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Inspection on 06/11/08 for 15 Sorrel Drive

Also see our care home review for 15 Sorrel Drive for more information

This inspection was carried out on 6th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The three people who live at the home live as part of the family. They see themselves very much as part of the family. Two people have lived at the home for over ten years. Throughout the visit, it was observed that people are offered help in ways that maintain their independence, dignity and safety. People are supported to gain access to advice from health professionals where they need, so their health needs can be met. Care and support is provided in a common sense, discrete, and relaxed manner. People looked comfortable and at ease at the home. There is a focus on positive risk taking and encouraging people to be as independent as possible whilst bearing in mind their abilities. The family are managing to maintain the balance of being a family home whilst understanding the need for some records and assessment of risks for people. The home has a warm and welcoming atmosphere which encourages positive outcomes for the people who live with them as a family. People are supported to keep in touch with their families and friends so that they do not lose relationships that are important to them. Opportunities to support both people to integrate into the community by taking part in social activities are encouraged. People are involved in planning their daily meals. A record of meals served show that a balance between healthy eating and choice is given. People at the home said that they enjoyed their meals.

What has improved since the last inspection?

The Statement of Purpose and Service User Guide have been reviewed and updated. The manager/ owner has produced the documents in picture format as recommended at the last inspection. This will help the people who live there to understand what they can expect from the service. Redecoration work has been undertaken in parts of the home. This includes painting of one bedroom to meet the preferences of one person and new flooring in another person`s room. The home has met the requirement set out in the last inspection that requires people working in the home to have up to date training in topics related to the needs of people in their care.

What the care home could do better:

Not all of the requirements made at the last inspection have been met. The owner / manager needs to ensure that complete Criminal Records Bureau (CRB) checks on any person who is involved in the care of the residents living in the home. This will support the protection of people living in the home. The manager/ owner needs to ensure that people working in the home are receiving upto date training in the protection of vulnerable adults, this will support the protection of people living in the home. The owner /manager, needs to ensure that medication is appropriately stored and administered only by those who are suitably trained to do so.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 15 Sorrel Drive 15 Sorrel Drive Boughton Vale Rugby Warwickshire CV23 0TL     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: Julie McGarry     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 33 Information about the care home Name of care home: Address: 15 Sorrel Drive 15 Sorrel Drive Boughton Vale Rugby Warwickshire CV23 0TL 01788546310 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Elaine Sandra Ward care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 15 Sorrel Drive was originally an adult placement home and was later registered as a small care home for younger adults with a learning disability. It is currently registered for 3 people, with varying levels of physical and learning disabilities. The home is a detached property, which has been extended to provide suitable and accessible accommodation for people living in the home. Situated in Boughton Vale on the outskirts of Rugby the home is close to local amenities and services. People living in the home have their own bedrooms and share the home with the Registered person and her family, as part of the family. The residents have access to all areas of the home and communal rooms include the kitchen, dining room, lounge, conservatory and bathrooms. There is a shower room facility on the ground floor. Three bedrooms are provided are available for people who choose to live in the home. Two on the ground floor of the property and a third on the first floor. At the rear of the property, there is a small, well-maintained garden. The registered manager has advised the Commission of the fees payable by people accommodated in the home these range from £371 - £420. Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 3 Care Homes for Adults (18-65 years) Page 5 of 33 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a Key Announced inspection; it was undertaken on the 6th November 2008. We visited the home on the 4th November on an unannounced visit, however people were going out that day and no one would have been at the service to assist in the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live at the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, Care Homes for Adults (18-65 years) Page 6 of 33 minimum standards of practice, and focuses on aspects of service provisions that need further development. The pre fieldwork inspection record was completed, as well as a site visit to the home, during which time staff, people living in the home and the manager were spoken with. The manager/owner supplied the commission with an AQAA (Annual Quality Assurance Assessment). Information from this has been used to make judgments about the service and have been included in this report. Surveys were sent to the people living at the home and two were returned. Both surveys were positive and show that people are very satisfied at the home. The findings of the surveys are reflected throughout the report. Two of the three people