Inspection on 13/10/09 for Acorns

This inspection was carried out on 13th October 2009.

CQC found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Acorns 25/10/07

Acorns 13/06/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Acorns Walton Heath Pound Hill Crawley West Sussex RH10 3UE     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Annie Taggart     Date: 1 3 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Acorns Walton Heath Pound Hill Crawley West Sussex RH10 3UE 01293885331 P/F01293885331 acorns@ilg.co.uk springmeadow@ilg.co.uk Evesleigh Care Homes Ltd (ILIACE Group) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) 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 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 categories: Learning disability - (LD). Date of last inspection Brief description of the care home Acorns is a care home registered to accommodate up to five people with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd (ILIACE Group) part of the Independent Living Group. The managers post for the home is at present vacant. The home is a detached property situated in a small cul-de-sac on the outskirts of Crawley, West Sussex. There is easy access to all community facilities including a local rail and bus station. Limited parking is available to the front of the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 Brief description of the care home house. Accommodation is provided over two floors. People have their own en suite bedroom, located on the first and ground floors. On the ground floor there is a comfortable living room with a large T.V. a good size kitchen, a utility room, a dining room, an office and a staff toilet. The garden is accessed via the kitchen door at the rear of the property. There is a large balcony area with decking and steps leading to a small enclosed garden. Current fees are from 1100.00 to 1750.00 per week. 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: zero star poor 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: In order to plan for this inspection an Annual Quality Assurance Assessment (AQAA) was sent to the manager for completion and surveys were sent to service users, staff and other professionals involved with the home. We looked at any information that we have received about the home since the last inspection and we read the last report. The AQAA was returned within the given timescales and it contained clear information about the services on offer in the home. No surveys were returned. The unannounced visit was carried out at 10.30am on Tuesday 12th October 2009 and the visit lasted for four hours. During the visit we spent time with three of the the four people currently living in the home, we spoke with the three staff members on duty and we observed staff practice. Three care plans and all supporting documentation such as daily records, food records Care Homes for Adults (18-65 years) Page 6 of 30 and risk assessment were tracked and we looked at how peoples health care needs are met and how medication is being managed. We tracked the recruitment files for three staff and found that they contained the required documentation and we looked at how staff are trained and supported. Records for the running of the business were seen and these included incidents and accidents, Regulation 26 providers visits, Regulation 37 reports, fire records, service user money management and quality assurance evidence. Feedback was given to the new manager following the visit. Care Homes for Adults (18-65 years) Page 7 of 30 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 30 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available to guide prospective service users and their families to the services on offer in the home. People have their needs and wishes assessed and recorded and contracts of terms and conditions of residency are agreed. Evidence: There is clear information available about the services on offer in the home and we saw that the Service User Guide is being reviewed and updated to ensure that it is more user friendly and accessible. No new service users have been admitted since that last key inspection visit and we saw that the people living in the home had comprehensive assessments recorded and contracts of terms and conditions of residency are in place. 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. There are person centred care plans and risk assessments in place to guide the staff team to the needs and wishes of the people they are supporting. Daily recording and monthly reviews need to be improved to ensure that care records are up to date. Evidence: For each person living in the home there is a care plan in place to guide the staff team to the needs and wishes of the people they are supporting. The plans are person centred and in the form of the Essential Lifestyle Planning format. We tracked the care plans of three people and saw that the plans detailed areas such as likes and dislikes, personal preferences, communication profiles, behaviour management and social and emotional wellbeing. Goals for personal development are agreed and recorded and there is a system in place for them to be monitored at monthly key worker meeting with service users. Risk assessments both environmental and personal are documented with details of Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: how the risks can be minimised whilst still supporting peoples choice and independence and we saw that people are encouraged to participate in the running of their home by helping with daily chores and cooking. From tracking records we saw that all monthly reviews, which are in the form of key workers meetings with service users were out of date, for one person there was none recorded since 2008 and we brought this to the attention of the manager. Each person also has a care book that details the daily records for people and some of these were also not fully completed. At the present time care plans are loose leaf documents placed in a large file case for each person, the new manager said that she is going to review and update all care plans and make them more accessible to the staff team and easier to monitor. This will be checked at the next key inspection visit. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some activities and outings arranged for people but attention must be given to providing a programme of activities that provides stimulation and development for people and issues of providing healthy nutrition must be addressed Evidence: From looking at daily records and activity plans we saw that although there are some structured activities for people, most of their time is spent in the home. We tracked that activities for three people and saw that three people attend a day care facility or college and that people sometimes go out shopping, to the pub for a meal or to visit their families and friends. The activities that people undertake are recorded in their care books each day for the morning, afternoon and evening. When tracking the activities for the past two months we saw that for many consecutive days they recorded, watched TV all day, watched Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: TV and DVDs all day, watched TV, had hair straightened, had dinner, went to bed, In room all day coming out only for lunch, watched TV and sat in garden. There were some records of people going out with staff for meals and shopping but these were not regular and none were recorded in the evenings. We spoke to the three staff on duty and asked why people did not go out and access the community