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Inspection on 28/01/09 for Aldwick Residential Care Home

Also see our care home review for Aldwick Residential Care Home for more information

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Aldwick Residential Care Home 92-94 Aldwick Road Bognor Regis West Sussex PO21 2PD     The quality rating for this care home is:   one star adequate 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: Annette Campbell-Currie     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Aldwick Residential Care Home 92-94 Aldwick Road Bognor Regis West Sussex PO21 2PD 01243865569 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Premila Sewpaul,Mr Ashok Kumar Sewpaul care home 27 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Only services users aged 40-65 years of age may be admitted in the cathegory mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home 27 Over 65 27 Aldwick Residential Care Home is a care home registered to accommodate up to twenty-seven service users who have a mental disorder, eleven of whom may be over the age of sixty-five years. The registered providers are Mr Ashok Sewpaul and Mrs Premila Sewpaul. Mr Sewpaul is also the registered manager. The property consists of two terraced houses, which have been joined together internally and extended for its current use. The accommodation consists of eleven single and eight double bedrooms Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home located on the ground, first and second floors. Communal areas include, a dining room and a lounge on the ground floor, whilst a second lounge and a hairdressing room. The home is located in the town of Bognor Regis close to the seafront and local shops and amenities, with easy access to local rail and bus stations. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The previous key unannounced inspection was carried out on 26th February 2008. Four requirements were made following that inspection and an improvement plan was requested. The current fees are 308 pounds per week. Annette Campbell-Currie carried out the site visit over six and three quarter hours. Mr Sewpaul, the registered manager and provider was not available so the acting manager and a senior member of staff assisted with the inspection. The information and documents required by us (the Commission) were available. There were twenty people living in the home at the time. The manager completed an annual quality assurance assessment form (AQAA) before Care Homes for Adults (18-65 years) Page 6 of 30 the inspection. The AQAA provided information that was used to help plan the site visit. During the site visit most of the people staying in the home were seen and five were spoken with. Time was spent with the acting manager, a senior carer, a newly appointed member of staff and the cook. A visiting social worker was also available to provide some comments about the home. Surveys were sent out to people living in the home, staff and health and social care professionals, to find out what people think about the service. Five staff and eleven people living in the home returned surveys, five people had help from staff to complete the forms. The information gathered has been used to help make an assessment of the service. A tour of the building included communal areas, the kitchen, laundry, bathroom and toilet facilities and a number of bedrooms. The following documents were read: the case records of four people living in the home, the complaints records, recruitment records for three newly appointed members of staff, some training records, a sample of medication records. The afternoon medication round was observed. The outcomes for people living in the home have been assessed in relation to twentyfour of the forty-two National Minimum Standards for Care Homes for Younger Adults; including those considered to be key standards to ensure the welfare of people living in the home. What the care home does well: What has improved since the last inspection? The care planning process has been improved and documentation has been brought up to date. Care plans are detailed and it was clear from evidence seen that peoples welfare is monitored and changes to care plans noted. A fire risk assessment has been completed and the individual needs of each person in the event of a fire have been documented. The acting manager was advised to seek the guidance of the fire officer regarding the evacuation plan because of the layout of the building and several fire exits are accessed through bedrooms. The acting manager and a senior carer have carried out appraisals with all care staff. A system for ensuring that all staff receive supervision at least six times a year is being developed. The acting manager confirmed that all staff have attended training in mandatory topics although some staff are due for updated training and the acting manager said that this is being arranged. Twelve of the sixteen care staff have now achieved the National Vocational Qualification (NVQ) at level two or above. Some areas of the home have been redecorated and a new window has been fitted to the hairdressing room. Care Homes for Adults (18-65 years) Page 8 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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. People have an assessment of their needs and aspirations before a decision is made about them moving to the home. People have an opportunity to visit the home before they make a decision about moving in. Evidence: The acting manager said that she or a senior carer go out to meet people to carry out a pre-admission assessment. She said that it is also important to make sure that information has been gathered from social care and mental health professionals before someone moves in so that the home has all the necessary information about the persons diagnosis and treatment. Some people are admitted to the home at a time of crisis and the acting manager gave examples of the process carried out to make sure as much information as possible is gathered in these circumstances. The social worker of someone who had moved to the home in an emergency said that the manager and staff had done everything they could to support the person with the move. The acting manager explained the process carried out to make sure the home was aware of any key Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: information and to make sure a more thorough assessment is carried out without delay. An example of a completed pre-admission assessment was seen and included relevant information to help the acting manager make a decision about whether or not the home could meet the persons needs. Cultural and spiritual wishes were noted on the case records and for one person there was a comment that X would like to see a vicar. There were also notes about the persons wishes following their death. Everyone who is interested in moving to the home is encouraged to visit before a decision is made. The acting manager in the annual quality assurance assessment form (AQAA) said that she encourages people to come to the home for lunch and a short stay so that they can establish a relationship with staff and other people living in the home to help make the transition period easier. One person recently had a series of short visits and then an overnight stay before making a decision to move in on a more permanent basis. 