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Inspection on 24/03/09 for Alexandra Road Crisis Unit

Also see our care home review for Alexandra Road Crisis Unit for more information

This inspection was carried out on 24th March 2009.

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

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

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: Alexandra Road Crisis Unit 32 Alexandra Road Hornsey London N8 0PP     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: David Hastings     Date: 2 4 0 3 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.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: Alexandra Road Crisis Unit 32 Alexandra Road Hornsey London N8 0PP 02083657287 02088889829 yvonne.biasio@haringey.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : London Borough of Haringey care home 8 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 8 The Alexandra Road Crisis Unit is owned and run by London Borough of Haringey. The unit is unique in the borough as it only provides short-term emergency and respite services for up to eight people with mental health problems. Stays are typically from three days up to two weeks and may be an alternative to hospital admission. The unit is a three storey converted and extended domestic premises situated in a quiet residential street between Wood Green and Turnpike Lane. There are eight single rooms, several bathrooms and shower rooms, a choice of two lounges, a staffed kitchen, a separate dining room with facilities to make drinks and snacks, an attractive conservatory that is used as an alternative place to relax and to do artwork and a private garden. Referrals to the unit come via the statutory and non-statutory mental health services. The unit has several aims: to provide good quality individualised support that is strengths and needs led; to facilitate personal development; to assist service users in development of alternative crisis responses and to foster appropriate coping strategies Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home in order to return to their appropriate environment. 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: We carried out this unannounced key inspection of Alexandra Road Crisis Unit on Tuesday 24th March 2009. We were assisted by the registered manager who was open and helpful throughout the inspection. We spoke in private with two people who use the service and six staff members. We observed the interactions between staff and clients. We looked around the home and examined various care records, staff files and health and safety documentation. The home completed an Annual Quality Assurance Assessment (AQAA) prior to the inspection at the request of the CSCI, and this was used to form part of the overall inspection process. Care Homes for Adults (18-65 years) Page 6 of 30 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The unit gathers current and detailed information regarding peoples needs before every short stay admission and also agrees a discharge plan at that stage. This assists the unit in effectively addressing peoples needs and maximising the benefit they receive from their short stay. Evidence: Four client files were inspected. Each showed a detailed assessment process, including a risk assessment process. The assessment information was multi-disciplinary and current. The assessment information showed the individuals assessed needs immediately prior to that persons admission. Input into this assessment process was seen from relevant health and social care professionals, staff at the unit and from the person themselves. It was clear that significant efforts were made by the unit to establish the persons current needs at the point of admission to ensure those needs could be effectively addressed. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: Information recorded included: presenting issues, psychiatric history, physical health needs, medication, aim of the referral and post discharge plan. The assessment process also includes establishing peoples needs in relation to equality and diversity. There was clear evidence that the individual had been consulted on their assessed needs and people who use the service confirmed that they were involved in this process. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and aspirations are clearly set out in their care plans including outcomes that are planned to have been achieved by the end of their stay. People who use the service are supported to make as many decisions as possible for them to retain and maximise their independence. They are also supported to take responsible risks to assist them to keep safe during their short stay at the unit. Evidence: The four care plans we examined were detailed, linked to the comprehensive assessment information available and contained clear short term goals with guidance for staff. Evidence was seen that clients were actively involved in the development of their care plan. One person who uses the service told us, Your constantly involved. The unit operates a key worker system and evidence was seen on peoples files of key worker sessions. These primarily related to objectives set out in the persons care plan. Evidence was seen that the care plans were actively reviewed and developed Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: through the placement, in some cases daily, with the clients involvement and with the input of health and social care professionals as required. We saw a number of key worker sessions going on during the inspection. A client told us, They are good listeners. The files inspected contained a signed copy of a client agreement form that specified what they could expect from staff and what staff would expect from them. This contained some restrictions clients while staying at the unit such as the prohibition of