Inspection on 17/03/09 for Riverside

This is the latest available inspection report for this service, carried out on 17th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Riverside 25/01/06

Riverside 25/10/05

Riverside 23/02/05

Riverside 21/07/04

Riverside 25/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Riverside Coventry Road Bulwell Nottingham NG6 8RA     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: Karmon Hawley     Date: 1 8 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 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 32 Information about the care home Name of care home: Address: Riverside Coventry Road Bulwell Nottingham NG6 8RA 01159277418 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): maureen.rickett@nottinghamcity.gov.uk Nottingham City Council Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 22 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 2 residents over the age of 60 Date of last inspection Brief description of the care home 22 Riverside is a purpose built care home, owned and staffed by Nottingham City Council. The home is situated approximately three miles from the city centre, and is close to local shops and transport options, including the tram. Care is provided for twenty-two people with a learning disability, with sixteen places deemed medium term, and six beds for emergency/ respite care. The home is situated on two floors, with the upper floor being accessed via stairs. There are a number of ground floor bedrooms, and assisted bathing facilities, so that a person with restricted mobility could live at Riverside and have their needs met. Fees: Fees are individually assessed by peoples social workers, and will depend on individual circumstances. Care Homes for Adults (18-65 years) Page 4 of 32 Care Homes for Adults (18-65 years) Page 5 of 32 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: The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. One regulatory inspector conducted the unannounced visit over 2 days. A review of all the information we have received about the home from the provider and the general public since the last inspection was considered in planning this visit and this helped decide what areas were looked at. Care Homes for Adults (18-65 years) Page 6 of 32 The main method of inspection we use is called case tracking which involves selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The acting manager, members of staff and people who use the service were spoken with as part of this visit. Documents were read as part of this visit and medication was inspected to form an opinion about the health and safety of residents at the home. A partial tour of the building was undertaken, all communal areas were seen and a sample of bedrooms to make sure that the environment is safe and homely. The service sent us an Annual Quality Assurance Assessment which outlines the developments and improvements the care home has made throughout the year. We used some of this information within the report to determine our judgements. What the care home does well: What has improved since the last inspection? Some support plans have been developed to make these more person centred to make sure that people are supported in their preferred way. Additional activities have been arranged so that people using the service have more to stimulate them. A maintenance person has been employed to address maintenance issues within the building to ensure that people live in a more comfortable environment. Care Homes for Adults (18-65 years) Page 8 of 32 Further progress has been made in regard to the quality assurance systems to ensure that people using the service receive quality outcomes and they have a say in how the service is run and managed. 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 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured that staff are able to meet their needs before they make a decision to move into the care home. Evidence: The manager visits people within the community if appropriate to carry out a preadmission assessment to make sure that staff are able to meet their needs before they make a decision to move into the care home. There is evidence of these assessments taking place within case files that we examined. Where this process is not appropriate the necessary assessments and meetings take place with the Local Authority and relevant others before a decision to move into the care home is made. People who may wish to use the service are encouraged to visit the home with their carer and spent time there. This is done on a gradual basis, for instance initially a visit to the care home will be arranged, then they may stay for tea, followed by a sleep Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: over. This is to ensure that people can get a feel for what it could be like to live at the care home and also gives them an opportunity to meet people who already live there and the staff that will be supporting them. Staff spoken with said that they are informed of peoples needs before they move into the care home so that they can support them appropriately. Care Homes for Adults (18-65 years) Page 12 of 32 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. People are assured that their assessed, changing needs and personal goals are reflected in their individual support plan, and despite these not always being person centred or updated frequently their needs are met. People using the service are supported to make their own choices and decisions about their lives and take risks as part of an independent lifestyle. Evidence: Support plans are in place for peoples identified needs and there is evidence that people using the service and their families if appropriate have been involved in the negotiation of these. This ensures that people are able to express their choices and preferences in the way that they are supported. Some support plans are more person centred than others and offer information about peoples choices and preferences and what is important to them, so that they are supported how they want to be. The acting manager stated that there are plans to Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: update those support plans that are less person centred and a number of staff have now attended training to enable this to take place. Support plans clearly show what people can do for themselves and areas where they may need support so that this is offered appropriately. There is evidence that some support plans are updated as peoples needs change so that they receive continuity of care, however there is evidence that despite in depth information being available within some daily running records that this information has not been utilised within a support plan. Nevertheless there is evidence of reviews taking place