Inspection on 11/11/08 for 295 Long Lane

This inspection was carried out on 11th November 2008.

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

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

Other inspections for this house

295 Long Lane 20/06/07

295 Long Lane 21/06/06

295 Long Lane 19/01/06

295 Long Lane 01/02/05

295 Long Lane 27/07/04

295 Long Lane 13/02/04

Similar services:

Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

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Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 295 Long Lane 295 Long Lane Grays Essex RM16 2QD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bernadette Little     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 295 Long Lane 295 Long Lane Grays Essex RM16 2QD 01375387952 Telephone number: Fax number: Email address: Provider web address: jane.fox@familymosaic.co.uk Name of registered provider(s): Type of registration: Number of places registered: Family Mosaic care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 295 Long Lane is part of the Family Mosaic organisation and provides care and accommodation for four adults who have a learning disability. The home is a large bungalow situated in a residential area of Grays. There is a pleasant and well maintained garden which includes a sensory area and a fishpond. The home is close to local amenities in the town of Grays, and is a short journey away from the A13 / M25 and Lakeside Shopping Centre, Thurrock. A statement of purpose is available and people can access copies of CSCI reports. Current charges at the home were said to be 1,179 pounds per week. Residents pay extra for some transport costs, some activities, chiropody and any special individual therapies such as aromatherapy. 4 Over 65 0 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: In June this year, we looked at the information we had about 295 Long Lane as part of their Annual Service Review, and decided that we needed to do a full Key Inspection. As part of this key inspection, we visited 295 Long Lane and spent seven hours there one day. We spent time with residents who were at home during the day and one person was able to tell us something about the home. We saw the way that staff talked with the people who lived at the home and the way they supported them. There have been different people managing the home lately and one of them sent us the Annual Quality Assurance Assessment that we asked for. This tells us what they think they do well, what they have done better lately and what else needs to be done. This information was looked at as part of the inspection and is part of the report. Care Homes for Adults (18-65 years) Page 5 of 29 Before we went to the home, we sent the manager some surveys to give out to people who use the service, to relatives, staff, care managers and health care professionals. These ask questions about how they feel the service works. We got surveys back from one person who uses the service and two from staff. We also got some information in a survey from a visitor between the annual survey review and this visit. We looked around the home as well as at some policies and procedures that tell staff the way things should be done. There was no manager at the home for most of the visit. The care staff we met were very helpful. We told them about the things we found during the day so we could make sure that we had the right information. We would like to thank all the people who helped us with the inspection of 295 Long Lane. 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 7 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 8 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. People thinking of 295 Long Lane will have a full assessment of their needs to make sure that the service can meet them, but may not have access to all information they need to help them make a decision about living there. Evidence: The statement of purpose and service user guide were requested for review. These are documents that provide information about the service to people who might be interested in it. The statement of purpose was inaccurate as it stated that there was currently a registered manager at the home and named the previous manager. The Annual Quality Assurance Assessment (AQAA) states that the scheme has a service user guide with a DVD. The last inspection report contained a recommendation that the home should develop a service user guide that was suitable and relevant to the needs of potential service users of the home. It was confirmed by staff at the site visit that no service user guide was available in the home. Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: A survey from a resident indicated that they had been asked if they wanted to live at the home and that they had been given enough information about the home before they moved in so that they could decide if it was the right place for them. Staff confirmed that there had been no new admissions to the home for some years. A recently reviewed policy and procedure folder contained an admission procedure that included gathering information from a range of sources, including the prospective resident, as making a full assessment of their needs prior to any admission. The manager from another service who attended part of the site visit confirmed that a comprehensive pre-admission assessment process would be undergone before any resident was admitted to the home. Care Homes for Adults (18-65 years) Page 10 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. People living at 295 Long Lane can expect detailed care plans that support staff to meet their care needs consistently and provide them with good care outcomes. Evidence: In their AQAA, the manager states that each resident has a well-documented support plan and care file. Care plans were reviewed for two people who use the service. They included short and long-term goals for each person on a wide range of aspects of daily living including personal care, health management, finance and social opportunities. Information was easy to find making them user friendly in daily practice for staff and therefore a more effective document. They were written from the resident viewpoint with I need or I like showing the persons needs, abilities and preferences had been taken into account, as far as these were able to be determined. Daily care records were routinely completed to show how people spend their day and the support offered, so providing a resource for monitoring the effectiveness of the Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: care plans. A monthly support plan review had been undertaken by the persons key worker. This helps to ensure that the care plan is still right for that resident and gives an opportunity to assess and make any amendments. Limitations placed on residents were clearly recorded on the individual care files reviewed. These indicated the