Inspection on 09/12/08 for 97 Old Street

This inspection was carried out on 9th December 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

97 Old Street 30/01/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 97 Old Street 97 Old Street Stubbington Fareham Hampshire PO14 3HG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Laurie Stride     Date: 0 9 1 2 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. 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 30 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 30 Information about the care home Name of care home: Address: 97 Old Street 97 Old Street Stubbington Fareham Hampshire PO14 3HG 01329668319 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care Management Group Ltd Name of registered manager (if applicable) Alison Cook 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: 5 The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD Date of last inspection Brief description of the care home 97 Old Street is a care home providing accommodation for 5 adults with a learning disability. It is owned by Care Management Group Limited, which also owns other registered premises. The home is located near to the centre of Stubbington with there being easy access to the local shops and public transport services. It is a detached property with a rear garden accessible to service users. All service users have their own bedroom. Communal space in the home consists of a lounge, dining room and conservatory. The home has a car for service users with designated staff drivers. The home has a hydro pool and a sensory room within the building. The current range of Care Homes for Adults (18-65 years) Page 4 of 30 care home 5 Over 65 0 5 Brief description of the care home fees is fifteen hundred to two thousand pounds sterling per week, depending on the assessed needs of individuals. This information was obtained at the time of the inspection visit. Members of the public may wish to contact the care home for up-todate information about fees. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection visit lasted approximately six hours, during which we, the commission, looked at how well the home is meeting peoples needs and supporting them to have a good quality of life. During this visit we looked at samples of records and spoke with the registered manager. We met three of the people who currently live in the home and spoke with them, however our communication was limited due to the nature of the individuals disabilities. We also spoke with three of the staff team and observed them interacting with people who use the service, which they did in a respectful and friendly manner. Further information used in this report was obtained from the previous inspection report for 30/01/07 and annual service review (ASR) report for 23/04/08, the homes Care Homes for Adults (18-65 years) Page 6 of 30 annual quality assurance assessment (AQAA) and from notifications the home had sent us between the inspection visits. We recieved comments through survey questionnaires from a member of staff and a healthcare professional who has contact with the service. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 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 assessment and admissions procedure ensures that people are matched with the right service to meet their needs. Evidence: The previous inspection report for 30/01/2007 identified that the homes approach to assessing prospective service users ensured that their individual needs and aspirations could be met. For this inspection, the homes annual quality assurance assessment told us that the most recent admission to the service had been a successful transition for the individual involved. We saw the initial assessment completed by the organisations referrals and admissions officer together with the manager. A transition plan had been put together covering the first 2 weeks of the admission. The placing authoritys care management review document was also seen. These records showed us that the homes admission procedure is being followed. Care and support plans had subsequently been generated from the assessment information and showed the individual had settled in and was taking part in activities. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The manager told us that the service is planning to put together a video/DVD version of the homes Statement of Purpose and Service User Guide, which will make the information more widely accessible to people with a range of needs who may be interested in using the service. Care Homes for Adults (18-65 years) Page 11 of 30 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 supported to make decisions and choices. Detailed care plans are reviewed regularly to ensure these reflect individuals changing needs and staff have relevant guidance. Evidence: The previous inspection identified that clear care plans and risk assessments were in place and that people who used the service were supported to make decisions about things that affected them. The homes AQAA stated that people who use the service are involved in their care plans and reviews. During our visit we saw that the home has been working on developing service user communication and involvement, for example one person has a tape recorder so that they can listen back to their reviews and recall activities they have taken part in. Since the last inspection the home has developed activity books that include photos and we saw examples of these showing individuals taking part in their care planning Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: process. A member of staff from another home acts as a Person Centred Planning coordinator to support individuals and their key workers in the reviews. We saw one of these meetings taking place supporting one person to participate. The activity books are kept in individuals rooms. The manager told us that care manager reviews had been held for four of the people who live in the home and a review was booked for the remaining person in the new year. Care plans contain daily records which key workers sign to show they are kept under review. We also saw examples of communication tools used to support people such as objects of reference and picture symbols. We looked at two individuals care plans and risk assessments with the manager and discussed each persons care needs. We saw that the identified care needs were reflected in the plans, for instance, physical disability, epilepsy and communication, with clear guidance on how the needs are to be met. Care plans also contained details of individuals morning and evening routines, for example, how one person liked their pillows at night. A