Inspection on 04/12/08 for 16 Kings Road

This inspection was carried out on 4th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

16 Kings Road 18/12/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 16 Kings Road 16 Kings Road Lee On Solent Hampshire PO13 9NU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Laurie Stride     Date: 0 4 1 2 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 28 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 28 Information about the care home Name of care home: Address: 16 Kings Road 16 Kings Road Lee On Solent Hampshire PO13 9NU 02392553068 02392556081 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Amanda Irvine Type of registration: Number of places registered: Care Management Group Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 only - 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 Date of last inspection Brief description of the care home 16 Kings Road is owned and managed by the Care Management Group Limited. The building is a large older style property that had originally been refurbished by the company to provide independent supported living accommodation. The decision was subsequently made that the home is to be used as a residential care home and the service was registered on 11/06/07 to provide accommodation, care and support for up to 6 adults who have a learning disability. The home is situated in a quiet road, close to the sea front and shops at Lee-on-Solent. The current range of fees is 1,166.50 to 1,368.58 pounds sterling per week, depending on the assessed needs of Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home individuals. This information was obtained at the time of the inspection visit. Members of the public may wish to contact the care home for up-to-date information about fees. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the second key inspection of this service, the first had been carried out on 18/12/07 and the home had been given an adequate rating. This visit lasted 8 hours, during which we, the commission, looked at how well the home is meeting peoples needs and supporting them to have a good quality of life. We also looked at how the service is meeting the requirements from the first inspection. During this visit we looked at samples of records and spoke with the registered manager. We met four of the five people who currently live in the home and spoke with two of them, however our communication was limited due to the nature of the individuals disabilities. We also spoke with four members of the staff team and observed them interacting with people who use the service, which they did in a Care Homes for Adults (18-65 years) Page 6 of 28 respectful, sensitive and friendly manner. Further information used in this report was obtained from the previous inspection report, the homes annual quality assurance assessment (AQAA) and from notifications the home had sent us between the inspection visits. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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. Improvements in the information given to people interested in using the service helps them to decide if the home can meet their needs. The assessment & admissions procedure also ensures that people are matched with the right service to meet their needs. Evidence: The previous inspection report identified that people who use the service did not have all the information they needed to help them decide if the service will meet their needs. Individuals had their needs fully assessed before coming to live in the home, but the service needed to ensure that all staff members were suitably trained to meet all the assessed needs. For this inspection, the homes annual quality assurance assessment (AQAA) told us that a Statement of Purpose and Service User Guide is in place. The AQAA also stated that work was underway to make these information documents more user-friendly. During this visit we saw that the home had an up to date Statement of Purpose and a Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Service User Information Handbook. One person who uses the service had agreed to do a Living at Kings Road guide with photos. This shows what it is like living there from the perspective of a person who uses the service. Another person had been admitted to the home earlier this year. We saw that the assessment and referrals team for Care Management Group had carried out an initial assessment of needs prior to the person moving in. The manager said she had then obtained more information, for example from a consultant and the Community Learning Disability Team, and we saw the records of this. This service user told us that their relatives had received a copy of the Statement of Purpose, visited the home and met the manager. The service user and manager spoke to us about the process for moving into the home. The service user said they had received the picture guide. Through looking at the homes records and from comments from members of staff, it was evident that training had also improved to meet the assessed needs of people who use the service (see section on Staffing). Care Homes for Adults (18-65 years) Page 11 of 28 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 who use the service are supported to make decisions and choices. Detailed support plans are reviewed regularly to ensure they reflect individuals changing needs and staff have relevant guidance. Evidence: The previous inspection report identified that the home supported people who use the service to make decisions about their lives and explored new ways to do this. Care planning and risk assessments were in place and would be enhanced by the further development of person centred plans. For this inspection, the homes AQAA told us that all service users have a comprehensive and developing person centred support plan and are involved in the day-to-day decision making in the home. We saw the home was in the process of developing a new format for care planning, which had clear links to risk assessments and health plans. We looked at the risk Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: asessments for three people, which contained details of control measures to reduce the risks to individuals, such as when out in the community. The records of monthly reviews included a lot of detail and demonstrated that the individuals were involved in these, for example by describing