Inspection on 23/10/08 for Abbeydale

This inspection was carried out on 23rd October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbeydale 20/05/08

Abbeydale 19/12/07

Similar services:

Agar Grove & St Augustine`s Alcohol Treatment & Rehab

Herbert Street

Haven (The)

Charis

Hartley House

Brook Drive, 124

Rugby House Project

City Roads Crisis Intervention

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Abbeydale 98 Bisterne Avenue Walthamstow London E17 3QS     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: Caroline Mitchell     Date: 2 3 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Abbeydale 98 Bisterne Avenue Walthamstow London E17 3QS 02085094100 02085094101 pchibagu@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Active Care Partnerships Limited Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence mental disorder, excluding learning disability or dementia Additional conditions: The Registered Person may provide the following category of service only: Care home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Past or present drug dependence - Code D Past or present alcohol dependence - Code A The maximum number of service users who can be accommodated is: 12 Date of last inspection Brief description of the care home Abbeydale Care Centre is part of Abbeydale Independent Hospital. There are four units within the hospital and Abbeydale is the only one to be registered with the Commission for Social Care Inspection as a care home. The home is registered to accommodate twelve people with past or present mental disorder, drug and alcohol dependence. At Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 0 12 12 12 Brief description of the care home the time of this inspecdtion there were four residents living at the home. The home is situated in a purpose built building and is near to Walthamstow town centre with all of the amenities that this offers. There are bus routes near to the home. The fees range from £700 to £1,000 per week and people using the service pay for their own toiletries, outings and holidays, and clothing. Following ?Inspecting for Better Lives? the provider must make information available about the service, including inspection reports, to the people who use the service and other stakeholders. 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: This inspection was unannounced so the manager didnt know that we were coming. The inspection took about a day to complete. The manager was very helpful throughout the inspection and we spoke to two residents at some length and met the other two briefly. All four told us that they were happy living in the home. We stayed for lunch and took the opportunity to chat with one resident and to one staff member. We looked at written records for three of the people living in the home. This included their assessments, care plans and the regular reviews of these, risk assessments, daily records, minutes of 1-1 meetings, review meetings and Care Programme Approach (CPA) meetings. We looked at the personnel records for four staff members. These included their applications, recruitment and pre-employment checks, training records, minutes of 1-1 supervision meetings with their managers, annual appraisals and Care Homes for Adults (18-65 years) Page 6 of 29 induction records. We looked at the complaints records and all of the written records about a complaint that the home had received, and which had recently been dealt with through the safeguarding procedure of the local authority. We checked the arrangements that are in place to maintain health and safety in the home and checked the staff rotas. Because the home was issued with a number of Statutory Notices in March 2008 we visited the home in July and August to check if these had been complied with. Summaries of what we found at these visits are also included as part of this report. 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 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 9 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. As no new admissions have taken place the rating for this outcome group is assessed as adequate. However, there is evidence to suggest that future admissions will have an accurate assessment of their needs that they, or people close to them have been involved in before they are admitted to the home. Evidence: At the key inspection in May 2008 at least one person had not had their needs appropriately assessed before moving to the home. At the visit we made in August 2008 we looked at the written records for three peoples files in relation to assessment. At that time the manager confirmed that there had been no new admissions since the key inspection in May 2008. However, it was clear that new assessments had been undertaken with each person who was living in the home and that these were based on self- assessment. Information gained from the selfassessment was collated into a development plan for the person and this information fed into the support plans that had been devised. The manager of the home told us that prior to admission to the home a prospective resident would complete the preCare Homes for Adults (18-65 years) Page 10 of 29 Evidence: assessment pack, which would include the self-assessment. He also stated that the placement contract for the prospective resident would detail both their expectations and those of Abbeydale. It was therefore the case that in so far as they were able, the home had complied with this section of the Statutory Enforcement Notice. At this inspection the manager told us that there had been no new admissions. He said that he had received some referrals and had undertaken some pre-admission assessments, but had made the decision that the home was not suitable for them. 