alcohol and illegal drugs. The files also included a form to specify whether the client gave consent to information about them being shared. This included information regarding emergency situations and whether this could be shared with relatives or other carers outside of the unit. There are a range of ways the unit engages with people who use the service including a daily coffee morning meeting and a community meeting with clients and staff held on a Monday evening. People accommodated are encouraged to manage their own finances and to retain as much independence as they can throughout their stay. One person told us, They leave you to chose, you have freedom. The files we inspected contained detailed risk management plans that had been agreed and signed by the client. These were based on a range of relevant information primarily obtained from risk assessments. Risk assessments are undertaken by external health and or social care professionals when a referral is made to the unit. Inhouse risk assessments are completed by staff immediately prior to admission and this information is in turn shared with relevant health and social care professionals. The manager told us that admissions are not made until there was an agreed risk assessment with relevant stakeholders. The plans seen showed identified potential risks and gave clear guidance to staff in assisting to minimise these. These risk management plans had been reviewed at the same intervals as the care plans. People who use the service told us that they were given copies of their plans and risk assessments. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can choose to participate, or not, in a range of appropriate activities both within the unit and within the community depending on their assessed needs. Contact with friends and relatives is supported subject to the individuals wishes and the privacy needs of other people at the unit. People are treated with respect and their rights and responsibilities are clearly stated with any limitations agreed with them. They also enjoy balanced and healthy meals that meet their needs and preferences. Evidence: The unit provides short-term care and support for clients and because of this activities are subject to individual negotiation during their stay. People can be supported to maintain employment, education or other activities if this is appropriate. It can also be agreed that stays are orientated toward providing people with a break from the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: pressures of living in the community and their usual activities. Evidence to support this was seen in peoples care plans. The unit offers a range of activities, the majority of which are therapeutic in nature and appropriate to support people that are experiencing some form of crisis at the time of their admission. Activities on offer include yoga, massage and a visualisation group run by staff in addition to a daily coffee meeting and weekly community meetings. People we spoke with said they enjoyed the activities on offer. The unit has installed two personal computers with Internet access for clients. These have proved very popular and clients often use them to gain further understanding of their own mental health needs. The computers are fitted with filters to prevent access to illegal or undesirable websites. People who use the service are supported to access the local community, or not, if that is appropriate to meeting their assessed needs. Clients are able to leave and return to the unit on their own during the inspection. Where people go out on their own they are required to inform staff when they intend to return and also to contact the unit if they are being significantly delayed from returning at the specified time. A client we spoke with said they had been out of the unit on their own but also said, When I didnt feel safe I had somebody with me. People who use the service continue to be encouraged to maintain links with family and friends on terms that they can cope with. Where it is agreed with the client the staff also support people to maintain their privacy during their stay. People told us the staff were kind and respectful towards them and maintained their privacy. We were informed that visitors are welcome between 9am and 11pm and that children can visit by arrangement although for the benefit of other service users they need to be accompanied during the visit. Visitors are required to abide by the units house rules when at the unit, e.g. regarding the prohibition of alcohol and illegal drugs. We inspected the kitchen and spoke with the cook. Menus are decided at weekly community meetings with clients. People told us they enjoyed the food provided by the unit. One person commented, I eat more here than I do at home. Another client told us, The food is very good. The cook has been working at the unit for over five years and has undertaken the appropriate training. The cook was aware of the likes and dislikes of the current client group and said he could provide special diets and culturally appropriate food as needed. The menu showed that there is always a vegetarian option available. Fridge and freezer temperatures were being monitored as well as the temperatures of food Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: being served. The environmental health department has recently inspected the kitchen and one recommendation made at that inspection has now been complied with. 