more and they told us that this was because there was only one driver on the staff team. We asked why public transport was not used for some people and were told that the former manager had not encouraged this and that also there always had to be two staff in the house at any time. We saw that in the dining room there was art and craft and other activities materials in place but daily records did not show when these were being used with people. On some days no activities had been recorded for people in their care books. When tracking menus and food records we saw that most meals consisted of fast food or pasta meals and records were kept each day in the care books. Examples of this were, lunch, pot noodles, dinner, burger and chips,lunch, chinese, dinner noodles, lunch Burger King, dinner sausage sandwich, lunch ravioli, dinner pizza and chips. We saw that a roast lunch was recorded on Sundays and that there was fresh fruit in the home but there were no records of when people had eaten fruit or sweets following their meals. We asked the staff team on duty why people had so many fast foods and carbohydrate heavy meals and one person told us that it is the service users choice and that when asked, one person chooses pasta for every meal. We brought the records of activities and meals to the attention of the new manager who agreed that both areas were in need of addressing as a matter of urgency. We also brought to the attention of the manager that observation during the day had showed that although the staff on duty during the day were kind in their dealing with service users, they were also over familiar, for example calling service users, love and darling and chatting to each other not including people. The manager told us that she had also observed this and agreed it was unprofessional behaviour and would be addressed. 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their healthcare needs assessed and recorded in Health Action Plans, they have access to professionals and are supported to attend appointments. Evidence showed that there was a lack of staff competence in signing medication records and in responding to and reporting incidents and accidents. Evidence: From looking at records we saw that there are completed Health Action Plans in place that detail the physical and emotional health care needs of each person. People have access to their local doctors, dentists and learning disability teams and we saw that for some people referrals had been made to ILGs own behavioural team. The staff team receive training in Strategies for Crisis Intervention and Prevention (SCIP),which is training in dealing with challenging behaviours and we were told that no physical interventions are currently in use in the home. When looking at a communications book we saw that there was a recent entry that said when staff had taken a service user swimming they had found bruising on the persons thigh, elbow and arm, we also saw that there had been a fall in a car park leading to a service user receiving bruising and other unexplained bruises were Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: occurring to one person. We looked at the persons daily care book and saw that the bruising had not been recorded, also it was not recorded in accident and incidents, no body maps had been completed nor medical advice been sought. Reports of the incidents had not been sent to the Commission as a Regulation 37 report or to West Sussex as a safeguarding referral. We were shown a small book for recording bruising that had been supplied for staff to complete by the persons mother. We spoke to the manager about this and she found three hand written accounts of incidents on loose leaf paper in the office. We spoke to the staff on duty and asked why appropriate action such as filling in accident and incident getting medical advice had been carried out. We were told that staff could not explain the bruising, that accidents and incidents had to be reported to the company on line and that only two people on the staff team knew how to do this or had the password. The new manager confirmed that accidents and incidents do have to be reported to the head office on line but this is only after the paperwork has been completed and relevant action taken by the home. There are policies and procedures in place for the administration and recording of medication and we saw that medication is suitably stored and that staff receive relevant training. When checking Medication Recording Sheets (MAR) we saw that for one person who is prescribed food supplements, there were three gaps in signing and for one person who is prescribed for a cream four times a day there were twenty five gaps in signing. This was brought to the attention of the manager. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a process in place for recording and responding to complaints and concerns but to ensure the safety of people at all times there needs to be a better staff understanding of safeguarding issues in the home. Evidence: There is a process in place for recording and responding to complaints and concerns and there is also a user friendly accessible version in words and symbols for service users. The procedures needs to be updated to reflect the new address of the Commission and the manager said that she would address this. No complaints have been recorded in the complaints log. When talking to the staff on duty they told us that they had received training in protecting people from risk of abuse or harm and we saw certificates on file in the home. The three staff on duty said that they would report any suspected abuse to the manager or area manager. When looking at the minutes of a staff meeting held on 30/4/09 we saw the following entry. It has been reported that (staff initials) swears inappropriately in front of service users. (another staff member initials) said that everyone swears, its not a bad thing and can be a happy thing and she didnt think anyone swore inappropriately in front of service users. The action from the manager for this was, be more aware when talking to each other who is listening. We brought this record to the attention of the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: new manager who agreed that this showed a lack of respect to service users and a lack of understanding by the staff team as to what constitutes abuse and she said that she would address this. A Requirement has been made for the home to review safeguarding training. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Acorns provides an attractive, homely and comfortable environment for the people who live there. Improvements are needed to dealing with health and safety safety issues. Evidence: The home is situated in a residential area and provides a comfortable and homely environment for the people who live there. There is a large lounge and dining room area and the lounge has access to a garden with a decking area with chairs and tables. Peoples private bedrooms are decorated to their own choice and all had been personalised with peoples own belongings such as pictures, ornaments, televisions and music systems. Each bedroom has a en suite bathroom and during the visit repairs were being carried out to leak in one of the bathrooms. People had their daily routines and preferences displayed in either their bathrooms or bedrooms by use of words and symbols on a sticky back system attached to the wall. For some people these had been completed but for others they were not. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: In the three upstairs bedrooms we saw that the bedroom doors had all been propped open, one with an old television, another with a large plant pot and the third with a large box. We asked the manager if this was usual practice as they could be a trip hazard for people with poor mobility skills and she said that as this was her first day she did not know. A Requirement has been made for the home to liaise with the fire department regarding safe ways of keeping service users bedroom doors open. The home was clean throughout with antiseptic hand gels in use . 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. There is a robust recruitment procedure carried out and the staff team receive training and induction. More support and supervision is needed to ensure that the staff team have the skills and knowledge they need to safely support people. Evidence: From looking at staffing records and rotas we saw that there are usually three staff members on duty during the day. During the visit there were two experienced team members with one person who was in their induction period and who was being shadowed at all times. The managers hours were in addition to the rota. From speaking to the staff on duty we found that the staff team although they said they wished to provide a good level of care for the people they support thought that the staff team was fragmented and did not work together as a cohesive team. There has been no registered manager in post for a month and as recorded in other parts of this report the staff on duty were not knowledgeable about the policies and procedures and working practices they should follow and records show us that this has lead to service user not receiving the correct levels of support they require. We tracked the recruitment records for three members of staff and saw that a robust recruitment process is carried out. Files contained the required documentation such as Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: two references and a current Criminal Bureau Check (CRB). One new staff member had a POVA first in place and was being supervised and shadowed at all times. New staff receive an induction in line with the Learning Disabilities Qualification (LDQ) and during this time mandatory training such as first aid and manual handling is carried out. We saw that there is a programme of training in place and staff attend courses such as acquired brain injury, epilepsy awareness and challenging behaviour management and in the AQAA we are told that of seven full time staff, five have NVQ at Level 2 or above. There is a policy in place for staff to receive regular supervision and support sessions in order to monitor their practice but records showed us that this was out of date for the three staff records we tracked. Care Homes for Adults (18-65 years) Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a new manager in place that has the experience and qualifications to manage the home. To ensure the safety of people at all times improvements are needed to the way the home has been managed, to completing records and to addressing health and safety issues. Evidence: The registered manager has recently left and a new manager has been transferred from another home in the group. The manager told us that she had been a registered manager and had a number of years experience in working with people with a learning disability. It was the managers first day in her new role. From looking at records we saw the Regulation 26, providers visits are carried out and reports and action plans are produced as a result of the visits. There are also regular audits carried out on subjects such as medication and health and safety and results of these are kept in the home. Fire checks and staff fire training was up to date and equipment checks were regularly undertaken and recorded Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: From looking at the organisations quality assurance manual we saw that there is a quality assurance process in place that elicits the view of service users and other people involved with service but there was no evidence of a recent programme having been carried out for Acorns. There is a system in place for the safe management of peoples monies, all transactions are recorded and there is a numbered tag on each persons personal cash file that is recorded and replaced each time the records are opened. We checked the records for one person and they were correct. As recorded in other parts of this report there are identified concerns about the safety of the levels of support being offered to people by the staff team not having the information they need to safely support people. Records in the home are not being kept up to date and these include monthly care plan updates, medication records, incident and accident reporting, the management of safeguarding issues and referrals and by Regulation 37 reports being sent to the Commission as required. Staff supervision is out of date and there are health and safety issues to be addressed with regards to potential falls hazards by peoples bedroom doors being blocked open by large items. Care Homes for Adults (18-65 years) Page 25 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 26 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 13 16 16 (2) (m)The registered provider must ensure that there is a programme of activities and outings in place that meet peoples needs and aspirations. This is to ensure that people are provided with an environment that offers stimulation and personal development. 30/11/2009 2 17 16 16 (2) (i) The registered provider must gain advice from a nutritional expert regarding the meals being provided in the home. This is to ensure that people are receiving a well balanced, varied and healthy choice of food each day. 30/11/2009 3 19 13 13 (1) (b)The registered provider must ensure that all accidents and incidents that occur to a service user 30/11/2009 Care Homes for Adults (18-65 years) Page 27 of 30 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 is responded to and recorded. This is to ensure that people receive the medical attention they need and to monitor accident. 4 20 13 13 (2)The registered provider must ensure that medication records are kept up to date and are fully completed. This is to ensure that there is a system to monitor that people receive the medication they are prescribed for. 5 23 13 13 (6) The registered provider must ensure that the staff team has a clear understanding of what constitutes abuse. This is to ensure that service users are protected from all forms of abuse at all times. 6 24 13 13 (4) (b) The registered provider must liaise with he fire department regarding a safe system of propping open service users bedroom doors. 30/11/2009 30/11/2009 30/11/2009 Care Homes for Adults (18-65 years) Page 28 of 30 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 This is to ensure that service users are not put at risk by their being hazards in place in doorways. 7 36 18 18 (2)The registered provider must ensure that all staff receive regular supervision and support. This is to ensure that there is a system on place to monitor staff skills, approach and working practices. 8 42 37 The registered provider must ensure that all incidents accidents and events that affect the wellbeing of service users are notified to the Commission. This is to ensure that there is a system in place to monitor the safety and management of the home. 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 30/11/2009 30/11/2009 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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