Inspection on 30/09/08 for 3 The Glade

This inspection was carried out on 30th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 04/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 The Glade 3, The Glade Bromham Beds MK43 8HJ     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: Sally Snelson     Date: 3 0 0 9 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: 3 The Glade 3, The Glade Bromham Beds MK43 8HJ 01234828704 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Caroline Earey Type of registration: Number of places registered: The Fremantle Trust care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care home code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning Disability - Code LD Date of last inspection Brief description of the care home 3 The Glade is a home for up to eight adults with learning disabilities, managed by Fremantle in conjunction with Bedfordshire Pilgrims Housing Association - who are responsible for the maintenance of the building. The home is a large bungalow situated on the outskirts of Bromham village, approximately 5 miles from Bedford town centre. There are eight bedrooms, a dining room, 2 lounges, an activity/quiet room, a staff office, laundry, kitchen, and bathing/toilet facilities. There are some facilities for people with a physical disability. The bungalow is set in substantial grounds, with parking for several cars to the front of the building. The home provides it own transport.The home has developed some user-friendly documents for current and prospective people using Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 8 Brief description of the care home the service. Full information regarding the service fees, including any additional charges, was not known at the time of writing. Care Homes for Adults (18-65 years) Page 5 of 31 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: Up until 1st March 2008 3 The Glade, a home for up to eight adults with learning disabilities, was managed by Bedfordshire and Luton Partnership NHS Trust BLPT. Fremantle now runs it in conjunction with Bedfordshire Pilgrims Housing Association - who are responsible for the maintenance of the building. This inspection was carried out in accordance with the Commission for Care Homes for Adults (18-65 years) Page 6 of 31 Social Care Inspection’s CSCI policy and methodologies, which requires review of the key standards for the provision of a care home for younger adults that takes account of residents’ views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment AQAA has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. The inspection was a key inspection, was unannounced and took place from 10.30am on 30th September 2008. The registered manager, Caroline Earey, was present throughout, and Mark Kingman, the operational manager joined the inspection. Feedback was given throughout the inspection and at the end. During the inspection the care of two people who used the service (residents) was case tracked. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home were observed for their reaction to situations and staff were spoken to and their opinions sought. Any comments received about the home, plus all the information gathered on the day was used to form a judgement about the service. Prior to the inspection four service users, four relatives and four members of staff had completed surveys. The inspector would like to thank all those involved in the inspection for their input and support. What the care home does well: What has improved since the last inspection? What they could do better: There were a number of concerns raised by this inspections which should be addressed by the provider and the manager in a timely way. Failure to met the requirements made at this inspection could result in enforcement action at future inspections. Areas that need to be addressed include:The contract between the home and the person using the service should be more explicit about what is provided by the company and what the individual is expected to pay for. Care plans and their reviews should be written in a way that current care needs are easily identifiable. Staff should ensure that they can demonstrate how people using the service have been supported to make choices and decisions Staff should continue to consider ways in which people using the service can take part in even more activities inside and outside the home. All medication must be correctly signed into the home, and a record kept of the medication held by the home for a resident. Staff must ensure that residents money is used appropriately at all times. All areas of the home must be accessible to those people using wheelchairs. Consideration should be given to keeping the home in a good decorative state. There must be sufficient qualified staff on duty at all times. Staff are only confirmed in post after all the necessary checks and references have been made. The reliance on agency staff should be decreased. Staff should have meaningful supervision sessions, which are well documented and Care Homes for Adults (18-65 years) Page 8 of 31 offer staff the chance to discuss work, personal issues, and training needs. Quality audits should be regularly undertaken. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 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 10 of 31 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. A well-produced service users guide and Statement of Purpose gave the people living at 3 The Glade the information they needed about the home. Evidence: Staff had worked extremely hard to produce a Service Users Guide of a good quality, and in a format that was appropriate for most of the people living at 3 the Glade. The guide was in words and pictures and included all the information required by the National Minimum standards. We were disappointed to learn, that after all the work that had been done to produce a document that was so ideal, a corporate service users Guide was to be introduced to replace the current guide. The statement of purpose had also been updated and included all the necessary information. The home had no vacancies, and therefore no plans to admit in the near future and there had been no new