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 who use the service receive appropriate personal support in accordance with their needs and preferences. They are supported to remain as independent as possible in addressing their mental and physical healthcare needs and are supported by community based health professionals as required regarding this. Clients are also generally well supported with their medication. Evidence: The manager told us that people who use the service do not usually need assistance with personal care. Where this has been identified as a need, outside workers are brought into the unit to assist people as it is felt that it would not be appropriate for key workers to assist clients with personal care within a therapeutic relationship. Clients we spoke with told us the staff were good at supporting them with their mental health needs, as identified on their plan of care. We also saw evidence that clients are supported to access health care professionals during their stay as appropriate. Because of the short-term nature of stays, clients keep their own GPs. The unit is not accessible to clients that have significant mobility needs as all the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: bedroom are on the first and second floors that can only be accessed by stairs. Sometimes clients ask the unit to support them with their medication if they are particularly unwell or at risk. This is decided at the beginning of their placement. All medication that clients bring into the home is recorded on their file whether the client self administers their own medication or not. Where clients self administer their own medication this is recorded on their plan of care. All medication held by the home on behalf of clients is stored in a locked cupboard. This is not generally a large amount of medication however the temperature of the storage area was not being monitored. We also felt that the medication storage cupboard may not be appropriate for its use. Two requirements have been issued regarding the safe storage of medication at the unit. Staff sign a medication chart for all medication they give to individual clients. Records of the receipt and administration of medication by staff were accurate and complete. We saw records that staff have received medication training on a regular basis. 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. People who use the service can be assured that any complaint will be taken seriously and dealt with in an open manner and within set timescales. People who use the service are protected from abuse by clear policies and procedures and by a well-informed, trained staff group. Evidence: The unit has a satisfactory complaints procedure that also included reference to the London Borough of Haringeys overall complaints procedure if a complainant was not happy with the response they receive from the unit. A copy of this is given to clients when they are admitted to the unit. The unit had dealt with two complaints since the last key inspection. The records of these were sampled and showed evidence that the complaints had been dealt with satisfactorily. People we spoke with said they had no complaints about the service but knew what to do if they did. The service has a satisfactory safeguarding policy and procedure, which is in line with the local authorities policy on safeguarding. The manager has dealt with three safeguarding referrals since the last inspection. The manager has followed the procedures and contacted the appropriate authorities. Risk assessments have been completed to ensure the continuing safety of clients where required. People that we spoke to told us they felt safe at the home. One person commented, I know Im safe, another person said, I lock my bedroom door, I feel Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: safe. Staff we interviewed has a good understanding of the way people with mental health problems could be at risk from abuse. Staff were also clear about their responsibilities to report any suspicions of abuse to the appropriate authorities. There is a rolling programme of safeguarding training for staff at the home. 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. Although the unit is clean and safe, the unit would benefit from the communal areas being redecorated and broken or old furniture being replaced. Evidence: The unit is a three storey converted and extended domestic premises situated in a quiet residential street between Wood Green and Turnpike Lane. There are eight single rooms, several bathrooms and shower rooms, a choice of two lounges, a staffed kitchen, a separate dining room with facilities to make drinks and snacks, an attractive conservatory that is used as an alternative place to relax and to do artwork and a private garden. We saw that the wooden stairs from the conservatory to the garden have now been repaired. This was a restated requirement from the last inspection that has now been complied with. The manager took us around the home and a client showed us their room. The decoration, fittings and furniture looked tired and some furniture was broken. The building has an institutional feel, which undermines the ethos of the home and the hard work undertaken by staff to support clients. The only exception was the conservatory, which had a homely and pleasant feel about it. A requirement has been Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: issued that the service must send an improvement plan to the Commission giving timescales when redecoration will take place as well as when furniture will be replaced. People we spoke with said they were satisfied with their rooms. Clients also told us the home was clean and tidy. There is a domestic worker employed six days a week and the home was clean and tidy throughout. The home has a satisfactory infection control policy and staff have undertaken infection control training. All toilets were saw contained soap and paper towels to limit the risk of cross infection. 