Inspection on 14/12/09 for Roseberry Gardens 36

This is the latest available inspection report for this service, carried out on 14th 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Roseberry Gardens 36 13/04/07

Roseberry Gardens 36 06/06/06

Roseberry Gardens 36 22/02/06

Roseberry Gardens 36 12/04/05

Roseberry Gardens 36 01/09/04

Roseberry Gardens 36 27/05/04

Roseberry Gardens 36 03/03/04

Roseberry Gardens 36 10/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

Key inspection report Care homes for adults (18-65 years) Name: Address: Roseberry Gardens 36 Roseberry Gardens 36 London N4 1JJ     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: 1 4 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 30 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 30 Information about the care home Name of care home: Address: Roseberry Gardens 36 Roseberry Gardens 36 London N4 1JJ 02088003230 02082118098 roseberrygardens@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Angelina Espino,Mr Jessie Espino care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: and who may also fall into the category of old age (LD(E)). and who may also fall into the category of old age (MD(E)) Limited to 3 people of either gender who have a mental disorder (MD) or have a learning disability (LD) Date of last inspection Brief description of the care home 36 Roseberry Gardens is a small care home situated in Haringey, close to the facilities of Green Lanes and within a short bus journey to Wood Green Shopping Centre. There are three single bedrooms, a galley kitchen and two small lounges. One of the bedrooms is on the ground floor and the other two are on the first floor. There are small front and rear gardens. The home is owned by Mr and Mrs Espino who live in the home. The weekly fees of the home depend on the assessed needs of service users but as at December 2009 the weekly fees begin at approximately 390 GBP. Following Inspecting for Better Lives the provider must make information Care Homes for Adults (18-65 years) Page 4 of 30 1 7 1 2 2 0 0 8 3 3 Over 65 3 3 Brief description of the care home available about the service, including inspection reports, to service users and other stakeholders. Inspection reports produced by the Care Quality Commission (CQC) are available upon request from the registered manager/provider or at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 5 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 unannounced key inspection of Roseberry Gardens lasted approximately five hours. I was assisted by the registered manager of the home who was open and helpful throughout the inspection. I had the opportunity to speak to one person who lives in the home, whilst the other resident was out at the time of the visit. The resident spoken to advised that they were happy with the standard of care provided at the home. I conducted a tour of the home and examined various care records, staff files and health and safety documentation. The home also prepared a self assessment (Annual Quality Assurance Assessment) as required and this was submitted to the Care Quality Commission prior to the inspection. Information provided in this report was also used as part of the inspection. Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Improvements need to be made in the detail provided in risk assessments for people living at the home to ensure that they are supported to take informed risks. Care plans should also be updated to include goals for people living at the home, to ensure that they receive support with these aspirations. Medication must not be predispensed, and should be signed for at the time that it is administered to ensure that no mistakes are made. A cleaning schedule should be Care Homes for Adults (18-65 years) Page 7 of 30 produced for the communal areas in the home, and improved recording is needed regarding food storage temperatures and cooking temperatures to ensure appropriate food hygiene. All staff should be supervised regularly, and a more sophisticated quality assurance system is needed for the home, to ensure that it is run in the best interests of residents. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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. People who use the service are assessed before they move into the home, and have the opportunity to visit and stay at the home on a trial basis, to ensure that they can be supported effectively. Evidence: Since the last inspection no new residents had been admitted to the home. Records were available for the two current residents including detailed assessments of their needs undertaken by the home, their placing authorities and relevant healthcare professionals. The manager advised that she visits prospective residents prior to emergency admissions, but other prospective residents have the opportunity to visit the home and stay on a trial basis, before deciding whether to move into the home on a permanent basis. This was confirmed by the resident spoken to during the visit. They advised that they had been involved in this assessment and had visited the home on several occasions before deciding to move in. They also advised that they were happy with the service. At the previous inspection a requirement was made relating to pre-assessments, and Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: this appears to have been met. As required at the previous inspection, the contracts of terms and conditions for the home had been reviewed and updated in August 2009, so that they no longer stated that the home provides twenty four hour waking staff at the home. The manager lives at the home and sleeps there during the night, so that sleeping in cover is provided in the event of an emergency. Care Homes for Adults (18-65 years) Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are involved in their care development and are supported to exercise choice and control over their lives. The manager understands the needs of the people living in the home. Risk assessments do not include sufficient