Inspection on 14/01/09 for 6 The Grove

This inspection was carried out on 14th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 The Grove 28/02/07

6 The Grove 02/11/05

6 The Grove 12/05/05

6 The Grove 21/10/04

6 The Grove 26/04/04

6 The Grove 02/12/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 6 The Grove 6 The Grove Westoning Bedfordshire MK45 5JW     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: Louise Bushell     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 33 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 33 Information about the care home Name of care home: Address: 6 The Grove 6 The Grove Westoning Bedfordshire MK45 5JW 01525718063 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): noemailasat.3.07.07 MacIntyre Care Name of registered manager (if applicable) Frances Barnes Type of registration: Number of places registered: 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: 6 The registered person may provide the following category of service only: Care home only - Code 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 - Code LD Date of last inspection Brief description of the care home 6 The Grove provides accommodation for six adults with learning disabilities. It is a purpose built house in a small, enclosed estate of three registered care homes, which all belong to Macintyre Care. The home is located in the village of Westoning and is in walking distance of the local shops, garden centre and pubs. On the ground floor there are three bedrooms, a lounge with a small kitchenette, a bathroom with toilet, a separate toilet and a laundry room. On the first floor there are three bedrooms, a bathroom with a shower and toilet, a separate toilet, a kitchen, a dining room and an office with toilet combined with en suite shower. A lift provides and a staircase, provide Care Homes for Adults (18-65 years) Page 4 of 33 care home 6 Over 65 0 6 Brief description of the care home access between the two floors. The rear garden is secure and private and has a leisure room that has been created from a potting shed. The home has a mini-bus for service users to access facilities in the community. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspections undertaken by the Commission for Social Care Inspection is based upon outcomes for the people who use the service and their views of the service provided. The primary method of inspection used was case tracking which involved selecting two people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. The visit was unannounced and planning for the visit included assessment of the notifications of significant events, which had been received from the service to the Commission for Social Care Inspection. Care Homes for Adults (18-65 years) Page 6 of 33 We looked at the last Inspection Report and information on safeguarding and complaints since the last inspection and we looked at the feedback received from questionnaires circulated to relatives, staff and people who use the service. The visit took place between 10.00am and 16.45pm. This enabled the inspector to directly and indirectly observe the care practices and the day to operations of the service. A selected tour of the building was conducted during which the inspector spoke with people who use the service, staff and visitors and the Registered Manager. The last Key Inspection was conducted on the 28th February 2007 with an Annual Service Review being conducted on the 29th February 2008. The fee range for the service is from one thousand one hundred and fourty pounds to one thousand three hundred and fifteen pounds per week. The fee range is dependant on individual needs. The fee excludes personal items, hair dressing, some personal choices for trips, new papers, toiletries and other personal items of choice. What the care home does well: What has improved since the last inspection? Staff at the service have worked hard in the development of visual aids. Examples of this include pictorial menu boards, individual complaints procedures and life development plans. The external sensory and activity room is near completion and sensory equipment is on order. Since the last inspection the service has had new carpets in all communal areas and is awaiting the delivery of a new fridge freezer. A number of new polices and procedures have been introduced to the service to ensure that the welfare and protection of the people who use the service is sustained. Care Homes for Adults (18-65 years) Page 8 of 33 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 9 of 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service ensures that prospective individuals needs can be met by implementing a satisfactory assessment process, exploring a persons individual aspirations, wants and needs. Evidence: The service has a Statement of Purpose with complies with the criteria set out in schedule 1 of the National Minimum Standards. There is also a comprehensive Service Users Guide, which is produced, in an easy read format with pictorial information. This information is made available to existing and prospective residents and their representatives. The service ensure that the Commission for Social Care Inspection reports are available in the home and are accessible. Due to the complexity of need of the people who use the service, these reports are kept in the office or on display in the entrance of the building. Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: There has been a recent admission to the service, and the individual plans of care evidenced that the service has robust admission procedures in place, including comprehensive assessments conducted by the service to ensure that they are able to meet the needs of prospective people. Assessments from funding authorities are also obtained and held on file. Prospective individuals would have the opportunity to visit the service on a number of occasions before deciding whether they would like to live there. The manager described in detail how a plan was arranged for one service user to test the service over a period of time. This was further evidenced by detailed visit notes taken throughout the visits. The religion and cultural needs section of the assessment had not been completed. This was discussed with the manager of the service who stated that this was due to them developing a growing knowledge of the person over a period of time. The manager added that the process is being reviewed by the company and new assessments and care plans are being developed. Each person has an individual service agreement in place which specifies the terms and conditions. These are currently being updated to reflect the changes in the fees. However it was noted that where an individual was unable to sign or unable to have the capacity to know what he or she was signing that action should be taken to ensure that a relative or significant had signed. This was discussed with the manager at the time of the inspection. On the day of the inspection three people who use the service were relaxing in the lounge area following breakfast, preparing to go out for lunch followed by visiting the theatre in Milton Keynes. All individuals looked relaxed and calm in their own surroundings. Although two of the people were not able to verbally confirm that they were happy, body language and positive communication signs were given. One person who was able to verbalise his thoughts stated that I like going out in the bus. He later added I like it here. The individual was relaxed and appeared pleased to be going out. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are at the centre of the care planning process, balancing risk and experience in the individuals best interest. Evidence: Each individual has a individual plan of care which is based on the information obtained thorough the assessment process. These are written from the individuals perspective and are person centred. The service involves individuals in the care planning process according to their individual abilities. Where the individual is not able to consent to their care plan or be involved in their care plan the service strives to ensure that significant others are involved. In addition to the care plan file there are two further files for each person. These are the Health Action Plan and a Person Centred planning file. The Health Action Plan is very detailed and provides a pictorial document detailing an individuals health needs, appointments, medication and other associated information. The Person Centred Plan Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: file is a working document and details the dreams and wants of the individual. Pictures of individual involvement in life skills and activities were available as well as documentation of the persons family (if applicable). Following discussions with the manager, the service is reviewing the care planning format used and developing further the Person Centred Plan to ensure that it is a working document which reflects the person dreams and wants. This will support a more uniformed approach to the systems used. During the visit to the service, times was spent with one individual looking through their Person Centred Plan. The person spoke about what they liked to do and, with support discussed attending his work placement once a week. The person commented that The staff are lovely and its good here. There is evidence that the individual plans of care are reviewed on a regular basis. There was clear evidence within the individual plans of care that individuals are supported to make decisions for themselves within all aspects of their daily lives, any limitations on choice were seen to be in the best interests of the person and supported by risk assessments. Each person has an individualised and comprehensive set of risk assessments which have appropriate controls to reduce and manage the risks identified, whilst enabling the person to achieve maximum control of their lives. The care plan for the individual who had recently moved into the service had not been completed. This was discussed with the manager who stated that a six week placement review had occurred which went very well and that she was waiting for the paper work to come through before completing the care plan. Records within the home are secured and held confidentially in order to respect each persons rights to confidentiality. Care Homes for Adults (18-65 years) Page 14 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported and encouraged to develop external relationships, experience balanced risks and participate in appropriate leisure activities. Evidence: There is clear evidence that staff use a range of methods to facilitate communication with individuals within the service and the community enabling them to fully participate in daily living activities. At the time of the inspection three people were getting ready to visit a local town for lunch followed by a visit to the theatre. Individual plans of care evidenced that the people who use the service have an individualised programme of activities throughout the week. These identify that they have educational opportunities are able to attend day centres and participate in Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: activities of their choice. The people who use the service are also able to opt out of activities should they wish to do so. The service has dedicated transport and there is clear evidence that the people who use the service are supported to access their local