Inspection on 19/02/09 for Appledown

This inspection was carried out on 19th February 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.

Other inspections for this house

Appledown 09/03/07

Appledown 23/02/06

Appledown 24/11/05

Appledown 23/02/05

Appledown 24/08/04

Appledown 18/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Appledown Heather Lane Canons Town Hayle Cornwall TR27 6NG     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: Diana Penrose     Date: 1 9 0 2 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 28 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 28 Information about the care home Name of care home: Address: Appledown Heather Lane Canons Town Hayle Cornwall TR27 6NG 01736740552 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Amanda Jane Wright,Mr Nicholas Peter Dowden Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 Appledown is a detached house situated in a quiet cul de sac in the village of Canons Town, just off the main road between Penzance and Hayle.The home is registered for 3 residents with a learning disability. The Registered Providers are Ms Amanda Jane Wright and Mr Nicholas Peter Dowden. Ms Wright provides care along with one care assistant. The residents accommodation comprises of three bedrooms, one of which is upstairs. There is a ground floor bathroom, a lounge and a kitchen / diner, shared with the Registered Provider. The upstairs bedroom has an en-suite bathroom. The home is clean, tidy, well furbished and maintained throughout.The residents currently living in the home attend weekday activities assessed for and provided by Cornwall Social Services Department. The residents are given ample opportunities for socialising and visitors are openly encouraged. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Information about the home is available in the form of a statement of purpose / residents guide, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from 469 to 899 (this includes a transport fee) pounds per week; this information was supplied to the Commission during this inspection. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as confectionary and toiletries Care Homes for Adults (18-65 years) Page 5 of 28 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: An Inspector visited Appledown Care Home on the 19 February 2009 and spent three and three quarter hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that the needs of people using the service are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that peoples placements in the home result in good outcomes for them. It was also to gain an update on the progress of compliance to the requirements identified in the random inspection report dated 15 June 2007. All of the key standards were inspected. On the day of inspection three residents were living in the home. The methods used to undertake the inspection were to meet with them and the registered provider to gain Care Homes for Adults (18-65 years) Page 6 of 28 their views on the services offered by the home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. Residents expressed satisfaction with the care and services provided at the home and were treated with kindness and respect. The registered provider has complied with the requirements set at the last inspection. She is aware that breaches in regulations have been made, these were discussed with her and recommendations have been notified in this report. During this inspection she agreed to address the regulation breaches to improve the service and outcomes for residents. What the care home does well: What has improved since the last inspection? What they could do better: Care plans need to be updated and written in more detail to fully inform and direct the staff now employed. They need to be reviewed regularly and updated between reviews if necessary. The use of medicine to be administered when required need to be included in the care planning. They need to state the use of this medicine, and directions on how to make an assessment if this medicine is required. The manager said that the documentation would be addressed with her staff. Care Homes for Adults (18-65 years) Page 8 of 28 The policy for managing residents money is brief and does not detail the procedure in place, it needs to be updated to direct staff in the process to be followed. The records of money transactions need to be signed when entered on the record page to show who was responsible. The registered provider needs to consider the locking of the cash tins and who holds the keys. Recruitment procedures and records need to be more robust to ensure full vetting of staff prior to employing them to work with vulnerable people. The induction of new staff has to comply with the Skills for Care standards. Staff who have not achieved an NVQ qualification in care must be enrolled onto a suitable course following induction. A training and development plan needs to be put in place and regular training and updating provided. Regular staff supervision and appraisal will inform the training plan and support staff in their roles. The registered provider would benefit from undertaking infection control training. 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Previous assessments of residents needs have been adequate, there have been no new people admitted to the home for several years to change our opinion in this area. Evidence: The registered provider stated that no one has been admitted since the last inspection. She said she has obtained further information regarding one resident as this was lacking at the last inspection. Documents were seen in the care files that show peoples needs are re-assessed annually. Care Homes for Adults (18-65 years) Page 11 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual care plans have not been updated and they lack detail to inform and direct staff on the care provision. Residents make decisions about their lives, risks are assessed and appropriate support is given to enable them to lead an independent lifestyle. Evidence: Each resident has a care file. Care plans, written by the registered provider were seen but had not been updated for two years. One person had a recent updated care plan provided the council following a review of her needs. The registered provider said that the other two people are having their reviews next week. She said the social worker and the residents family are involved in the reviews with the resident and herself. Although some information is available regarding peoples care needs the registered provider must ensure that detailed care plans are written for each resident to comply with legislation and to inform and direct the staff employed. This was discussed with Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: her and she agreed to do this. The registered provider said that residents have a review with their key-worker at the learning centre regularly. Daily records for each person are maintained in separate diaries and are informative. The registered provider said that peoples rights are respected and they are assisted with decision making. She said that goals and targets are set in the home and at the day centre. There is a reward system in place. People talked about what they do at day centres and at the weekends and it was evident that they decide what they want to do. We were told that people using the service are encouraged to take responsible risks and written risk assessments were seen. These cover the activities of daily living, electrical appliances, the environment including outside. Personal safety training takes place as required and road safety training is ongoing. A reference