Inspection on 13/11/08 for 1 Beech Close

This inspection was carried out on 13th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Beech Close 27/05/08

Similar services:

Kings Lane (32)

Pemdale

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Extracts from inspection reports are licensed from CQC, this page was updated on 12/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Beech Close 1 Beech Close Dunstable Bedfordshire LU6 3SD     The quality rating for this care home is:   one star adequate 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: Nicky Hone     Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 29 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 29 Information about the care home Name of care home: Address: 1 Beech Close 1 Beech Close Dunstable Bedfordshire LU6 3SD 01582708999 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): TACT UK Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning Disability - Code LD Date of last inspection Brief description of the care home 1 Beech Close is a home for up to six adults with learning disabilities. On 01/03/08 TACT UK Ltd took over as provider of the service from the Bedfordshire and Luton Mental Health and Social Care Partnership Trust (BLPT). The bungalow is owned by the MacIntyre Housing Association (MHA), which is responsible for the maintenance and upkeep of the building. The bungalow is situated approximately one mile from Dunstable Town Centre. It shares a site with three other registered care homes and a resource centre. The bungalow has six single bedrooms, two lounges, a dining room, kitchen, laundry and bathing facilities. There is a fair-sized, enclosed garden to the rear of the property, with adequate parking to the front and side of the building. The Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home home provides its own transport. Full information regarding the fees, including any additional charges, was not known at the time of writing. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: For this inspection we (the Commission for Social Care Inspection) looked at all the information that we have received, or asked for, since the last key inspection of 1 Beech Close. As this was the second key inspection during the year, we did not ask for another AQAA (Annual Quality Assurance Assessment), and we did not send any feedback surveys to people living at the home, their relatives or other stakeholders. We looked at: - What the service has told us about things that have happened in the home. These are called notifications and are a legal requirement; Care Homes for Adults (18-65 years) Page 6 of 29 - Any safeguarding issues that have arisen; and - Information we asked the home to send us following our last visit. This inspection of 1 Beech Close included a visit to the home on 13th November 2008. No-one knew we were going to visit on this day. We spent time talking to people who live at 1 Beech Close, the staff and the manager. We looked round the bungalow and observed what was happening. We also looked at some of the paperwork the home has to keep including care plans, risk assessments, medication charts, and records such as staff personnel files, staff rotas, menus and fire alarm test records. Following our last inspection the registered manager resigned from her post. The home has been managed on a temporary basis by the manager of 2 Beech Close. In our last report we talked about one of the people who lives at 1 Beech Close who shows that he does not want to live here. Sometimes his behaviour does not have a good outcome for the other people who live here. Alternative accommodation for this person must be found as a priority, so that the quality of everyones lives improves. What the care home does well: What has improved since the last inspection? What they could do better: Two requirements we made last time have not been fully met, and we have made a further five requirements. What the home could do better includes: - have enough staff on duty so that peoples needs can be met, and offer staff enough training so they can do their jobs well - make sure health care is written down properly, and make sure medication administration record (MAR) charts are completed correctly. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available about the service for people thinking about moving here and people can be confident that their care will be based on good information the home has collected about them. Peoples needs are met better than they were, but are still not fully met. Evidence: For this inspection, we looked at the paperwork the home has to keep about two of the people who live here. In the file we found a Service User Guide which gives good information about the home. It includes pictures and symbols, is written in large print, and uses easy language, so is suitable for most of the people who live here. The Service User Guide tells people what they can expect from the home, and what the home expects of them, so would give useful information to anyone thinking about moving here. All the people who live at 1 Beech Close have lived here for a long time. We saw that detailed assessments of peoples needs had been done in 2007 when the home was Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: transferring to a new provider. We noted that the assessment document does not cover all of the headings in standard 2 of the National Minimum Standards, nevertheless the information was in sufficient detail for the home to be able to work out whether or not they could meet the persons needs. Each person (or their representative) has signed a statement of terms and conditions (contract) with the home, which gives as much information as possible about the cost of the care part of the service, what it covers, and what else people have to pay for. People also have a licence agreement with the housing association, which details the rent they pay, and any service charges. In our last report we wrote about one person whose needs were not being managed well, and whose needs were detrimental to the lives of the other people who live here. Although this persons needs are now being managed much better, we saw during our visit that he still has a negative impact on the other people he lives with. Bedfordshire County Council have assessed that this persons needs would be met better in a different setting, but so far the Council has failed to find suitable alternative accommodation. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support plans are clear and detailed, and give staff good guidance on the way each person wants to be supported. Evidence: Staff we spoke with said that since TACT took over there has been much improvement in the focus of the service. It is now much more person-centred, and focuses on peoples rights and choices and how staff can better support each persons needs. Staff said fresh eyes are bringing in new ideas and the service is constantly improving, moving towards people being more independent. Each person has a care plan folder in place which contains a great deal of information. We looked in detail at two of these. The plans use a person-centred approach and people have been involved, as much as possible, in having some input into the plans. The plans include a lot of good, detailed information and give a clear picture of the person and how they like to be supported. Each person has a communication passport Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: so that staff know the best ways to communicate with that person, and the routine support plan includes goals which people want to achieve. A monthly summary charts the progress the person has made. For one person, a review in February 2008 was done in a person centred way and identified what has been achieved, what works well, what would the person like to change and so on. Staff write good daily notes which give a clear picture of each person, detailing what the person has done, what sort of a day he has had, what he has eaten, and so on. We saw that detailed risk assessments have been done, including a risk assessment for each person about the changes to the night staff (see Staffing section of this report). For one person, there were risk assessments in place for accessing the community, working in the kitchen, fire, swimming, eating, medication and so on. We suggested that the risk assessment for eating could be developed further, to include whether there is any risk of choking, and what to do if this happens. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The opportunities offered to people for personal development and activities, so that they can lead full, satisfying and interesting lives, are improving. Evidence: One person made tea and coffee for us, and brought it to us on a tray. This showed a marked development as this person would not have been able to do this the last time we visited. Staff told us, and we found evidence to show that the home is now being run much more based on the needs, wishes and choices of each person as an individual. Staff encourage people to take pride in their rooms and their home, and to help with household chores. People make choices about what they want to do, and help their keyworkers draw up a plan of activities for the week. Records showed that people are Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: being offered a wider range of opportunities and activities than the last time we inspected, and are doing more. The manager said this still needs to continue to improve, with more choices and opportunities found for each person. The home asked an Occupational Therapist for advice on activities they could offer one person. The OT suggested horse-riding or using a trampoline. The manager said these activities had not been arranged yet. However, this person now leads a very busy and active life. He has shown by his behaviour that he prefers to be away from the home, so he goes out at least twice every day. On the day we inspected, two people went out in the morning, and two staff took another person to visit a relative. Extra staff were brought in so that one person could be admitted to hospital, and other people could still go out in the afternoon if they wanted to. Staff told us that three people have decided to go to church each week, one to the Catholic church and two to the Church of England church. While the house was being decorated, all the people who live here went on holiday to Clacton. They, and the staff supporting them, stayed in caravans, and staff said everyone enjoyed themselves. Three people also went to Blackpool for a holiday. The files we looked at showed that the staff have a lot of contact with peoples families. Families have been involved in putting the care plans together, and have signed a contract with the home. Families were invited to a meeting in July so that changes at the home, such as the change of manager, and changes needed because of our last inspection report could be discussed. The manager said that afterwards some of the families said how pleased they were to be involved in what is happening at the home, and to have things explained to them. Staff support people to plan what they want to eat, using pictures for people to make choices, and by knowing foods that individuals like or dont like. Three people like to go food shopping on Friday each week. Menus show that people are offered a healthy, balanced variety of meals. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported with their personal care in the way they prefer, but some health needs could be documented better to make sure they are met. Some small improvements are needed to the way medicines are handled. Evidence: Behaviour management guidelines for one person (see Choice of Home section of this report) were in place so that staff can work consistently, with a monthly summary which charts the progress the person is making. We also found guidelines for another persons epilepsy On one file we found evidence that some of the persons healthcare needs are met. He had seen a chiropodist, doctor, OT, and a consultant, and his weight is monitored regularly. We do not know if he has seen a dentist or an optician, or had his hearing tested if needed. This person did not have a Health Action Plan (HAP) in place. HAPs were recommended as part of the governments Valuing People initiative, and the government hoped that everyone with a learning disability would have a HAP in place by 2005. We asked the manager to look into this. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: On the other file, we read that the person had seen a dentist and an optician. We noted that there are now guidelines in place for managing this persons diabetes. The risk assessment for this tells staff what to do if the persons blood sugar level is above the recommended level. Each person has a medication file which contains information about the medication the person takes. One we looked at showed that, amongst other information there were clear guidelines for staff on the way this person likes to be supported to take his medication. Each person has their medication in a locked cupboard in their bedroom. The Medication Administration Record (MAR) charts were signed correctly by staff. However, it was not clear on this persons chart why one cream had been crossed out, and another alteration was not signed or explained. On another persons chart, a hand-written entry was not signed or dated. The medication policy has been revised since our last inspection and is now relevant to the home. Staff training records showed that not all staff have had training to administer rectal diazepam, and those who had done this training have not done their annual update. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident their concerns will be listened to, however not all staff have received adequate training to know best practice in keeping people safe. Evidence: The home has a complaints and compliments procedure, so that people know how they can complain about (or compliment) the service. A record had been made of concerns raised by relatives on four occasions since our last inspection: these had been dealt with well so had not turned into formal complaints. Relatives had also sent cards or letters expressing their gratitude for, and satisfaction with, the service their relatives receive. All the people who live at 1 Beech Close need support with their money. They keep a small amount of money in the office safe and staff support them when they need to take money out. Records are kept to show what the money is spent on. We looked at the records for two peoples money and the records were accurate. Some people are not safe to go out alone, so alarms have been fitted to the external doors. In this way, staff know when one of the doors has been opened and they can keep people safe. Records of staff training indicated that 9 of the 14 staff have received training in adult Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: protection/safeguarding (SOVA). Staff we spoke with showed us that they have a good understanding of the procedures to follow if they suspect abuse. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1 Beech Close offers a comfortable, homely, clean and well-maintained home for the people who live here. Evidence: When we looked round, the home was tidy and clean, and smelt fresh. A lot of work has been done since we last visited to make the home more comfortable for the people who live here. Most of the shared areas of the home, such as the sitting room, dining room, activity lounge, kitchen and corridors have been redecorated. New flooring has been laid in the activity lounge and in the kitchen, and some new furniture purchased. Staff are working with each person to find out what they want in their bedrooms so the bedrooms can be more personal to each individual. At the time of the inspection the amount of things people could have on show in their rooms was limited, because one person still goes into other peoples rooms and re-arranges or puts away anything left out (see Choice of Home section of this report). Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not always enough staff on duty to meet peoples needs, and not all staff have received sufficient training to make sure they know the best way to support each person. Evidence: The manager said that there are always four staff on duty during the day/evening, and two staff on waking duty at night. Other staff come in during the day when more are needed for some activities. We saw this on the day we visited: additional staff came on duty during the afternoon as two staff were needed to support the person who was being admitted to hospital. The four staff includes the deputy manager who only has one office day a week. Risk assessments have been done to work out whether one of the waking night staff could be replaced with a member of staff sleeping in. Staff we spoke with said that sometimes there are not enough staff for everyone to do what they had planned to do, because some of the people who live at 1 Beech Close need one-to-one or two-to-one support when they go out. This happened on the morning we were at the home. One person was not able to go out as he wanted to do as there were not enough staff available. Although we understand that people cannot always go out when they want to, there must be enough staff to make sure people can Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: do the activities that they have planned to do. We looked at the personnel file of one new member of staff. All the information the home has to have before the staff member can be employed (such as two references, a Criminal Record Bureau (CRB) check, proof of identity and so on) were in the file. Staff told us that all their training had been brought up to date before the service transferred to TACT in March 2008. In the 8 months since then they had done some more training, such as person centred planning, medication administration, IT (computers), and risk assessments. Although they had autism awareness training previously, they suggested more in-depth training based on the people they support would give them a better insight into peoples behaviour. Records showed that 9 out of 14 staff had done safeguarding adults (SOVA) training, and 5 staff have completed a National Vocational Qualification (NVQ) in care level 2. A training requirement record showed that a number of staff were due to re-do training in moving and handling, health and safety, fire, food hygiene and autism before the end of 2008. Records also showed that not all staff have had training to administer rectal diazepam, and those who had done this training have not done their annual update. One of the staff on duty was from an agency: this staff member told us they had done a lot of training through the agency, including SOVA, and NVQ level 2. They had worked at 1 Beech Close previously, but still did an induction, including fire safety, when they started their shift. Permanent staff said they receive regular one-to-one supervision from the manager or the deputy manager, and staff meetings are held. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is managed much better than it was, so that the quality of life for the people who live here is improving. Evidence: The registered manager resigned from her post in August 2008. 1 Beech Close has been managed since then by the manager of 2 Beech Close, while the provider recruits a new manager. Staff said they are happy with the new manager, she has done well, she is approachable and supportive. The improvements we have seen, and the fact that we have made fewer requirements this time support this view. One staff member said a lot has changed with the new manager. The service is now more organised, very much helping the people we support. The manager told us about the new quality assurance system that has been introduced. Surveys had been sent to families and other stakeholders. The results were analysed and a copy of the evaluation was sent to each of the families. Keyworkers work with each of the people who live at 1 Beech Close to make sure the Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: service being provided is what each person wants and needs. We looked at some of the records the home has to keep. Tests of the fire alarm and emergency lighting systems had been done regularly as required. Only one fire drill had been recorded, and another was planned. All staff must be involved in a fire drill at least once a year. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 3 14 The home must be able to 31/07/2008 demonstrate that it can meet the needs of the people who live there. The management of each person?s needs must not have a detrimental effect on the other people whose home this is. This requirement is carried forward from August 2007 it was not met. 2 33 18(1)(a) There must be an adequate number of staff on duty to meet the needs of the residents. This requirement is carried forward from the inspection in August 2007 -it was partly met. 31/07/2008 Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 12 The way peoples healthcare needs are met must be fully documented. So that we can be sure people are supported to stay healthy. 31/01/2009 2 20 13 All hand-written entries on the MAR charts must be signed and dated. So that medications are administered as safely as possible. 31/01/2009 3 23 13 All staff must have training in Safeguarding Vulnerable Adults (SOVA). So that the people who live at 1 Beech Close are protected from abuse and harm. 31/01/2009 4 32 18 All staff must have sufficient, up to date training in all relevant topics. 28/02/2009 Care Homes for Adults (18-65 years) Page 27 of 29 So that staff know how best to support the people who live here. 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 19 Each person should have a Health Action Plan in place, fully completed, and kept up to date, so that their health needs are fully documented. At least 50 of the staff on duty on each shift should have a qualification (such as an NVQ in care). 2 35 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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