the persons level of participation. Records of care manager reviews were also on file. The records showed, for example, one of the people who use the service was communicating better and had been more settled. Person centred plans are being further developed using photos and include sections about How I like to be supported and how to help me make decisions and choices. Through looking at the plans and photos and through discussion with the manager, we learned how one service user now enjoys going to a ceramics workshop, hydropool and pamper sessions. The individuals plan also indicates what happens when they are happy or sad. It gives the signs and triggers for their behaviours and guidelines for staff in managing them. The persons records show they have been interacting with other people more since the last inspection. There are risk assessments and guidelines for accessing the community, travelling in the company vehicle and going to the shops. Each service user has a key worker who works with the service user to make sure their views are heard. They use listen to me workbooks to facilitate this. A person who uses the service told us about their keyworker. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from opportunities to access a wide range of activities both within the community and at home. People are supported to maintain relationships and a healthy diet. Evidence: The homes annual quality assurance assessment (AQAA) said that each service user is supported to take part in social, recreational and day activities of choice, including local amenities such as swimming, bowling, shopping, cinemas and hydropool. During our visit we saw that each person had an activity book. These were large, colourful books using photos to show activities people had taken part in and provided a reflective activity for the individuals involved. For example, one person had been to Legoland while two others had gone to Beaulieu motor museum and others had been to monkey world and seaworld. One individual was enjoying a new activity of walking a Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: dog belonging to a member of the local community. Two people who use the service had a week on the Isle of Wight in October and another person said they were going to Butlins this month. We saw that menus include individuals choices and this was confirmed by one person who told us they were having curry with rice. This person went out shopping for this later in the visit. People who use the service are encouraged to take part in the daily routines of the home. Another service user explained to us what the coloured mops and buckets were for. This person is in their second year at college and has awards and certificates from the previous year. The individual attends a church group and has recently started fishing which they said they enjoy. They have also been working on a business plan in relation to music and entertainment. The daily diaries have improved since the last inspection and provide useful links to activity information, for instance they include the choices individuals make on a daily basis. For example a person choosing to help cook dinner, which the individual confirmed while talking to us. The diaries show what activities are offered, if the activities on the structured plan are declined and what is actually done. The activity plans themselves are in a picture format, making these more accessible for the people involved. We spoke with a member of staff, who is the homes communication champion. She demonstrated the use of picture symbols and objects of reference to support service users communication. Records we saw showed people who live in the home were supported to maintain links with their families, which was further confirmed through discussion with one service user. Care Homes for Adults (18-65 years) Page 15 of 28 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 personal support and healthcare that people recieve is based on their individual needs and they are protected by the homes improved medication procedures. Evidence: The previous inspection report identified that the healthcare and personal support people received was based on their individual needs. A requirement was made that systems put in place to reduce medication errors were monitored and adhered to, ensuring that records were fully maintained. For this inspection the AQAA stated that the service had improved the medication system to ensure that medication given to people who use the service is correct. We saw that each person has a health action plan, which show when people attend appointments or are visitied by health care professionals and the outcomes. We saw that the home had sought advice from the community team about one persons behaviours and another persons sexuality issues. Care plans show how people like to be supported and are kept up to date by key workers. We saw care records for the four people who live in the service. Three staff members confirmed they update the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: care plans. We received survey comments from an external health professional who has involvement with the service. The health professional told us that the service often seeks advice but may take longer to document actions. The health professional said that better documenting of care plans would ensure consistency and stated that the home does respond to the individuals needs quickly. Medication procedures have been improved since our last visit and meet the previous requirement. The administration records now contain two staff signatures, which provides a check that the medication prescribed is given. Protocols for as required medication are in place and the manager said they are trying to get the General Practitioners to sign them. We saw there are guidelines for administering insulin and purpose built storage facilities for this. The manager reported that one individual is now on reduced as required medication and this is linked to a reduction in challenging behaviour. The manager develops behavoural analysis reports from the incident reporting, which helps to identify any patterns to inform management and external professionals. New incident forms were being developed which include more detail in relation to staff and service user responses during incidents, to enable the service to learn more from the incidents that occur. Each person has an individual medication file with their photo attached. We looked at a sample of the medication administration records for two people. There were no gaps in the recording. There is suitable storage for general medication and we advised the manager about the need to update the Controlled Drug storage in line with recent legislation. We also advised that the manager checks as to the suitability of a secondary medication storage cabinet. The manager agreed to do this. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that their concerns are listened to and acted upon. People who live in the home are protected by the procedures for responding to abuse and how the service manages their finances. Evidence: The previous inspection report identified that there were systems in place to ensure that individual concerns are listened to and acted upon. A requirement was made that included staff having training in understanding and managing challenging behaviour. The AQAA told us that staff training is monitored and the service takes all opportunities to meet training needs. There is a complaints procedure in picture symbol format on display in the home, which needs updating with the commissions current contact details. Near the front door are books where people can write complaints and also positive feedback. There were two complaints in the book and the manager told us another complaint from a service user had been recorded in the managers file. We discussed with the manager the form in which complaints are recorded in the home, as the current format does not lend itself to easy auditing or confidentiality. The manager said she would review how complaints and feedback are recorded. A service user told us they knew who to speak to if they were not happy about something and how to make a complaint. A health professional who took part in our survey indicated that the home usually responds Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: appropriately if they or the person using the service have raised concerns about their care. Two staff members who completed questionnaires said they know what to do if someone has concerns about the home. There have been two safeguarding referrals, which the home had reported to us, and a final safeguarding meeting with Adult Services is to be confirmed for January 2009. We spoke with three members of staff about safeguarding procedures and they told us they would report any incidents of suspected abuse to the manager or senior on duty. Training records showed that staff receive relevant training in safeguarding matters. The staff members confirmed they receive this and also training in prevention and managing challenging behaviours (PMCB). There are guidelines and procedures for staff using physical interventions as a last resort, which are specific to the individual needs of people who use the service. During our visit we looked at the homes arrangements for managing peoples money. The organisation provides each service user with an activities allowance and this is kept and accounted for seperately from individuals personal money. With the manager we looked at a sample of a service users records and balances. Full records were available of payments, credits and withdrawals. There are records of regular management checks for both activity and personal money. Care Homes for Adults (18-65 years) Page 19 of 28 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 who use the service benefit from living in a clean and homely environment, that is suited to their individual and collective needs. Evidence: We looked at the communal areas of the home, accompanied by the manager. There were pieces of art and craft work in the hall that had been made by a service user in their ceramics class. Photo-pictures were placed in certain parts of the home to assist a person to find their way around. The hallway and stairway had been repainted since the last inspection and the external lighting by the front door had been fixed. On the day of our visit part of the lounge was also being re-decorated. The manager showed us lamp shades that had been matched to the communal rooms by one of the people who live in the home. This person allowed us to see their bedroom, which was spacious enough to keep their personal possessions in, such as DJ equipment. The service user asked the manager to look after their room keys while they went out. Another person let us see their room, which they told us they liked and we saw it contained their personal artwork. Another person also showed us their room, which had sensory lights and a new communication board. A fourth service user showed us the picture they had bought that day while doing Christmas shopping and hung in their bedroom. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The door to the kitchen is locked when staff members are not available to supervise. This had been risk assessed in relation to specific individuals and we observed service users being able to access the area during the day, with staff support if required. The manager told us this situation is being kept under review. We saw that there was a good overall standard of cleanliness in the home and there were no visible hazards. There are infection control procedures in place and relevant training is included in the staff training programme. A service user also demonstrated their awareness of the use of different coloured mops and buckets. One of the people who use the service had completed our survey questionnaire, supported by the manager, and told us that sometimes the carpets get dirty and that the home is getting new flooring. The manager confirmed what had been stated in the AQAA, that there are plans to remove the carpet from the dining room and ground floor hallway and replace it with a more hygienic and easier to clean material. The AQAA also told that the garden has been developed with the participation of people who use the service, who have had the opportunity to grow fruit and vegetables. There are plans to expand this next year. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected by robust recruitment practices and are supported by suitably trained staff. Evidence: The previous inspection report identified a requirement that staff should receive comprehensive training to ensure they can meet the needs of all people using the service, both prior to admission and once they are living at the service. The AQAA stated that the organisation offers comprehensive and extensive training. We saw the staff rota for the day, which showed four staff members on duty on each of the morning and late shifts, plus another member of staff working a middle shift. The manager was supernumerary to these numbers and there were two staff members covering the night shift. The rota reflected the number of staff on duty during our visit. The manager told us that there are currently two nights per week that the staff team cover by working overtime. If agency staff is used the home asks for individuals who are already known by the people who use the service. We looked at the records for two recently recruited staff members and saw that for each there were completed POVA (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) checks, two references and employment histories on file. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: We spoke with a staff member who confirmed that she has done all the training courses, except that for Autism, which was being rescheduled. The organisations Autism trainer had arrived on the day of our visit so the manager rescheduled the training. The staff member spoke to a person who uses the service, who was becoming more excited, in a calm and level manner and we observed other staff members interacting positively with service users. People who live in the home were clearly at ease with the staff. A person who uses the service indicated in our survey questionnaire that the staff treat them well, listen and act on what they say. The manager confirmed that seven of the eighteen permanent staff members have completed National Vocational Qualification (NVQ) level 2 or above and five had signed up to do the NVQ level 3. Two other staff members each have a degree in health and Social Care and another is on a student visa. Two new staff members were working through their induction. We spoke with three other members of staff, who were positive in the way they talked about their work and confirmed they had received training, for example in managing challenging behaviour. The manager said she had up-to-date information about training completed by individual staff members on a spreadsheet but was unable to access this through the homes current computer. We were informed that the organisation will be equipping services with Information Technology over the coming month. There was sufficient information on various paper records to indicate that staff had received or were signed up for training, including mandatory health and safety matters, managing challenging behaviour, safeguarding and medication. Two members of staff who completed our survey questionnaire indicated that they are given training that is relevant to their role, helps them understand and meet the individual needs of service users and keeps them up to date with new ways of working. One staff member wrote that they have requested additional training and the manager is looking into this. The other wrote that there is ongoing training and new ideas and input is always available. Both staff members confirmed they have regular supervision. Care Homes for Adults (18-65 years) Page 23 of 28 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. The home is well run and its development is underpinned by the views of those who use the service. The health, safety and welfare of people in the home is promoted. Evidence: The previous report identified a requirement in relation to the registered manager needing to have sufficient time to ensure she can fulfil her role within the service. The registered manager has the support of a deputy and there is now a senior manager for the organisation based locally. The manager is currently working on the NVQ level 4 Registered Manager Award. We saw that the previous requirements had been met and the manager told us that she is able to decide when to work hands on and when to focus on management tasks (this also meets a previous requirement). Prior to our visit and as part of this inspection, the manager had submitted a very clear and well detailed AQAA. A staff member told us that the manager is always available to discuss matters, whether professional or personal. There is a business plan for the service for 2008-09. Care Management Group has a Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: corporate quality assurance system that includes stakeholder surveys. The manager told us the service had not yet received the results of this years surveys and she was working on improving quality assurance questionnaires to make them more specific to the service. We saw that minutes were kept of service user meetings and the manager said a meeting was scheduled to discuss arrangements for Christmas. Staff meetings are also held regularly and recorded. The manager said that staff handovers were still being held in the dining area due to the lack of space in the office. This is not ideal as it could undermine confidentiality when staff discuss service user issues. We saw evidence that regulation 26 monitoring visits are undertaken by the organisation and actions are drawn up for the manager to improve the service. There were some gaps in the records of these visits and the manager said that the recent organisational restructure may have had an impact on the frequency of visits. Monthly health and safety checks within the home are recorded. We saw a list of staff who are trained in emergency aid and records indicated that staff receive training in other mandatory subjects such as fire safety, moving and handling and infection control. We saw that records are kept of regular fire drills and the names of those attending; weekly inspections of the means of escape in the event of a fire; fire equipment checks and services. Fire safety risk assessments were in place and had been reviewed in May 2008. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The home must make sure that a suitable storage facility is available for any controlled drugs that individuals may be prescribed, in line with changes to the legislation about peoples medication. This is to ensure that the proper and legal safeguards are in place when care workers give controlled drugs to people who use the service. 05/03/2009 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 27 of 28 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. 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