Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/12/08 for 2 Central Avenue

Also see our care home review for 2 Central Avenue for more information

This inspection was carried out on 2nd December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 2 Central Avenue 2 Central Avenue Billericay Essex CM12 0QZ 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: Bernadette Little Date: 0 2 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 33 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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: 2 Central Avenue 2 Central Avenue Billericay Essex CM12 0QZ 01277655394 01277655394 russell.groves@estuary.co.uk www.estuary.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Estuary Housing Association Ltd Name of registered manager (if applicable) Mr Russell Neil Groves Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 4 Care home 4 Learning disability Additional conditions: Date of last inspection 1 8 1 2 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Central Avenue is a Care Home for four people with Learning Disabilities aged up to and over 65 years of age. It is sited between Billericay and Stock. The house is an ordinary bungalow with four single bedrooms, a bathroom, a lounge, kitchen/dining room and a small conservatory area with access to a large garden to the rear of the premises. There is also a garage for the homes minibus. There is a laundry in a room behind the garage. All residents thinking of coming to live there are given a Statement of Purpose and Service User Guide that tells them about the home. The manager said the weekly fees for 2 Central Avenue is 1615 pounds. There are extra charges for chiropody, personal toiletries, bedroom furniture etc. 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: 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 Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home We spent one day at 2 Central Avenue with residents, the manager and staff. The information we got from talking to people and seeing everyday life at the home is part of this report. We looked around the house and at some records, policies and procedures that tell us how things are done at Central Avenue. Before we came to the home, the manager sent us an Annual Quality Assurance Assessment. This is for them to tell us what they do well, what has improved and what could be done better. The Annual Quality Assurance Assessment did not have a lot of information for us to use. Before we came to the home we also sent the manager some surveys to give to residents, relatives, staff and professionals if they wanted to fill them in to tell us about Central Avenue. We got a survey back from one staff and from three residents who were helped by the manager to fill them in. Care Homes for Adults (18-65 years) Page 7 of 33 After we had been to Central Avenue we sent a letter the registered provider straightaway to tell them we were worried that residents might not be safeguarded. This was because the manager could not show us records showing that the right checks had been done on new staff before they worked with residents. The registered provider wrote back to us to tell us that they had done the checks. We looked at all the information we got from different people to help us to write this report and would like to say thank you to all those people who helped us. What the care home does well Everybody living in Central Avenue has their own bedroom with some of their own bits and pieces to make it individual and give them some privacy. They also have different communal areas to be in, giving them choice and space. Care Homes for Adults (18-65 years) Page 8 of 33 Some of the staff have worked at Central Avenue for a long time. This means they know the residents well and the ways they like to be supported and the things they are interested in. It also means residents have familiar people around them that they can get to know and build relationships with. Residents were able to make choices and help with cooking and baking their meals. They said that they liked the food at Central Avenue. What has got better from the last inspection The manager has had training on medication and safeguarding to keep his knowledge up to date and help him to better support the residents. Care Homes for Adults (18-65 years) Page 9 of 33 We found information to show that all the right checks had been done to make sure that agency staff were satisfactory people to work with the residents. People living in Central Avenue had more opportunities to take part in different activities such as aromatherapy and painting. Safety for residents had improved and things like cleaning liquids were locked away safely and the fire equipment had been checked regularly to make sure it was working properly. What the care home could do better Care Homes for Adults (18-65 years) Page 10 of 33 There must be records to show that all the staff have been checked properly before they come to work at the home to help to keep residents safeguarded. There needs to be better ways to look at how well the service is meeting the needs of the people living there and to get their views. Other ways of checking how the service is running need to happen regularly and when things are found not to be right or working properly, they need to be put right quickly. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Bernadette Little CSCI CPC1 Capital Park Fulbourn Cambridge Care Homes for Adults (18-65 years) Page 11 of 33 CB21 5XE 01223 771300 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 12 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 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 13 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 thinking of living at Central Avenue could expect to have good information about the service in a suitable format to help them make a decision to live there and would have a full assessment of their needs to make sure the service could meet these. Evidence: The statement of purpose and service user guide were readily available within the home and are in a clear and easy to read format. They had both been updated in April this year, an improvement since the last inspection. The service user guide had information on the cost of living at 2 Central Avenue. No new people had come to live at 2 Central Avenue since the last inspection or for some years. The manager confirmed that there would be a full assessment of any prospective residents needs that would include the person and all the relevant people in their lives. This would help ensure that the persons needs could be met at this home. The service user guide had information on the preadmission assessment process. Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: A licence to occupy along with a pictorial service user contract was seen on a resident file. This had information for the resident on the services to be provided and the fees to be paid. Care Homes for Adults (18-65 years) Page 15 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 living at 2 Central Avenue can expect individual care plans that support staff to meet their care needs consistently and provide them with suitable care outcomes. Evidence: In the AQAA, the manager states that each resident has an extensive care plan and risk assessment in place that is reviewed six monthly. Two care plans were looked at and one assessed in detail. This had been reviewed since the last inspection. There was evidence that it had been read to the resident as part of their inclusion, as recommended at the last inspection. The care plan showed two specific areas that were currently being developed with the person relating to improving communication skills and life skills. These had clear directions for staff to follow to support their achievement. There were also numerous working practice documents that told staff how the person was to be supported in everyday practice. They were written from the residents viewpoint with I need or I like showing that the persons needs, abilities and preferences had been taken into account, as far as these were able to be determined. Each working practice area was Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: supported by a risk assessment and included issues such as bathing to help staff to promote health and safety. Limitations placed on residents were clearly recorded on the individual care files reviewed. These indicated the rationale underpinning the decision for the limitation, for example locking a kitchen cupboard to support management of eating inappropriate items. The completed staff survey received confirmed that the person felt they were given up-to-date information about the needs of the people they support for example in the care plan and through effective team communication. Some residents were unable to comment verbally on their care, however one person confirmed that they could make choices about what they did during the day and that the care they received at Central Avenue was fine. Care Homes for Adults (18-65 years) Page 17 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 . People living at 2 Central Avenue can expect to experience a developing range of opportunities and meaningful activities and to have a varied diet that meets their needs. Evidence: The managers AQAA states that people using the service are able to take part in appropriate activities including in the local community and this is an area where they have improved in the past year. In discussion, the manager advised of the wide range of abilities and the age difference between the residents, with the majority of residents being well past retirement age and that this needs to be considered when reviewing their social, leisure and occupation needs. None of the residents currently attend formal daycare placements or other communitybased educational projects. However, the manager advised that information has been obtained on accessing courses at the local college for one resident who was particularly Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: interested and suited. The care plans sampled included a weekly chart of activities for the individual person, and included household tasks enjoyed such as mopping the floor. Other planned activities included an aromatherapy session, watching television or a movie, going out for lunch or shopping. A resident spoken with confirmed that they go swimming, to the gym, local shops and to an evening club and another resident told us that they had gone to the cinema recently. Confirmation of this was seen in financial records and daily care notes, which provided good detail and also showed that residents recently went to a Christmas party. These and other records also indicated an increased range of activities at home including craft and cooking sessions. Staff spoken with said that these activities were more suited to the residents, taking into account their age and abilities. Residents were seen to be involved in a painting activity during the site visit. Records note that some residents have varying degrees of contact with their family, which is supported and encouraged by the manager and staff at Central Avenue. A resident confirmed that they met with their family regularly, would be spending Christmas with them and would enjoy a Christmas dinner and a pint. Staff were observed to offer residents choices during the day, for example in relation to what they had to eat and drink and when, where to spend their time and whether to participate in activities are not. A resident spoken with said that they chose what to do with their time, that their privacy was respected and