admission to this home since the last inspection. It was therefore not possible to fully assess this standard under the new providers, but it was possible to assess the managers understanding of the process, and the companys Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: policy. Under the previous providers the registered manager would have had little say in who could be admitted to the home, as a panel made the decision. The manager was aware of Fremantles procedure for assessing a prospective resident, to ensure that the home could meet their needs and that they would appear to fit in with the current client group. We therefore felt confident that when there was a vacancy, the pre-admission assessment of a prospective resident would be correct. Staff had had a variety of different training and considered the collective needs of the clients when planning training. This is discussed fully in the staffing section of this report. Service users had been issued with new contracts since transferring to the new providers. These were pictorial and had also been made available on audi tape to help some of the people using the service to understand them. More detail was required in the contracts about exactly what Fremantle provides and what the resident is responsible for paying for. Care Homes for Adults (18-65 years) Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans had been written in sufficient detail to ensure that the care needs of the service users would be met in a consistent way. However the reader might not be aware when plans had last been reviewed. Evidence: We looked at the care files for two of the people living at 3 The Glade. The plans were detailed and reviewed, but it was difficult, when looking at the plan to confirm if, or when, a review had taken place. This was because the review, which was being done monthly, was on different documentation and not always stored with the original plan. Therefore when we looked at the care plans it appeared that they had not been reviewed for more than six months. We believe staff, particularly bank or agency staff, who were less than familiar with the care files, may also be confused about current care needs. Because of the way that some of the care plans had been written there was little Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: evidence that people made choices. The home needs to embrace Person Centred Planning (PCP) so that statements such as (service users name ) clothes need to be sorted and those that are torn thrown away and, she needs to buy clothes in more cheerful colours and from updated stores, are replaced with statements that provide evidence that the service user has been involved with this decision and has agreed it. At the time of the inspection staff were meeting weekly with residents for key worker sessions. However it did not appear that that much progress was made at these meetings, and the same subjects were discussed week after week. If it is not possible to progress these meetings because of their frequency then consideration should be given to not holding them so often, and consequently raising expectations that result in nothing happening. For example we saw details for weeks on end about the redecoration of a residents bedroom. The manager had introduced a system whereby staff signed to state that they had read and understood a residents care plan. We noted that one person on each shift on the day of the inspection had not signed. Therefore at night 50 of the staff were not aware of the information in the current care plan. Risk assessments were in place and appeared to be written with insight into the needs of the individuals. Staff must be sure that where the assessment recommends a monthly review, such as in nutritional assessments, this takes place. Care Homes for Adults (18-65 years) Page 14 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were being provided with more opportunities to participate in meaningful activities throughout the day and the outcomes of the activity was recorded for each individual. Evidence: It was apparent that people using the service now had more opportunities to take part in activities outside the home. On the day of the inspection some people were out of the home at a day centre, an aromatherapist came to give a foot massages to two people and the music man session was enjoyed by most of the people living in the home. Some people had been due to go swimming, but because the local pool was closed this was not happening on the days expected; however it had been rearranged for a different pool. There was still some confusion as to what constituted an educational experience and what was relaxation, so staff were not sure whether to bill Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: the provider or the individual for the activity. There was also some discussion about funding a day care centre. The manager, the operational manager and the parents of the person using the service were involved in this discussion. In the future the contract should make this clear at the point the person using the service is admitted. Although we were told that people made choices during the day as to how they spent their time, we saw activity programmes in peoples file. In one file there were two different programmes and it was not clear which was current. We were told that the night staff wrote on a board in the office what each person was doing the next day, but as two of these entries on the board were for a swimming session at a pool that was closed for refurbishment, this was not a satisfactory way of indicating what people had chosen to do, and enjoyed doing, with their time. We did not witness any relatives or friends visiting the home, but professionals visitors were welcomed into the home and people living at the home appeared relaxed with visitors. Four relatives responded to questionnaires sent to them in advance of the inspection. All felt staff supported their family member to keep in contact. However one relative felt some of the activities were not suitable for their relative and another stated that staffing levels at the weekend restricted some activities that could take place during the week. Few