Inspection on 08/09/09 for Westhope Place

This is the latest available inspection report for this service, carried out on 8th September 2009.

CQC found this care home to be providing an Adequate 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Westhope Place Westhope Place Ltd Off Queensway Horsham West Sussex RH13 5AY     The quality rating for this care home is:   one star adequate 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: Lesley Webb     Date: 0 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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: Westhope Place Westhope Place Ltd Off Queensway Horsham West Sussex RH13 5AY Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sally Kelly Type of registration: Number of places registered: care home 7 Westhope Limited skelly@westhopecare.com Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: (1) The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care need on admission to the home are within the following categories: Learning Disabilities (LD) Physical Disabilities (PD) (2) The maximum number of service users to be accommodated is 7. Date of last inspection Brief description of the care home Westhope Place is located in the town centre of Horsham, West Sussex. The home is registered to provide 24 hour residential care for up to seven people with learning disabilities and/or physical disabilities. All bedrooms are en-suite. The home has a large lounge and dining room along with a fully fitted accessible kitchen. Westhope Place has landscaped communal grounds that are shared with a supported Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 7 7 Brief description of the care home living scheme located in the same building. Fees currently charged for living at the home range from £1548.00 to £2036.00. Interested parties should contact the provider to find out further information regarding fees, what is included and what is excluded. 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: one star adequate 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: We visited this home on Tuesday the 8th September 2009, arriving at 11.50 am and staying until 6.30 pm. This was the first inspection we have undertaken of this service since it was registered with us in March 2009. The purpose of this inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The manager was not present during our visit. We were informed that the deputy and activities coordinator were responsible for managing the home in the managers absence. Both assisted us throughout our visit. During our visit to the home we had conversations with two residents and four staff. We examined the care records of three residents and recruitment records of three staff. We also looked at other documentation maintained in the home such as health and safety records, monitoring forms for staff training and supervision and complaints. Care Homes for Adults (18-65 years) Page 6 of 30 In addition to this we looked around the home and indirectly observed interactions between residents and staff. Information from all of the above sources was assessed and used to help us form judgements on the quality of service provided to residents. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The service user guide must contain all required information as detailed in Regulation 5(1)in order to comply with the law and to ensure people have sufficient information about the service. Care plans must be put in place for residents identified needs that give enough information in order that staff know how to meet individuals needs safely. CQC and West Sussex Safeguarding team must be notified of any allegation of misconduct by a member of staff in order comply with the law and to safeguard residents from harm. Two written references must be obtained for all staff before they commence work. Care Homes for Adults (18-65 years) Page 8 of 30 Also if staff commence work without the registered person having obtained a full enhanced CRB disclosure Department of Health guidance must be followed to ensure residents are protected by the homes recruitment practises. Assessment processes should be consistently applied in order that all needs are identified for potential new residents. Terms and conditions of residency should be completed in full in order to protect residents legally. The practise of residents funding meals when outside of the home from their personal funds should be investigated to ensure no one is financially disadvantaged. Personal inventories should be completed for all residents in order that there is a record of each persons personal belongings. 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 9 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 10 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available to people that informs them of services and facilities provided by the home but in some parts this is not complete or accurate. This means people might not have the right information on which to make decisions about the home. Assessment processes are in place but these are not comprehensive and consistently applied. Terms and conditions of residency are incomplete and may not protect residents legally. Evidence: We viewed the homes statement of purpose and service user guide. The statement of purpose gives information about the home that includes aims of service, quality policy, menus, equal opportunities, environment, social activities, service users rights, facilities and services including health care, the registered provider staff, admissions procedures and complaints. We noted that the information regarding management of the home and the registration authority is out of date and should be reviewed in order that information is accurate. The statement of purpose also gives information about fees charged for living at the home. We did note that information is not included regarding areas not covered by the fees charged. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The service user guide has been produced in an alternative format to that of the written word in order that information is accessible. This document gives very detailed information regarding activities that people can participate in if they choose to live at the home. It does not include any other information as required by the Care Home Regulations 2001. We sampled three residents files all of which contained evidence that assessments of need have been completed. We found that the amount of information gathered and documented varied for each individual. For example one persons assessment detailed medical history, personal care, speech, risks and planned care. Another persons gave information for health, care, likes, dislikes, behaviours, finances and family. A comprehensive daily living and needs assessment form was on each of the three residents files. For two individuals this had not been completed and for one it was part completed. All three files contained blank admissions checklist forms. Each residents file that we looked at also contained a terms and conditions of residency agreement. The sections for recording who the agreement is between, date, room occupied and fees including food had not been completed for anyone. When examining the financial records for one resident we found that they have been funding meals from their personal money when outside of the home. The lack of information in the homes brochures and the incomplete terms and conditions of residency mean this person maybe financially disadvantaged. Care Homes for Adults (18-65 years) Page 12 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. The lack of care plans for some residents means that their needs might not be met consistently and safely. Residents are supported to make decisions and to exercise choice and control over their lives through a risk managed framework. Evidence: We examined the care files of three residents. None contained care plans that have been completed by the home that inform staff how to meet residents needs consistently and safely. Copies of the placing authorities care plans were on file for each individual that identify individual needs but these do not describe the actions staff should take to meet these. The deputy informed us that the home is in the process of changing its care planning systems and produced a completed file for one resident. This contained a variety of care plans and associated documentation that not only describe the individuals needs but also give detailed information on how staff should meet these. The deputy confirmed the new system has only been completed for one of the five residents currently living at the home. We informed the deputy that a requirement would be made with regard to care planning in order to ensure all Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: residents needs are met consistently and safely. The same three residents files also contained blank missing persons information forms, blank consent forms to use photographs of the individuals and for two of the residents blank daily living assessment forms. The index at the front of each residents file directs readers to sections for next of kin details and service user profiles. These sections were empty for all three residents. Monthly reports are completed for each resident. Those that we viewed were detailed and informative. Each resident is allocated a key worker. All staff that were spoken with demonstrated a good understanding of this role and the needs of people they support despite the lack of care plans for residents. For example one person explained, every member of staff is responsible for care, health and hygiene. Key workers follow up appointments, time for talking to residents, purchasing birthday cards for relatives and sending off. They are like personal assistants, make sure everything is done. A resident that we spoke with also expressed satisfaction with their key worker stating, its nice here, have key worker, he makes sure I get everything I need, staff good. Some of the people who live at this home have a range of needs that have the potential to impact on them being involved in decision making. Observations during our visit confirm that residents are encouraged to make decisions about their day to day lives. For example staff were observed giving choices at meal times and in activities. Staff having received training in communication and many documents have been produced using symbols to aid communication. Risk assessments were seen to be in place for a number of personal risk areas for individuals. Examples being use of wheelchair, falls and smoking. The new care planning system that has been completed for one resident cross references care plans and risk assessments, promoting an holistic approach to care management. This system is not yet in place for any other residents. Care Homes for Adults (18-65 years) Page 14 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. Residents are supported to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: During our visit we spoke with residents and staff, observed practises and examined records, finding evidence that residents are supported to undertake a variety of activities, develop life skills and access the wider community. For example residents attend local colleges and day centres and access community facilities including the local pub and parks. The home has an activities coordinator. They explained their role to us stating, I arrange all off site activities such as day care, college, arrange transport and staffing. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: I meet with each resident and discuss what they want to do. Individual activity programmes were seen to be in place for each resident that include the use of symbols to aid communication. These detail a variety of acitivities including swimming, cooking, music and art and shopping. Families and friends are made welcome at any time. Staff informed us that there are no restrictions on visiting times but that families usually telephone first to ensure their family member is at home. Observations during the visit showed that residents are treated with kindness, dignity and respect and were very animated and happy when interacting with staff members. Both residents that we spoke with informed us they like living at the home. A variety of meals are available and meals are also provided that support peoples ethnic identity. As with other documentation in the home the use of symbols form part of menu choices to aid communication. We did note that there is only one choice offered for the main cooked meal each day. However staff informed us that before meals are prepared residents are asked if they would like an alternative. As one member of staff explained, We show package, tell them what about to cook so can have different if want. Both residents that we spoke expressed satisfaction with the meals provided by the home. One told us, Food nice and the other food excellent. Care Homes for Adults (18-65 years) Page 16 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. The health and personal care that residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practise. In the main medication practises offer protection. Evidence: Efforts are made to promote the dignity and independence of residents. For example staff were observed seeking permission to enter residents bedrooms before entering and bathing aids are in place that support residents to undertake elements of their personal care independently. Records show that the home works with a variety of health care professionals including psychologists, occupational therapists, local doctors and the district nursing team. Staff that we spoke with demonstrated understanding of supporting residents to maintain good health. As one person explained, All residents get regular medication reviews, if look ill or unhappy they get to see GP that day. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Another member of staff informed us that a new resident is due to move into the home and that staff have received training in epilepsy in readiness to support this person with this particular health need. We sampled three residents medication administration records. The home uses a monitored dosage system. In the main all medication and records were in good order and accurate. We did note that staff had not signed the medication administration record to confirm medication had been administered on the 5th of September at 8pm for one resident. We checked the blister pack that contained this persons medication and found that the medication for that time was not in place. This indicates that the medication had been given but not signed for. Residents consent for staff to administer medication is maintained with their individual medication records. The form used for recording this had not been completed for one of the three residents we looked at. We did note that the home maintains a stock of medication above that of the 28 day cycle provided by the pharmacy. The deputy said that a stock record is not maintained and agreed this should be implemented to aid monitoring and safety. The temperature in the medication cupboard is currently not monitored. Without this the home cannot be sure medication is being stored in line with manufacturers instructions. We were informed this would be addressed within 24 hours of our visit. No residents who currently live at the home are prescribed controlled drugs and there is no controlled drugs cabinet in place. We were informed that a cabinet is due to be installed before the 16th of September as a new resident is moving to the home who will require this facility. The deputy informed us that all staff who administer medication have received training and that she also undertakes competency assessments to monitor their practise. Records of the competency assessments are not completed. We discussed this with the deputy directing her to the CQC website where information regarding these can be found. We observed the lunch time medication being administered. Good practise was noted including staff observing that the resident had taken their medication before signing the medication administration record and offering a drink afterwards. Care Homes for Adults (18-65 years) Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to a robust, effective complaints procedure that supports them to raise concerns. Staff have a good understanding of protection however some practices place residents at risk. Evidence: There is a complaints procedure in place, which is also provided in an accessible format using pictures and symbols. There is a complaints folder that includes a log of complaints, actions taken and outcomes. This details one complaint that has been received by the home since it opened. All staff that we spoke with demonstrated understanding of supporting people to raise concerns. As one person explained, I would bring in office, talk, discuss way forward, keep eye on them. If something further would involve manager or director and another if nothing I can do advise to go to manager, explain their rights to them. Policies and procedures are in place for the protection of vulnerable adults. These include a Whistle blowing policy. The training matrix details twenty staff employed at the home, eleven who have received training in safeguarding. We asked staff how they ensure people they support are protected from harm. All Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: were able to explain what they would do. For example one stated, we have to be vigilant, many forms of abuse, staff very aware of each other and open door policy and whistle blowing policy that not afraid to use, residents come first. When looking at other documentation maintained in the home we found evidence that a member of staff has been dismissed on the grounds of gross misconduct under the homes disciplinary procedures. The manager was not present during our inspection. We discussed this with the two members of staff responsible for running the home in the managers absence. Neither could confirm if a safeguarding alert had been raised by the home for this or could produce evidence that the CQC had been notified in line with Regulation 37 of the Care Home Regulations 2001. Whilst we were still at the home contact was made with a senior manager who confirmed neither of the above actions had been undertaken. We explained that a requirement would be made in relation to this in order to safeguard people living at the home. There are systems in place to help residents manage their personal finances. These include individual records that detail income, expenditure and balances. We did note that the records for one resident detail personal monies used to purchase meals taken outside of the home. This practise is not reflected in the terms and conditions of residency or in the homes statement of purpose or service user guide. A senior manager was contacted by telephone whilst we were at the home regarding this. They agreed to investigate this further to ensure no one is financially disadvantaged. Of the three residents files that we looked at two contained blank inventories of personal possession forms and the other an inventory of possessions for items they brought with them when they moved into the home. This however had not been updated to include a CD player they have purchased since. Care Homes for Adults (18-65 years) Page 20 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. The physical design and layout of the building encourages independence. Evidence: The home has been purpose built and is located on the ground floor of a two story building. There are seven bedrooms which are all above the National Minimum Standards with regard to size and can all accommodate wheelchair users if needed. Ensuites are large with wet room showers, adjustable toilet and wheelchair height sinks. There is call bell and a link system in place that residents can access if assistance is required. The communal space at the home includes a large lounge area, dinning area, and a kitchen. Windows have security locks and restrictors fitted. Low level radiators that have individual temperature controls are in place throughout the home. The home also provides one assisted bath on the ground floor to ensure residents have choice. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Corridors in the home are wide and there is signage to aid direction. External areas consist of small car park to the front of the building and a small garden to the rear the property, the garden is accessible by wheelchair ramps with hand rails. All areas of the home were seen to be clean and free from offencive odours. The training matrix informs us that only one of the twenty staff employed at the home have received infection control training. Greater numbers of staff should undertake training in this area to ensure good infection control practises are promoted. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who live there. Improvements to some recruitment practises are needed to ensure residents are safeguarded in full. Evidence: Staff observed during our visit appear to have built positive relationships with the residents in their care. For example they were seen to be patient and attentive. Staff spoken with were knowledgeable about the residents needs and appeared interested in their work. There are currently five people living at the home. We were informed the home deploys four staff on each early and late shift and two staff during the night. There is also an on call system in place to support staff. Rotas that we looked at confirmed this information We examined the recruitment records of the three newest people to start working at the home. All included application forms, two forms of identification and Pova first declarations. There was only one reference on file for one person. Another contained two references but both were from friends and did not include a reference from the persons previous employer as the homes application form requests. The same person Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: does not have an enhanced CRB disclosure with records confirming this is still being chased. Staff in charge of the home at the time of our visit informed us the member of staff concerned does not undertake any personal care and is supervised. A risk assessment with regard to this person working without a full enhanced CRB disclosure had not been completed. We directed the home to the CQC website where the Department of Health guidance information regarding employing staff without a full enhanced CRB can be obtained. We explained that a requirement would be made regarding recruitment practises to ensure people living at the home are protected. Staff that we spoke with confirmed they received an induction when first employed. They informed us that this included shadowing other staff, reading policies and procedures and information about people living at the home. Information supplied to us during our visit states seven of the eighteen staff employed at the home hold a National Vocational Qualification (NVQ). Other training documentation evidences that some staff have received training in areas including challenging behaviour, role of the care worker, epilepsy and communication. Staff receive regular formal supervision both on an individual basis and as a group. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management of the home is not meeting all residents needs safely with regards to care planning, safeguarding and some recruitment practises. Quality monitoring processes are being implemented that will allow the home to monitor the service residents receive. Evidence: The manager has been in post since May 2009 and an application for registration is currently being processed by CQC. The manager was not present when we visited the home. We were informed that the deputy and activities coordinator were responsible for managing the home in the managers absence. Both were present during our visit and assisted by providing written documentation and answering questions relating to the inspection process. Staff that we spoke with expressed satisfaction with the management style adopted by the manager. For example one person said, shes very flexible and another she gets things sorted, approachable. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Evidence gained during our visit to the home indicates improvements must be made with regards to care planning, safeguarding and recruitment in order to ensure risks to residents are minimised. Quality monitoring processes have started to be implemented at the home. These include Regulation 26 Registered Providers visits. We found records in place for April, June and July 2009. No records were available for any other months that the home has been operating. Copies of certificates have been seen as part of the homes initial registration application. These include those for domestic electrical installations, emergency lighting, servicing of the fire detection alarm system and gas appliances. Risk assessments relating to equipment and safe home management are in place. The training matrix states that of the twenty staff employed at the home seven have received training in fire, nine food hygiene, eight manual handling, nine first aid and four health and safety. We viewed accident records maintained in the home. These include monthly audits of incidents. There were no water temperature monitoring records for us to view. We were informed that these are not undertaken due to the wrong thermometer being purchased. We were assured this would be rectified within 24 hours. The risk to residents is reduced as temperature valves are in place that regulate water temperatures. 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 1 5 The registered person must ensure the service user guide contains all the required information as detailed in Regulation 5(1) This must happen in order to comply with the law and to ensure people have sufficient information about the service. 08/10/2009 2 6 15 The registered person must ensure care plans are in place for residents identified needs that give enough information in order that staff know how to meet individuals needs. This must happen in order that residents needs are met consistently and safely. 08/10/2009 3 23 13 In line with Regulation 13(6) 15/09/2009 the registered person must report any allegation of misconduct by a member of staff to West Sussex Page 28 of 30 Care Homes for Adults (18-65 years) 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 Safeguarding team and to the CQC. This must happen in order to comply with the law and to safeguard residents. 4 34 19 In line with Regulation 19(2) 15/09/2009 and Schedule 2 the registered person must ensure two written references have been obtained for all staff before they commence work. Also if staff commence work with the Registered Person having obtained a full enhanced CRB disclosure Department of Health guidance must be followed. This must happen to ensure residents are protected by the homes recruitment practises. 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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