that they had a key which they used to lock their bedroom door when they wished to. Staff were also clearly aware that some residents were not so able to indicate their preferences and make decisions verbally and were able to explain how they monitored the persons expressions and responses over time to interpret their choices. Ample food stocks were available. Residents were encouraged to join in preparation of the lunch during the site visit and were offered clear choices. A clear plan was in place for one person to support them to lose weight as part of a healthy living, healthy diet and exercise programme. There was evidence that person had been involved with this planning and that it had been effective. Staff advised that the menu plan is done at the weekends and is based largely on staff knowing what residents like and dislike, supported by residents who are verbally able to participate. A resident spoken with said that the food at Central Avenue is very nice. Two other residents confirmed that they had enjoyed their lunch. Care Homes for Adults (18-65 years) Page 19 of 33 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 . Residents of Central Avenue can expect to be supported to access healthcare services to meet their needs and to have their medication safely managed. Evidence: The systems for supporting the health care and medication needs of people using the service were reviewed to assess if residents needs were being met at Central Avenue. Care plans indicated the persons preferences in relation to personal care and identified the support they needed, along with the tasks they could complete themselves to support independence. They also took the residents privacy and dignity into account for example asking that staff knock on their bedroom door before coming in. Staff spoken with said that they supported residents to maintain their own privacy and dignity, for example by ensuring that only one person used the bathroom at any one time and that they were dressed appropriately going between bathroom and bedrooms. They also said that they knock and wait before going into a residents bedroom and encourage residents to respect each other in this way. In the AQAA, the manager said that one of the ways they have improved the service is with the use of individual healthcare plans. A separate healthcare plan was in place on the resident files sampled. They were supported by symbols and photographs to make Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: it easier for people to understand. They were also written from a person centred approach and had information on the support needed by the individual including in relation to medication, which is good practice. Records showed that routine appointments were maintained relating for example to chiropody, dentist and optician and a resident told us that they had got a new glasses this year. Care notes evidenced that staff monitored residents health and well-being, for example where a resident had a recent stomach upset, this was followed up and reported on in the subsequent care notes. The manager stated that residents have their medication reviewed every six months. Medication was safely stored. Records of medication received and administered were appropriately maintained. Routine medication audits were undertaken. The manager confirmed that all staff are trained in-house on medication as part of their induction and this was observed in practice. The manager also confirmed that staff have annual competence assessments and that he has recently attended updated medication training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Central Avenue can expect to be listened to and to be safeguarded by staff knowledge and training. Evidence: The AQQA confirms that no complaints had been received by the service in the previous year. However, at the site visit, the manager advised that a resident had recently made a complaint and that this was being investigated appropriately with the involvement of social services and the community nurse. The manager advised that they were unclear as to what the full content of the complaint was but that a formal outcome is now awaited. Although the Regulation 26 report states that the Commission had been informed, we had not received information on any complaints about the home since the last inspection. Pictorial information on how to make a complaint was displayed on the information board and is also included in the service user guide. There was evidence to show that the manager had undertaken updated training in safeguarding vulnerable people and so had met the requirement identified in the last inspection report. The whistleblowing procedure was clearly displayed in the office and so was readily available to staff, meeting the recommendation in the last inspection report. Staff spoken with, both permanent and agency, were able to demonstrate appropriate knowledge on defining ways of abuse can occur in everyday practice and appropriate Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: responses on reporting it. Records showed that most staff have had updated training in safeguarding vulnerable people and a new member of staff confirmed that their training on this subject was booked for the week following this site visit. Staff recruitment records did not demonstrate that effective recruitment procedures were in place to safeguard residents. This is considered further in the section on staffing in this report. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at 2 Central Ave have a homely environment with areas that would benefit from updating and more effective maintenance and repairs. Evidence: In the AQAA, the manager said that they provide a homely and personalised bedroom for each person and homely surroundings throughout the house, and that the home is warm, safe and secure. Most areas of the premises were viewed. All residents have their own bedroom and share a communal lounge, dining room, kitchen and bathroom. A resident showed us their room and confirmed that they found it comfortable. All bedrooms were decorated in individual styles and colour schemes. Another resident said that their bedroom was nice and decorated the way they liked it. The AQAA advised of plans to redecorate the communal areas, an issue also identified in the last inspection report. The premises remain very much as at the last inspection with communal areas being tired and in need of refurbishment and redecoration. A report undertaken on behalf of the registered provider as required by Regulation 26 noted that the decoration was due to have begun in October but did not explain why this had not occurred. Other Regulation 26 reports identified that the shower has been out of use for some Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: time and so was not available to those residents who would prefer to use this rather than have a bath. Again the report does not identify why this has not been effectively actioned. All areas of the home were seen to be clean and tidy and there were no obvious health and safety hazards. Hazardous items (Control of Substances Hazardous to Health) were safely stored, a noted improvement from the last inspection. Thermometers were also readily available to test bath water temperatures to ensure resident safety, another noted improvement from the last inspection. The AQAA identifies that all permanent staff have received training in the prevention and control of infection. 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 . Residents can expect to be supported by a trained staff team that will work positively with them to promote good care outcomes, but the quality of staff recruitment may not best safeguard residents. Evidence: Rotas reviewed confirmed information provided by staff that there are two staff on duty during the day and one awake staff at night. Staff spoken with advised that they find this is adequate to meet the needs of the people they support. Despite the recent recruitment of permanent staff, rotas show that there continues to be frequent use of agency staff. The manager confirmed they endeavour to use regular agency staff to support continuity for residents. The manager confirmed that all four permanent long serving staff members have achieved NVQ level 3. Information was not available on whether any of the regular agency staff have achieved this training although one person spoken to confirmed that they had not. The last inspection report contained a requirement relating to staff recruitment as profiles were not available for a number of agency staff that had provided care for residents. Profiles were sampled for three regular agency staff at this site visit to ensure the manager had clear information that staff had been safely recruited and Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: were appropriately trained to safeguard residents and promote quality care outcomes. These were readily available and so met the requirement identified in the last inspection report. The manager stated that recruitment is managed by the registered provider through their human resources department. Recruitment files sampled for two permanent staff recruited since the last inspection did not contain all the required records and checks. Neither contained a photograph of the person. Application forms had been completed online so were not signed to confirm the accuracy of the information. They did not have a full employment history or evidence that this had been explored, one did not include reasons for leaving the previous employment, they did not have a declaration of mental and physical health or of any offences as required to ensure that residents are safeguarded. Neither contained evidence of criminal record bureau check but did have a memo from human resources department advising that these had been obtained. A letter of serious concern was immediately sent to the registered person who responded promptly to advise of actions taken and of a more effective system to manage recruitment files in the future. This includes joint responsibility being with both the human resources department and the registered manager of the home to ensure these are in place before a staff member commences their first shift at the home. A requirement relating to staff recruitment will remain included in this report. Induction records were in place for both members of staff that included Skills for Care induction logs, which the staff are currently working through. While written records were not available, there was information on computer of training completed in risk assessment, moving and handling, first aid and in-house medication. There was also evidence of booked training on safeguarding and food hygiene. The training undertaken as part of the induction was confirmed by a staff member spoken with and in the staff survey received. There was evidence that both new staff were being provided with regular formal supervision meetings by the manager that covered appropriate topics and supported them through their induction. In the AQQA, the manager states that one of the things the service does well is the provision of staff training that they plan to continue to have updates and to recruit more permanent staff for the home. A training matrix was not maintained. The manager said they leave this to the registered provider to manage and to know the dates that updated training is needed for each staff. Each permanent member of staff has an individual training plan and a training file that contains certificates showing that they have access to regular basic training issues such as moving and handling, food safety, fire and health and safety. Profiles viewed for agency staff also confirmed that they have had appropriate basic training and updates. 