when areas of concern arise and we saw that appropriate discussions and risk assessments have been implemented to address any issues, for example a persons ability to cross the road when out in the community by themselves. Some support plans contain a lot of historical information which leads to difficulty in cross referencing issues and being clear about what is up to date information. The acting manager stated that there are plans to change the format of support plans to address this issue. To ensure that risks such as going out in to the community, behavioural issues and being at risk of exploitation are managed and reduced appropriate risk assessments are in place. Staff spoken with are able to discuss peoples needs and the areas in which they need support, they show a good understanding of ensuring that peoples independence is maintained and that they support people to live a quality life. They told us, it is important that we make sure people feel safe and nice and comfortable in their own home, and I feel confident in dealing with challenging behaviour if it arises, I ensure that I look after people and treat them with respect. Relatives spoken with said that they feel involved in the care planning process and the way in which support is offered to their relatives. People using the service told us that their needs are met with the support of staff and that they are happy living at the home; it is lovely and friendly here, I am looking at moving though because I want to be more independent and look after myself, the staff are nice, they help me, I am happy here but I am afraid to go out alone, so the staff come with me, I am happy here, I am well looked after, and I am very happy here, life here is flexible, I can do as I wish. Care Homes for Adults (18-65 years) Page 14 of 32 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. People are supported and enabled to take part in activities of their choosing, maintain contacts with people that are important to them and are part of the local community. Evidence: Several consumer and staff meetings have taken place recently so that activities at the home can be further developed. Staff spoken with confirm that these have taken place, that they now initiate more activities and that people using the service are doing more than they used to. There are photographs displayed around the home of people on trips out into the local community and places of interest. In addition to in house activities most people also attend day centres and social clubs Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: where they take part in varied activities. People using the service told us, I normally go to college, I am doing cooking, art and writing, I love going there. I am allowed to go into Bulwell and town, I use the bus or tram, some people go to the pub on Monday nights, I dont often go, I like to stay in and watch films, I go to Bestwood Day Centre and go out to the pub for a drink, I do several activities such as playing on the play station, football, basket ball, the gym and the computer, I lead a very busy life, and I have been out to Chesterfield today on my own, I always like to go out and about when I get the chance, I have been on holiday with the staff to Blackpool, Bognor and Skegness, I enjoy my holidays. Staff spoken with feel that there is sufficient for people to do when they are at home and said, there are lots of activities going on in the unit, such as baking, which people enjoy, people can go out on day trips and out shopping, they can do what they want, spend their time as they like, we make sure that we respect their wishes and they make up their own minds about what they do, and staff can instigate activities, there is enough to occupy people, the majority of people join in activities when we do them, they enjoy cooking and decorating cakes, they do this at least once a week; some people also go to Harpington House, a club on a Tuesday, we hire a mini bus taxi, they have a disco there. On the second day of the visit we saw people occupying themselves, chatting with staff and playing on a games station. Relevant support plans are in place in regard to supporting people in leading an independent lifestyle as able. We also saw that people are supported in making moves to other accommodation when they wish to lead a more independent life. So that people are supported in maintaining contact with people that are important to them, there are no restrictions on visiting and people may receive their visitors in private. Staff spoken with confirmed this and said that people may also go out and spend time with people that are important to them. People using the service said, visitors are allowed to come, we can go to my bedroom, I have my own key, and my family come to see me when they want. Three relatives spoken with told us that they can come and visit anytime that they want and also their relative can come home and spend time with them. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: A new menu has been devised with the assistance of the cook and people using the service. The main meal of the day is served in the evening as most people are out during the day. We saw that a varied and wholesome menu is on offer with choices at each mealtime. The cook has completed the National Vocational Qualification (a nationally recognised work and theory based qualification) in professional catering and spoke of how this has helped them in the menu planning at the home. It is ensured that there is always a healthy option at meal times and so salads and yoghurts are readily available. People using the service told us that the food is very nice and that choices are available at each meal. Care Homes for Adults (18-65 years) Page 17 of 32 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 personal support in the way that they prefer and their physical and emotional health needs are met. Although people using the service generally receive medication as prescribed, they may not always get this when are not at the care home. Evidence: Support plans in regard to peoples personal care are in place as required and contain sufficient information about peoples choices and preferences. Staff spoken with are able to discuss how they support people and make sure that their rights and choices are maintained. Case files examined demonstrate that people are supported to access specialist services such as the dietician, doctor, age appropriate screening and dentist as required. There was evidence of input from the speech and language department with the emphasis on improving peoples communication, which would obviously allow better access to choice. One person using the service communicated with us via a Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: communicating device and told us that the