Inspection on 18/11/08 for ABI Homes

This inspection was carried out on 18th November 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

ABI Homes 28/11/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: ABI Homes 34 Dyers Mews Neath Hill Milton Keynes Buckinghamshire MK14 6ER     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: Joan Browne     Date: 1 8 1 1 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 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: ABI Homes 34 Dyers Mews Neath Hill Milton Keynes Buckinghamshire MK14 6ER 01908605066 Telephone number: Fax number: Email address: Provider web address: info@abihomesuk.co.uk Name of registered provider(s): Name of registered manager (if applicable) Resuscitate Care Ltd Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies 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 categories: Learning disability (LD). Date of last inspection Brief description of the care home 34 Dyers Mews is a detached property located in a residential area of Milton Keynes and has capacity to accommodate up to five people in single room accommodation. On the day of the inspection there were three service users living in the home. The location of the home enables people living at 34 Dyers Mews to have good access to public transport networks and the facilities of the nearby city centre where there are good shopping, leisure and recreational resources available. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 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 unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection (CSCI) was undertaken by Joan Browne on 18 November 2008 and lasted for approximately seven and a half hours. The last key inspection on this service was completed on 28 November 2007. The CSCI Inspecting for Better Lives (IBL) involves an annual quality assurance assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection process and is referred to in the report. The information contained in this report was gathered mainly from records kept at the Care Homes for Adults (18-65 years) Page 6 of 30 service and information contained within the AQAA. We also looked at care plan documentation, staff recruitment files, training records, medication documentation and health and safety records. A tour of the premises was conducted. Comment cards were sent to the home to be distributed to people using the service and staff members. Their comments have been reflected into the report. Three requirements and four recommendations of good practice were issued on this visit. Please see individual needs and choices outcome area, personal and health care support outcome area, concerns complaints and protection outcome area, environment outcome area, staffing outcome area, and conduct and management of the home outcome area for full disclosure. Feedback was given to the responsible individual and the director of care at the end of the inspection. The weekly charges for this service range from 1600.00 pounds to 2500.00 pounds. We (The Commission) would like to thank all people using the service and staff who made the visit so productive and pleasant on the day. What the care home does well: What has improved since the last inspection? What they could do better: Awareness raising on adult protection must be offered to people using the service to ensure that they are not placed at risk of harm or abuse. To comply with current regulations the home must ensure that the Commission is notified of any incidents which adversely affects the well-being or safety of any person using the service. The homes recruitment procedure must be reviewed to ensure that evidence of staffs Care Homes for Adults (18-65 years) Page 8 of 30 suitability to work with vulnerable people is appropriately explored and a clear audit of the process how individuals were recruited should be in place. Staffs food and handling practice must be consistent to ensure that opened packets of food and sauces are labelled and dated so that they are used within the used by timescale. 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 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that peoples diverse needs are assessed prior to providing a service. Prospective service users and their family are treated with dignity and respect for the life changing decisions they need to make. Evidence: Pre-admission assessments were seen for the three service users living in the home. The assessments were detailed and outlined the support individuals required from staff to assist them with their daily living activity, health needs, relationships and social activities. The three service users were placed in the home by a placing authority and a summary of their health and social care management assessments were made available to the home prior to the home undertaking a pre-admission assessment. We were told that all staff were involved in the admissions process. The homes manager and the speech and language therapist would normally carry out assessments. Once an agreement has been reached to accept a referral a transition plan is developed and a key worker is identified. Prospective service users are Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: expected to visit the home and spend sometime. They are also assessed on their compatibility to fit in with existing service users. Wherever possible overnight stays are arranged with the service user, care manager and family. Information about the home such as brochures, a DVD on the lay out of the home, the statement of purpose and service users guide are given to prospective service users. The service users guide seen was written in a pictorial format to ensure that people would be able to understand the contents. Evidence seen confirmed that staff spend a significant amount of time and effort planning to make individuals admission to the home personal and well managed. Service users who responded to the Commissions survey said that they were given a choice to move to the home and that they had received enough information about the home before deciding it was the right place to live. Care Homes for Adults (18-65 years) Page 12 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 using the service are involved in the decisions about their lives and are supported by staff to take risks to maintain their