community. There are regular outings provided and staff support all people who use the service on an individual basis with activities such as shopping and cooking. All individuals are supported to maintain their faith and are able to attend local churches and associated activities. There is clear evidence that individuals are supported to maintain links with family and friends through a variety of methods such as home visits, letters and telephone calls. The staff also maintain a list of family events such as birthdays and anniversaries to support the person to maintain family links. The people who use the service are able to participate in a range of household activities, which promote their independent living skills such as meal preparation, shopping and general household chores. One person using the service was being supported to make lunch and complete his own laundry. Individuals are supported to express their individuality through their personal appearance in choice of clothing and hairstyles. Individual plans of care evidenced that peoples preferences were recorded, which includes their food preferences. The staff have developed visual aids to enable residents to participate in the planning of the menus. The service is able to balance the preferences of individuals whilst maintaining a healthy balanced diet. One staff member discussed the process for supporting people who use the service to choose their meals. The staff member stated that on a weekly basis the people who use the service are supported through the use of pictures and objects of reference to make positive choices regarding food. Sample food menus were available and records of foods consumed were maintained if the person consumed something different than that stated on the menu. One person who uses the service discussed visiting the local working mans club once a week where he plays pool and has a beer. The person added I like James Bond. The staff member stated that they often attend the cinema and if people choose they can attend church on a Sunday. Care Homes for Adults (18-65 years) Page 16 of 33 Care Homes for Adults (18-65 years) Page 17 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that their personal and health care support is promoted however systems need to be introduced to ensure that medication is administered safely. Evidence: Individual plans of care provide detailed instruction to staff about the individuals health personal and social care needs. Daily records were detailed and demonstrated that the care specified was being provided and that individuals are able to exercise choice within their daily lives. There was evidence that the staff have a good understanding of the individual needs and that they related well to residents. There was also evidence that residents wishes regarding the gender of staff providing personal care and their privacy was respected. Indirect and direct observations were made during the inspection and staff were seen to interact well with all individuals whilst respecting and dignifying their individual needs. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: The people who use the service appeared well cared for and appropriately presented. There was evidence that they have appropriate aids and adaptations to assist in their activities of daily living. Individual plans of care evidenced that individuals are supported to accesses appropriate health care services, including routine health checks, medical treatment and hospital services. Health care specialist such as podiatrists, dietitians, Occupation Therapists, physiotherapists, opticians and audiologists are also accessed as required. Individuals have access to individual key workers who work with them on a regular basis and monthly link meetings are held. Medications systems were reviewed the service operates with a Monitored Dose System supplied by a local high street chemist. Medication systems were in good order, each resident had a Medication Administration Records which specified the prescribed medication. A detailed policy is in place which the company has recently reviewed to introduce further management systems to support all in the safe administration of medication at the service. The service is able to administer simple homely remedies to the individuals at the service, with the agreement of their local GP. An agreement sheet is in place, however this was dated 03/02/00. Simple Linctus was prescribed as a homely remedy for a number of the individuals. The administration record was a form adapted by the service. An entry was made on the general record and then an individual record reflected the individuals consumption following administration. The forms do not state the maximum dosage to be taken in a period of time. A sample signature sheet is not in place to support the audit completion and to check who was administering medication at a specific point in time. Where a person had refused a medication or was absent for the medication a code had been entered into the MAR. The explanation for this refusal or being absent was not recorded on the back of the MAR. Systems were in place for the ordering, safe storage and disposal of medication. It was noted that service did not have a controlled drugs cabinet in place. The manager stated that this was because currently at the service no individual was prescribed any controlled drugs. An audit of a sample of medication occurred. In general it was found to be accurate, Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: however one persons medication had a tablet missing. The manager was able to provide a verbal reasoning for this however there was no evidence available to support this. A number of bottles did not have the date of opening on them. The room where the medication was being stored was secured, however was very warm. Records of the room temperature were not being recorded and it was not possible to assess whether the medication was being stored in environmental conditions as specified by the manufacturer. Management of terminal care and death was reviewed, and there was evidence that information is recorded within the individual plans of care, the management are mindful of the changing needs of the individuals and the implications of ageing, terminal care and death. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust complaints procedure and sound polices for the protection of vulnerable people ensure that staff are confident and able to respond appropriately and immediately to reporting suspicion or an allegation of abuse. Evidence: There have been no concerns or complaints made about this service. There is a robust compliant procedure and that this is made available to all individuals through the Service Users Guide, individual plans of care and each person has their own individualised complaints procedure, which is produced in a format most suitable for the individual. Discussions occurred with the manager regarding a complaints logging system. The manager agreed to have a folder in place with a log of all complaints, detailing the date of receipt, action taken and when the complaint was closed. Through discussion with management and staff it was established that concerns are welcomed and that they are used to inform service development. One person who uses the service commented that I like the staff they are kind. The service has access to the current Local Authority Guidelines on the Safeguarding of Adults and staff have received training in this area, Staff spoken to were able to Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: demonstrate a good level of understanding of protecting the vulnerable and the associated processes. Staff were seen to relate well to all individuals and the people who use the service appeared to be relaxed and to enjoy the company of staff. Staff were seen to be sensitive to the non verbal communication of residents and were able to interpret the individuals wishes. The manager stated that all individuals have their own bank accounts. A number of the people who use the service are supported by their families to manage their finances in order to ensure that they are protected. The service holds a small amount of money for each person so that they are able to have access to funds at any time if they are supported or choose to engage in a leisure activity of buy an item. This does not exceed thirty pounds per person. There is a float of petty cash available if the person requires additional funds at short notice. Receipts are recorded and clear audit trails are in place. Two of the people who use the service are supported with the management of their finances, however the system adopted does not fully protect the person from possible abuse as the manager of the service is a signatory on the account. This was discussed in full with the manager and the service is in the process of changing this process in line with the Mental capacity Act and is seeking information and best practice guidance. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is comfortable and suitable to meet the diverse needs of all individuals. Evidence: The environment is comfortable, well maintained and homely and currently meets the needs of the existing people. The exterior of the premises is safe and provides people with access to an enclosed rear garden. A newly converted activity room had been completed through fund raising and through charity contributions. This space provided additional resources for people to have access to. A snoozlum was in the process of being equipped. The service currently provides communal and private space that promotes the privacy and dignity of all people. Each person has a single room which they are encouraged to personalise their bedrooms. It was observed that the staff support the individuals to make changes and to personalise their rooms to individual preferences. The bathroom and toilet facilities are appropriate to need and are in sufficient number and quality. The service provides specialist aids and adaptations to meet individual needs. A number of people require the use of wheel chairs and the environment is laid Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: out to accommodate there safe use. Improvements to the unit continue and the kitchen floor has recently been replaced. The service has a current developmental plan in place. The manager stated that they are waiting a new fridge freezer which is on order. The management of the service provides robust infection control procedures and the home was clean and hygienic throughout. The staff were able to confirm that all of the equipment was in good working order. There are separate laundry facilities that support good infection control practices. There are adequate supplies of hot water. Care Homes for Adults (18-65 years) Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service employs robust recruitment procedures and appropriate numbers of inducted and trained staff to ensure that the residents are in safe hands at all times. Evidence: The service has an appropriate duty rota in place, which clearly demonstrates that there are sufficient staff on duty to meet the needs of the existing residents. There are always at least three staff on duty throughout the day and one waking night person. There is an on call rota which is covered by a number of different service managers and on the same site there is another service with a sleep in member of staff who can offer emergency support if required. The staff group are reflective of the