member of staff who took part in our survey indicated that they are always given up to date information about the needs of the people they support, for example in the care plans. We received survey comments from an external health professional who has involvement with the service. The health professional told us that they have always received appropriate referrals from this home and that the home has also sought advice with regard to new care plans. They said that the care service has implemented all their recommendations. Care Homes for Adults (18-65 years) Page 13 of 30 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 benefit from opportunities to deveop personally and to access a wide range of activities both within the community and at home. People are supported to maintain relationships and a healthy diet. Evidence: At the previous inspection we saw how people who use the service benefitted from the arrangements for educational, social and community activities. We also saw that healthy and varied meals were provided with the involvement of people who live in the home. The AQAA stated that people who use the service are now more involved in daily routines and learning skills. During this visit we saw examples of activity plans for two people who live in the home, which were in picture formats. The photos and entries in their activity books Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: showed that each person was doing the activities detailed in their individual plans. For example one person had reflexology, foot spa sessions and time in the sensory room. This person had just started having indian head massage and the manager said this was working very well for the individual. The other person was doing yoga exercises for which there was an external facilitator. Other activities included swimming, going for drives, music sessions and taking part in the daily routines of the home. One of the service users had a care plan about nutrition and self help. The records showed that this persons hand-eye coordination had improved enabling them to be more independent at meal times. The manager told us that all the people who live in the home had been on holiday this year. The most recently admitted person had been away twice on holiday, which we were told they had previously been unable to do. Key workers support individuals to choose holidays from brochures. Significant relationships are recorded in care plans and people who use the service are supported to spend time with their families. The results of the homes quality assurance questionnaires for relatives were positive. We saw three examples and these provided lots of positive feedback, for example Old Street is simply fantastic. The home tries to maintain active community links and the Deputy Mayor attended last years Christmas party. Individual newsletters are sent out by the key workers to peoples next of kin to keep them informed. The home is using photos and pictures to involve service users more in meal planning. The menus showed individuals choosing different breakfasts and lunches. Care plans contained guidelines in relation to nutrition and support at meal times for the two people whose records we saw. Prior to the inspection the home had informed us about an accident that resulted in a service user being scalded with a hot drink. During our visit we saw signs in the kitchen reminding staff about drink temperatures and that staff are expected to use a temperature probe to check each drink to avoid such an accident happening again. We saw that fresh fruit was available in the kitchen and was included on the menu. We observed that there was flexibility in where and when people who use the service ate their lunch. A health professional who completed our survey questionnaire told us that the service provides a friendly, warm living environment with a good variety of activities and opportunities for social engagement. Care Homes for Adults (18-65 years) Page 15 of 30 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. The personal support and healthcare that people receive is based on their individual needs and they are protected by the homes medication procedures. Evidence: The previous inspection identified that people were supported to maintain their health and received personal care in ways that met their individual needs and preferences. A requirement was made in relation to a moving and handling assessment of one service user. During this visit we saw the health action plans for two people which showed when appointments with health professionals take place and the outcomes of these. The records also showed how each individual prefers to be supported and how they communicate. District nurses visit regularly for one individual and guidelines were in place for staff changing the persons dressings. There were also guidelines for staff on appropriate physical contact with a person who uses the service. The person responds to physical contact and boundaries to this had been put in place to protect the service user and staff. A recent medication review with a doctor took place for an individuals Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: epilepsy. The homes records showed this person had a dentist appoinntment in November and that there were no problems in relation to this. A hearing test was being organised by the persons doctor. We saw that the home had obtained a doctors agreement to staff giving people their medication in their food. This is not done covertly as individuals are made aware they are having their tablets in their food, which helps them to swallow the medication. With regard to the previous requirement about moving and handling for one person and the equipment used, we saw Occupational Therapy (OT) assessments for the person concerned and the guidance for transferring the individual matched the OT assessment. The records showed that staff were following guidance and this meets the requirement. The manager told us that the home is having a new vehicle delivered later in the month, which is having a special chair fitted to it to meet the individuals mobility needs. A health professional who completed our survey questionnaire told us that the service has a good awareness of safe practices with regard to moving and handling. The medication storage arrangements were generally suitable, using a locked cabinet and individual blister packs. We advised the manager about the need to update the storage for controlled drugs in line with changes to the regulations. We saw lists of the staff authorised to give medication and the manager said that staff do not give medication until they have received formal training. Staff members