independence. Evidence: Three care plans were examined. They were person centred, and presented in a pictorial format to ensure that service users could understand them. The information in individuals plans focused on their preferences and what support was needed from staff in assisting them to promote their independence and to make decisions. The plans contained information relating to individuals daily living activity, safety, goals, aspirations, skills and health care needs. Information in the annual quality assurance assessment (AQAA) stated that each service user has a named key worker who actively provides one to one support and who updates the care plan and feeds back to the rest of the staff of any amendments to the plan. Evidence of care plans being reviewed on a regular basis was seen. We Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: noted that some care plans were not signed by the service user or their representative. As a good practice a recommendation is made to ensure that all care plans are signed by the service user or their representative to confirm their involvement in the development. None of the service users living in the home were assessed as able to fully manage their own finances. Family members leave a small amount of money with the homes staff to cover the cost of toiletries and shopping trips. Money held for service users were kept in individual cash tins. The records were checked and the money held tallied with the transaction sheets. Staff spoken to were able to demonstrate how they support service users to make choices. Talking stories for individuals were developed by the homes speech and language therapist to enable staff to work creatively with service users. Risk assessments and management strategies for individuals were in place to support them with activities outside and inside the home to enable them to lead an independent life. We were told that risk assessments were regularly reviewed. Evidence of training given to service users about their personal safety was seen. At the previous key inspection it was recommend that the home should review its missing persons procedure to reflect that staff need to notify the Commission within 24 hours of anyone being missing from the service, to comply with the regulations. It is pleasing to report that the home had complied with the recommendation made. Care Homes for Adults (18-65 years) Page 14 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. The home enables people to be involved in meaningful day times activities of their choice and according to their individual interests, diverse needs and capability. The staff support individuals to prepare their meals so that they are able to enjoy the food they prefer and like. Evidence: The homes annual quality assurance assessment (AQAA) stated that each service user is given an opportunity to develop their skills to lead an ordinary and meaningful life as possible. Written evidence was seen demonstrating how staff were supporting service users to take part in a wide variety of activities. Each individual had a detailed daily activity timetable in a format that they could understand. On the day of the inspection all three service users participated in activities outside of the home supported by staff. Two service users attended a local day centre, a second attended a Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: work programme. The home has a full time specialist activity coordinator and her role is to liaise and provide specialist autistic spectrum disorder (ASD) advice and training with existing day activity providers and develop new opportunities for service users in education, work and leisure activities. We were told that arrangements were in place for service users depending on their needs to visit the local leisure amenities such as, the local gym, pubs and cinema. We were told that staff support service users to maintain links with family and friends. Pictures of outings and social events with family members were seen. If required arrangements would be made for the staff team to support individuals to develop and maintain intimate personal relationships with people of their choice, and provide information and guidance to help the service user to make appropriate decisions. The daily routines and house rules promote independence. Individuals are expected to keep their bedrooms and bathrooms clean and tidy. They have unrestricted access to the home and grounds and are issued with keys for their bedrooms and the front door. Service users are responsible for preparing their own meals daily with support from staff. We were told that all service users were involved in food shopping and creating menus of their choice and taste. Food items are purchased from individuals preferred supermarkets. Risk assessments were in place and social stories implemented to the specific tasks that they choose to undertake to minimise any identified hazards. Care Homes for Adults (18-65 years) Page 16 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 home ensures that people using the service receive personal and health care support using a person centred approach with support provided based upon the rights of dignity, respect and equality. Evidence: Care plans examined provided a good description of service users personal support needs and what they are able to undertake for themselves. For example, evidence was seen of how staff was supporting a particular individual who had difficulty remembering the process of washing. A visual aid, treatment and education of autistic communication handicap (TEACCH) programme was developed by the homes speech and language therapist to enable staff to support the individual with this task. Evidence of health care plans, positive behaviour support plans and communication guidelines were seen in individuals care plan folders. Information in the annual quality assurance assessment (AQAA) stated that the homes speech and language therapist, and the behavioural therapist meet with the staff to provide group or individual training. Evidence of four weekly meetings with the multi-disciplinary team, senior Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: managers and staff to review service users progress was seen. All service users were registered with a general practitioner (GP) and have access to health care treatment