rationale behind decision for the limitation, for example the use of a listening device to monitor both for seizures and to assist in identifying a specific and known noise trigger so that staff could intervene at an earlier stage and offer support to the person before their behaviour escalated. Risk assessments were seen to be available and recently reviewed and included issues such as falls management, mobility, going out in the minibus, swimming or going on holiday. Surveys received from staff confirmed that they are given up-to-date information about the needs of the people they support, for example in the care plan. Residents were generally unable to comment fully on their care, however one person confirmed in a survey that they could make choices about what they did during the day. Staff on duty related well to all residents and the staff we spoke with demonstrated a good understanding of residents needs. Care Homes for Adults (18-65 years) Page 12 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 living at 295 Long Lane can expect opportunities to experience meaningful activities and to have a varied diet that meets their needs. Evidence: The managers AQAA states that people using the service have a varied and individual choice in relation to social activities on offer and that they actively enjoy outings, social gatherings and one-to-one with their keyworkers to places of interest to their own individual tastes. They recognised the need to look for ways to develop exploring new friendships and encouragement to support similar interests with other service users. The care plans sampled considered peoples social/leisure/occupation needs and preferences. They also identified specific requirements to support these, for example Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the need for one-to-one staff, or consideration of how some events with particular lighting may affect a persons epilepsy. The four weekly key worker support plan report identifies in detail, and reviews, the meaningful activities both inside and outside the home that each person has participated in. None of the residents attend formal daycare placements or other community-based educational projects. Each person has a weekly opportunity plan in place. Those viewed, and caring notes sampled, included for example records of one-to-one shopping at Lakeside, going to the barbers for a haircut, going out for a walk locally, aromatherapy sessions, light/sensory sessions, hand massage, cooking, helping with the washing and chatting with staff. Two residents were going on holiday the week following the site visit and the other two were going out for a meal one evening. A resident spoken with confirmed they were going on a trip to the transport museum in London and they were clearly looking forward to this. They also confirmed other outings that they had been on recently. Records note that one resident has regular contact with their family. Staff spoken with confirmed that contact with family/friends is encouraged for all residents where this is available. The survey from the visitor confirmed that people are usually supported to live the life they choose wherever possible and that staff have the right skills and experience to meet residents social care needs. The AQAA made no reference to food and nutrition for residents. There were appropriate food supplies available in the home and a six-week rotating menu was in use to support variety. Information was maintained in the kitchen that confirmed that in care plans and showed specific mealtime information and differing care needs for residents in relation to food and nutrition. This included specific instructions for one resident who needed feeding, how to interpret their responses and was supported by a risk assessment and a copy of their communication support plan so that staff had full information on the persons preferences. On the day of the site visit, residents had home-made shepherds pie for lunch and a resident confirmed that they liked it. A clear record was maintained of the food served/eaten for each person, each day and for each meal. Observation of the lunchtime meal showed that staff sat with residents, interacted with them and offered them support in a way that met their needs and respected their dignity. Care Homes for Adults (18-65 years) Page 14 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. Residents of 295 Long Lane can expect to be supported in a dignified and respectful way, to access health care services to meet their needs and to have their medication managed safely. 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 295 Long Lane. The AQAA advises that staff knowledge of each individual resident is used to support the person in these areas. Staff showed awareness of peoples individual needs and preferences for example in relation to personal space. Each person has an allocated keyworker and there was evidence of a four weekly keyworker support plan review. 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 I like a bath each morning and ask that staff knock on my bedroom door before entering and make sure I am appropriately dressed before I go from my Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: bedroom to the bathroom. Care plans identified specific needs such as epilepsy from a person centred approach, and identified goals such as enjoying optimum health. This included an annual health check plan, identified clear timescales for checkups and interventions such as the dentist and chiropodist and regular medication reviews. Records showed that these had occurred. They also indicate that staff monitored the health of residents, for example noting a cough and arranging an escort for the person to see the GP. Inhouse health monitoring also included maintenance of epilepsy and weight charts. Medication was safely stored. A monitored dosage system is used. The Medication Administration Records were appropriately maintained with no gaps in recording and concurred with the medication available for that person. In the AQAA, the manager confirmed that all staff are provided with external training on the monitored dosage system and trained in-house on medication as part of their induction. Staff do not administer medication until this training is completed. Staff advised that they have annual updates on the system but do not have annual in-house medication updates or competence assessments. Protocols were in place for medication administered on an as required basis to support effective care outcomes and monitoring. Medication administration was observed to be undertaken in a way that respected the person. Care Homes for Adults (18-65 years) Page 16 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 living at 295 Long Lane can expect to be safeguarded by staff knowledge and training, but may not be so reassured by staff recruitment procedures. Evidence: The AQAA states that no complaints