living there were identified for close examination by reading their care plan risk assessments daily records and other relevant information. This is part of a process known as case tracking where evidence is matched to outcomes for people. A tour of the environment was undertaken and home records were sampled including training and maintenance records. The inspector would like to thank the people who live at the home the manager/owner and family for their hospitality and co-operation during the inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: Not all of the requirements made at the last inspection have been met. The owner / manager needs to ensure that complete Criminal Records Bureau (CRB) checks on any person who is involved in the care of the residents living in the home. This will support the protection of people living in the home. The manager/ owner needs to ensure that people working in the home are receiving up Care Homes for Adults (18-65 years) Page 8 of 33 to date training in the protection of vulnerable adults, this will support the protection of people living in the home. The owner /manager, needs to ensure that medication is appropriately stored and administered only by those who are suitably trained to do so. 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 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 33 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 living in the home have information about their placement, which will support them to live comfortably within a family environment. They have their needs assessed and a contract that tells them about the service they will receive. Evidence: Two people who live at the home have lived there for over ten years. They moved into the family home before the service needed to be registered and there was not any formal assessment process. One person has recently moved to live there. There is no preadmission assessment on file for this individual, however other records at the service show that this person visited the service on a number of occasions with staff from their previous home, their social worker and on occasions their occupational therapist prior to moving there. Discussions with the occupational therapist during the inspection confirmed that detailed assessments, including risk assessments were carried out prior to this person moving to the service to ensure the needs of the person could be met. The person who Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: recently moved to live at the service told us they were involved in making the decision about where to live. There are personal profiles in place in the individuals care records. Two peoples files were checked. Both people have been issued with contracts detailing the terms and conditions of their stay at the home so they are clear about what they are entitled to and what they have to pay for. Since the last inspection the manager has provided copies of the Statement of Purpose and Service User Guide in an accessible and suitable formats for people living in the home. The information in both documents are detailed and up to date, providing those who live there with information about the home. Details of the complaints process is also available in an accessible format for the people who live at this home. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to make everyday choices so that they can exercise some control over their daily lives. Care plans and risk assessments are completed to describe peoples individual needs to ensure that they receive the care and support they need in a consistent manner. Evidence: Care plans of two people were examined. Elements of these are good in providing detailed guidelines for staff in supporting people, and the home is working towards a more person centred planning approach with aspects of the care plans. Examples of good recording include detailed information for staff on how to support and respond to the needs of two people who have epilepsy; how personal care should to be provided for people with mobility needs; and the support needed for one person with swallowing difficulties. Further work must however be undertaken to ensure documents are completed in full to ensure records evidence current needs and they are being appropriately managed. For example, a recent social services report for one person Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: states that their is a risk of skin breakdown, however there is no risk assessment plan or care plan in place to tell staff how to manage this persons skin to mininise the risk of breakdown. The manager also tolds us of the good practice actions staff take to support one person with anxiety, however this is not recorded. The needs of two people who have lived at this home over ten years have remained fairly stable over the past year and the recent review of the care plans and risks assessments reflect this. People spoken to told us that there have been no changes to their health and wellbeing or lifestyle in the past year. Information provided by the manager reflected that detailed in the care plans risk assessment plans. Discussion with the manager/ owner and records seen evidence that these are kept under review. The approach to risk management makes sure that there is a balance between enabling the individuals to retain their levels of independence within a safe framework. For example one person is supported to go swimming at weekends, transport is provided however, on occasions this person likes to use public transport on their own. Arrangements have been made to promote positive risk taking whilst ensuring areas of possible risks have been considered. The inspector met with all of the people living at the home. Both people case tracked were able to verbally communicate their views and satisfaction with their lifestyle. People told us about about the range of activities offered to them and opportunities they have in going to college and doing courses of their choice, attending the Gateway Club, and one person