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. Each person living in the home has a plan of care that reflects their assessed and changing needs. People are supported to make decisions in their daily lives and to take risks as part of an independent lifestyle. Evidence: The acting manager said in the AQAA that the home promotes person centred care planning so that each person is treated as an individual and their lifestyle in the home reflects their individual needs. Independence is encouraged and supported within a risk assessment framework. The format used for recording care plans remains the same and includes details of an initial assessment with some key information for quick reference. There is also a more detailed assessment that covers all aspects of each persons needs. A care plan is drawn up for each person with guidance to staff about the way people prefer their care to be provided. People spoken with said that they are happy with the care that they receive and they are able to choose how they spend their time. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: The case records of four people were seen and three were looked at in detail. The acting manager had carried out re-assessments since the previous inspection; these records included clear details and guidance for staff. It was clear that independence is supported and encouraged. Guidance seen on care plans included: support X in making his own choices, staff to encourage X to be as independent as possible, risk assessments to be completed if necessary, X will now be attending cookery lessons on Friday afternoon and continues art on a Monday and X now cannot walk far and would not have the capacity to cross the road, observe at all times and staff to promote routine. Risk assessments had been carried out in key aspects of each persons life. The acting manager gave an example of a recent risk identified for one person living in the home and the referral that had been made to the general practitioner (GP). It was clear from the case records seen that the care is monitored on a regular basis and when changes occur this is reflected in an updated plan of care. The social worker spoken with said that the home had developed a detailed care plan over a period of time with the person he was visiting and the staff had adapted well to providing a different level of support as the person became more settled. A newly recruited member of staff said that she found the information that she needed to know about people in their care plans when she began work. The staff who returned surveys also indicated that communication about peoples needs in the home is good. It was clear that during the day of the site visit the mental health and wellbeing of one person was being monitored and action was taken to make sure she had the support that she needed. 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. People have the opportunity to take part in activities in the home and the wider community. People are supported in their relationship with relatives and friends. People are provided with a healthy and nutritious diet. Evidence: People living in the home are encouraged to take part in activities of their choice in the home and in the local community. The case records that were seen showed that peoples interests and hobbies were noted. There was a note on one persons records: likes to do knitting, art, crafts and going for walks, however there was little information about the persons background or personal history that might also help when providing appropriate activities. Comments on another persons care plan were: X attends creative response on Monday. Staff to encourage X in day-to-day activities. During the day some people were going out for walks or into the town and in the Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: afternoon a bingo sessions was well attended in the lounge. People spoken with said there is always something to do in the home and they can choose to take part if they wish. Art and craft , quizzes and music sessions are held on a regular basis and sometimes there is a baking activity in the afternoons. One person said that staff take her out to do her personal shopping sometimes and another said that theatre trips are arranged from time to time. People are supported to attend local day centres or college courses if they choose. There is a quiet lounge on the first floor that is sometimes used for group sessions and people also use this for reading, doing puzzles or games. Two people said that they are supported to attend local churches. People are supported to maintain contact with family and friends in the community and relatives are kept informed of peoples progress if this is appropriate. Special events are celebrated in the home and relatives and friends are invited. People living in the home were involved in making cards, decorations and food treats at Christmas and relatives were invited to help them celebrate. People are encouraged to make choices in their daily lives and to use advocacy services if necessary. The acting manager said that one person had recently been linked to an advocate because of issues relating to a previous home in which he had lived. People are responsible for keeping their rooms clean and the way they prefer if they are able to. Residents meetings are held so that any issues arising in the home can be discussed and resolved. The cook has a ten-week rota of meals that people like. He said that he talks to people every day to see how they are doing and to let them know what is for lunch, which is the main meal of the day. People bring ideas about the meals to discuss at residents meetings. There was a discussion with the acting manager about the possibility of involving people more directly with food planning, shopping and preparation so that people are more involved and develop or maintain their independence skills. Some people said that they take part in baking cakes from time to time. There is one small dining room and a dining area in the main communal lounge. The acting manager has purchased table clothes so that the dining areas look pleasant. There is some choice of food however the menu is not displayed to enable people to make a choice about what they would like to eat. This matter has been raised at two previous inspections and has not yet been addressed. A recommendation has been made regarding this issue. The cook said that special diets are catered for and there is information in the kitchen about peoples likes and dislikes and any special dietary needs. 