of the people living in the home could help to prepare and serve meals. This was because the size and design of the kitchen was not appropriate to meet their needs. The housing association was planning to refurbish the kitchen and include some surfaces that were suitable for those residents who used wheelchairs. Care Homes for Adults (18-65 years) Page 16 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported to attend health appointments, but documentation to support health care was not person centred and did not indicate that it had been reviewed regularly. Evidence: All of the people living at the home needed some degree of support with their personal care. Care plans had been written for these activities, but would benefit from being regularly updated. For example, a seizure plan had been written in 2003, updated 21.9.07, but since then the rescue medication had altered. The manager told us they they were waiting for the GP to agree the new plan, but in the meantime we were unsure of the current treatment. We also saw communication passports that had been written over 2 years previously, and although these gave details and explanations, they would benefit from indicating that they had been reviewed so that the reader could be sure they were current. Staff ensured that service users kept appointments with GP’s, consultants, and other health professionals, and had ensured that people were provided with the equipment Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: they needed for mobility, to relieve pressure, and to make them as comfortable as possible. Staff had supported a person using the service during a recent stay in hospital and this had been beneficial to the person and the staff at then hospital. Staff commented that the community nursing service had been supportive to them with caring for a resident following discharge from hospital. Each person using the service had their own locked medication cupboard in their bedroom. The manager was auditing the medications weekly, but as new medications were not correctly signed into the home with an indication as to whether old stock were destroyed, sent back, or carried forward, it was not possible to reconcile the medications that were not in blister packs at this inspection. All of the medications in the blister packs reconciled correctly and Medication Administration Charts (MAR) had been completed correctly. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training of staff in safeguarding was regularly arranged by the home. Other training around dealing with physical and verbal aggression was also made available to staff as needed, and as a result the need to use restraint and calming medication had reduced considerably. Evidence: Staff were aware of the complaints policy and how complaints should be dealt with. All of the residents had a pictorial copy of the homes complaints procedure. There had been no complaints made to, or about, the service since the last inspection and the four relatives surveyed told us that they were aware of how to make a complaint if they needed to. When we looked at the monies held by the home on behalf of the two residents whose care was tracked we were concerned that despite the money being checked at least twice a day, one persons money had had an extra 1p added to it, without any explanation as to where it had come from. In fact there was no entry in the credit line of the balance chart, simply an increase in the persons balance. The manager said it was probably that staff had found the 1p, but as it had not been documented in the income column the accounts did not make sense and staff should have identified this. The practise of checking the balance of residents money at the change of every shift was not in line with Fremantles procedure, but was carried over from the old provider. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: We also found receipts that suggested that a service user had been charged for the full cost of re-fuelling the homes transport and for two meals out on the same day; the second meal could possibly have been for a staff member. The manager told us that this was a temporary measure and by the end of the month she would be going through the receipts to ensure that the monies paid out by individuals, that were not the responsibility of the resident, was paid back from petty cash. This was not acceptable and should not happen even for a short time. The operational manger offered to send in someone from head office, to audit all the personal monies immediately. Had this not been offered, and we were confident it was a short term arrangement, this situation would have been referred to safeguarding and the section made poor. There had been an improvement in staffs understanding of safeguarding vulnerable adults (SOVA). This had come about as the result of additional SOVA training and a better relationship with the safeguarding team. Any allegations of abuse, including service user on service user were now being correctly reported to us via Regulation 37, and to the safeguarding team at the Local Authority. There had been one safeguarding incident reported to the Local Authority since the last inspection. After strategy meetings involving the police, the incident had been passed to the home to complete an internal investigation and the member of staff alleged to have been involved remained suspended. We were concerned when looking at training records to note that the manager, and the staff member alleged to have been involved in an incident of possible abuse, were not among the staff who had had NonAggressive Physical and Psychological Intervention (NAPPI) training. This intervention had resulted in staff using de-escalation techniques to manage residents challenging behaviour. Care Homes for Adults (18-65 years) Page 20 of 31 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. The home was kept clean and tidy and made as homely as possible. Some environmental changes were needed to make the home more suitable for those people using the service who used wheelchairs for mobility. Evidence: The people living at 3 the Glade all had their own bedrooms and could access one of the four communal rooms. There were