also complete an annual competency questionnaire to ensure medication is properly managed. A procedure was in place for giving as required medication, which takes into account particular environmental factors and other issues that may affect the person concerned. We also saw there is a procedure in place for signing medication in and out when individuals go to visit relatives. Information on medication side effects was available. We saw that the manager had been working on a medication pack to be used for staff induction, which contained procedures in relation to storage, receiving medication, self administration and links to the relevant National Minimum Standards. Care Homes for Adults (18-65 years) Page 17 of 30 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 who use the service have access to a suitable complaints procedure. Peoples rights are protected by the homes policies and procedures and the way the service manages their finances. Evidence: During our previous visit we saw that people who use the service were supported to make their views known and the homes procedures protected them from abuse. The homes AQAA stated there have been no complaints or safeguarding referrals since the last inspection and the manager confirmed this during this visit. The manager said there is a complaints log that would be used to record any complaints and their outcomes. We have also not received any complaints about the service since the last inspection. We saw that care plans contain guidance for staff in relation to service users behaviours and how to manage these, for example calming techniques and support for one person. Records indicated and a staff member confirmed that training is provided in prevention and management of challenging behaviour. The manager stated that physical interventions are not used in the home and staff are trained to diffuse challenging situations. We saw that guidance in relation to whistle blowing was on display and the manager said that safeguarding training had taken place in October 2008, which included definitions and types of abuse, reporting procedures and related policies. Staff Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: members are asked to complete a questionnaire after the training. We spoke with a member of staff who confirmed they had received the refresher training a couple of months ago and who demonstrated a clear understanding of their responsibilities in relation to the recording and reporting procedures. The manager told us that all but one of the people who use the service have bank accounts. The manager said she had recently sent signatory forms to the organisation to open an account for the remaining service user. The manager said the persons benefits are currently being paid into the house account and clear records are kept. Each service user has a financial folder and only the manager and deputy have access to the homes safe, in which small amounts of cash are kept. We saw staff members checking money tins at handover and signing the records. We also saw records in relation to one service users money that had been taken out for shopping and put back in. Care Homes for Adults (18-65 years) Page 19 of 30 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 who use the service benefit from living in a clean, comfortable and homely environment. Evidence: The homes annual quality assurance assessment (AQAA) told us that the service has the specialist equipment to meet individual needs, including those with physical disabilities. We were shown round the home, accompanied first by a member of staff and then by the manager. There is a well equipped sensory room with a water bed and a hydro-pool room. A large conservatory is used as a dining/sitting/activity area. The manager told us that the service is getting a ceiling hoist fitted in the Hydro-pool room, which will enable three of the current service users, who cannot fully access the pool because of the steps, to benefit from the facility. We were shown where staff and service users had worked on a sensory garden and the manager said there are plans to develop a vegetable patch. We met two of the people who use the service. One person was going shopping with a member of staff and another staff member was involving a service user in decorating the Christmas tree. In one service users room we saw that a new adjustable bed to suit their needs had just arrived. There were photographs showing the individual enjoying various shows Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: they had been to. In another persons room we saw that a special bed, mattress and adjustable bed-rails were in place, for which the manager said a risk assessment had been recorded. This room had also been personalised and the manager told us the occupant has started to watch TV and engage with staff more. In another persons room there were flow of the day objects of reference and pictures, which the manager said the individual has started to use to communicate their needs and wishes to staff. The home has a bathroom that is equiped with a manually operated bath seat and hand rails. There is a separate shower room that is showing signs of wear and the manager said she hopes to have the space converted into a wet room. This would benefit one person in particular, whose sight impairment causes them some difficulties when getting in and out of the shower. The laundry room is equiped with suitable washing and drying machines and there are hand washing facilities. Each service user has their own laundry basket and dissolveable bags are used to transfer linens into the machine. We saw that cleaning materials are kept locked away when not in use and there are written assessments for these. Coloured mops and buckets were available and the manager confirmed that staff learn the infection control procedures as part of their induction. At the time of our visit the homes boiler was reported to have broken down and the maintenance person was on site. The manager made arrangements for spare heaters to be available. The heating and hot water had come back on by the time we left the home. Care Homes for Adults (18-65 years) Page 21 of 30 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 who use the service are protected by robust recruitment practices. Improvements in the system and recording of training delivery would ensure that training to meet the needs of people who use the service is provided in a timely fashion. Evidence: At the start of our visit a staff member told us that there were five members of staff on duty in the morning as it was a busy day. The staff rota shows eight staff are usually deployed throughout the day: four in the