details, to support people to take informed risks. Evidence: The care plans for both people living at the home were examined. At the previous inspection a requirement was made that these plans be updated to include more written information about each persons needs and how these were being met, as they had consisted of a number of tick boxes with only brief information about care needs of each individual. A significant improvement was noted in the care plans available at the current inspection. These covered past medical histories, and daily living skills including personal hygiene, mental health, physical health, mobility, continence, medication, communication, dietary needs, relationships, social needs, and finances. These had been reviewed within the last six months, involving people who use the service in the process. One resident has been at the home for a number of years, and Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: they advised that the manager and staff understood their needs very well. However it is recommended that care plans for residents be further developed to include agreed goals to be achieved, and support provided with these, with regular progress updates, to evidence that people are supported to develop their independence skills, and achieve their goals. The resident spoken to confirmed that they were supported to choose how they spent their day and were given freedom to make decisions about their life. It was clear from discussion with the manager that she supports people to make their own choices and decisions about their lives within safe boundaries. Risk assessments had been carried out for both residents at the home, and had been reviewed since the last inspection. However these assessments were brief, tick box assessments, and did not always cover all identified risks e.g. access to cleaning materials or ability to self medicate. A requirement is made accordingly that more detailed risk assessments be introduced for all residents including information about how any risks are to be reduced. This is to ensure that residents are supported to take informed risks whilst being protected from harm as far as possible. Care Homes for Adults (18-65 years) Page 13 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. People who use the service are free to pursue their own leisure and recreational interests and are supported to treat the home as their own. The manager encourages religious and cultural observance, and people enjoy the food served within the home. Evidence: Daily notes for both residents indicated that they are out and about on most days, although their were few activities recorded in the evenings and at weekends. One person undertakes supported employment on a part time basis, and the other person chooses to go out on most days, either alone or with the manager. The resident spoken to advised that they were happy with the activities they undertake and it was clear that they enjoy the freedom to come and go as they please. Both residents have their own key to the home. The manager advised that she has offered to take residents to religious services of their choice but no one has requested this, she was knowledgeable about the religious beliefs of residents in the home. One person told Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: me about their religious beliefs and that the manager supports their religious observance according to their wishes, however this was not clearly documented in the care records, and a requirement is made accordingly. The resident spoken to advised that the staff were respectful towards them and upheld their privacy. Records of activities provided to residents over the last six months included barbeques, occasional meals out, shopping trips, a cinema trip, and a game of bingo. One resident enjoys playing the guitar in their room. However residents should be offered more opportunities to go out with staff support, particularly in the evenings and at weekends. Currently no one at the home has any special dietary requirements. The resident spoken to advised that they enjoyed the food served at the home. As required at the previous inspection a record is now being maintained of what residents are eating confirming that they are provided with nutritious meals at the home. However records were not maintained of lunches provided within the home, and this should also be recorded. The manager advised that residents sometimes help with preparing meals and washing up, although the resident spoken to advised that they prefered not to do their own cooking. 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. People who use the service have good access to healthcare professionals. There is room for further improvement in the recording of medication administration to ensure that people are not put at risk. Evidence: No one at the home currently needs direct assistance with personal care, however the resident spoken to advised that the manager and staff were respectful towards them and upheld their privacy. Care records indicated the support needed by people with every day living skills including prompting where necessary. The manager advised that they occasionally need to manage challenging behaviour from one resident at the home. It is recommended that the use of ABC charts should be implemented to consider Antecedents, leading to challenging behaviour, the Behaviour itself, and the Consequences including any action taken by staff, and its effect, in the interests of fully understanding the residents communication, and managing challenging behaviour effectively. Records examined indicated that people have good access to healthcare professionals Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: and had regular contact with their GPs, dentists and opticians in addition to consultant appointments. The resident spoken to advised that they were satisfied with how the home was supporting their healthcare needs. As required at the previous inspection, both residents had had their medication reviewed by their doctor within the last year. The service uses blister packs that have been prepared by the pharmacist for administration of prescribed medicines to residents. Records were kept of all medicines received into the home, and medicines disposed of. The manager advised that there is currently no resident self medicating. However I was concerned to see that medication for a full day was being predispensed from blister packs, and that medicines were not always signed for at the time that they were administered. A requirement is made accordingly. 