a number of bathrooms and toilets with a variety of aids and adaptations. The home was generally clean and tidy, but some areas needed to be redecorated and some furniture and carpets replaced, in order for the home to be considered more homely. We noted that residents were consulted about new furniture and new colours in the home, but as these consultations often took a long time to come to fruition, these discussions could be meaningless to the people living at 3 The Glade. There were plans to change the kitchen so it was accessible to those people using wheelchairs, and not just those people who were mobile. The plans included wider doors, and a sink and a work surface that a wheelchair could fit under. The current kitchen was open to people living at the home and we saw people being encouraged to make drinks for themselves. There were also plans to make the laundry room Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: accessible to wheelchairs. A housekeeper was employed to keep the home clean and tidy. Care Homes for Adults (18-65 years) Page 22 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were shortfalls in recruitment practises and insufficient evidence that staff had the necessary training to met all the needs of the people using the service. Evidence: Since the last inspection staff had been given the opportunity to undertake a greater variety of training including NVQ training. The manager had details of the training that staff had undertaken. However there were some gaps in training record and we were disappointed that the induction training booklet, given to all new staff, had not been signed by the manager to confirm the practical part of the training had been completed. There was still a reliance on agency staff, but management told us that this was to be reduced as more staff were employed. To provide consistency for the people living at 3 The Glade agency staff were block booked. We looked at the recruitment files for two of the permanent members of staff. One person had the correct checks and references but the second had only one reference and that was not from their last place of work. The manager stated that this was an oversight on her part. It was dealt with during the inspection. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Staff were having supervision, but it was not regular and it was apparent that not all the staff would have the required six supervision sessions during the year if this continued. Care Homes for Adults (18-65 years) Page 24 of 31 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. There needs to be systems in place to show that the home fulfils its stated purpose and meets the needs of the people living there. Evidence: There was evidence that the manager undertook training and development and had completed her NVQ level 4 qualification. When Fremantle took over the management of 3 The Glade a quality audit was carried out. This audit was detailed and referenced back to the last report and the National Minimum Standards. The manager did meet regularly with the staff, and staff had regular key-working meetings with the people using the service. However, the service must now continually monitor, assess and plan. We must also see evidence that all stakeholders have been involved in quality reviews. All staff must take care to ensure that any documentation is signed and dated and kept under review to ensure that it is meaningful. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: No health and safety concerns were noted during the inspection. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 14 16 It must be clear to people using the service what is paid for by the provider. In respect of Regulation 16 (2)(m) People using the service should be supported to have a break away from the home 01/01/2009 2 20 12 All medication must be correctly signed into the home and a record kept of the medication held by the home for a resident. This ensures that the manager or another responsible individual can regularly audit the medication. 16/11/2008 3 23 16 Staff must ensure that residents money is used appropriately and in an agreed way. 26/10/2008 Care Homes for Adults (18-65 years) Page 28 of 31 Residents money should not be used to pay for staff meals or for fuel for the homes transport. 4 24 23 All areas of the home must be accessible to those people using wheelchairs The residents using wheelchairs must have the opportunity to gain life skills. 5 32 18 The must be sufficient qualified staff on duty at all times. Staff must have the skills and experience to provide the necessary care for the residents. 6 34 19 Staff are only confirmed in post after all the necessary checks and references have been made. Safely recruited staff ensure residents are kept safe. 7 39 24 Quality audits should be regularly undertaken. Quality audits must show stakeholder involvement and influence the annual development plan for the home. 8 41 17 Records must be dated and signed and kept under review. 22/11/2008 01/01/2009 26/10/2008 16/11/2008 01/01/2009 Care Homes for Adults (18-65 years) Page 29 of 31 Records must be kept to provide evidence that the correct care and support has been given at all times. 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 5 The contract between the home and the person using the service should be more explicit about what is provided by the company and what the individual is expected to pay for. Care plans and their reviews should be written in a way that current care needs are easily identifiable Staff should ensure that they can demonstrate how people using the service have been supported to make choices and decisions Staff should continue to consider ways in which people using the service can take part in even more activities inside and outside the home. Consideration should be given to keeping the home in a good decorative state. The reliance on agency staff should be decreased. Staff should have meaningful supervisions, which are well documented and offer staff the chance to discuss work, personal issues, and training needs. 2 3 6 7 4 12 5 6 7 24 33 36 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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