speech therapist had got it for them. People using the service told us, I can go to see the doctor, it is only down the road, I also go to the opticians in Bulwell and the hairdresser comes here, and the staff help me with my personal hygiene and I go to doctors when I need to. Riverside uses a monitored dosage system, which provides each person with a weekly card, which contains each dose of medication in a blister pack, for ease of the staff dispensing it. Although staff have been trained in the safe administration of medication, this took place some time ago, therefore the manager is enquiring about accessing accredited training. We saw that all medication charts are well kept and handwritten entries are signed by two members of staff to ensure that these have been checked as correct. Peoples medication charts all matched the prescription to make sure that they get the correct medication. Although charts are clear, we did see that on two occasions a person had not been given their antibiotics when they went to the day centre, which could affect the effectiveness of the course. One person using the service told us that the staff look after their medicines for them as they are not able to do it themselves. Care Homes for Adults (18-65 years) Page 19 of 32 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 using the service are assured that their complaints will be listened to and acted upon and that they are protected from abuse. Evidence: The complaints procedure is made available to people using the service so that they are able to make a complaint should they feel the need. This is also explained to people when they first enter the care home so that they are supported to understand it as needed. There are several leaflets in the main entrance about how to make a complaint and the complaint procedure is also on display. The service has not received any complaints since the previous inspection and the acting manager said that he makes sure that people know they can come and see him to discuss concerns if they want to. Three relatives spoken with told us that they are very happy with the care their relatives receive and that staff are always approachable when needed. Staff spoken with are able to discuss what they would do if they received a complaint to make sure that this was resolved to the persons satisfaction. We saw that staff, people using the service and their relative all have a good Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: relationship and talk freely. Each person using the service has a key worker who they can discuss their concerns with if able. One person using the service told us, If I was unhappy I would tell my key worker, they listen to you. There are relevant policies and procedures in place in regard protecting people from abuse and staff training records show us that most members of staff have undertaken training in this. On speaking with them they are able to discuss this subject and their roles and responsibilities in ensuring that people remain safe. As some people using the service keep their money in the care home safe we checked three peoples personal allowances. All of these demonstrate that receipts are kept for all transactions and clear audit trails of money spent are available. People using the service may access this money at any time. Relevant support plans are in place so that people are supported to keep their finances safe. Two people using the service told us that they have money kept in the safe and that staff look after this, my money is paid on a Friday, the staff look after this, they give me some everyday so that it lasts me all week and the staff look after my money. Care Homes for Adults (18-65 years) Page 21 of 32 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. People live in a comfortable and homely environment, however some maintenance issues remain as the negotiations about the relocation of the service are still ongoing. Evidence: The major problem with the asbestos within the roof spaces remains, and while this is currently contained, it is potentially a major problem. Therefore ongoing discussions are taking place in regard to relocating the service. People using the service are being kept up to date with these issues by way of consumer meetings. Due to this no requirements have been made within this outcome area. The building is over thirty years old, and is need of a major refurbishment, which is made more difficult as a result of the asbestos, however since the previous inspection a maintenance person has been employed who is working on minor repairs within the care home. The care home however remains homely and comfortable and there are various seating areas that people may use around the care home. The building was found to be clean and tidy in all areas accessed. One person using Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: the service said that staff work hard to keep the home clean and tidy. Those people that are able are supported to keep their own rooms tidy and do their own washing. One person using the service confirmed that they did this, and said they liked doing as it gave them more independence. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by sufficient numbers of staff who are able to demonstrate that they have the necessary skills and knowledge to support people using the service, despite a lacking in documentary evidence to support this. Evidence: The staff duty rota shows us that care staff, senior and management staff are provided for each shift. There is evidence that some shifts are also staggered so that there is appropriate support for people using the service when they are at home. Additional catering and domestic staff are also available throughout the day. People using the service told us that they are happy living at the home and that they feel there is enough staff available to help and support them when needed. Three relatives spoken with all feel that there are sufficient staff available to meet peoples needs. Staff spoken with offered the following comments, I like it here, there is a good staff team which is friendly, there are enough staff for the amount of residents that we Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: have at the moment, and I enjoy working here, there is a good atmosphere, we could do with a few extra staff at the weekend so that we spend more time with people, however they are doing more than they was before. Riverside is a care home owned, managed and operated by Nottingham City Council, all of their recruitment is managed centrally through the councils Human Resources department. Arrangements were made and staff files were made available to us on the second day of the visit. Staff files examined do not contain all the documentation required by law, such as references, proof of