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. People who use the service are listened to and know how to complain should they wish to. People are protected from abuse by clear policies and procedures and an appropriately trained staff team. Evidence: The resident spoken to advised that they had no complaints about the service but knew what to do if they did have a problem. There have been no complaints recorded since the last inspection. It is recommended that a record be kept of all informal concerns expressed by residents or other visitors to the home, and how these are addressed to evidence that the home is proactive at dealing with peoples concerns. The service has a satisfactory policy regarding complaints and adult protection. The manager advised that all staff have attended safeguarding adults training, and this was confirmed by the certificates maintained on the staff files examined. The manager was aware of the action she would take in the event of an allegation of abuse occurring at the home. The resident spoken to advised that they felt safe at the home. No safeguarding alerts had been received regarding the home since the last inspection. Care Homes for Adults (18-65 years) Page 18 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. Roseberry Gardens has a homely and friendly atmosphere. The home environment has been improved following a programme of redecoration. Evidence: The home is located in a residential street close to shops and cafes. Each resident has their own room and there are two communal lounges and a kitchen. The resident spoken to advised that they were satisfied with their bedroom and the facilities available to them. There is a small garden at the back of the house where residents are requested to smoke, and I observed this in use during the visit. I conducted a tour of the premises accompanied by the manager. She advised that the communal areas had been redecorated since the previous inspection, as recommended at the previous inspection. A new dining room table and chairs had been provided, and new cabinets had been provided in the dining and lounge areas and residents bedrooms. The home was warm on the day of the visit, and the resident confirmed that it was comfortably warm at all times. New flooring had been provided in the kitchen and two new fire doors were installed on either side of it. The manager advised that she was planning to change the carpets in the homes hallways in the coming year. She advised that she had access to a steam cleaner within the home. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: It is recommended that some more plants be provided within the communal areas as suggested by one resident, and that a freeview box be purchased for the home so that residents have access to more television channels. A chair should be replaced in an identified residents room and consideration should be given to providing a computer for residents use. Bathrooms and toilets contained anti-bacterial soap, however they did not all contain paper towels, at the time of the inspection. Whilst this was explained by the manager, if paper towels are not appropriate, an alternative should be found to limit the risk of cross infection. The home was generally clean at the time of the visit, although the dining area was in need of a clean. The manager noted the difficulty in keeping areas clean when they are constantly in use by residents. A cleaning schedule should be provided for the kitchen and communal areas, with records kept of each time areas are cleaned. Recording schedules can be obtained from the local authority environmental health department. Care Homes for Adults (18-65 years) Page 20 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. People who use the service are supported by a staff team who are appropriately trained and who have undertaken the required checks to ensure the safety of residents. Evidence: The registered persons live at the home and one or both of them are always available. This was confirmed by the resident spoken to. Sometimes the manager or her husband are not available and one of the managers family will cover the shift. Satisfactory criminal record checks were seen for the other family members. Two of the four family members who cover shifts at the home have an NVQ level 2 in care or equivalent. I saw training certificates that confirmed that the manager and her family attend regular training. Training undertaken included fire awareness, food hygiene, first aid, infection control, medication, mental health awareness and safeguarding adults. The manager has undertaken the appropriate management qualification. The resident spoken to advised that the manager and her family were very friendly and they felt comfortable with them noting they are like my family. There were no changes to the staff team since the previous inspection, and Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: appropriate recruitment records were found on file. However there were no records to indicate recent supervision of individual staff members. Care Homes for Adults (18-65 years) Page 22 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. Residents are confident in the management of the home, however there is room for improvement in quality assurance systems. Improvements have been made regarding health and safety and fire safety within the home so that residents are protected from harm. Evidence: Mrs Espino has been the manager of the home since 1987 and advised that she has had a long experience of working