ethnicity, culture, age and gender of the people who use the service. There is evidence that staff are encouraged to pursue National Vocational Qualification in Care level 2 and 3. There is evidence to demonstrate that staff receive all mandatory training, including a comprehensive induction programme, Moving and Handling, First Aid, Fire Safety, Safe Administration of Medication, Basic Food Hygiene, Infection Control. In addition staff all receive training specific to the needs of the Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: individual residents, for example epilepsy awareness. Through discussion with staff it was established that they had a good understanding of the needs of the residents and were able to demonstrate competence in their roles. Recruitment practices within the service ensures that people are protected from harm. A sample check occurred on three staff including new starters and all the required documentation was held on their files. the files were stored off site and the inspector was able to access them through the main office. The manager stated that the recruitment process involves the people who using the service meeting the candidates as they visit the service as part of the interview phase. Care Homes for Adults (18-65 years) Page 26 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate leadership, guidance and direction means that the service is managed in the best interests of the residents. Evidence: A limited tour of the premises was conducted and no hazards were identified and safe working practices were evident. Kitchen records were viewed and evidenced safe food hygiene practices. Fire records were viewed which indicted appropriate maintenance and routine checks which also evidenced safe working practices. Staff are suitably trained to promote the Health & Safety of residents and staff. Polices and procedures are accessible to staff and are up to date. The current manager is experienced, qualified and is registered with the Commission for Social Care Inspection. The service has both a development and business plan in place to develop the service in enable the stated aims and the objectives to be met. Quality Assurance practices were reviewed and demonstrated that the service seeks Care Homes for Adults (18-65 years) Page 27 of 33 Evidence: the views of people who use the service, their relatives, professional contacts and staff. The process of internal quality assurance was discussed in detail with the manager. The service currently does not review the findings and display them for all to see. An action plan is not created for the most recent surveys that have occurred. Staff gave positive feedback with regards to the management of the service and many confirmed that the manager was approachable and adaptable. The manager was indirectly observed during the inspection and showed to be approachable and professional in her approach to both staff and the people who use the service. Care Homes for Adults (18-65 years) Page 28 of 33 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 29 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 Any shortfalls in medication must be accurately recorded, and appropriate actions taken to ensure the safe handling and management of medication. To ensure that the welfare of the individual is protected and that medication is administered accurately. An immediate requirement was issued following the inspection and full compliance was achieved. 12/02/2009 2 20 13 Instructions for the 26/03/2009 administration of medication must be accuarte detailing frequency and maximum dosage. To ensure that the health care needs of the individuals using the service are supported. Care Homes for Adults (18-65 years) Page 30 of 33 3 20 13 Temperatures must be taken 26/03/2009 where medication is being stored. To ensure that the medication is being stored as prescribed by the manufacturers and that the storage is in compliance with the manufactures guidance. 4 39 23 Quality assurance systems must ensure that suitable feedback is provided in order to improve the service. To ensure that the service continues to improve and takes appropriate actions to develop in the best interest of the individuals. 01/04/2009 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 1 2 The service should ensure that the assessment process details individuals cultural needs and explores these elements in detail to ensure that it is able to identify and provide a service that is tailored to the individuals needs. The service should ensure that individuals are supported and encouraged to sign their terms and conditions of residency upon review. The care planning system should be reviewed to ensure that a stream lined version is implemented to encourage a uniformed approach and non duplication. A coding system should be used to provide clear reasons for a diversion in the administration of a prescribed medicine. A sample signature sheet of all staff who are able to administer medicines should be in place for audit purposes. Page 31 of 33 2 5 3 6 4 20 5 20 Care Homes for Adults (18-65 years) 6 7 20 23 All boxes and bottles should be marked with a date opening. The service should introduce a complaints logging system to ensure that all complaints are managed well, detailing the date of receipt of the complaint, the complaint, any actions taken and when the issue is resolved in full. Management systems for the safe keeping and management of individuals finances should be reviewed to ensure that they are in line with good practice guidance in relation to the Mental capacity Act. The manager should review being a signatory on an individuals account. 8 23 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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