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. The home has improved the assessments and plans of care for each person and makes sure that the person, or someone close to them, has been involved in creating these. People are able to make decisions about their life, including their finances, with the support they need. This is because the staff promote their rights and choices. People are supported to take risks to enable them to be as independent as they can. This is because the risk assessments have been improved and the staff have appropriate information on which to base decisions. The staff help people to make informed choices and decisions. Evidence: At this inspection the records that we saw for three of the people living in the home showed that they had completed their self-assessments, which were broken into separate relevant areas, such as support, respect, community, decisions, strengths and peace of mind. Each person had been supported to complete the sections in detail and this information had been translated into care and support plans. For example, Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: one person had the aim, to improve my physical and mental well being so that I can remain well and stable. There were steps that would be taken to realise this and a detailed support plan. This support plan also stated that the person should attend counselling and there was evidence that they had been supported to do this. At the key inspection in May 2008 the registered person was required to make sure that information contained within the service user plan be put into practice to ensure the people that use this service have a good quality of life and that residents are enabled to take action regarding the decisions they make with respect to the care they receive to develop a good quality of life. At this inspection we found that this has been addressed. The system of assessment and care planning that has been introduced is of a good standard and is based on the choices and aspirations of each person. There was lots of evidence that these were being followed and translated into practice. With regard to the risk assessments the registered person was previously required to make sure that risk assessments were completed to enable residents to live as independently as possible, whilst also ensuring that there are safeguards in place to protect them. At this inspection we were pleased to note that the risk assessments had been improved considerably. The two people we spoke to told us that they had been involved in their assessments, care planning and risk assessments and that staff were very supportive. One person said they were more confident and going out on their own more. 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. Each person is treated as an individual and the home is responsive to peoples 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 the local community. The home supports people to follow personal interests and activities. People are able to keep in touch with family and friends and the home supports them to have appropriate personal and family 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. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: In discussion with the manager it was clear that he is committed to improving peoples lifestyles and is making sure that there are enough resources to provide opportunities for people to get out into the community and engage in meaningful activities. At the time of this inspection some residents were out on a trip to the London Eye, and enough staff had been provided to facilitate this. One person has a regular work placement, in the bakery of a local supermarket. Others, who had chosen not to go on the trip, were coming and going freely to the local shops and cafes. The manager showed us lots of photographs of the activities that people have been doing recently, these included a visit to the Millennium Dome, Madam Tussuads, shopping at Lakeside and various other trips. He said that it is his intention to get these framed and put up in the home. A new staff member had just been recruited with the specific role of co-ordinating activities with the people living in the home. Most meals are prepared in the large kitchen, which caters for the hospital as a whole. In peoples plans we saw cooking their own meals was part of some peoples aims for a more independent lifestyle. There is a kitchenette in of the main lounge and this is where the people who live in the home are involved in cooking. We stayed for lunch and sat and talked with one of the people who lives in the home and one staff member. The person we talked to said he is getting more involved in cooking. The staff member said the person is becoming more confident and makes a good spaghetti. The manager told us that one person who lives in the home is enthusiastic about cooking his own meals and and does so regularly, and that others are becoming more confident with the support they receive in the home. There is a room in the home that is set up as a gym and we saw one person working out, using the equipment. When people returned from their trip, one person went out to visit an elderly relative. This is something that he does on a regular basis. 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. 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. People are encouraged to be as independent as they can with their medication and the home supports them with it in a safe way. Evidence: A Statutory Requirement Notice was issued by the Commission in May 2008 in relation to the homes failure to ensure that people were enabled to create their own privacy, to freely use all areas of the home and to leave the building when they chose. At that time we noted that the front door to the home was locked and residents did not have keys to enable access as they wished. One person said that they had asked for a key to their bedroom but had not received one for around six weeks. The communal bathroom was locked, so that people had to ask a member of staff to open it if they wished to use it. At the inspection in August 2008 it was positive to note that the front door was open and one of the people living in the home was sitting outside. The manager told us that Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: all residents had been given keys to their front door and to their bedrooms. The residents we spoke to confirmed this and there was signed, written confirmation on each persons file stating they had been given keys. The bathroom door was checked at the inspection in August and at this inspection, and was found to be unlocked. Two people told us that it was no longer being locked by staff. At this inspection we looked at the written records for two people in relation to their personal and health care support. At the inspection in August and at this inspection we spoke to two people in some detail and they told us that they get regular access to physical and mental health care support. Their records showed this to be the case. The four people living in the home are all relatively independent in their personal care and their care plans tell staff about what help they need in this area. The people we spoke to said that they had been involved in designing their care plans and their needs were reflected in them. They both said that staff support them in a way that is respectful and sensitive. At the inspection in May 2008 