has been away on holiday. One person also told us that they enjoy listening to Reggie music and can spend time in their room listening to their music. Comments made by people living there included XX and XX are very nice and I like living here. People at the home were observed to freely walk around and make decisions for themselves about their lunch and evening meal what they wanted to do that day. Comments by staff demonstrated a detailed knowledge of peoples care needs. Staff were able to illustrate examples of good care practices. For instance, staff were able to discuss the safe practices they follow to ensure that one person with mobility difficulties is able to move around freely within the home with minimal risk of falling whilst promoting their independence. And how they support one person when they become anxious by taking them out for a walk in the local area and spending one to one time with them discussing their concerns. Care Homes for Adults (18-65 years) Page 14 of 33 Care Homes for Adults (18-65 years) Page 15 of 33 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 people living in this home are supported to make choices about their lifestyle and to develop life skills and participate in their local community. Meal times are made a positive experience by good staff support and involvement from people who live there. Evidence: On arrival at the home all three people were in. Two people went out later, both to their day services, whilst one person remained at home for appointments with their physiotherapist and occupational therapist. People living in the home have access into the community either by their own car which a member of staff drives for them, a taxi, or the owners car. On the day of the inspection, the manager had made arrangements to look into the best arrangements to meet the transport needs of the newest person to move to the home. This involved Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: a local transport service provider visiting the home with a vehicle that could be used to support this person to access the community. The person was able to test drive the vehicle to ensure it was suitable to meet their needs. The home encourages people to maintain contact with friends and relatives. One person visits their parent at their home, and another person told us that they get to see their friends everyday. Family are invited to join in any events arranged by the manager, for example in a recent Body Shop night, the newest person to join the service was able to spend time with their two sisters. Staff have recorded individuals cultural needs for example one persons cultural needs are met through the cooking of Caribbean foods and listening to Reggie music. Comments from those who live there support that this happens: I like my room, sometimes I go upstairs and listen to my music I like Reggie music. And, I have a good diet, I like rice chicken, and I enjoy my packed lunch. People told us that they all eat together as a family in the dining room. Mealtimes are relaxed and unhurried. A lunchtime meal was observed and assistance was provided when needed in such a way that maintained peoples dignity and safety. There is a sample menu in place but in reality as most families do they all decide on the day what they would like to eat. They are trying to promote healthly eating with one person in particular whilst still maintaining that persons right to choice. Due to the needs of the people who live there, they require staff support to make any meals snacks. It was seen on the inspection that staff understood when people wanted something, and staff responded in a timely and respectful way. Staff were observed offering choices to the people who live there, for example, the evening meal included chicken and rice. One person said that they did want want rice with their meal and were offered a choice of alternatives. Staff were observed communicating effectively and respectfully. People spoken to told us about their interests and hobbies and confirmed that they are able to do a range of activities through the year. On the day if the inspection one person spoken to said that they like to spend their time in their room in the evenings to watch certain TV programs on Sky Sports, they told us that they were able to do so. The manager/ owner organises annual events throughout the year, which the residents are involved in these include barbecues, Christmas parties, and peoples birthdays are celebrated. The night before the inspection, the manager made arrangements to celebrate Halloween. This included a fireworks display and the neighbours were invited Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: to involve the local community. Care Homes for Adults (18-65 years) Page 18 of 33 Personal and health care 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. The health and personal care that people in this home receive is based on their individual needs. Family respect the people and promote their dignity and privacy. Medication systems need to improve to make them safe. Evidence: The care plans for both people were examined, these were well laid out and presented an informative assessment and recognition of each persons care needs. Care records demonstrate that support services are accessed as required to meet their specific and changing needs this includes advice on aids and adaptations and assisting in meeting personal care needs. People receive personal support in the way they prefer and require as evidenced through observations during the inspection discussions with staff and examination of records. For example, on the morning of the visit not all residents were up and dressed. Residents arose at varying times and made choices about where to have breakfast and what they wished to eat. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: Comments from people who live here include: My personal care is very good I have a shower everyday. I have different clothes every day, I like to be smart. There were positive relationships and interactions observed between the family and the people who live at the home. They all commented that they get on well and other family members and they treat them well. There were positive relationships and interactions observed between staff and the people who live at the home. The staff and manager encouraged and supported people in a relaxed way. All of the people living in the house said that they like and get on well with the staff. Discussions with people, staff, and entries in individual health records show that people access appropriate health care support where required. Peoples records show that they have been supported to access an extensive range of consultants and health professionals. Peoples health records and care plans showed that their right to good quality physical and mental health care is being promoted. The records show that as part of promoting their health people make regular visits to a dentist, specific health consultants, their GP, and a chiropodist when needed. The staff have recently reviewed peoples care plans. As previously mentioned, further work needs to be done to ensure that records are fully completed and up to date. The home currently carries no controlled drugs that would necessitate any special storage and recording arrangements. There are no drugs that need to be stored in the fridge. Other medication is stored in a locked cabinet in the ground floor bathroom. This is not an appropriate place to store the medication. Alternative arrangements need to be made to ensure all medications are stored in accordance with the Royal Pharmaceutical Societies guidelines. There was no record of temperature recording. The manager/owner needs to ensure medication is stored below 25 degrees to ensure the stability of the medicines. Only one family member is trained in the administration of medication however another family member helps to administer medication. This is not acceptable practice. The manager needs to ensure that only those who have the appropriate training administer medication. There is a policy in place for medication however, further work needs to be done to ensure the policies and procedures are more detailed to fully inform staff about administration, training, and disposal of medication. Care Homes for Adults (18-65 years) Page 20 of 33 Care Homes for Adults (18-65 years) Page 21 of 33 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. Complaints procedures make sure that peoples and representatives concerns and complaints are listened to and acted upon. Family and staff have a good knowledge of how to respond to any suspicion of abuse and to keep people safe from harm support the people living at the home. Evidence: There is a complaints procedure in place with details of how to contact the commission. Residents regularly have the opportunity to meet and talk with people and professionals outside the family. When asked about whom they could talk to if they were unhappy, all of the people were able to identify someone in the home or from their own family to talk to. Peoples surveys also show that they know who to speak to if they are unhappy and know how to make a complaint. There have been no complaints or allegations of abuse received by the home or commission since the last inspection. Although the manager / owner has not been on any formal training in relation to the protection of vulnerable adults as required at the last inspection, there is an adult protection procedure in place at the home so that all the family and staff know how Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: and to whom they can report any suspicions of abuse. The manager/ owner and a member of staff spoken with were confident of how to use these procedures. People spoken with said they felt safe living at the home. The home keeps a float of peoples monies, this is held securely in the home. Two individuals financial records and money were checked. The money held matched the records. Receipts were evident to show items that were purchased. The manager is reviewing how support is provided to people in relation to the management of their finances to ensure peoples independence is fully promoted. Care Homes for Adults (18-65 years) Page 23 of 33 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. People live in a homely, clean, comfortable shared family environment. Evidence: There is a warm and welcoming atmosphere in the home. Situated in a residential setting, the owners provide accommodation and support services for three adults with learning and physical disabilities. The home is near to shops and other local facilities. A homely environment is available which is sufficient to meet the needs of the people that live there. The people who live in the home see it as their home. They have their own bedrooms and the inspector was allowed to view the bedrooms. One bedroom is on the first floor and the other on the ground floor for ease of access. Peoples bedrooms were personalised and reflected their personalities and their interests. One person had a range of photographs and pictures of family and music artists of interest. Another person has recently had a new wood floor fitted, and ongoing maintenance takes place in the home to ensure the environment is safe and well presented. Surveys from people show that the home is fresh and clean. Since the last inspection the manager has also employed one domestic staff to help maintain a clean and hygiene home. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: One person who recently move into the service was asked their opinion on how the room should be decoratedprior to moving in, and was able to choose the colour of paint. The ground floor bedrooms are designed to give level access to all rooms on this floor, and are suitable for two people with mobility needs. Doors have sufficient width to accommodate wheelchair access. A ceiling hoist is in place in one bedroom to meet the needs of one person. The garden to the rear of the home is easily accessible. The garden area is suitably landscaped to provide easy access for both people including when using a wheelchair. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from the training attended by the owners of the service, which promotes safety, consistency and continuity of care. Evidence: The family team consists of the manager/owner, and her husband. There is one member of staff who has been recently employed to help meet the needs of the person who has most recently moved to live at the home, part time domestic staff and a part time care worker to provide live in support should the owner/ manager and her husband go on holiday. Since the last inspection the family members who live or work in the home have had a CRB (Criminal Records Bureau) check. The part time domestic and care worker have also had CRB checks. There is also evidence that references have been taken up. The most recent member of staff to join the service has however not had a Protection of Adults First (POVA first) check or a CRB check carried out. One reference from a previous employer was received the day prior to the inspection and this was three weeks after they started their employment at that service. On discussion with the manager / owner, it appears the manager / owner has misinterpreted the Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: requirements that are needed to ensure new staff are checked and deemed suitable to work in the home. The manager has agreed to address this straight away. On further discussion with the member of staff and the manager/ owner we were told that this staff member does not spend time unsupervised with any of the people who live here. The home has met the requirement set out in the last inspection that requires people working in the home to have up to date training in topics related to the needs of people in their care. Care Homes for Adults (18-65 years) Page 27 of 33 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. Management and operation of the home ensures the safety of residents at all times which supports and increases their self worth and quality of life. Evidence: The manager / owner and her husband have continued to organise and collate the information required to support and evidence outcomes for the people living in the home. This information is collated in folders for easy access. The husband of the registered manager / owner has reviewed fire procedures in the home so that people living in the home are aware of what to do in the event of a fire. Smoke and fire alarms are tested weekly, and records are maintained to demonstrate this. The evacuation plan to be followed in the event of a fire was seen. Records, policies, and procedures read include health and safety, Medication Administration Records (MAR) Charts, complaints and missing person policies. However some of these would benefit from being reviewed and new policies developed to ensure all apsects of safe wokring practices are considered, for example, there are Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: no policies or procedures in place for the management of peoples finances or infection control. A quality survey from which to determine the views of people that use the service and other professionals has been developed. Samples of the surveys were examined and these show that positive feedback about the services provided by the home had been received. Samples of feedback include: The meals provided are excellent, there is a focus on the quality of care at this home there is a person centered planning approach to care planning and support - social worker. What I like about the home is the commitment to Equality and Diversity, an ethos of anti discriminatory practice, and the personalisation of service users - social worker. I am given enough opportunities to take part in leisure activities and particularly. like attending Ken Marriott Leisure Centre - person who lives at the service. family setting lovely home lovely area welcoming atmosphere - relative. Care Homes for Adults (18-65 years) Page 29 of 33 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 23 18 All people working in the 30/06/2008 home must attend up to date training in the protection of vulnerable people. This will support the protection of people living in the home. All people working in the home to provide care to the people who live in the home must have all appropriate checks carried out, this includes a criminal records bureau check. This will support the protection of people living in the home. 31/03/2008 2 42 19 Care Homes for Adults (18-65 years) Page 30 of 33 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 You must make 28/11/2008 arrangements to ensure that peoples medical conditions are monitored appropriately to their needs. This includes monitoring the skin integrity for one person identified as being at risk of breakdown. This is to make sure peoples health is promoted and changes in their condition are detected. Regulation 12 of the Care Homes Regulations 2001 requires you to promote and make proper provision for the health and welfare of People. 2 20 13 Storage of all medicines must be in accordance with the legislation The Royal Pharmaceutical Society. This is to ensure that the medicines are stored appropriately and safe to administer. 28/11/2008 Care Homes for Adults (18-65 years) Page 31 of 33 Regulation 13 . 2 of the Care Homes Regulations 2001 requires you to make arrangements for the recording, handling, safekeeping, safe administration, and disposal of medicines received into the care 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 41 The manager needs to ensure that suitable policies and procedures are in place to ensure safe working practices at the home. This includes policies and procedures on management of peoples finances and infection control. Care Homes for Adults (18-65 years) Page 32 of 33 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 © (2008) Commission for Social Care Inspection (CSCI). 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