have been received by the service in the past year and this was confirmed by staff. The Commission has not received any information of complaints about the home since the last inspection. A clear complaints procedure was readily available in the home and information about it was displayed. The suggestion from the last inspection that they should include information that people can go to Social Care (Social Services) with concerns, had not been actioned. There was limited information displayed in pictorial format for residents regarding things that they might not be happy about. It did not support them with information on what to do in that case. The survey received from a resident indicated that they would know how to make a complaint and who to speak to if they were not happy. Surveys received from staff confirmed that they would know what to do if a resident, relative etc had any concerns about the home. Family Mosaic notified us promptly about to safeguarding events at the home. These had been referred appropriately to both the safeguarding team and the police. Formal outcomes are awaited from the professionals involved. With agreement, a senior Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: manager from Family Mosaic carried out an internal investigation, suspended the manager, put actions in place to improve safety for residents at the home and reinforced information for staff on reporting incidents effectively. Actions included changes to the premises that were observed in place at the time of the site visit. Staff spoken with confirmed that, as a result of the safeguarding events, they had had a group meeting where they had been reassured by a senior manager at Family Mosaic to report anything that concerns them, not to be worried about whistleblowing and that they would be supported. Three staff spoken with said that they had had recent training on safeguarding vulnerable people, although this was not borne out in training records reviewed. However, in discussion, staff were able to identify types of abuse and demonstrated clarity and confidence in reporting it appropriately. Staff recruitment records were not available to evidence that effective recruitment procedures were in place to safeguard residents. This is considered further in later sections of this report relating to Staffing and Management. Care Homes for Adults (18-65 years) Page 18 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. People living at 295 Long Lane have a comfortable and well maintained environment that meets their needs. Evidence: All areas of the premises were viewed. Since the last inspection, the premises had been completely redecorated. A resident showed us their room and confirmed that they found it comfortable. It also reflected a particular personal interest with pictures and ornaments. All bedrooms were decorated in individual styles and colour schemes. All residents have their own bedroom and share a communal lounge, dining room, kitchen and bathroom. New furniture has been provided for the dining room. The AQAA advised of plans to fit a new kitchen, possibly in September this year, but this is still awaited and expected. There was a well maintained garden with a sensory area and pond. A resident advised that they had done gardening and that they fed the fish. Changes have been made to the premises such as to remove the dado rail and level the floor between rooms in some areas, to promote and residents well-being and safety as part of a falls management programme. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: All areas were seen to be clean and tidy and there were no obvious health and safety hazards. Cleaning schedules were in place and had been routinely recorded as completed. Good practice was observed in relation to hand washing as part of infection control management. Care Homes for Adults (18-65 years) Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to be supported by a consistent staff team, but shortfalls in recruitment, induction and training processes do 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 advised that this is adequate to meet the needs of the people they support. There are currently seven permanent members of staff working at the home, one of whom is on long-term leave. Rotas show that there are also regular bank staff, to support continuity of care for residents. Staff stated that four of the bank staff are medication trained so they are competent to provide this support to residents should there be no permanent staff on duty. Staff spoken with confirmed the information in the AQAA that three of the permanent staff have achieved NVQ Level 3 in Care. Some of the staff have worked at the home for a number of years and were clearly aware of residents needs and personalities. Warm and friendly banter and responsive non-verbal communications were observed that indicated interactions with staff provided positive relationships for residents. New staff had been recruited to work at 295 Long Lane since the last inspection, Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: including some who have transferred from other Family Mosaic services. No recruitment records were available for two transferred staff. Only some required records were available for another member of staff to evidence robust and effective recruitment processes to safeguard residents. There was no references, evidence of identity, employment history, Povafirst or full original criminal record bureau check. This is an outstanding requirement from the last inspection report. An immediate requirement form was issued to the senior person at the home and a formal response is awaited from the registered provider on how this matter is to be addressed. Induction records were requested for three staff. A format to Common Induction Standards was available for one person who was recorded as having started work at the home some months ago, but it was almost completely blank. The staff member had regularly worked alone with residents. The supporting manager advised training is now booked for the staff for this week on safeguarding vulnerable adults and health and safety. They have also this week attended a one-day organisation induction and personal safety training that includes management of challenging behaviour. No induction or training record was available for another member of staff who had recently transferred to the service. An induction record for the third member of staff was not available. It was stated that it was in their possession as they were currently working their way through it. There was no evidence of training for the staff member who had been in post for over three months although it was stated that they had attended safeguarding and personal safety training. A training file was available and contained records for only three of the permanent staff. Staff advised that certificates are no longer provided by the organisation