Inspection on 18/03/09 for 8 Queensview Crescent

This inspection was carried out on 18th March 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Queensview Crescent 25/02/08

8 Queensview Crescent 26/10/06

8 Queensview Crescent 09/03/05

8 Queensview Crescent 21/09/04

8 Queensview Crescent 03/03/04

8 Queensview Crescent 27/01/02

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 8 Queensview Crescent Warley Road Scunthorpe North Lincolnshire DN16 1QN     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: Stephen Robertshaw     Date: 1 8 0 3 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.cqc.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: 8 Queensview Crescent Warley Road Scunthorpe North Lincolnshire DN16 1QN 01724280862 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Maria.Powell@dimensions-uk.org Dimensions (UK) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home 6 3 8 Queensview Crescent is a care home providing personal care and accommodation for six adults aged 18-65 years with learning disabilities, three of these places are for people who also have a physical disability. 8 Queensview Crescent is owned by Dimensions (UK) Ltd and is situated close to two other homes owned by Dimensions The home is located in a residential area close to the centre of Scunthorpe. It is close to local shops, amenities and public transport. The home has it?s own transport. The home is a purpose built bungalow. All of the people that use the service have access to a single bedroom with a wash hand basin. Bedrooms are decorated and furnished to meet individual service users requirements and preferences. Communal areas of the home are decorated and furnished in a domestic style. Aids and adaptations are provided as required to meet service users needs. The current weekly fees for the service are #877.20. There are additional charges for hairdressing, private chiropody Care Homes for Adults (18-65 years) Page 4 of 33 Brief description of the care home treatment and for newspapers and magazines, holidays and activities. Information on the specific charges for these can be obtained from the manager of the home. 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 site visit to the service was unannounced and took place on 18 March 2009. The Commission were at the home for approximately 6 hours. The visit included meeting and talking to staff, management, visitors and people who live at the home. It also included a tour of the premises, observation of staff and individuals care files and all of the other documents that related to the service. Most of the people that lived at the home had very limited verbal or manual communication skills, therefore the Commission spent time observing activities instead of conducting formal interviews. The Commission also interviewed the acting manager and three of the care staff. Care Homes for Adults (18-65 years) Page 6 of 33 The report also includes any information that the Commission has received about the service since the last inspection. 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.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 33 printed copies from enquiries@cqc.org.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.This means that the people that live at the home have their needs assessed by the service before they are admitted. This is to make sure that the people that use the service can be safely looked after. Evidence: The Commission looked at the all of the information held in the home that related to two people that use the service.This included looking at all of the written information that related to their personal and health care needs and included contact with outside agencies. Both care files that were observed by the Commission had received an assessment of their needs before they had been admitted to the home. This meant that the service could identify if they could safely support the needs of the people that are admitted to the home and to make sure that the admission was appropriate to the registration of Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: the service. The manager of the home stated that the homes pre-admission assessments of need forms had been improved, however since the last inspection of the service there had been no new admissions to the home to use these documents with. The new format for the assessments appeared to have improved and would be better for identifying how individuals needs affect them in their daily lives and the support that they would require to improve their quality of lives. The new format also suggested that future assessments of need carried out by the home would be individualised and more person centred. The Commission as part of the inspection site visit observed the interactions between the people that live at the home and the staff and this helped to support the evidence that the staff have the knowledge and skills to be able to care for the individual needs of the people that use the service. 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the people that use the service are given opportunities for making choices to meet their needs through their daily lives at the home. Evidence: The Commission looked at all of the recorded information in that home that related to two of the people that lived there. Thee had been no new admissions to the home since the last inspection. All of the care files that were seen by the Commission included individual support plans and these demonstrated how the health and personal care needs would be supported for the people that they involved. These care plans have begun to improve and are Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: becoming much more person centered as opposed to generic care plans. the acting manager of the home stated that it has been a priority to improve the quality of care plans and assessments in the home. She also stated that where old information was in a generic format all of the care plans in the home would soon be transfered to the new paperwork. The home continues to makes good use of photographs involving the young people in their daily lives and activities. Care pals showed that the people that use the service or their representatives had given permission for the photographs to be taken and used. however there was no evidence in their care files to support that the individuals concerned or their representatives had given permission for pictures to be taken and used. One person had cot sides fitted to their bed, however there wasnt a risk assessment in position to use them. The manager of the home should risk assess any use of cot sides on beds and make sure that they are well maintained and serviced. Risk assessment tools for were in position for peoples mobility, tissue viability, medication, and nutrition needs. Individuals daily plans were provided to them in format that they understood, one example of this was a pictorial format. All of the people that live at the service have some communication problems and few of the people that use the service have verbal communication skills. During the site visit we directly observed the interactions between the people that use the service and the staff that supported them. This helped to support the evidence that people that use the services provided by the home are encouraged to make decisions for themselves about their daily lives and the activities that they are involved in at the home. 