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. The staff at the unit work hard to meet the needs of the clients and are provided with good training opportunities to further enhance their knowledge and skills. Recruitment practices are sufficiently detailed in order to protect people who use the service. Evidence: The staff rota inspected showed a minimum of three staff members on duty for the majority of the weekday morning and afternoon shifts with two staff members on duty for the remainder. There are also two staff on some shifts during the weekends and three staff on others. One waking and one sleeping in staff are on duty during the night. Clients we spoke with were very positive about the staff team and told us there were enough staff to meet their needs. One person told us, Your not left on your own and They get things done. There is a rolling programme of NVQ training and over fifty percent of staff have now completed this training. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff were positive about the training opportunities available to them but some staff said they would like to have more clinical training and particularly training in personality disorders. This was also the view of the manager. A requirement has been issued that staff attend training regarding supporting people with personality disorders. Training records we examined indicated that staff have attended mandatory training courses. These training courses included: infection control, safe administration of medication, adult protection, exploring diversity, food hygiene and first aid. Staff we spoke with had an excellent knowledge of the people they support at the service. Three staff files were examined from staff employed by the home. We checked these files to see if the homes recruitment procedures were being followed so that clients are protected from unsuitable staff working at the home. The files examined contained all the information needed to protect people including two written references, proof of identity and evidence of criminal record checks. Some references we examined did not contain a company stamp or letter headed paper to further confirm the authenticity of the reference. A good practice recommendation has been made relating to this issue. 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 registered manager has the experience and knowledge needed to run this service in a way that benefits both clients and staff. People who use the service have opportunities to have a say in how the unit is run. The health and safety of clients and staff are being promoted and protected. Evidence: Staff and clients we spoke to told us that they felt the unit was well managed. People were positive about the registered manager. One staff member told us the manager was, on the ball another staff member told us the manager was, Always there to listen. We saw evidence that the manager attends training on a regular basis. The unit continues to monitor the quality of the service it provides in an appropriate manner for a short stay crisis unit. Every client is invited to fill out an evaluation form at the end of his or her short stay. People who use the service that we spoke with confirmed this. The responses from these forms are evaluated on a regular basis and contribute to the units overall aims and objectives. An external manager visits the unit Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: regularly on an unannounced basis and records of these visits are retained in the unit. The unit has relevant health and safety policies in place, for example around infection control and fire safety, and staff undertake health and safety training. Fire extinguishers were situated around the unit. Fire exits were clearly signed and free from obstruction. Fire alarms are tested weekly, and the home holds regular fire drills. As the unit has a dedicated night staff team a good practice recommendation has been issued that night staff undertake fire drills every three months. This should ensure that night staff know exactly what to do in the event of a fire occurring at night. The unity has an up to date fire risk assessment, which is being regularly reviewed. The home had in date safety certificates for gas safety, PAT testing and electrical installation, Legionella, along with in date employers liability insurance cover. Staff training records indicated that staff are undertaking the required health and safety training in order to protect both clients and staff. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must 29/06/2009 ensure that the temperature of the medication storage area is monitored and recorded. This is to ensure that medication being held on behalf of clients is being stored at the correct temperature. 2 20 13 The registered person must 29/06/2009 ensure that all medicines are being stored in accordance with the relevant professional guidance. This is to make sure that all medicines held on behalf of clients is being stored securely. 3 2 2 The registered person must 31/07/2009 ensure that a improvement plan is developed and sent to the Commission giving timesales when redecoration of the communal areas will take place as well as Page 28 of 30 Care Homes for Adults (18-65 years) timescales for replacement of old or broken furniture is to be replaced. This is to ensure that clients stay in a comfortable and homely environment. 4 35 18 The registered person must ensure that all staff at the home undertake training in supporting people who have a personality disorder. This is to ensure that all staff at the home have the appropriate training in order to support the people who use the service. 31/07/2009 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 34 The registered person should ensure that all professional referees are requested to provide a company stamp or letter headed paper with all references in order to further confirm the authenticity of the reference. The registered person should ensure that night staff undertake fire drills every three months. 2 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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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