Inspection on 28/10/08 for 32 Mays Lane

This inspection was carried out on 28th October 2008.

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

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

Other inspections for this house

32 Mays Lane 31/10/07

32 Mays Lane 15/01/07

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

Extracts from inspection reports are licensed from CQC, this page was updated on 13/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 32 Mays Lane 32 Mays Lane Stubbington Fareham Hampshire PO14 2EW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Laurie Stride     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 32 Mays Lane 32 Mays Lane Stubbington Fareham Hampshire PO14 2EW 01329668833 01329668833 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Manager post vacant Type of registration: Number of places registered: Care Management Group Ltd care home 5 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: 5 The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home 32 Mays Lane is registered to provide care and accommodation for five adults with a learning disability. The service is provided in a bungalow within a residential area of Stubbington. The home is a short car ride away from the local shops and transport links. The home has a car for service users with designated staff drivers. All service users have their own room. The home has a hydro pool and a sensory room within the building. It is owned and run by Care Management Group. The current fees range from 1550.01 to 2413.64 pounds sterling per week. This information was obtained at the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home time of this inspection visit. Members of the public may wish to contact the care home for up-to-date information about fees. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection visit lasted approximately eight hours, during which we, the commission, looked at how well the home is meeting peoples needs and supporting them to have a good quality of life. We also looked at how the service is meeting the requirements from the previous inspection, which took place on 31/10/07. During this visit we looked at samples of records and spoke with the manager, who has been managing the home on a day-to-day basis since July and is applying for registration. We met three of the people who currently live in the home, however our communication was limited due to the nature of the individuals disabilities. We spoke with two of the staff team and observed staff interacting with people who use the service, which they did in a respectful and friendly manner. We also met and spoke Care Homes for Adults (18-65 years) Page 6 of 28 with the regional director for the organisation. Further information used in this report was obtained from the previous inspection report, the homes annual quality assurance assessment (AQAA), notifications the home had sent us between the inspection visits and contact with people expressing their views about the service. This includes survey questionniares received from two doctors and a care manager. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements in the record keeping will help to ensure that prospective service users can be confident that their needs will be assessed and met as part of the services admission process. Evidence: The previous report for 31/10/07 identified that the home kept the assessed needs of people who use the service under review. The homes annual quality assurance assessment (AQAA) told us that the organisations assessment & referrals team work closely with homes manager, staff and people who use the service to identify the right person for the home. A compatibility assessment is completed and a transition plan is drawn up with care managers, community teams, relatives and the homes manager. The AQAA states the plan is continually reviewed. We had received information detailing concerns about a new admission to the service on 24/04/08 and the impact this was having on other people who live in the home. The service user was admitted to the service with information from their previous Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: placement, which was also another service within the same organisation. This information did not appear to be complete as there were time gaps in the records. We saw care plans for this service user, but many essential elements for this were dated September 2008. We had also received concerns from staff in relation to there not having been sufficient information and guidance about how to meet the service users needs at the time of admission. We could not see what had been put in place for the service user on and immediately after their admission to the home. It was not possible to fully assess the effectiveness of the homes admission procedures. The manager gave an explanation for gaps in records that related to a service user and a previous member of staff but we were not able to ascertain the exact circumstances at the time of the inspection. The current manager has been in post since July this year. Since August the manager has made progress in rebuilding the care and support plans and reviewing individual needs. This has included obtaining information from the community nurse for the service user admitted in April. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The review of care planning provide staff with appropriate information to meet the needs of people who use the service. The use of communication tools enables people who use the service to participate in the day to day running of the home. Evidence: The previous report identified that care plans were specific and detailed and linked to clearly written risk assessments. A requirement was made that people who use the service must have their needs and daily activities kept under review and for their personal plans to reflect this. As already mentioned, the sample of care and support plans we saw contained gaps and the manager was engaged in the task of rebuilding the plans. We saw that the needs of the individuals concerned were being reviewed as their plans were being redeveloped. The available plans contained clear guidelines and risk assessments, which Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: were initially placed in a read and sign folder so that each staff member familiarises themselves with the upated information. Two members of staff we spoke with during our visit told us that the new manager had worked hard