for training attended and they are required to record training on their individual training record. Records available indicated for example that some staff did not have updated moving and handling training for three years, and that staff had had no training on fire, health and safety or challenging behaviour. Staff spoken with stated the records were not accurate or up-to-date. The supporting manager provided evidence that they had undertaken supervision sessions for one staff member to support them through their induction/probation period. There is insufficient management support to the service for the remaining staff to have regular supervision and this was confirmed by staff spoken with. Care Homes for Adults (18-65 years) Page 22 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect a management approach that in many ways promote their best interests, but where the recent period of management instability and some management systems may not best safeguard them. Evidence: We undertook an Annual Service Review of 295 Long Lane in June 2008. This identified shortcomings in management responses and information. Because of this, the recent safeguarding issue and the failure of the service to distribute surveys as requested to other stakeholders so that we could gain their views, we changed our inspection plan to undertake a full Key Inspection of the service. In the previous six months there has been a period of unsettled management and the registered manager resigned. The home was then supported two and a half days each week by the registered manager of another home, who was also still managing their own service. A permanent manager was appointed for 295 Long Lane to commence the post at the beginning of October. Unfortunately, the new manager is currently on Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: sick leave and there is no identified person managing the service. The manager from the other service is now providing some basic support one day a week to Long Lane, for example to audit medication and resident finances. The remainder of the time, two long serving members of care staff are overseeing aspects of the everyday running of the home. Some aspects of the service continued to progress effectively. Other aspects of management need attention, including the registered provider ensuring that the outstanding requirement from the last inspection report to evidence robust recruitment procedures is met so that residents are safeguarded. The registered provider also needs to demonstrate effective staff induction, training and supervision. As part of this key inspection process, surveys had again been sent to the service to distribute. The supporting manager advised that they had sent some to healthcare professionals. The remaining surveys for residents, staff and relatives were on the desk in the office. We asked for them to be distributed to staff the complete and for staff to support any resident able to participate in responding to the survey. The required visits to be undertaken monthly on behalf of the registered provider to assess how the service is running, had been completed by the supporting manager until July 2008. It was then recognised by the registered provider that this was inappropriate. A further visit had been undertaken by an appropriate representative of the registered provider in August 2008. That was no evidence that the required visits to monitor and support the service had been undertaken for September and October. The AQAA states that regular quality assurance surveys are undertaken by the organisation. Staff were unable to provide access to evidence of this. The AQAA also identifies a plan to introduce specific meetings for residents, ensuring support and a positive environment to promote their individual choices. Policies and procedures are in place for residents money. Records of two residents money were sampled and were found to tally. Accident records reviewed contained relevant information and showed evidence that they had been returned regularly to Family Mosaic where they had been reviewed and signed by a senior manager. Monthly health and safety audits had been completed until September to ensure there is a safe environment for residents and staff. Regular checks had been completed by staff on hot and cold water temperatures and fire alarm and emergency lighting systems. Current certificates were available for these as well as for fire equipment, water tank disinfection, gas and the assisted bath. Fire drills were recorded as occurring monthly. Care Homes for Adults (18-65 years) Page 24 of 29 Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 34 19 The home must be able to evidence that residents are protected by staff being recruited safely. Staffing records as required by regulation must be available for inspection. 01/09/2007 Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 34 19 Make available staff recruitment records to evidence robust recruitment procedures. To safeguard people using the service 25/11/2008 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 34 19 Make available staff recruitment records to evidence robust recruitment procedures. To safeguard people using the service 25/11/2008 2 35 18 Provide staff with training 25/11/2008 appropriate to the work they are to undertake. This includes structured induction training. So that staff are competence to provide quality care outcomes and safeguard residents. 3 37 10 Ensure that the care home is 15/12/2008 effectively and competently managed. Care Homes for Adults (18-65 years) Page 27 of 29 To safeguard residents and comply with regulation. 4 39 26 Ensure that monthly visits and reports as required are completed by a suitable representative of Family Mosaic. To ensure that the home is running effectively and that residents best interests are promoted. 01/12/2008 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 2 3 1 1 22 The statement of purpose should be reviewed and updated and a copy sent to the commission. A copy of the revised and user-friendly service user guide should be available in the home and provided to residents. Information on how to make a complaint should be available in a range of formats more suitable and relevant to the needs of the people using the service. The complaints procedure should include information for people that they may also approach Social Care (Social Services) with their complaint. At least fifty percent of staff should achieve relevant NVQs. All staff should be provided with effective supervision at least six times each year. Make available the outcomes of quality assurance to staff within the home so they are readily available for inspection. Complete monthly health and safety audits routinely to ensure there is a safe environment for residents and staff. 4 22 5 6 7 8 32 36 39 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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