with people with mental health needs. Evidence was seen confirming that she attends regular training. The resident spoken to advised that they felt confident in her management of the service. Regular resident meetings and staff meetings are held within the home, and records of these indicated that these are used effectively. A completed Annual Quality Assurance Assessment was completed for the home and returned to the Care Quality Commission as appropriate. An improvement plan was also completed as requested at the last inspection. Information provided in these reports indicated that the home has signed up to a programme for updating the staff teams skills and provide them with personal Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: development training. However there was little evidence of quality assurance measures taking account the views and needs of residents in the home. A requirement is made accordingly. This will enable the manager to identify improvements needed to the service. Records were available confirming that the fire alarm call points and emergency lighting are being checked weekly. There were also records that indicated fire drills are taking place on a regular basis, however it is recommended that more details be recorded about these events. Records confirmed that the fire alarm had been tested and serviced, and gas and electrical installation certificates were also available alongside evidence of portable appliances testing within the home. The fire risk assessment for the home had been reviewed within the last year, and appeared to be up to date as required. As required at the previous inspection the local fire safety authority had been consulted and visited the home in February 2009, with regard to fire safety in the home, and two doors had been replaced alongside an area of the kitchen being blocked off. Although records were maintained of daily temperature checks of one refrigerator and freezer, there were two refrigerators in the home, and a requirement is made accordingly. No records were maintained of food cooking temperatures, and this too is required. Care Homes for Adults (18-65 years) Page 24 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 25 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 9 13 The registered persons must 29/01/2010 ensure that risk assessments are further developed to specify action taken to address individual risks including access to cleaning chemicals, to ensure that residents are supported to take informed risks whilst being protected from harm as far as possible. . 2 14 16 The registered persons must 29/01/2010 ensure that residents are offered more opportunities to go out with staff support, particularly in the evenings and at weekends, and that this is recorded, and that records are kept of cultural support offered/provided to residents, to evidence that their social, recreational and cultural needs are met. Care Homes for Adults (18-65 years) Page 26 of 30 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 20 13 The registered persons must 29/01/2010 ensure that medication is not predispensed from blister packs and that it is signed for at the time that it is administered to avoid the possibility of mistakes being made. . 4 30 23 The registered persons must 29/01/2010 ensure that a cleaning schedule is provided for the kitchen and communal areas and that records are kept of each time areas are cleaned. An alternative to paper towels must be found where necessary to ensure hygienic hand-drying provision in toilets and bathrooms. . 5 36 18 The registered person must ensure that all staff members are provided with individual supervision sessions at least six times annually. . 6 39 24 The registered person must ensure that more sophisticated quality assurance systems are 26/02/2010 29/01/2010 Care Homes for Adults (18-65 years) Page 27 of 30 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 developed for the home including feedback from all stakeholders, regular audits of all areas of the homes performance, with findings used to inform the business plan for the home. . 7 42 13 The registered person must 15/01/2010 ensure that daily records are kept of the temperatures of all refrigerators and freezers within the home, and that cooking temperatures are recorded to ensure that foods are stored and cooked safely in the interests of people living at the home. . 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 for residents be further developed to include agreed goals to be achieved, and support provided with these, with regular progress updates. It is recommended that the contents of lunch provided to residents within the home should be recorded, to evidence that they are provided with a varied and nutritious diet. It is recommended that the use of ABC charts should be implemented to consider Antecedents, leading to challenging behaviour, the Behaviour itself, and the Consequences including any action taken by staff, and its effect, in the interests of fully understanding the residents Page 28 of 30 2 17 3 18 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations communication, and managing challenging behaviour effectively. 4 22 It is recommended that a record be kept of all informal concerns expressed by residents or other visitors to the home, and how these are addressed to evidence that the home is proactive at dealing with peoples concerns. It is recommended that some more plants be provided within the communal areas as suggested by one resident, and that a freeview box be purchased for the home so that residents have access to more television channels. A chair should be replaced in an identified residents room and consideration should be given to providing a computer for residents use. It is recommended that more detailed records be kept of each fire drill held at the home including names of all staff and residents involved, and the time of the drill (which should be varied). 5 24 6 41 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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