we found that the home had failed to make adequate arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the home. During inspections in July, by the Commissions Specialist Pharmacy inspector, and August all of the areas identified during the key inspection at the home were re-examined. It was positive to note that the storage of medication was safer. A new medication room had been set up, and the medication cupboard was attached to a solid rather than a stud wall. The temperature within the medication room was being recorded daily and was consistently below 25 degrees Celsius. The medication administration file was examined and it was positive to note that a current photo of each resident was in place. An issue regarding as and when required (PRN) medication that was being administered to one resident had been resolved by the GP. This was appropriately recorded on the medication profile. The medication profiles were examined and these were observed to be more detailed that at the key inspection in March. It was positive to note that PRN protocols have been improved for PRN medication. Guideline for administration were very clear. Where PRN medication had been administered the rear of the medication chart was signed accordingly. Whereas, there had previously been issues about PRN medication being provided by the pharmacist in the same blister bubble. At this inspection we found that the home had changed to the Boots monitored dosage system, where each drug is kept separately. We also noted that training was being provided regularly by Boots. It was very positive to note that since all of these improvements have been made the use of PRN medication had been reduced Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: significantly, and particularly for one of the people living in the home. Care Homes for Adults (18-65 years) Page 18 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. If people have concerns about their care and support, they know how to complain. Their concern is looked into and action taken to put things right. The home has improved the way that it safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. Evidence: At the inspection in May 2008 we found that the home had breached Regulations related to complaints, which state that the complaints procedure shall be appropriate to the needs of the people using the service. At the key inspection in May, there were adequate policies in place. However, there was no evidence that these were being put into practice within the home. At the visit we made in August and at this inspection the members of staff we spoke with said that they had attended a very thorough session on complaints in August. The minutes of this meeting were seen and showed that nine staff members had attended and received the training. We also saw records of further work that the management team had been doing with the staff in subsequent staff meetings, and evidence of the work planned for the future around responding to complaints and safeguarding people from abuse. We looked at the record of complaints at the visit in August 2008 and at this inspection. It was positive to note that the file included records of action taken and a Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: dated record of responses to complainants. All complainants had been responded to within a twenty-eight day timescale. For complaints that were on-going, there was evidence to show that responses were sent to any letters received, in a prompt manner. The records also demonstrated that a full investigation has taken place regarding each issue. It was also positive to note that all complaints were being recorded, both those received informally and those received formally. We spoke to two of the people living in the home and both were very clear about how to complain, and what the process would be. They were also clear that they had no complaints to share with us at the time of this inspection. They both said that they felt safe and well supported in the home. At the key inspection in May 2008 the registered person was required to make sure that the residents are protected from the possibility of harm or abuse. This was in relation to there being no evidence of staff training in safeguarding and to risk management plans not being in place for all areas of identified risk. As previously stated in this report the risk assessments that we saw at this inspection had been improved considerably and were very comprehensive. Although a lot of training about safeguarding people has been provided in-house, a recommendation is made for staff to also attend external training in this area. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe, clean and reasonably well-maintained home. Efforts are being made to make it more homely, comfortable and pleasant. The home has enough space and facilities for people to lead the life they choose and to meet their needs. Evidence: This is a purpose built unit and, although it is spacious, it is rather clinical in appearance. At the key inspection in May 2008 the registered person was required to make sure that the care home was made less institutional and more homely and comfortable. At this inspection there was evidence that the manager is making efforts to make the place more homely. There is still some work to be done in this area and in acknowledgment of the progress made so far, a recommendation is made about this. The manager had ordered new furniture, some of which had arrived. He told us that he had also ordered more pictures and showed us the photographs that he said are going to be framed and put up in the shared areas of the home. At the last key inspection the registered person was required to make sure that suitable arrangements are made for maintaining satisfactory hygiene levels at the home. This was particularly in relation to the communal bathroom. At the visit in Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: August and at this inspection we found that all communal parts of the the home were clean. We particularly noted that the large kitchen, which provides food for the hospital as a whole, was cleaned to a particularly high standard. Care Homes for Adults (18-65 years) Page 22 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. Although there has been an unsettled period because of some staff changes, new staff have been recruited and people have safe and appropriate support as there are enough competent, qualified staff on duty. They can have confidence in the staff at the home because checks have been done to make sure that they are suitable, although