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 . Residents can expect a management approach that is developing systems to better gain their views and promote their best interests. Evidence: The manager has been in post for some time and has one supernumerary day each week for managerial tasks. The manager advised that they have undertaken a range of training since the last inspection to keep their knowledge and practice up-to-date including leadership skills, safeguarding adults, moving and handling, health, safety and fire training, risk assessment, first aid and medication training and so complying with the requirement in the last inspection report. The manager stated that they are getting more information on budget planning and allocation from the registered provider and are now having more input to these. They are also having regular meetings with their service managers to support development and more effective communication between the registered provider and the manager of the care service. This report demonstrates that the manager has complied with a number of requirements and recommendations from the last inspection. As stated in the section on staffing, more effective systems are being introduced to jointly manage Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: and ensure robust recruitment procedures. The manager advises that most of the current service users have some communication difficulties. However meetings have been introduced for residents that include relatives and some professionals as a way of trying to ensure that the views of people who use the service are promoted. The minutes of these meetings contained limited detail, particularly on resident input. The manager stated they also plan to survey relatives, friends and healthcare professionals as a way of gaining views on the quality of the service provided. While they have not been undertaken monthly as required, following requirements in previous inspection reports, it is noted positively that the registered provider has undertaken more regular visits to Central Avenue to ensure that it is running properly. The reports of these visits were informative but showed less than effective systems in place to action issues that needed to be addressed by the registered provider, for example the shower being out of order and the portable appliance testing being out of date for some time. Systems for recording accidents and resident finance were reviewed. Accident and incident records were appropriately maintained. The system for managing residents money was sampled. A weekly float system had been introduced to promote safe management of residents personal allowance. Safe storage was available. Very recent individual records and receipts were available, with other records being returned to head office on a weekly basis for audit. A separate record was also available that noted the date, the amount spent and what was purchased for each person and was signed by a member of staff. The majority of records examined relating to health and safety were satisfactory. Regular checks had been undertaken of the hot and cold water systems. These are not monitored by the manager as part of a premises quality assurance audit. Where they showed regular inappropriate readings, no action was taken. The manager stated that they would review with staff how to take accurate readings. A new fire alarm and emergency lighting system was installed since the last inspection and records evidenced that these were checked regularly. Regular fire drills were recorded that included the name of the staff that attend. A current safety inspection certificate was available relating to the fire equipment. Care Homes for Adults (18-65 years) Page 29 of 33 Are there any outstanding requirements from the last inspection? Yes  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 39 26 (2) (3) (4) To ensure that the home is 01/02/2008 (5) (c) running in a manner appropriate to the needs of the residents the registered provider must undertake regular monthly visits to the home under Regulation 26 and prepare a written report on the conduct of the home. Previous timescales of 01/08/06 and 30/10/07 not met. 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 Description 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 Description Timescale for action 1 34 19 Staff must not be employed to work at the home unless all required information, references and checks have been obtained in respect of that person and evidence of these is available. 14/01/2009 To safeguard residents. 2 39 26 The registered person to 31/01/2009 arrange to visit the home unannounced at least once a month and take timely and effective action to address any shortfalls noted. To review the quality of the standard of care and services provided to residents and support its maintenance. 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 Care Homes for Adults (18-65 years) Page 31 of 33 improving their service. No Refer to Standard Good Practice Recommendations 1 24 Furniture and decoration in the communal areas should be better maintained and updated to provide residents with a more pleasant living environment. More effective and timely maintenance should be employed to repair the shower so that residents have a choice and can have their preferences met. The manager should implement a system to routinely audit health and safety checks and should also ensure that staff are competent to undertake the checks recorded. To safeguard residents, the portable appliances used in the home should be routinely checked. 2 27 3 42 4 42 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). 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!