such as, the dentist, optician and chiropodist. For those service users who find it an anxious experience visiting the dentist individual social stories were developed to reduce their anxiety and to provide coping strategies to enable them to build up their confidence. We were told that there were no service users assessed as having the capacity to selfmedicate. The home was not covertly administering medication to service users. The medication administration record (MAR) sheets were examined and no unexplained gaps were noted. There were no service users prescribed for controlled medication. All the staff who administer medication had undertaken training in the safe handling and administration of medication. We noted on one particular MAR sheet handwritten entries were recorded. Consideration should be given to ensure that handwritten entries recorded on the MAR sheets are signed by a second staff member to minimise the risk of errors when transcribing. It is also good practice to ensure that the list of staff members authorised to give medication including a record of their approved initials is kept in the medication folder. Care Homes for Adults (18-65 years) Page 18 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. An effective complaints procedure is in place to listen to the views of people using the service and their representatives. Adult protection training needs to be provided to people using the service to raise their awareness. Evidence: The home has a complaints procedure. Information in the annual quality assurance assessment (AQAA) stated that all service users had been issued with a copy of the homes complaints procedure. We were told that the homes speech and language therapist had reviewed the complaints procedure in a simplified format so that service users could understand. A copy of the procedure was displayed on the service users notice board. People who responded to the Commissions survey said that they knew how to make a complaint. No information regarding complaints made to the service by service users or their representative had been received by the Commission. The home has adult protection and whistle blowing policies and procedure in place. Staff spoken to said that they had undertaken training in the protection and safeguarding of vulnerable adults. Those spoken to were knowledgeable on the action that should be taken if they suspected or witnessed any incident of abuse. The home declared in the annual quality assurance assessment (AQAA) that one safeguarding of vulnerable adult incident had been investigated. The Commission was not made aware of the incident. We were told that one of the service users had reported the incident to a third party outside of the home in the wrong context. This is common to individuals Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: with autistic spectrum disorder. The home had co-operated fully with the investigation and the allegation was not proven. To ensure good communication and joint working the home have invited staff members from other agencies to participate in their autistic spectrum disorder in-house training. This is to enable them to gain greater insight into the needs of individuals with ASD and to prevent any further incidents occurring. It is equally important that service users understand their rights and are supported to explain incidents in the appropriate context. Consideration should be given to provide awareness raising on adult protection to people using the service. A recommendation is made for awareness raising on adult protection to be offered to them. To comply with current regulations the home must ensure that the Commission is notified of any incidents, which adversely affects the well-being or safety of people using the service. Care Homes for Adults (18-65 years) Page 20 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 excellent 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, homely, comfortable, pleasant and hygienic and is fully able to meet and promote peoples diverse needs. Evidence: The home is a large detached property at the end of a mews in Milton Keynes, close to local and city centre facilities. The premises are in keeping with the local community and are attractive and have a style and ambience that reflect the homes purpose. There is a good size enclosed garden with a covered patio area and parking for four vehicles. The ground floor accommodation consists of a kitchen and dining area, a utility and laundry room, activity room, toilet, staff office, two lounges and a conservatory. Upstairs there are five bedrooms for single use. Four bedrooms are used for service users. The fifth bedroom is for the use of staff and is used as an on-call room. Three bedrooms have en-suite bathrooms and the fourth bedroom has a wash hand basin with the bathroom and toilet area across the landing. The fixtures and fittings are of a high quality. The AQAA stated that service users had an input in the furnishing within the communal areas. Bedrooms seen were personalised with family pictures, and personal belongings such as music centres and DVD players reflecting the individuality of service users. We were told that individuals are encouraged to see the home as their own. All the service users had been issued with keys for their Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: bedroom and the front door. People who responded to the Commissions survey said that they felt safe living in the home. On the day of the inspection the home was clean, hygienic and free from offensive odours. Recommendations were made at the previous inspection for a risk assessment to be prepared to ensure the safety of staff using the laundry room at night and during bad weather, as infection control measures require that people do not walk through the kitchen with washing but walk around the outside of the home to get to the laundry. The director of care said that a risk assessment had been put in place. A second recommendation was made for a risk assessment to be put in place for the exposed pipe work at skirting level in the downstairs toilet. The exposed pipe work was boxed in which meant that the potential risk was eliminated. We noted that a yellow bag with clinical waste was left next to the clinical waste bin because the bin was not large enough. It is recommended that consideration is given for a larger bin to be obtained to prevent the risk of the spread of infection by rodents and vermin. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff working in the home are provided with sufficient training to enable them to care for people using the service and to support the smooth running of the service. Improvement is needed in the homes recruitment procedure to ensure that there is a clear audit of the process by which staff are recruited. Evidence: The home employs a multi-cultural staff team to meet service users diverse needs. The home does not use agency staff. Shift patterns on the rota demonstrated that the home was being staffed efficiently with particular attention given to busy times of the day and changing needs of the service users. The home aims to ensure that there are three members of staff rostered to work on an early shift and two on a late shift. During the night there is just one member of staff on-call that sleeps in on the premises. Staff were observed interacting with service users in a respectful manner. Those staff spoken to were aware of individuals needs and their likes and dislikes. Four of the nine support staff have achieved the national vocational qualification (NVQ) in direct care at level 2 or 3. One staff was working towards achieving the level 2 qualification. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The home has a training and development plan which includes mandatory and specialist training. Each member of staff has a training and development portfolio highlighting the training courses attended. There was evidence that staff were in receipt of regular supervision. A staff member who responded to the Commissions survey said that the home make sure that all the staff are given relevant training to the job. Examination of five staff recruitment records demonstrated that all staff had completed an application form and were in receipt of an enhanced criminal record bureau (CRB) clearance. Photographic evidence to confirm proof of identity was seen in files. Two references had been obtained however, in one staff members file the references seen were not original and were addressed to whom it may concern. In a second staff members file there was no written evidence that gaps in employment record was explored at the interview. To comply with the current regulations whenever possible, the home must obtain from individuals written verification of reason for leaving previous similar employment (if available). 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 is run and managed appropriately, which should ensure that people using service and staff safety is promoted. Evidence: Since the last inspection there have been management changes to the home. The managers position has been vacant and the deputy manager was acting up as manager. A director of care was recently appointed. The acting manager is line managed by the director of care. The manager is a trained nurse with experience in learning disability. Senior support workers and support staff assist the manager in the day- to- day operation of the home. In addition the home employs a part-time speech and language therapist, a behavioural therapist and a full-time specialist activity cocoordinator. There are clear lines of accountability within the home. Members of staff spoken to on the day of the inspection were clear about their roles and responsibilities. The annual quality assurance assessment (AQAA) contained good information that was supported by appropriate evidence. The home demonstrated a good level of self Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: awareness and recognises the areas that it still needs to improve on. We were told that the homes business plan and policies and procedures were reviewed in June 2008. Evidence was seen of reports from regular monitoring visits undertaken by the responsible individual and the director of care. Review of documented records demonstrated that health and safety checks were routinely carried out at the home. Records indicated that the fire panel and water temperatures were regularly checked. Daily safety checks are carried out by staff to ensure that the building is safe. Care workers files examined demonstrated that they had undertaken the relevant training to enable them to protect service users health, welfare and safety. We noted that staffs food and handling practice was not consistent. Some opened packets of food and sauces in the refrigerator were not labelled and dated. A recommendation is made to ensure that opened packets of food and sauces are dated and labelled. This is to ensure that food is not used beyond the used by timescale once opened. 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 23 37 The home must ensure that 14/01/2009 the Commission is notified of any incidents which adversely affects the wellbeing or safety of any person using the service. This is to ensure that current regulations are complied with. 2 34 19 The homes recruitment 14/01/2009 procedure must be reviewed to ensure that it complies fully with the current regulation. This is to ensure that evidence of staffs suitability to work with vulnerable people has been explored and a clear audit of the recruitment process is in place. 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. Care Homes for Adults (18-65 years) Page 28 of 30 No. Refer to Standard Good Practice Recommendations 1 6 Care plans should be signed by people using the service or their representative to confirm their involvement in the development. Handwritten entries on the medication administration record (MAR) sheets should be signed by a second staff member to minimise the risk of errors when transcribing. Awareness raising on adult protection should be offered to people using the service to ensure that they are supported to to explain incidents in the appropriate context. Consideration should be given to obtain a larger clinical bin to store clinical waste to minimise the risk of the spread of infection. Opened packets of food and sauces in the refrigerator should be labelled and dated to ensure that once opened they are not used beyond their used by date. 2 20 3 23 4 30 5 42 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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 30 of 30 - 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!