the records of these could be improved. Peoples needs are met and they are supported because staff get the right training, supervision and support they need from their managers. Evidence: At the key inspection in May 2008 we found that the home had failed to ensure that a qualified nurse was on duty at all times and the registered person was also required to make sure that an accurate rota is maintained at the home. During the inspection in August 2008 and at this inspection we looked at the staffing rotas for a four week period on each occasion. This information was cross checked with the daily records of staff and confirmed that, for each week we looked at, the rota provided an accurate record, and a qualified nurse had been on duty on each shift. At this inspection the manager showed us that he is introducing a better, more organised system of providing and monitoring the 1-1 supervision provided to staff. He Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: has made some progress with this and a recommendation is made for the work to be continued, to make sure that all staff are provided with sufficient support. There is already a system in place to make sure that staff have an annual appraisal. We saw evidence that the manager has been auditing the staff personnel files to make sure that they include all of the necessary information required under the Care Home Regulations. He has made sure that the files clearly state peoples job title and the hours that they are contracted to work. We looked at files for 4 staff members. All files had most of the information. However, some didnt include a copy of the original application. In acknowledgment of the progress made by the manager in this area a recommendation is made for him to continue with the planned schedule to make sure this work is completed. We saw a copy of training matrix, which shows what training staff have undertaken and highlight the training that they need. This showed that several of the newer staff need some core training and others are due for updates. We also saw the plan of training, showing what training is to be provided over the next several months. The manager is proactive in addressing the staffs training needs and staff are being booked on training sessions as they are planned. The training provided most recently includes medication, managing complaints and safeguarding people, food hygiene and moving and handling. A recommendation is made for the manager to continue with the progress made to make sure that all staff have all necessary core training. Care Homes for Adults (18-65 years) Page 24 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. The environment is safe for the people who live there and the staff because health and safety practices are carried out. People get the right support from the home because the management team run it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home keeps records appropriately and makes sure staff understand the way things should be done. Evidence: Although the manager is relatively newly appointed, he has been very proactive in addressing all of the issues brought to the attention of the registered provider at the key inspection in May 2008. He has applied to be registered with the Commission. At the inspection visit in August and at this inspection there was lots of evidence that he has worked hard to make sure that the service is more person centered, flexible and respectful of the people living in the home. As noted throughout this report he has led and introduced improvements in a number of areas. People are asked regularly about their satisfaction with the home, in 1-1 sessions, residents meetings and review meetings. The manager told us that the people living in the home and their families Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: are asked to complete questionnaires, as are the various social care and health care professionals who visit the home regularly. We saw the written feedback from people and this was quite positive. We saw lots of evidence that the feedback is used as part of the quality assurance system and that quality monitoring systems and processes are being improved generally. We looked at most of the written records kept in the home at this inspection and were pleased that there were good, detailed records of what activities each person living in the home has been engaged in and good monitoring records of their mental health and wellbeing. These showed that for some people, there has been an improvement in the kind of life choices that they have been making recently, and as stated previously in this report, reduced use of PRN medication. At the key inspection in May 2008 the registered person was required to make sure that notifications of the death, illness or any other event that affects the well being of the residents are made to the Commission in writing, without delay. Since this requirement was made the home has notified the Commission of all events promptly and consistently. At the last key inspection the registered person was required to make sure that measures are in place to reduce hazards to residents safety, particularly in relation to the management of risks, and that these are implemented and maintained. At this inspection we found that the risk assessments were much improved, reflected the practice in the home and that the routine checks regarding health and safety in the home were being undertaken and recorded. Care Homes for Adults (18-65 years) Page 26 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 27 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 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 3 23 24 24 It is recommended that staff be provided with external training regarding safeguarding people from abuse. It is recommended that the manager continue progress made with the planned schedule to make sure that It is recommended that the work undertaken to provide a dividing wall between the kitchenette and the main lounge be completed, including re-decoration of the area. It is recommended that the manager continue progress made with the planned schedule to complete the audit of staff personnel records and to make sure that all staff files include all necessary information. It is recommended that the manager continue progress made with the planned schedule to make sure that all staff receive all core training. It is recommended that the manager continue progress made with the planned schedule to make sure that all staff receive regular 1-1 supervision. 4 34 5 35 6 36 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!