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Inspection on 04/12/08 for 20 - 32 Horton Street

Also see our care home review for 20 - 32 Horton Street for more information

This inspection was carried out on 4th 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: 20 - 32 Horton Street 20 - 32 Horton Street West Bromwich West Midlands B70 7SG     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: Linda Elsaleh     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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 20 - 32 Horton Street 20 - 32 Horton Street West Bromwich West Midlands B70 7SG 01214152720 01214728449 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sense, The National Deafblind and Rubella Association care home 7 Number of places (if applicable): Under 65 Over 65 0 sensory impairment Additional conditions: Date of last inspection Brief description of the care home 7 Horton Street is a purpose built residential care home registered to provide care and accommodation for 7 adults with sensory disabilities. Care is provided by Sense and the building is owned and maintained by a housing association, Black Country Housing. The home is situated in an industrial area that is being regenerated. Its position is convenient for shops in the immediate vicinity, West Bromwich Centre, the Metro to Birmingham and Wolverhampton, Sandwell Valley and swimming in Halesowen. The service has its own transport and there is limited off-road parking to the side of the building. The home has 6 single bedrooms in the main body of the home. Each bedroom has an en-suite with toilet, basin and accessible shower. There is kitchen, lounge, dining room, laundry, 2 bathrooms (assisted bath is provided in the ground floor bathroom). There is also a self-contained accommodation for one person on the first floor. At the rear of the premises is a large rear garden with paved and lawn areas. For information about weekly fees the reader should contact the service. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This unannounced inspection was carried out on 4th December 2008. The purpose was to assess the services performance against the key standards in the National Minimum Standards for Care Homes for Adults. Our findings are based on the information received by the Commission for Social Care Inspection (CSCI), examination of relevant records and documents kept at the home and discussions with staff and observations made during this visit. At the time of this visit the newly appointed manager had yet to take up his post. The Care Homes for Adults (18-65 years) Page 5 of 29 day-to-day management of the service was being carried out by the two deputies. They were being supervised and supported by the Area Manager. The atmosphere within the home was relaxed and friendly. A tour of the premises found it to be suitably furnished, clean and tidy. What the care home does well: What has improved since the last inspection? The service has made improvements to its assessment process by ensuring it is in receipt of a completed Community Care Assessment for people who are funded by the Local Authority. It has improved the information provided in peoples care plans to ensure all their personal, health and social care needs are identified. The provision and quality of the activities offered to people living at the home has improved, with more focus placed on being age appropriate. The staffing complement for the service has been increased by the recruitment of another deputy manager and senior care assistant ensuring suitable staffing levels are maintained. A senior, experienced staff member is identified on each shift that is responsible for ensuring peoples needs are being met appropriately and to provide staff with guidance and support. Procedures are in place for use of agency/bank staff. The service is supported by the organisations bank co-ordinator to ensure appropriate employment checks have been carried out and the person is suitably experienced and trained to meet the needs of the people living at the home. People are protected from abuse by the arrangements made for all staff to receive training in adult abuse. The service has reviewed its whistle blowing policy and a copy of the local authoritys Safeguarding Vulnerable People procedure is available in the home. Care Homes for Adults (18-65 years) Page 7 of 29 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is available to enable people to make an informed choice about where to live. There needs and aspirations are fully assessed prior to coming to live at the home. The service arranges for people to visit the home and a trial period is agreed before a placement is confirmed. Evidence: A copy of the Statement of Purpose was provided to us by the service. This was last reviewed in May 2008. Staff told us this document is available in alternative formats on request. The Service User Guide is produced in the individuals preferred format. Copies of documents produced in alternative formats were not made available at this visit. Seven people are living at the home and all have been resident for over 12 months. The organisation has a structured referral and assessment process to ensure the needs Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: of the person can be met by the service. The assessment process includes opportunities for the person to visit and for her/him to spend a trial period at the home before a decision is made to confirm the suitability of the placement. We looked at the file for the person who last came to live at the home. It contained information about the persons history, preferred method of communication and lifestyle. A copy of the assessment carried out to identify the individuals personal, health and social needs and how these can be met is available on her/his file for which a care plan is produced. Records are also kept of any changes identified during the trial period. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and personal goals are reflected in their care plans. They are encouraged to participate in decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: We looked at the care plans for two people. The plans included peoples needs, interests, preferred routines and how these are to be met. There are systems in place for monitoring and regularly reviewing care plans. In-house monitoring meetings are held each month. Review meetings include the persons relative/representative and relevant health care professionals. Records of these meetings are held on the persons file and care plans are amended accordingly. The records we looked at contained few details of how people are encouraged and supported to make decisions. Staff told us there are times when they make decisions on behalf of people who are unable to communicate their wishes. This is based on their Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: knowledge of the person likes, dislikes and interests. For example, staff chose the colour scheme and soft furnishing for one persons recently decorated bedroom. Information provided to us by the service shows it has identified the need to improve its recording systems for supporting people to make decisions and when decisions are made on their behalf. It has also identified staff would benefit from more training in effective communication skills, ie hand under and hand over signing, is being given priority. Training is also being planned on the Mental Capacity Act. At present the service consults with individuals on a day-to-day basis and during their individual monthly meetings. It is looking at providing opportunities for people to support each other in expressing their views about the service. For example, it is considering the benefits to the current group of people living at the home of regular residents meetings. Individual risk assessments are carried out where concerns have been identified that there is a potential for harm. For example, the file we looked at for one person shows s/he requires assistance to bathe. This is provided by staff members who have been trained in the use of the hoist. Pictorial information on the use of the hoist is available to staff and the person receiving support. Another persons file has a risk assessment to ensure s/he is able to safely enjoy her/his regular trips swimming. A recently reviewed risk assessment showed changes in a persons behaviour had reduced the risk of her/him self-harming. The risk assessment had been amended to reflect this. Staff we spoke to showed us they are familiar with peoples risk assessments and the action to be taken to protect individuals from harm. At times people living in the home present behaviours that challenge the service. These behaviours have the potential to cause harm to the individual or others. Staff told us they work closely with the organisations behaviour support team to identify possible triggers for the behaviour and to develop strategies for protecting people from harm. The behaviour support team also provide training for staff in dealing safely with behaviour likely to cause harm. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in a range of activities, maintain links within the community and relationships with family and friends. They are treated with respect and dignity. Meals are provided that meet peoples dietary needs, likes and dislikes. Meals are served in pleasant surroundings and people are supported to enjoy mealtimes. Evidence: People are encouraged discuss their lives and experiences. This provides opportunities for them to develop their communication and social skills. Support is provided to help them produce their own life books and memory boxes. Staff told us this enables them to find out more information about peoples interests and the kind of activities they would like to try. Senior staff said these activities have identified some shortfalls of skills within the team. Hence, more training is being planned in communication Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: methods and intensive interaction. Care plans we looked at show one person enjoys listening to her/his music on their own, one likes to spend time in the garden and two others enjoy painting. A wooden 3-room building has been erected in the garden to provide more opportunities and space for people to participate in a range of activities. Once fully equipped, this will provide art & craft, sensory and relaxation rooms. The service has its own transport. The number of drivers within the staff team has increased. This enables the service to provide more planned and unplanned activities in the community. Staff told us the provision of in-house and community-based activities has improved and is becoming more age appropriate. For example, staff identified two people who enjoy music and told us they are looking at suitable nightclub venues for them. Arrangements are also made for people to take a holiday. The most recent was a trip to Wales for two people who were supported by three staff. We were told everyone had enjoyed the holiday. The service has policy for facilitating contact with/visits by family and friends. Staff demonstrated awareness of the importance of supporting people to maintain relationships. This includes keeping contact by telephone and letters and/or e-mails. Care plans show some people are provided with transport to visit family and/or be supported during visits by a member of staff, where required. One person has relatives who live overseas and staff told us they are looking at how s/he could be supported to visit them. Peoples preferred routines are included in their care plans. Staff respect peoples right to privacy and gave examples when some people like to spend time alone, such as listening to music in their own room. We observed people being addressed by their preferred name and being encouraged to make their own choices about what they wanted to drink or where they wanted to sit. Staff identified two people whose routines must always be followed very closely in order for them to be happy and feel safe. Both people do not like change and require one-to-one support throughout the day. The service has identified a small team of staff for each person. A worker from each team is allocated to provide care and support in a way that meets the individuals needs and in the way s/he prefers. Each person is offered a choice of meals. A record is kept of their dietary needs, likes and dislikes. The records for one person shows regular meetings are held with her/his GP, family and health care professionals to ensure her/his dietary needs are and continue to be met appropriately. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: People generally take their meals in the pleasantly furnished dining room. The meals are well presented and people who require support to eat receive this in a sensitive manner. Staff we spoke told us they had attended training in basic food hygiene. Certificates are available on their files. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal, physical and emotional are needs are met in the way they prefer and require. They are protected by the services procedures and practices for dealing with medication. Evidence: Personal care needs and how these are to be met are included in peoples care plans. As previously stated, it is important for some people that these are very closely followed. Good arrangements have been made for this to happen. Other people enjoy some changes and the service is able to provide this flexibility. Personal care is always provided in the privacy of the persons bedroom or the bathroom. Visits made by health care professionals also take place in private. There are good systems in place to ensure peoples health care needs are met. Records are kept of visits made to or by health care professionals. These show us people receive regular routine healthcare checks from professionals such as their doctor, dentist and chiropodist. The service is transferring peoples health care plans to a more up to date format. It has identified a need to ensure follow-up appointments Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: are clearly recorded to reduce the risk of these being missed and to ensure a key member of staff is on duty support the individual. The service works closely with a range of specialist health care professionals. Regular hearing and vision assessments are carried out by specialists who are available to provided advice and guidance to staff. Training has been provided to some staff to help them support people with other health-related issues such as diabetes and epilepsy. It is the services intention for all staff to receive this training. The services control, storage, disposal, recording and administration of medication procedures were reviewed in 2008. Information provided by the service states none of the current people living at the home are able to self-medicate. Therefore, this is managed on their behalf by staff that have been trained to do so. The small team of staff that provides care and support to a person who has diabetes are trained to administer her/his insulin. We looked at the medication administration record (MAR) sheets for two people. These appeared to be in order and the relevant codes are being used when required. Periodic in-house competency assessments are carried out with staff and where there are any concerns have been raised about practice. This shows us the service has good systems in place for dealing with and addressing medication issues. The arrangement for the storage of medication is adequate. However, following discussions at previous visits, the service has reviewed its storage arrangements and identified another location which they feel is more suitable. This was being prepared at the time of this visit. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 express their views and have these listened to and acted upon by the procedures and practices in place at the home. There are procedures for protecting people from abuse, neglect and self-harm. They are supported by staff trained in adult protection. Evidence: Details about how to make a complaint are available in the Statement of Purpose. It also informs the reader how to obtain a full copy of the complaint document. This was last reviewed in 2007. Information provided by the service shows no complaints have been received by them during the last 12 months. This was confirmed by staff and they told us they were aware of how to deal with any concerns or complaints raised with them. No complaints about the service have been reported to us (Commission for Social Care Inspection). Adult protection policies and procedures are available in the home. The records for staff we looked at show they have attended training in safeguarding vulnerable adults and regular refresher training is also arranged. Staff confirmed they have received training and are familiar with the procedures to be followed should any concerns be raised. The organisation has a whistle blowing policy and disciplinary procedures. It is Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: currently investigating reports that a member of staff has not been following procedures. This demonstrates the organisations commitment to ensuring people receive a good service and are not placed at risk or potential harm by poor performing staff. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at this home live in a homely, clean, safe and comfortable environment which is well maintained. Evidence: Horton Street is comfortable, clean, accessible and homely. A programme of redecoration and refurbishment is in progress. This has included, as previously stated, a wooden building in the garden to accommodate a wider range of activities. New dining furniture has been purchased and the floor covering has been replaced here and in the hallway. The flooring in the kitchen has been replaced, cupboards upgraded and a new cooker installed. We saw two recently re-decorated bedrooms. The lounge in the selfcontained accommodation is in the process of being decorated. There are plans for the bath and shower rooms to be upgraded. Aids and adaptations are provided such grab rails, bath hoist and hearing loop system. Senior staff told us it is the intention to introduce sensory elements to each room such as tactile markers and sensory walls. Regular checks are made and routine maintenance on the premises is carried out to ensure the environment is safe and free from hazards. Information provided by the services shows it has procedures for the prevention and control of infection and over 60 of staff has received training. The files of two staff Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: we sampled show they have received this training. Training for other staff is to be arranged. We observed staff wearing the appropriate protective clothing when carrying out personal care, catering and domestic tasks to ensure the risk of cross contamination is reduced. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience 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 by adequate numbers of competent and appropriately staff so their needs can be met. They are protected by the homes recruitment practices. Evidence: During the last twelve months nine members of staff have left the service and new people recruited to the vacant posts. The service has identified the retention of staff as an area it will be looking at. The staff complement has increased with the appointment of another deputy manager and senior member of staff. The service has two designated practice development workers that have responsibility for carrying out assessments with staff and identifying the teams training needs. Information provided to us by the service show nine of the sixteen care staff hold a National Vocational Qualification (NVQ) Level 2 or above. The file of member of staff who has been employed for over two years shows s/he obtained the NVQ Level 3 certificate in June 2008. The rotas show each shift has appropriate staffing levels and is run by a senior staff to ensure peoples needs are appropriate meet. On the day of this visit the staff members named on the rota was on duty. The two people identified as requiring one-to-one Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: support were receiving this from one of the workers in the small team allocated to them. New members of staff are recruited in line with the organisations procedures. We looked at the file of the most recently appointed member of staff. The records kept included a completed application form, health self-assessment and notes from her/his interview. References were obtained and satisfactory security checks received prior to the applicant commencing employment. The records and certificates on the persons file shows a comprehensive training programme had been completed as part of the induction and probationary process. The persons file shows they received four individual sessions, a practice observation and a probationary review during the first six months of employment. There are times when the staff team is supported by a casual worker. The organisation has recruited a bank co-ordinator who is responsible for ensuring relevant employment checks are carried out, the worker is suitably experienced and receives appropriate supervision and training. Staff we spoke to told us they feel they are provided with good opportunities for training and, where a specific training course is not available from the organisation, arrangements are usually made for this to be provided by an external trainer. They told us the provision of individual supervision sessions had improved and working towards a planned monthly supervision session for each member of staff. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are living in home that is run well and where their views underpin selfmonitoring, review and development of the service. They should benefit further from the leadership of a designated manager. The service has procedures for promoting and protecting the health, safety and welfare of the people who live here. Evidence: The day-to-day running of the home is being carried out by the deputy managers under the supervision of the Area Manager. A person has been appointed to the post of manager and is due to commence in January. A registration application for the manager should be forwarded to us (CSCI) as soon as possible. Regular visits are made to the home by representatives from the organisation to assess the services performance and a report is produced based on the findings. Surveys are sent periodically to relatives and other interested parties as part of the services quality assurance. This process has enabled the service to identified areas for further development, such as practice and training issues. One area in particular the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: service has identified is to provide people with a more stable staff team by looking at ways to improve the retention of staff. The service has good records of routine checks, servicing and inspections of appliances and equipment. Health and safety training for staff includes safe working practices. Accident records are appropriately maintained and, where applicable, the relevant agencies notified. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 42 23 Copies of bacteriological 30/09/2006 certificates must be provided to the Commission for Social care Inspection Requirement first made March 2005 and not met at this inspection August 2006 Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 1 The serivce is advised to keep copies in the home of documents that provide information about the service available in alternative formats. Systems should be implemented to record how people are supported to make decisions and where any decision is made on a persons behalf to show it has been made in the persons best interests. The service is advised to include prevention and control of infection in the training programme for staff that have not yet received this training to ensure they understand the procedures and aware of the importance of following good practice. An application for the registration of the newly appointed manager should be forwarded to CSCI as soon as possible. 2 7 3 30 4 37 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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