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. People have the personal, emotional and physical and healthcare support that they need. The medication practices normally protect people from harm. Evidence: Peoples personal and healthcare needs are noted in their care plans with guidance to staff about the way to provide care. Comments on one persons care plan were: requires prompting with bathing and changes of clothes and on another persons records: unless prompted his hygiene will seriously deteriorate. Staff are provided with information about the way to provide personal care in order to protect peoples privacy and dignity. There are men and women employed as care workers and usually there is a balance of men and women on each shift so that people could have a choice about the gender of the person to provide their personal care. Peoples healthcare needs were noted in their care plans. The acting manager said that the home has a good relationship with local primary care teams and the local community mental health team so that people receive the healthcare input that they need. From discussion, observation and records seen it was clear that people have their health care needs monitored and referrals for specialist input are made when Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: necessary. There was detailed guidance on care plans seen about ways to support people with mental health issues for example: Staff not to dispute what X is expressing- these beliefs are real to X and keep things in reality by saying eg I believe this is what you think . Some people living in the home have regular visits from a community psychiatric nurse (CPN). The acting manager said that CPNs sometimes provide training workshops for staff or guidance about managing particular behaviours. There are policies in place regarding medication and all staff who administer medication have attended training. None of the people living in the home are able to be responsible for their own medication. A synopsis of all the medication prescribed to people in the home has been drawn up so that staff can check information about possible side effects or concerns to help them monitor the welfare of people taking the medication. The administration of medication was observed and samples of medication records were seen. The medication records should include a photograph of each person prescribed medication to avoid possible errors in administration. There was an error in the record book where a medication had been signed for as taken and was still in the blister pack, the acting manager said she would follow this up with the member of staff as a matter of urgency. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their views and concerns are listened to and acted upon. There are some procedures in place to protect people from harm however the recruitment practices do not protect people. Evidence: There is a complaints policy that is provided to everyone in the home. People can also raise concerns through the regular residents meetings. The acting manager is in contact with people living in the home six days a week and checks to make sure how people are every day so that any concerns could be quickly dealt with. There is a system for recording complaints; no complaints have been recorded since the previous inspection. The home follows the West Sussex multi agency policy and procedure for safeguarding vulnerable adults. All staff have attended training about adult abuse and reporting procedures. The acting manager said in the AQAA that there have been four safeguarding alerts to West Sussex Social Services Department and three investigations. The acting manager said that the Commission was informed of these incidents. There was no record in the home of the contact with staff from social services regarding the alleged incidents. The recruitment procedure is not sufficiently robust to protect people living in the home. A sample of recruitment records were seen and showed that two of the three Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: people had begun work before a Criminal Record Bureau (CRB) or POVA First check had been received. The acting manager said the third person had begun work before a CRB check carried out by the home had been received. For two staff there was only evidence of two written references. The recruitment practices do not protect people living in the home. A requirement has been made regarding this matter. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely and comfortable environment. There are areas of the home that are in need of upgrading. There is no development plan in place to show that the quality of the facilities provided is being monitored and any problems addressed. Evidence: Aldwick Residential Care home provides a homely and safe environment for people living there. The home consists of two terrace houses and an extension and the layout of the rooms is unusual. The environment is not suitable for people who are wheelchair users or who have poor mobility. There are a number of staircases to access rooms on the first and second floors. The acting manager said in the AQAA that all equipment in the home has been serviced as required and that the home meets the requirements of the fire officer. A fire risk assessment has now been drawn up and there are details of the support each person would need in the event of an evacuation of the building. This information would assist staff or others needing to assist people to leave the building. The acting manager was advised to seek the advice of the fire officer regarding the details of the evacuation plan because several fire exits are through peoples bedrooms and everyone in the home needs to be clear about what to do in the event of a fire. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Some areas of the home have been redecorated and there has been a temporary roof repair. The window in the hairdressing room has been replaced. There is no ongoing development and maintenance plan for the building and the acting manager does not have any control in budget planning in the absence of the registered manager who also owns the home. Areas of the home are in need of refurbishment including some of the bathroom facilities and the wash hand basins in peoples bedrooms. A requirement has been made regarding this matter. A number of bedrooms were seen and people had their personal items around them. The acting manager said that people who wanted to have locks on their doors have that facility. Some people have lockable drawers or cupboards in their rooms; items of value could also be kept in alternative safe storage. There are eight double rooms in the home however not all of these are occupied by two people at the moment as there are only twenty people in the home. People spoken with who share a room were satisfied with this arrangement. There are sufficient numbers of bathrooms and toilets and some bedrooms have ensuite facilities. There is one assisted bath for people who have mobility problems. This bathroom is accessed via a persons room or through the garden. The acting manager said that one person who does not live in that area of the house is currently using this bathroom and has to go outside to access it. Arrangements must be made for people who need additional support to bathe so that they can do this in a safe and comfortable environment. The communal areas are