Inspection on 10/10/08 for 9 Roseland Avenue

This inspection was carried out on 10th 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

9 Roseland Avenue 05/10/06

9 Roseland Avenue 05/12/05

9 Roseland Avenue 25/08/05

9 Roseland Avenue 28/09/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 9 Roseland Avenue 9 Roseland Avenue Devizes Wiltshire SN10 3AR     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: Malcolm Kippax     Date: 1 0 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 9 Roseland Avenue 9 Roseland Avenue Devizes Wiltshire SN10 3AR 01380728507 01672569477 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lisa Cheryl Harridine Type of registration: Number of places registered: Cornerstones (UK) Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Any placement for short-term care or for an emergency placement must be agreed with the Commission before the placement commences. For the purpose of this condition, short-term is defined as a placement that is expected to last not longer than 3 months. An emergency admission is defined as an admission whereby someone is likely to be placed at short notice without an up-to-date assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. Only the one, named, female service user between the ages of 18 and 64 years with a physical disability referred to in the application dated 5 October 2003 may be accommodated in the home and this person must be accommodated on the ground floor. The home may only accommodate one person with a learning disability aged 65 years and over. The maximum number of service users who may be accommodated in the home at any one time is 6. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 1 0 6 1 Date of last inspection Brief description of the care home 9 Roseland Avenue is one of a number of care homes in Wiltshire that are run by Cornerstones UK Ltd. The home is in a residential area close to the centre of Devizes. Each person has their own bedroom. Two bedrooms are on the ground floor and the others are on the first floor. The communal rooms consist of a lounge and a conservatory type extension that is used as a dining area. The home has a domestic type kitchen and there is a small office. At the rear of the house there is a paved garden, a garage and a parking area. People who live at the home receive support from the homes manager and a team of support workers. Information about the home is available in a Statement of Purpose. Copies of inspection reports are available from Cornerstones UK, and are also available through the Commissions website at www.csci.org.uk Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: We asked the home to complete an Annual Quality Assurance Assessment, known as the AQAA. This was their own assessment of how they were performing. It also gave us information about what has happened during the last year, and about their plans. We sent out surveys to the home, so that these could be given to the people who live there, to staff, and to other people who know the service. We had surveys back from the six people who live at the home, from two staff members, and from two GPs and another health care professional. Earlier in the year, four relatives had also completed surveys and we have taken their comments into account. We looked at all the information that we have received about the home since the last inspection. This helped us to decide what we should focus on during an unannounced Care Homes for Adults (18-65 years) Page 6 of 29 visit to the home, which took place on 10th October 2008. We met with four of the people who live at the home. We also met with the manager of the home, and with the support workers who were working at the time. We looked at some records and went around the home. There were six people living at the home at the time of this inspection. The fee for each person was 765 Pounds per week. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visits. What the care home does well: What has improved since the last inspection? Individual support plans for people have been rewritten and updated, so that they provide better information about their needs and goals. Peoples service user guides have also been updated, to give better information about the things that they have to pay for out of their own money, because they are not covered by the fees. The guides have also been personalised, so that they are more Care Homes for Adults (18-65 years) Page 8 of 29 meaningful to the people who live at the home. Parts of the home have been refurbished and received attention, so that the environment has been improved and made more attractive for the people living there. The number of staff with a National Vocational Qualification has increased, which means that people at the home are receiving support from staff members who are better qualified in the work that they undertake. The homes manager has achieved the Registered Managers Award, which makes her better qualified to run the home. 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2 was not looked at on this occasion. The standard was met when last inspected and Cornerstones UK has a policy and procedure in place for new admissions. Evidence: Nobody had moved into the home for several years. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and goals are well reflected in their individual support plans, which helps to ensure that staff provide consistent support in the way that people prefer. People are assisted to make decisions and they receive support, which reduces the risk of being harmed. Evidence: We looked at the records for three people who live at the home. These included a Care and Assessment file for each person. The files were well organised, with sections for care assessments, care plans, and risk assessments. The care plans and assessments had been rewritten and updated during 2008, so that they reflected peoples current needs. The care plans consisted of a range of forms, covering areas such as Safety Awareness, Social Skills, Communication, Medication and Daily Routines. They provided clear guidance for staff about peoples needs and preferences in these areas. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: One section of the care plans concerned peoples goals for the future, and how they would be supported with achieving these. Mrs Harridine had recently amended these parts of the plans, so they gave a better description of the goals and how any tasks would be completed. In their surveys, staff told us that they are always given up to date information about the needs of the people that they supported. There were references highlighted in red within the care plans to show when risk assessments had been undertaken. This helped to ensure that staff were aware of the hazards relating to a particular activity or area of support. The risk assessments were recorded on forms that included sections about hazards and potential risks. The benefits of the person participating in a particular activity or task, for example being out in the community, were not being recorded, although this would have reflected a more person centred approach to the carrying out of the assessment. Sometimes a risk assessment had resulted in a restriction being imposed on what the person at the home could do. However the reasons for the restrictions were recorded in peoples care plans, and these were primarily to do with peoples safety. For example, one person was required to sit in the back when travelling in a car, to ensure that the driver was not distracted. Following a risk assessment, there was also a restriction in place about the use of the kitchen. Individual review meetings were being held, when people could talk about new things that they wanted to do and make decisions about the future. People at the home also met together on a regular basis. In the minutes that we saw of a recent meeting, people had talked about the appointment of a new staff member, so that they were being kept up to date with events in the home. People received support with managing their money. Their service user guides have been updated since the last inspection to give information about what things they would have to pay for out of their own money, because they were not covered by the fees. The guides had also been personalised, so that they were more meaningful to the people who live at the home. People made decisions about the meals that they would like to have. The choice of meals was recorded in a kitchen file. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support that helps them to maintain relationships and to be part of the local community. People have the opportunity to participate in activities that they enjoy. They benefit from an individual approach to the meal arrangements and to the daily routines. Evidence: People told us about their weekly activities and how they liked to spend their time. They went into Devizes regularly and attended local resource and day centres. When we arrived at the home, some people were getting ready for a trip to an arboretum, which Cornerstones UK had arranged as part of their own activities programme. People returned during the afternoon and said that they had enjoyed the trip, and had also done some shopping. Somebody else had spent the day at a community farm where they had a work placement. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Another person went out clothes shopping during the day, and received one to one support with this from a staff member. They later showed us the clothes that they had bought and were very pleased with them. We saw examples of the records that were maintained after people had been shopping. Receipts were obtained and numbered, and then the records were signed by two staff members, so that peoples money was well accounted for. People were engaged in different activities when they returned from their day activities. Some people spent time in the lounge where the television was on. One person looked after two pet budgerigars, which they kept in their room. We saw that somebody else had a kettle in their own room, so that they could make drinks independently. Some other people needed support from staff with making drinks. We observed someone, who did not communicate verbally, being offered a choice of mugs, from which they selected one. We were told that the mugs were reference objects for the person, from which they chose one to show the type of drink that they wanted. Peoples rooms reflected their individual interests, such as collecting different things and listening to music. There was information in peoples care plans about their likes and dislikes, and their preferred activities and routines. We read in the plans that people were being asked if they would like to attend church. There was also information recorded about the support that people would need with voting and whether people had any interest in doing this. Details of peoples family contacts and important relationships were recorded in their individual files. Staff supported people to keep in contact with their family and friends. In their surveys, we had asked peoples relatives what they felt the home did well. One person commented Make it easy to pop in to visit or take my brother out when we want to. Another person commented social outings - pubs, walks, activity centres. There was a section on Eating in peoples individual plans, which provided information about individual needs and preferences. Mrs Harridine said that two people were on low fat diets, and we saw guidance about this displayed in the kitchen. A dietician had been involved with one person at the home. At the weekends, people talked about the meals that they would like to have and a menu for the week ahead was then written. We saw another record, which showed when people had chosen to have something different to what was on the planned menu. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met. Staff provide assistance, to ensure that people receive the support that they need from outside health professionals. People are generally well protected by the homes procedures for dealing with medicines. Evidence: Peoples care and assessment files included details of the personal support that they needed from staff. There was also guidance for staff about peoples care routines at different times of day. We read in peoples records about the involvement of outside professionals, including the contact that people had with the Community Team for People with Learning Disabilities (C.T.P.L.D.). A consultant psychiatrist was currently involved with one person. We saw records of GP visits and hospital appointments. People had visited the dentist earlier in the year. Mrs Harridine said that each person received free chiropody, which included a nail cutting service. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: We received surveys back from two GPs and a community nurse. They commented positively about the care, and the support with medication, that people received at the home. They thought that the home communicated clearly and worked in partnership with them. One of the health professionals commented when I have seen the client, care provided is appropriate and complete. We read that one person was visiting a specialist centre, to help them with the management of their epilepsy. Their records included an epilepsy profile and intervention plan that had recently been updated. The community nurse had helped to complete the plan. Mrs Harridine said that this persons needs were being kept under review. This was with the aim of reducing the amount of epileptic activity, which was being monitored by staff throughout the day. A protocol had been agreed for the use of a listening monitor in this persons room during the night. A risk assessment had also been undertaken, as it was recognised that the use of the monitor could have an impact on the persons privacy. There was also a risk assessment for this persons safety when in bed. We saw that the person’s bed had been fitted with bed rails (with a padded cover fitted), although this had not been referred to in the risk assessment. Mrs Harridine confirmed that the assessment would be reviewed. Mrs Harridine said that, following assessment by an occupational therapist, the bed was shortly to be replaced with a new type, which would not require rails. Each person had a separate file, which contained their health related records. Health action plans had not been completed; we thought that these would be useful in providing an overview of people’s health needs and how these are being met. Information about peoples medication was included in their individual plans and personal records. Medication came to the home as part of a monitored dosage system and was stored in a metal cabinet. We looked at the current medication records, which were being appropriately completed. There was guidance for staff about the use of PRN as required medication. We talked to Mrs Harridine about one persons medication, which was being recorded as a controlled drug and kept separately in the cabinet. Some of this medication was waiting to be returned to the pharmacist and we confirmed that this should happen without delay. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to raise concerns and are listened to by staff. Staff members receive training and guidance, which helps to protect people at the home from harm. Evidence: A pictorial complaints procedure had been produced for the people who live at the home. One of the relatives who completed a survey told us that complaint forms, which included symbols, were available in the home and that with help their relative in the home would be able to make a complaint. A staff member also reported that symbols were used to help explain to people how they could make a complaint. The complaints procedure had been discussed with people at house meetings, when they also had the opportunity to raise concerns. A staff member told us that one person who is unable to communicate verbally would show their feelings through facial expressions. The staff members who completed surveys confirmed that they knew what to do if somebody raised concerns with them about the home. It was reported in the AQAA that the home had not received any complaints during the last year. The home had a procedure for following up allegations of abuse. Guidance was available to staff about the arrangements being made in Wiltshire for safeguarding vulnerable adults, and about how any allegations will be investigated. The home has Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: had experience of a safeguarding adults investigation in recent years, although there have been no incidents involving an investigation during the last 12 months. Prevention of abuse and the safeguarding of vulnerable adults were included in the Cornerstones UK staff training programme. When we looked at the staff members individual records we saw that they had received this training. The home had a policy on physical intervention. We were told in the AQAA that there had not been any incidents involving restraint during the last 12 months. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are benefiting from improvements that are being made to the accommodation and facilities. The home is kept clean and tidy. Evidence: The home is in a residential area, which is close to Devizes town centre. 9 Roseland Avenue was registered as a care home before 2002 and provides accommodation that was approved prior to the introduction of National Minimum Standards. Each person had their own bedroom, which varied in size and outlook. Space for socialising in one of the bedrooms that we saw was very limited, although it had an ensuite toilet and shower. Another, larger bedroom on the ground floor also had ensuite facilities. Decorating and refurbishment work had taken place since the last inspection. This was most noticeable in the lounge, which had a new floor covering and three-piece suite. The kitchen had been redecorated and fitted with new units, which gave it a modern look. Overall the refurbishment work had improved the environment for people and given the accommodation a more stylish appearance. Doors in the home were fitted with self-closing devices. During our visit we found that some of the doors in the home were closing with a lot of force, which could be a Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: hazard to people. This was brought to Mrs Harridines attention. Some of the bedroom doors had been fitted with internal bolts so that people could secure their rooms. These were being used rather than an appropriate type of lock, which would enable people to lock their rooms from both sides of the door. We had recommended at the last inspection that people are offered the opportunity to have a key operated lock fitted to their bedroom doors. A garage at the rear of the property was being used as a laundry and utility area. There was a requirement at the last inspection for the garage to be cleared and tidied up if it was also to be used as a storage area. This has received attention, and the storage area of the garage has now been partitioned off. Other work has been carried out to give people a larger patio area at the back of the home. An in-house inspection of the premises was being carried out every three months. A checklist was being completed and we saw that the inspection has been extended since our last inspection to include the grounds and the exterior of the property. There were locked cupboards in the kitchen and in the bathroom, so that cleaning materials could be kept safe. The home generally looked clean and tidy. There was a dispenser of antibacterial gel in the kitchen. We talked to Mrs Harridine about providing this gel in more locations, such as outside the kitchen so that people could use it before they entered. An environmental health officer had last visited the home in June 2006. A new kitchen log book for the recording of food served and temperature checks was introduced as a result of that visit. We saw that this book is being completed daily and included records of fridge and freezer temperatures, which were being checked to ensure that they are operating safely. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home are supported by staff who are developing their skills, but have not yet received all the training that they are expected to in order to meet peoples individual needs. People are generally well protected by the homes recruitment procedure, although there are shortcomings in the process and in the records that are kept. Evidence: In addition to the manager, there was a team of nine staff members, of whom five were parttime. The number of qualified staff had increased since the last inspection, with seven members of the staff team having achieved a National Vocational Qualification at level 2 or above. The team included a deputy manager, although Mrs Harridine said that the person in this role was on long term leave, and they had only worked in the home for a week since October 2006. Staff meetings were being held, usually bimonthly, with minutes kept. Three staff members had been recruited since the last inspection. We looked at the recruitment records for these staff. References had been received and there was Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: documentation relating to Criminal Record Bureau CRB disclosures and checks of the Protection of Vulnerable Adults POVA list. Application forms had been completed, in which the applicants had provided details of their employment history and answered a question about their current health. One person had also completed and signed a separate statement about their health and fitness, although these were not available for the other two staff members. We talked to Mrs Harridine about how some matters arising from application forms and CRB disclosures had been followed up. Mrs Harridine said that there had been discussions about a prospective staff members suitability. However these discussions had not been recorded, which meant that there was a lack of evidence about this part of the recruitment process. Mrs Harridine said that it was the intention to produce an employment checklist form, which would provide a record of the recruitment process and the checks that had been undertaken. We met one of the new staff members during our visit. They had experience of working in another care setting and had undertaken relevant training in their previous employment. New staff members underwent a period of induction. For staff who were new to working in a social care setting this was an accredited induction programme which included the common induction standards. Five staff members had completed the accredited programme. The staff members employment files included records of the training that they had attended. We talked to Mrs Harridine about also having a training matrix, which