including needs around equality and diversity issues. To help ensure that all the needs of service users are being met in a comprehensive and consistent manner. 2 20 13 The registered person must 31/12/2008 ensure that Medication Administration Record charts are maintained appropriately and kept up to date. To help ensure that service users receive prescribed medications as appropriate. 3 24 23 The registered person must ensure that maintenance issues within the home are addressed in a timely and prompt manner. In particular, the registered 31/12/2008 Care Homes for Adults (18-65 years) Page 28 of 30 person must ensure that the following maintenance issues are addressed:, the broken wardrobe in a service users bedroom must be repaired, the broken bed in a service users bedroom must be repaired, the lock on the bedside cabinet in a service users bedroom must be repaired. To help ensure that service users benefit from a safe and homely environment. 4 42 23 The registered person must ensure that fire doors within the home are not left propped or wedged open. To help ensure the health, safety and welfare of service users and others. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!