identity and an application form to make sure that people are protected from unsuitable people being employed. However staff spoken with told us that they completed a Criminal Record Bureau check (a police check to see if an individual has a police caution or criminal record) before they commenced employment. Staff training files examined show us that there are deficits in some compulsory training such as first aid and food hygiene. There is also evidence that some members of staff have not received any updated training over the last few years and that some staff have not received any training at all to ensure that they have the necessary knowledge and skills to support people using the service. There is evidence that a new training programme has been initiated to address some of these issues. Staff told us, I have done the NVQ (national vocational qualification, a nationally recognised work and theory based qualification) in professional cooking, I enjoy doing it, I love baking and putting what I have learned into practice, for example promoting and supporting people with healthy eating. I definitely feel supported in my training, and I had an induction over a three week period, it was very helpful, I had five days of solid of training. I am looking at doing my NVQ. The induction covers all mandatory training, I have done, first aid, food hygiene, manual handling, person centred care planning and much more; training has helped me in supporting people. People using the service told us that they feel the staff are well trained to support them as needed. The annual quality assurance assessment that we received told us that 14 members of staff have completed the National Vocational Qualification; a work and theory based qualification which is designed to enhance peoples knowledge and skills in caring for people. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Staff files demonstrate that staff are undertaking supervisions on a regular basis, where they are given the opportunity to discuss their development. Staff spoken with confirm that these take place and that they feel they are helpful to them. Care Homes for Adults (18-65 years) Page 26 of 32 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. People live in a home that is well run and managed where they are supported and enabled to express their views and opinions which are listened to. Evidence: The acting manager has worked at the care home for several years and was previously the deputy manager. He continues to undertake compulsory and management training to ensure that he is effective in his job role. People using the service spoke highly of the manager and the way in which the home is run and managed, Pete is very good, he is not strict, and Pete is a good manager. The relatives spoken with also stated that they feel that the home is well run and managed and the acting manager always has time for them. Staff spoken with said, the manager is good, I feel more supported, I can go to him, he is approachable and open about things, and it is a lot better, if we need any Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: equipment we just ask Pete, he sorts it out, he is brilliant, very supportive, he has made positive changes. The acting manager undertakes a quality audit on a monthly basis and uses documentation which looks at seven outcome areas such as, the quality of life, making a positive contribution, personal dignity and respect, freedom from discrimination and harassment, improving health and wellbeing, and exercising choice and control. We can see that this has been applied to people that are currently using the service to address any issues of concern and to ensure that they receive quality outcomes in these areas. Information provided is very thorough and we can see how staff have developed and dealt with issues to make sure people have better outcomes. People using the service may express their views and opinions about the service by way of consumer meetings and questionnaires should they wish. The last meeting minutes show us that issues such as activities and outings, menus and any issues of concern have been discussed. Following the meeting minutes there are updated notes to show what actions have been taken to address any issues. One person using the service told us that they have meetings at the home and that they are helpful in sorting things out. One member of staff told us, there are monthly meetings for people using the service so that they can give feedback on what they do and dont like about the menu, what they havent had and what foods they would like to try. Regular staff meetings are also held at all levels and issues such as activities and outings, in house training and quality outcomes are discussed. Staff spoken with said that they have plenty of meetings and that it is a lot better, they are helpful in sorting things out. The annual quality assurance assessment shows us that regular servicing and maintenance is taking place within the building and on equipment as necessary. During our visit we examined the electrical certificates and gained evidence that the gas testing has been completed to make sure people using the service are protected. On examining fire safety files, we saw that tests are being carried out as required and staff have undertaken fire drills to ensure people are protected from the risk of fire. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 20 13 You must ensure that people 10/05/2009 receive their medication as prescribed. This will ensure that peoples health is maintained. 2 32 19 You must ensure that all the documentation required by law is obtained before people work at the service. This will ensure that people using the service are protected from unsuitable people being employed. 20/05/2009 3 33 18 You must ensure that there is documentary evidence to demonstrate that all staff have completed mandatory training. This will ensure that all staff have the necessary knowledge and skills to support people using the service. 20/06/2009 Care Homes for Adults (18-65 years) Page 30 of 32 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 Implement systems that will ensure that support plans are not lost within all the historical information and staff are easily able to access up to date information so that they are clear about the support people need. Implement systems that will ensure that all plans of care are person centred to ensure that people receive support in their preferred way at all times. Implement systems to ensure that support plans are updated as changes are highlighted within daily running records to ensue that contiunity of care is enhanced. 2 6 3 6 Care Homes for Adults (18-65 years) Page 31 of 32 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. 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