morning, three in the afternoon and another staff member working a middle shift. The manager told us that all the service users are funded for one-to-one support over a twelve hour day. The manager said that three staff on duty in the mornings is sufficient as some service users routines mean they will not get up until later. For example, one person will not get up until after a particular radio programme has ended. We saw the recruitment records in relation to two recently employed staff members. These contained completed application forms with employment histories, Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, two written references, probation period and induction records. Contracts and job descriptions Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: were also on file and a contract had also been provided written in Polish for one worker. We saw that the home uses Skills for Care induction workbooks and the manager said that new staff have an experienced staff member working with them to start with. There is a staff training matrix that the manager told us required updating. This meant it was not easy to track how many staff had completed various training courses and how many required the training. The service providers monthly visit report for October 2008 had identified the need to update the matrix and had given a timescale of two weeks. The manager found sufficient information on various records to indicate that staff had received, or were identified as requiring, training including mandatory health and safety matters, managing challenging behaviour, safeguarding and medication. The manager has done train the trainer courses in safeguarding and medication. The previous inspection had identified a requirement in relation to staff being suitably trained and competent to maintain health and safety at all times. This applied particularly to one service user in relation to moving and handling and choice of equipment. As mentioned in the section on personal and healthcare support, the home had met a related requirement about moving and handling assessment and equipment. The manager identified four staff members requiring moving and handling training. The service caters for people with physical disability as well as learning disability. The manager said new staff are given a handout at induction in relation to back-care and we saw guidelines for transferring individuals are contained in their care plans. As already mentioned, a health professional who completed our survey questionnaire told us that the service has a good awareness of safe practices with regard to moving and handling. The organisation has a training programme but it can be difficult for all staff to access training locally when it is due. The manager told us that this has created a backlog. For example, training in epilepsy had been booked for 14/11/08 but was cancelled due to the small number of staff names on the list of attendees. However three of the homes staff had registered to go and there are also two new staff who need the training. A member of staff confirmed that staff meetings are held once a month and they receive regular supervision and support. The staff member said that the training is thorough and staff were keen to go on courses. Another staff member who completed a survey questionnaire indicated that they are given training that is relevant to their role, helps them understand and meet the individual needs of service users and keeps them up to date with new ways of working. The manager reported that eleven out of sixteen permanent staff had NVQ level 2 or above in health and social care. Care Homes for Adults (18-65 years) Page 23 of 30 Care Homes for Adults (18-65 years) Page 24 of 30 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. The home continues being well run and its development is underpinned by the views of those who use the service and other stakeholders. The health, safety and welfare of people in the home is promoted. Evidence: The manager has worked in the home since it was opened and has been the registered manager for three years. The manager is supported by an experienced deputy manager and has access to the regional director who is based locally. There is a business plan for the service for 2008-09. Care Management Group has a corporate quality assurance system that includes stakeholder surveys. We saw survey responses from the relatives of three people who use the service. The responses were generally very positive about the quality of service in relation to such things as communication, review processes, health, finances, care and visiting. One individuals next-of-kin said of the care given to a service user: It feels like he now has a home with staff that really care for all his needs and where he is valued, liked and enjoyed Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: and fantastic quality provision led by an outstanding manager and deputy. As already mentioned, the home provides individualised newsletters to peoples next-ofkin to keep them informed. We saw evidence that regulation 26 monitoring visits are undertaken by the organisation on a monthly basis and actions are drawn up for the manager to improve the service. The last report for October had highlighted an action point in relation to updating the staff training matrix. Records we saw indicated that staff receive training in mandatory subjects such as fire safety, emergency aid, moving and handling and infection control, although some staff were due training updates in moving and handling and other topics. We saw that records are kept of regular fire drills and the names of those attending; weekly inspections of the means of escape in the event of a fire; fire equipment checks and services. Fire safety risk assessments were in place and had been reviewed in April 2008. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The home must make sure that a suitable storage facility is available for any controlled drugs that individuals may be prescribed, in line with changes to the legislation about peoples medication. This is to ensure that the proper and legal safeguards are in place when care workers give controlled drugs to people who use the service. 09/03/2009 2 35 18 The organisation must 09/03/2009 ensure that a system of staff training is in place for all staff to receive necessary training and this is accurately recorded. To ensure the individual needs of people using the service are met. Recommendations Care Homes for Adults (18-65 years) Page 28 of 30 These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 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. 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