comfortable and homely and a second lounge on the first floor provides a quiet space for people to use. The office is used as a walkway for people who want to access the garden at the back of the building or the smoking area. This means that there is little privacy for confidential discussions or meetings. The acting manager said that she has been discussing a plan to set up an office space that would provide more privacy. A member of staff is employed for domestic duties and the communal areas and the majority of bedrooms that were seen were clean. The acting manager was advised to carry out risk assessments for people who are sufficiently independent to use electrical equipment in their rooms. There is no ongoing plan for deep cleaning of floor coverings, the kitchen and laundry room, although the cook said that the kitchen has had a deep clean in the past twelve months. The laundry area is small and soiled laundry has to be carried around the outside of the building as the only other access is through the kitchen. There was a leak in the laundry room ceiling that is in urgent need of repair. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who are suitably trained and supported. The recruitment procedure does not protect people living in the home. There is an appraisal and training programme in place. Evidence: There were sufficient numbers of staff on duty during the day of the site visit and the staff who were supporting people were aware of peoples needs. This was clear from discussion and observation and feedback from people living in the home and a visiting social worker. Samples of the staffing rota were seen and showed that during the day there are three carers, a domestic and the acting manager on duty. From five in the evening until ten oclock there are three carers including a senior and at night there are two waking night staff. The acting manager works from Monday to Saturday and in order to provide continuity a senior member of staff who supports the manager, works on Sundays. The acting manager has been responsible for recruitment in the absence of the registered manager. The recruitment records for three members of staff recruited in the past twelve months were seen. Each person had completed an application form. There was only one written reference for two of the members of staff and there were no records of interviews to show that any gaps in employment or issues raised in Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: reference letters had been discussed with the candidate before a decision was made about offering them employment. There was evidence that the home had received POVA First and Criminal Record Bureau checks for two people, however both people had begun work before these checks had been received. The home must establish a robust recruitment procedure to ensure that people in the home are protected. A requirement has been made regarding this matter. Twelve of the sixteen staff have now achieved a National Vocational Qualification (NVQ) at level two and two people are due to complete the award at level three. There is an induction programme and a newly appointed member of staff said that she had all the support that she needed when she began work. The acting manager said that all staff have attended training in mandatory topics although some people are due to attend refresher training to make sure their skills and knowledge are updated. The acting manager said that all staff have had an appraisal of their work and examples of these were seen. The supervision programme is being established so that all staff will receive the support they need to do their jobs well. The surveys returned by staff showed that people receive the support they need. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager has not been available to run the home for over twelve months. There are no clear quality assurance systems in place. The health, safety and welfare of people living in the home and of staff are promoted and protected. Evidence: Mr Sewpaul, the registered manager and owner, has not been available for the daytoday management of the home for over twelve months. Mr Sewpaul has not kept us (the Commission) informed of the management arrangements that are in place. The acting manager said that she and a senior carer have worked together to run the home. Mr Sewpaul is in contact by telephone and Mrs Sewpaul who is joint owner of the home comes in once a week to do the shopping. The acting manager is studying for the NVQ in care at level four. Questionnaires are provided to people in the home to find out what they think about the service. There was no recent information available regarding feedback from people living in the home or other stakeholders who have contact with the home and the people living there. Residents meetings are held on a regular basis and minutes of the Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: meetings are kept. People spoken with and those who returned surveys indicated that their views are listened to. Quality monitoring systems must be put in place to make sure that the quality of the home and the service provided is reviewed and improved as required. The manager said in the AQAA that the equipment in the home is serviced as required. A fire risk assessment has been carried out as discussed and the acting manager agreed to seek the guidance of the fire officer with regard to the evacuation plan for the home. Staff have attended mandatory training and refresher sessions are planned to make sure that all staff have attended updated training. Incidents and accidents are responded to and recorded as required. Risk assessments have been carried out for aspects of the environment that could cause a risk to people in the home. 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 24 23 A maintenance and development plan must be established to make sure that the environment meets the needs of people living in the home. 30/04/2009 2 34 19 The registered person must 30/04/2009 ensure that there is a robust recruitment procedure and that all the required checks are carried out before a new member of staff begins work to ensure that people living in the home are protected from harm 3 37 38 The registered manager and provider must inform the Commission of the management arrangements that are in place during his absence from the home 30/04/2009 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 to ensure that the business is efficiently run and effectively meets with the regulations. 4 39 24 The registered manager and 30/04/2009 provider must establish systems for ensuring that the quality of the service is kept under review and the views of people living in the home are taken into account in the development of the service to ensure that the needs of people living in the home are at the centre of the development of the service. 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 17 Menus should be provided for people so that they know what choices of meal are available each day. 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. 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