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the people that use the service are encouraged to develop and maintain their personal lifestyles at the home. Evidence: The care plans that were observed by the Commission supported the evidence that people are encouraged to maintain and develop their personal lifestyles at the home. Direct observation also helped to support tis evidence. Staff were observed interacting with the people that use the service and making sure that the individuals were happy Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: with the care and support that they were receiving. The care staff were very aware of the individual personal and healthcare needs of the people that use the service.to the people that live at the home, However the care staff stated that due to the limited abilities of the people that live at the home it was difficult to engage them in any regular or stimulating activities. Therefor they relied on individual support to the people living at the home and were flexible to allow them to access activities that were appropriate to them as individuals.. Activities made available through the home included offering hands massages and nail care, community outings, pub visits, ten pin bowling and shopping trips. Observation of documentation in the home and interviews with care staff supported that people that use the service are provided with the opportunity of an annual holiday. The care plans showed that individuals had chosen where they wanted to go on holiday. The people are given the opportunity to go on holiday by themselves with support or with other friends that live at the service. The care file information that was observed by the Commission supported the evidence that the people that use the service are encouraged and supported to develop and maintain relationships with their families and friends. On the day of the site visit relatives were observed to visit the home and to take their family member out for the day. In their discussions with the Commission the relatives were very supportive of the care and support provided through the service. Three meals are provided at the home every day and a supper is also provided to anyone that wants it. direct observation showed that individuals were asked what they would like to eat for their meals and were then given appropriate support to have their meals. This was observed to support the individuals dignity and respect. Where appropriate specialist nutritional/dietary assessments had been completed by the relevant outside health care professionals. Care Homes for Adults (18-65 years) Page 16 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that personal support is provided to people that use the service in a way that promotes and protects their health care needs and upholds their privacy and dignity. Evidence: As part of the site visit the Commission observed the interactions between the people that use the service, their peers and the staff that were supporting them.This helped to support the evidence that the people that use the service have their privacy, dignity and respect upheld at all times within the service. All of the bedrooms in the home are for single accommodation. The care staff interviewed by the Commission stated that this helped to uphold peoples dignity and respect when they were being seen by visiting health care professionals including Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: general practitioners and community nurses. Individual care files clearly identified when people had been seen by outside professionals to support their health care needs and their care plans supported any actions that were needed to support these needs. As part of the services monitoring of individuals health care needs, all of the people that use the service have their weights recorded on a regular basis. This helps to identify if people are gaining or losing excess amounts of weight and indicates when a person may need referring to a nutritional specialist to aid with their diet. The care workers that administer prescribed medication in the home had completed appropriate medication training. None of the people that use the service have the ability to safely self medicate. Therefore their care files included risk assessments to say that the care staff had their authority or their representatives authority to administer medication to them. The home uses the monitored dosage system (Blister packs) for drug administration to help to make sure that the appropriate medication is given out. Medication records are also supported with photographs of the people that the medication is prescribed for. This helps to make sure that everyone is given the medication that is prescribed for them. ALL of the medication records in the home were up to date and had been accurately recorded. There were no controlled drugs prescribed to anyone at the home at the time of the inspection. Care Homes for Adults (18-65 years) Page 18 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the service can assure staff and people that use the service that any complaints or concerns will be listened to and be acted upon. Evidence: Since the last inspection of the service there hadnt been any complaints recorded at the home or had been sent directly to the Commission. The home has a clear complaints policy and procedure and all staff that were spoken to b the commission had a clear understanding of them. None of the people that use the service were able to confirm to the Commission their understanding of the complaints process. There had been no referrals made to the local safe guarding adults team since the last inspection report. A procedure for responding to allegations of abuse was available, which reflected the multi-agency procedures in respect of referral and investigation. The manager of the home stated that it was a priority to make sure that all staff received safeguarding training or refresher training on a regular basis to ensure the Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: safety of the people that use the service. Training records identified where safeguarding adult training had been planned. The acting manager of the service also stated that the local authority would be contacted to provide the staff with training in relation to the local authorities policies, procedures and reporting systems to report allegations of suspected abuse. Care staff that were interviewed by the Commission stated that their National Vocational Qualification (NVQ) training covered abuse/safeguarding adults issues, however this did not inform them of the local agreements or reporting systems. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. This means that the environment provided for the people that use the service is homely,however the decoration of the home needs to be unproved to create a more homely and comfortable environment for people to live and work in. Evidence: As part of the site visit the Commission made a tour a tour of the premises. The home was clean and tidy and there were no bad smells around the home. This helps to create a homely environment for the people that live there. The Commission looked at the bedrooms for three of the people that live at the home.All of these were seen to be clean and tidy and were furnished and decorated in a homely to the individuals tastes and preferences. The corridor areas of the home and the bathrooms were in need of decorating to create a more homely and comfortable environment. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: Specialist equipment needed to make sure that people that use the service have their needs met were observed to be available in the home and this included a mechanical hoist to aide mobility and specialist bathing equipment. Service and maintenance records for all of this equipment were all observed and were up to date. The bathrooms were well spaced around the unit. The hot water pipes were exposed and were at a high temperature in all of the bathrooms. These pipes need to have a protective cover to prevent any harm to people that use the rooms coming in to direct contact with them. The home keeps a record of the hot water temperatures. These showed that the hot water in the taps range between 30.7º C and 38.9º C. The temperature of the water should be close to 43º C (between –2º C and ?2º C) to support the health and safety of the people that use the water system. The homes laundry was well organized. The washing machine was programmable to disinfection and sluicing standards and a new drying machine had been included in the laundry area. The kitchen area was clean and tidy and was well organized. The flagstones at the rear of the building are uneven and could cause a trip hazard to the people that access this area. Care Homes for Adults (18-65 years) Page 22 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that the staff have the knowledge and skills to be able to safely care for the people that they are responsible for. However the staff need to receive formal supervision on a more regular basis to make sure that they have all of the knowledge and skills that they require to safely care for the people that use the service. Evidence: The roles and responsibilities of staff are clearly defined and understood by the people that work in the home. Staff that were interviewed by the Commission clearly understood their own roles and those of their colleagues. Staff commented that in general the staffing levels were satisfactory, however it was stated that extra staff were needed at key times. There was no evidence to show a formal review of staffing had been carried out, despite records and discussion with staff indicating the dependency levels of some service users had increased over the years. At the time of the site visit it was observed that an additional member of staff Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: came in to work early to assist with taking people that use the service to the dentists. The Commission were unable to examine the personnel files for any of the staff as the company now holds these centrally. This means the Commission were unable to support that the service takes the appropriate steps to protect people that use the service through sound recruitment and selection practice. Training records showed staff were not all up to date with all of the mandatory training areas. There was some evidence that some staff had had specific learning disability/service user training however this was not the case for all the staff. This needs to be an area of development to ensure staff have the necessary skills and competencies to meet the changing needs of service users. Staff interviewed by the Commission had not received the minimum training that was required of them to make sure that they could fulfill their responsibilities. Two support workers are normally on duty at anyone time. Through the night there is one waking staff. If they require support through the night they must contact one of the sister homes in the local area as this service does not have an additional sleep-in cover. This could leave people who use the service, or staff at risk if there was an emergency during the night. The home had a structured induction program in position, which met the Common Induction Standards of Skills for Care for new members of staff. The Commission were informed that five out of ten support staff had completed a National Vocational Qualification (NVQ) in care at level 2 or equivalent. This equates to 50 of the staff having achieved the award. Another member of staff is registered on the award and is working to wards it. There was no evidence to support that staff receive regular supervision to make sure that they understand their roles and responsibilities and to identify any of their training needs. The management of the service must make sure that staff are provided with a minimum of six formal recorded supervision sessions per year (pro-rata). Care Homes for Adults (18-65 years) Page 24 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. This means that although the service still has not registered a manager with the Commission, the service is supported by the acting manager of the home. Evidence: There is currently no registered manager for the home. Since the last inspection of the home the company have appointed a manager for the service, however at the time of the inspection they had not made a application to the Commission to be recognised as the registered manager of the home. The acting manager of the service said that she had discussed her registration with her managers and would be submitting an application to the Commission within a short period. The acting manager of the home discussed the services quality assurance and Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: monitoring program and agreed that it need to be more robust and include the views of a greater depth of people that have contact with the service.This will help the home to identify ho the services or environment can be unproven for the people that use the service. The registered person should implement a quality assurance program, that fully meets the requirements of NMS 39. This is needed to make sure that everyone is consulted about the running of the home and to ensure continuous improvements are made. Systems were in position to make sure that all of the homes equipment was up to date and had been well maintained. This included service contracts for maintenance and service histories. Certificates were also in position for gas; portable