would provide an overview of the training that staff had received and show when refresher training was due. There was a policy for staff training, and a plan that set out the training that staff were due to receive. Training was listed in the plan under the headings of Essential, Desirable, Specialist and Mandatory. The training plan looked very comprehensive. Mrs Harridine said that she had recently met with the training manager from Cornerstones UK, and assessed the staff teams training needs for the year ahead. Refresher courses had been arranged in subjects that included moving and handling and first aid. Mrs Harridine confirmed that this would ensure that staff were up to date with the training that was identified as mandatory in the training plan. It was reported in the training plan that staff would receive the Essential training within 12 months of employment, with annual refresher training. The Essential training included subjects such as risk assessment, challenging behaviour and equal opportunities. Staff were not attending this training consistently and arrangements had not been made for staff to attend the training in the future. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home and from the improvements that are being made. Their health and safety is being protected. Evidence: Mrs Harridine has been the homes manager for over five years. She was managing another care home in the Cornerstones UK group before moving to 9 Roseland Avenue. Mrs Harridine had completed the Registered Managers Award since the last inspection, and was currently undertaking a National Vocational Qualification in care at level 4. There had been a delay in completing this qualification, although Mrs Harridine said that she was expecting to finish in the next few months. The home had been without a deputy manager for most of the time since October 2006. Mrs Harridince said that she could delegate some tasks to the staff team, but some management and supervisory tasks could not be delegated. A representative from Cornerstones UK visited the home regularly and carried out an Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: audit of standards in the home as part of the organisations system of quality assurance monitoring. People at the home and their representatives were asked for their views in meetings and through the use of annual surveys. These contributed to an annual development plan for the home, which was produced by Mrs Harridine. The most recent report had been written in April 2008. We were given information in the AQAA about the improvements that had been made during the last year. These included for example, the refurbishment of parts of the home, and the rewriting of peoples individual care and support plans. The AQAA also included information about the arrangements in place for maintaining the homes fire precaution systems and other servicing which involved outside contractors. A fire drill had been held in August 2008 and staff training in fire precautions had taken place between July and September 2008. Gas installations were serviced in March 2008. Portable electrical appliances were being checked and a further test was not due until March 2009. Risk assessments had been undertaken concerning the environment and peoples safety within the home. The homes fire risk assessment was reviewed in March 2008. Radiators in the home were covered and the temperature of the hot water was being regulated to ensure that it did not exceed safe levels. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 24 23 The doors in the home must receive attention where necessary to ensure that they close more gently. This is to stop to the doors from banging and so that the force of the doors closing does not present a hazard to people. 17/12/2008 2 34 19 A record must be kept to 17/12/2008 show that any matters arising from staff application forms and Criminal Record Bureau disclosures had been appropriately followed up. This is to ensure that there is evidence of a robust recruitment process being operated, which protects people at the home from being supported by unsuitable staff. 3 35 18 Arrangements must be made for staff to attend the Essential training that they are required to receive in 31/12/2008 Care Homes for Adults (18-65 years) Page 27 of 29 accordance with the homes training policy and plan. This is so that people at the home are supported by staff who have received the training that is necessary in order to meet peoples individual needs. 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 9 That, in addition to the hazards, the benefits of people participating in a particular activity or task are also recorded on the risk assessment forms. This is so that there is a more person centred approach to the risk assessment process, and that peoples rights are considered as part of this. That health action plans are completed with the people who live at the home. These will be useful in providing an overview of how peoples health needs are being met, and will be met in the future. That people are offered the opportunity to have a key operated lock fitted to their bedroom doors. Where locks are fitted, these should be of a type that enables the door to be unlocked from either side in the event of an emergency. (Recommendation outstanding from last inspection). That an employment checklist form is used, which would provide a record of the recruitment process and the checks that have been undertaken. That arrangements are made for the post of deputy manager to be filled on a temporary basis while the permanent post holder is away from the home. 2 19 3 24 4 35 5 37 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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