to road safety was seen in one of the care files. One resident goes out alone on public transport she has a mobile phone to communicate with the registered provider. The home has a written procedure in respect of the action to be taken if a resident should go missing from the home. Care Homes for Adults (18-65 years) Page 13 of 28 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 using the service take part in appropriate activities and are assisted with training to encourage their independence and individuality. They have appropriate contact with family and friends and are supported to develop relationships according to their wishes. Dietary needs are well catered for with a varied selection of food available to meet their taste and preference. Evidence: We were told that people are encouraged to continue their education, undertake training and join in activities as they wish. They all attend day centres and progress reports are issued each term and kept at the home. Certificates are given for achievements made. They undertake activities such as cooking, dancing, sports and shopping. None of them are attending college at the moment. One resident helps to care for animals at a local centre. Literacy and numeracy skills are taught at the day Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: centres and encouraged by the registered provider. They are all helped to manage their money. Residents talked about their day on return to the home during this inspection. The registered provider said that people using the service are encouraged to maximise their independence and make use of local community resources. They go out with the day centre staff and they have an annual holiday. The registered provider takes them out shopping, walking and for meals and so on. One resident goes out alone in accordance with her care plan and risk assessment. They have a pet cat and a young dog at the home and residents were enjoying their company. The dog in particular was receiving a lot of attention. The registered provider said that all of the residents have contact with their families as they wish. The records show that contacts are made and that visits take place. Residents talked about visiting their families and friends. One was waiting to pack her suitcase as she was going on a visit for a few days. Another talked about christmas with her family. The inspector was shown photographs of a resident on a trip out with her friend. Residents said they have boyfriends who can visit the home and they meet them at the Gateway Club. The registered provider said residents have access to the home telephone and one has a mobile phone. There is a schedule for people to participate with the household tasks and the daily routines promote independence. The registered provider said that residents open their own mail and are they were addressed by their preferred name. A three week menu was seen, it was nutritious with choices available. The registered provider said there are other choices besides those on the menu. A variety of meals are provided at the day centre each week and this has to be considered when organising the menu. A copy of the menu from the daycentre is kept in the home. Fresh fruit and vegetables were seen. Food records are maintained. Residents talked about what they like and what they were having for tea. They were helping with the meal and one resident made cups of tea during this inspection. Care Homes for Adults (18-65 years) Page 15 of 28 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. Residents have access to health care services as necessary, personal support is given according to peoples needs, ensuring their individual preference is respected. There is a suitable system in place for dealing with medicines that assures peoples safety. Evidence: The registered provider said she ensures that appropriate personal support, care and encouragement are provided in such a way as to respect residents privacy and dignity. She said prompting people is working far better now so there is not a lot of assistance required from staff. Two people and had a bath unassisted during this inspection and their privacy was respected. The daily routines are flexible particularly at weekends and this was evidenced in the records. All residents are registered with a GP and the provider said that specialist health care workers are consulted as necessary, for example two people have speech therapy. Nutritional screening takes place and a healthy diet is provided and residents weight is monitored. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: There is a suitable medication policy. Medicines are stored securely in a locked wall cupboard. A monitored dose system is in use and appropriate records are maintained. For people prescribed to have medicines administered when required we found that there were no care plans in place about the use of this medicine, or any directions on how to make an assessment if this medicine is required. The manager said that the documentation would be addressed with staff. Patient information leaflets are kept and the registered provider has a copy of the royal pharmaceutical guidelines for care homes. The registered provider has undertaken appropriate medications training and is seeking an appropriate course for staff. She has provided some in house training. Care Homes for Adults (18-65 years) Page 17 of 28 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. There are suitable policies and processes in place for complaints and adult protection to ensure that people using the service are safeguarded. The system in place for managing residents money is not suitable to fully safeguard peoples finances now that staff are employed. Evidence: There is a suitable complaints procedure in place that is available to the residents and their relatives. The residents were relaxed in the home and aired their views openly. There have been no complaints to the home or the Commission. The home has a written adult protection and whistle-blowing policy. There is also a copy of the Cornwall Partnership Trust leaflets on abuse and the Adult Protection training video. The registered provider has attended the No Secrets training and has a copy of the local inter agency procedures. One safeguarding allegation was referred to the department of adult social care in May 2007. This was investigated with the assistance of the Police and the Commission for Social Care Inspection. The allegations were unfounded but two requirements were notified to the registered provider following a random inspection. The registered provider told us that a second referral has been made in respect of a residents behaviour but has not yet been investigated. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: None of the people using the service manage their own finances; the registered provider is appointee for them all. There is a policy for managing residents money but it is brief and does not detail the procedure in place. It needs to be updated particularly as staff are being employed and will be handling the money. The provider said that each person has a bank account. She told us that their allowances are received every month and each week money is put into their lockable cash tins. Receipts for purchases were seen in the tins as well. Records of transactions and money received are maintained but not all records had a running total to show what should be in the tin. Some had a negative balance and the provider said that this is made up from petty cash. Transactions have not been signed but this needs to happen now that other staff will be dealing with the money and records, not solely the registered provider. The provider told us that she reconciles each persons account every month and showed us how this is done. Receipts for each person are checked, stapled together and stored. She said people have money to spend on request. One person said she keeps money in her purse. Another was going to take some money with her when she stayed with a friend for a few days. Care Homes for Adults (18-65 years) Page 19 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean and free from offensive odours, the grounds are well maintained providing a pleasant, safe environment for residents, staff and visitors. Evidence: The home provides a warm, comfortable, homely environment. It is clean, well furbished and free from odours. There is adequate heating, lighting and ventilation. People using the service can easily access the garden, which is well maintained and equipped with garden furniture. The registered provider said there is an ongoing maintenance programme for the decoration and renewal of fabric in the home. New carpet has been provided in one bedroom and some decoration has been done since the last inspection. Extra settees have been incorporated into the dining and lounge areas as well. Peoples rooms are personalised with their own possessions. There are suitable laundry facilities situated in a utility room. Protective clothing is provided for infection control purposes. Planning permission has been granted to extend the property which may enable more people to be accommodated. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 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. Recruitment procedures and supervision of staff need to be more robust to ensure residents are safeguarded and supported. Staff have no formal qualifications and training needs to be developed to ensure that residents are supported by competent qualified staff. Evidence: The registered provider is responsible for the care provision along with one care assistant. Her hours worked are recorded in a book. The recruitment process has commenced for the employment of a second care assistant. The registered provider said employing staff has enabled her to have time away from the home and to have a holiday. Neither of the care assistants have NVQ qualifications in care. The registered provider needs to ensure she implements the Skills for Care induction standards and then enrols her staff onto NVQ level 2 courses. This was discussed with her. There is a recruitment policy and a file that holds staff information. The provider agreed to hold each persons details separately. The one person employed did not complete an application form or provide a CV, the registered provider said she has Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: known her for years and has worked with her previously. It was advised that the provider gain a health declaration from her. There were no interview records held. References were received and an enhanced CRB check prior to employment. It is recorded in her file that she re-commenced work in June 2008, but there was no resignation information. The registered provider stated that she left paid employment but had been doing voluntary work so had not actually resigned. An induction checklist has been signed by the provider but it does not comply with the Skills for Care induction standards. There are no certificates of training or supervision records in her file. There is no training and development plan for the home but the AQAA states that the provider is looking to implement a plan with the recruitment of new staff. Some in house training has taken place. The registered provider has a file containing information about training courses, she hopes to confirm various dates soon. She said she has booked herself and the two care assistants onto a first aid course in March 2009. She said she is awaiting dates for POVA training. There needs to be evidence in the home that the staff have the necessary knowledge and skills to care for vulnerable people. A blank appraisal form was seen in the staff file, formal staff supervision has not commenced. The registered provider said issues have been discussed at staff meetings. Care Homes for Adults (18-65 years) Page 23 of 28 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 provider is competent in running the home and systems are in place to monitor and improve the service for residents and staff. Safety checks are undertaken to ensure the health, safety and welfare of residents, staff and visitors. Evidence: The registered provider is competent and experienced to run the home. She has achieved the Registered Managers Award and said she keeps up to date by attending relevant study days and reading care publications. She has attended Mental Capacity Act training since the last inspection and is booked onto a Deprivation of Liberties course. She has not yet undertaken infection control training recommended in the last two inspection reports. She has a good rapport with people using the service and they interact very well with her. They said the registered provider looks after them well. The registered provider has developed a quality monitoring system for the home that includes surveys with the residents and their family and friends. It does not include external stakeholders. The results of the last survey, October 2008, were seen and Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: were positive about the home. The day centre also undertakes a questionnaire with the residents based on their goals. The registered provider said she has regular contact with the residents relatives and they are involved in the way the home is run. Staff meetings take place and notes are kept in a diary, they are brief but show that things get done. The registered provider completed her Annual Quality Assurance Assessment (AQAA) and returned it to the Commission following a reminder letter. There are environmental risk assessments for the home and a fire risk assessment has been completed. There is a fire manual and fire drills take place regularly. Service safety checks have been kept up to date. Hazardous substances are stored safely and data sheets and a policy are available for COSHH purposes. The registered provider achieved the Basic Food Hygiene Certificate a few years ago and said she is due for an update. First aid training has been booked as stated previously and it is again recommended that she undertake infection control training. There is an accident book but no accidents have been reported. Details regarding unexplained cuts, bruises and self harm have been recorded in the daily records. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Each person using the service should have an up to date care plan developed with them and detailed to inform and direct staff in the care to be provided The registered provider should update the policy and procedure for the management of residents money to ensure staff have detailed information to safeguard peoples finances Staff need to undertake an induction progamme in line with the skills for care standards and undertake relevant training to ensure they have competencies and qualities to care for vulnerable people The recruitment process needs to be more robust to ensure that people using the service are safeguarded There needs to be an appropriate training and development plan to ensure staff have the skills to meet the changing needs of people using the service A suitable system needs to be introduced for the supervision of staff to ensure they are supported in their roles 2 23 3 32 4 5 34 35 6 36 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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