electrical appliances; fixed electrical systems and the homes water system. The acting manager of the home stated that hr manager completed regular regulation 26 visits to the home. The Commission observed their reports from these visits. The home maintains all of the records that are required for the protection of the people that use the service. However some of these records had omitted to include any signatures or dates identifying when they had been completed. The care staff stated that management approach to the home was very open and supportive to their needs and personal development. The acting manager was observed interacting with the people that use the service and in the staff group in a very professional and caring manner. Care Homes for Adults (18-65 years) Page 26 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered person must 30/04/2008 make sure that all fees payable by people who use the service are included in the homes statement of purpose and service user guide. This must include the services contribution towards a seven-day annual holiday and any costs that may be incurred to people that use the service. This will allow individuals to make a more informed choice in relation to moving to the home. The registered person must 30/05/2008 make sure that all assessments completed for people that live at the home are detailed and are specific to their need and are not included on a generic `plan?. These assessments must be completed before the person is admitted to the home with the exception of an emergency admission. The registered person must 30/05/2008 make sure that individual care/support plans include enough information to make sure that staff can understand the way in which the care should be delivered. Page 27 of 33 2 2 14 3 6 15 Care Homes for Adults (18-65 years) This would support the health and safety of the people that use the service. 4 6 12(3) The responsible person must 30/06/2008 develop support plans in a more accessible format for service users. (Previous Timescales of 31.3.05 and 31.11.05 and 31/03/06 and 31/03/07 were not met.) 5 9 13(4a),(4b),( The registered person must 30/05/2008 4c) make sure that completed risk assessments are supported with risk management plans and these must be evaluated on a regular basis to make sure that they are still appropriate to the individual needs of the people that use the service. 4, 13.6 The registered person should 30/04/2008 make sure that the people who use the service are not expected to pay for staff meals and accommodation when they support individual?s out for lunch or on holiday. The registered person should 30/04/2008 make sure that the people who use the service are not expected to pay for staff meals and accommodation when they support individual?s out for lunch or on holiday. The registered person must make sure that all fees payable by people who use the service are included in the homes statement of purpose and service user 30/04/2008 6 11 7 14 4, 13.6 8 14 4 Care Homes for Adults (18-65 years) Page 28 of 33 guide. This must include the services contribution towards a seven-day annual holiday and any costs that may be incurred to people that use the service. This will allow individuals to make a more informed choice in relation to moving to the home. 9 16 20 The registered person should 30/04/2008 review the homes policies and procedures for transport. People that use the services transport should not be expected to pay for the maintenance of the vehicles involved and this must not impede their freedom of movement. The registered person must ensure staff are provided with adult abuse training. (Previous timescales of 31.3.06 and 31/12/06 were not met) The registered person must ensure that the gardens are safe and accessible to all service users. (Previous timescales of 16.10.03 31.11.05, 31.03.06 and 31/01/07 were not met) The registered person must make sure that staff records are open to inspection. This will make sure that employment policies and procedures are followed. The registered manager must obtain an NVQ level 4 or equivalent. (Previous timescales of 31.12.05, 30/06/2008 10 23 13 11 28 23(2)(o) 30/06/2008 12 34 19 (Schedule 4) 30/05/2008 13 37 18 30/07/2008 Care Homes for Adults (18-65 years) Page 29 of 33 31.7.06 and 31/03/07 were not met) 14 39 24 The registered person must 30/06/2008 develop a quality assurance and monitoring system that meets the requirements of this standard and produce an annual development plan based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. (Previous timescales of 19/2/04, 31/12/05, 30.4.06 and 31/01/07 were not met) Care Homes for Adults (18-65 years) Page 30 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 37 8 The registered person must make sure that the home has a manager that is registered with the Commission. This will help to make sure that they are a ,fit person, and have the abilities to manage the service and provide safe services for the people that live at the home. 19/06/2009 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 registered person should use the person centred assessment format when they assess people to use the service. This will help to identify how individual needs should be supported and tailor the services to how they will best suit the individual and support their individual lifestyles. The registered manager of the home should make sure that individual care plans are evaluated on a regular basis to make sure that the still support the needs of the people 2 6 Care Homes for Adults (18-65 years) Page 31 of 33 that the plans have been developed for. 3 9 The registered manager should make sure that where cot sides are used on beds appropriate risk assessments have been completed to support the health and safety needs of the people that this apparatus is used with. The registered person should make sure that the outside area of the home is safe to access for anyone that uses it. This includes leveling out the uneven flagstones The bathrooms in the home should be redecorated and the hot water pipes should be covered to ensure the health and safety of the people using the bathrooms. The registered person should make sure that all staff working in the home have a minimum of an annual appraisal of their work and a minimum of six formal recorded supervision periods per year (pro-rata). This will help to make sure that the staff have all of the knowledge and skills to be ale to safely care for the people that use the service. The registered person should make sure that the homes quality assurance and monitoring program includes the views of all of the people that use or have contact with the service. This will help the service to identify areas for improvement. The registered person should make sure that all records completed a=by the service and full signed and dated to help to identify who had completed the documents and when. 4 24 5 27 6 36 7 39 8 41 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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