getting things organised and that they now know where to find care plan information when it is needed. One told us that they had previously not been able to find relevant information about the most recently admitted service user. Both staff members demonstrated their awareness of the individual needs and preferences of people who use the service. During our visit we observed that staff offered choices to people who live in the home, for example about drinks and activities. Staff members we spoke with demonstrated their knowledge of how individuals communicate their needs and wishes. The majority of the people who use the service have some form of communication difficulty or learning disability that restricts their level of engagement and how they express their needs and wishes. The home has developed alternative communication tools to support individuals to have an understanding of their environment and what is going on day-to-day and this work is continuing. We saw records and correspondence showing that the home is in contact with external professionals, such as the community nurse and speech and language therapist, who provide further assistance in relation to meeting individuals communication needs. The home has implemented key worker meetings since July 2008, where individual service users needs and choices are discussed by named members of staff. We saw the minutes of one of these meetings, the other minutes we were told were not available. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have opportunities to develop and participate in social and recreational activities. Evidence: The previous report showed that, while the majority of people living in the home had opportunities to take part in activities, the home needed to ensure that all individuals were equally involved in activities. A requirement had been made in relation to this. The homes annual quality assurance assessment (AQAA) stated that the service had introduced activity diaries and during our visit we saw evidence of this. The activity diaries had commenced in July 2008 and gave an indication of what each service user did and enjoyed on a daily basis, such as using the hydro-pool, going for drives, boating, music sessions and other activities. Some entries were completed more fully Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: than others and the manager said that the staff team were still getting used to using the diaries. There were plans to use more photographs in the diaries, which will enable service users to engage more with this aspect of their support plans. Each individual has a weekly activity plan and personal activities allowance. We saw that service users have access to clubs and activity centres, a drum workshop, the cinema and beauty sessions. Comments we received from a care manager indicated that staffing levels had curtailed individuals involvement in activities. At the time of our visit we were told that staffing levels had increased and we observed sufficient numbers of staff on duty to support individuals within and outside of the home. The manager said that outside activities are now happening again following a period of disruption. An external activities facilitator visits once a week providing additional support. The manager told us that service user holidays had not yet taken place this year, as the home was trying to co-ordinate these to happen at the same time as major work on the floors take place, to lessen disruption to service users lives. We observed staff members supporting individuals for in-house activities, going out to the shops and for appointments. The home is situated on the outskirts of a small village. The home supports people to maintain contact with family and friends and individual care plans included contact details and records of visits. Care plans included details of the food that each person likes or dislikes and the support they require with diet and eating. The home draws up menu plans that indicate choices individuals have made supported by staff, although not all of these we saw had been completed. The home had recently involved the service of a dietician and a visit was scheduled in relation to one service user. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recent improvements in the recording, monitoring and review of peoples personal and health care needs mean that people can now be more confident that they will receive care and support in the way that they prefer and meets their needs. Evidence: The previous report identified that people who use the service were being supported with their personal and healthcare needs, including the safe administration of medication. The report pointed out that health action plans needed to be kept under regular review. The AQAA stated that these were now reviewed monthly and this was confirmed by viewing the care and support plans for three individual service users. The homes daily records showed that a range of health and social care professionals are involved in the review of individual needs. Service users have access to the necessary health care services, including GP, dentist and dietician. One service user moved into the service with a range of health needs. As previously mentioned, it was not possible to access all the records for this service user to ascertain how their needs were being met. The service user had been losing weight and there was no evidence of Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: regular monitoring of this. The current manager has rectified this and with the help of the community nurse and GPs input, the service user is gaining weight and this is now monitored appropriately. Another service users support plan was seen. This showed that there had been concerns over weight loss, which were referred to the community team. Again, there are records to show that their weight has been monitored since Sept 08, but no record of this before this time. Staff in the home are working on building up communication tools that can be used for individuals within the service to assist with their communication. For example, some activity boards use pictures and photos to aid communication about activities. Comments from two GPs received through our surveys, were positive about the service with one saying that the home sought advice when necessary. In the AQAA, the service has identified that the home could improve by gaining knowledge and understanding of each condition and filter this information throughout the staff team for consistency. We saw that the service completes regular medication audits to ensure records and stocks are maintained appropriately. The pharmacist had conducted their own check in September and found that the storage of and recording of medication administration were satisfactory. We also saw records indicating that individuals medication are reviewed by their GP. There is currently no storage facility for controlled drugs within the home. We advised the manager of recent changes to the regulations about the storage of controlled drugs and that the home needs to obtain a suitable updated storage facility. This is so that the home is properly equipped in the event that someone is prescribed a controlled drug. The manager reported that the organisation is aware of this and will be providing suitable facilities. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure supports those who use the service and their representatives to have their concerns looked into appropriately. Staff members understanding of procedures within the service safeguards people from abuse. Evidence: The previous report made a requirement in relation to the home improving the administration of peoples monies. This had been resolved following the inspection visit. During our visit we looked at the homes current arrangements for managing peoples money. The organisation provides each service user with an activities allowance and this is kept and accounted for seperately from individuals personal money. The homes AQAA stated that the service is trying to open bank accounts for people who use the service. The manager told us they are finding this difficult due to bank rules and individual capacity issues. With the manager we looked at a sample of two service users records and balances and these were correct. Full records were available of payments, credits and withdrawals. The home uses a system of double signatures and regular management checks for both activity and personal money. The home has a complaints procedure that is also available in a picture format. Staff members we spoke with were aware of how individual service users communicate and that this can sometimes be through behaviours that challenge. The manager told us that she had made sure that service users relatives had received a copy of the homes Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: statement of purpose, which includes the complaints procedure. We looked at the complaints log and this contained details of the four complaints the home had received in the last 12 months, together with records of actions taken and the outcome. These demonstrated that the service takes complaints seriously and attempts to resolve them within timescales. We received two complaints about the service in May 2008, that we passed on to the organisation to look at. The complaints highlighted a range of concerns about service, including care delivery and record keeping. The organisation investigated these complaints and took some action. The AQAA stated that there had been four safeguarding referrals and two investigations in the last year. We were aware of three of these and the manager was unable to recall what the fourth one was in relation to. We spoke with two members of staff who were both clear about their roles and responsibilities under the safeguarding and whistleblowing procedures. The homes records indicated that relevant training is provided. The AQAA told us that there had been no incidents involving restraint. Staff members we spoke with told us there is no need for physical interventions and they know how to use techniques to distract people and diffuse situations. The staff members confirmed they received training in managing challenging behaviours. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a home that is clean, comfortable and has suitable facilities for them to lead the life they choose and to meet their needs. Evidence: The previous report identified that the service provided a well-maintained, clean and homely environment. Since the last inspection the home has put a system in place to monitor the temperature in the conservatory, which is part of the communal area accessed by service users. During this visit the manager told us about planned work to replace most of the lower floors in the home, which are currently affected by wet and dry rot. The kitchen floor has been re-done and the home is awaiting completion of work on a service users bedroom floor. Since our last visit, the lounge, hall and conservatory had been redecorated. An ensuite shower room for one service user has been converted to a bathroom to meet the needs and wishes of that service user. The home has a separate laundry facility with semi-industrial washing machines that washes to a high temperature. At the time of the last inspection and during another period since then the washing machine had been out of action and staff used another Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: local home to do laundry. This meant it proved difficult for the service to adequately maintain levels of infection control. This issue had been resolved at the time of this inspection. We saw a good standard of cleanliness in the home and staff members receive training in infection control and health and safety. Staff members are provided with protective clothing, liquid soap and paper towels and the home has a clinical waste contract for disposing of continence aids. The home has its own hydro-pool and a sensory room. We saw that sensory objects were fixed to the walls around the home to assist the people who use the service to familiarise themselves and feel comfortable with their environment. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by suitably trained staff who are recruited using a robust system of checks Evidence: At our previous visit to the home we saw that the service carried out thorough staff recruitment checks. During this visit we looked at the personnel records for two recently recruited staff and these showed that the home continues to protect people who use the service through its recruitment procedures. The records contained evidence of Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, written references and employment histories. The manager told us that prospective employees are invited to come to the home for an informal visit prior to interview, so that they can meet the people who use the service. During this visit we saw that the home had met a previous requirement that all staff must undertake an induction that is in line with Skills for Care guidance. We saw a Skills for Care induction workbook in relation to a recently employed worker. There is a staff training programme that includes mandatory health and safety subjects as well as more specialised training, for example the management of challenging behaviour. We saw that the manager keeps a record of the dates training is provided to individual Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: staff members and also a record of training needs. Certificates of attendance were also held on file and we saw a sample of these and spoke with two other staff members who confirmed they had the relevant training. One staff member told us that the provision of training had improved, for example night staff were said to be better accommodated now in relation to training. Another member of staff told us they were doing training in relation to epilepsy at the end of the week. The manager said that she can also access specific training, for example for supporting individuals with particluar medical conditions, through the organisations central training unit and also through the community team. The manager reported that nine out of eighteen staff members had completed or were currently undertaking National Vocational Qualifications (NVQ) in care at level 2 or above. A care manager had expressed concern that there have been a lot of staff changes resulting in a loss of experienced staff at the home. The manager told us that the service has recently benefited from experienced staff members who have been transferred from other homes within the organisation. We had received concerns about a lack of guidance for staff being in place in relation to the most recently admitted service user. As mentioned in the first section of this report, we were not able to see what had been put in place for the service user on and immediately after their admission to the home. We spoke with one staff member who said that they had not been able to find relevant information about the service user when the previous manager was in post, but they had since got to know the service user better and can now find information when necessary. Another staff member said that the current manager is more organised. Both staff members we spoke with told us that the service user has now settled very well. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current management arrangements are supporting improvements to the service to ensure it is run in the best interests of those using it. Evidence: The current manager has previous experience of managing registered services within the organisation and has the NVQ level 4 Registered Manager Award. The manager said she was in the process of applying for registration in respect of this service. An experienced deputy manager has recently transferred to the home from another service. During the last inspection we had seen evidence that the service undertook quality reviews and audits. During this visit the manager told us that she had sent quality survey questionnaires to service users relatives at the end of September but had not yet received any responses. We saw staff handover records for October indicating increased satisfaction with the service from two service users relatives. The manager said she planned to re-start surveys for external professionals once the home had got Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: onto a more even keel. A care managers comments indicated they had not been kept informed of service users experiencing difficult times earlier in the year; concerns were raised by a service users relative. The manager reported that there is no current annual development plan for the service but that she had identified priorities, for example staff performance and development. The manager told us that the recent AQAA had been written more like a business plan for the service. The previous inspection report had identified a requirement that monitoring visits must be undertaken by the organisation on a monthly basis. During this visit we saw that monthly reports of these visits were on file and held in the home. This meets the requirement. The complaints received highlighted concerns about lack of record keeping which are reflected in the sections above and potentially placed people who use the service at risk of not having essential health care needs met. The current manager has worked to rectify this. The previous manager had been responsible for two other services at the same time as her appointment as manager of this service. We had seen action plans for these other two services, which placed a lot of emphasis on the manager to carry out the tasks. It was clear that there had also been significant issues in this home requiring action from the manager at the time of their appointment. Since the last inspection, the organisation has been re-organising personnel and management structure. We would expect the monitoring arrangements are now sufficient to ensure that the improvements in the service are sustained and sufficient time and support is available to managers to be able to undertake their role. During the previous visit it was also noted that a staff handover had been carried out in a communal area of the home, putting confidentiality at risk. The manager confirmed that staff handovers are now held in the office. The previous inspection had raised a requirement in relation to staff members receiving fire safety training. During this visit we saw a sample of the homes staff training records, which showed staff had received training in mandatory subjects such as fire safety, emergency aid and moving and handling. Infection control training had been re-scheduled for November 2008. We also saw that records are kept of regular fire drills and the names of those attending; weekly inspections of the means of escape in the event of a fire; fire equipment checks and services. Contractual arrangements were in place for the servicing and testing of gas, electrical and water appliances. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The home must make sure that a suitable storage facility is available for any controlled drugs that individuals may be prescribed, in line with changes to the legislation about peoples medication. This is to ensure that the proper and legal safeguards are in place when care workers give controlled drugs to people who use the service. 27/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!