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Inspection on 21/10/08 for Barrow Hall Care Home

Also see our care home review for Barrow Hall Care Home for more information

This inspection was carried out on 21st October 2008.

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: Barrow Hall Care Home Wold Road Barrow On Humber North Lincolnshire DN19 7DQ     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: Wilma Crawford     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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: Barrow Hall Care Home Wold Road Barrow On Humber North Lincolnshire DN19 7DQ 01469531281 01469532544 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) : Guardian Care Homes care home 37 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Additional conditions: 37 37 The maximum number of service users who can be accodated is: 37 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE, maximum number of places 37 Mental Disorder - Code MD, maximum number of places 37 Date of last inspection Brief description of the care home Barrow Hall is a listed building and retains many of its period features. The home is set in pleasant grounds in the village of Barrow, providing easy access to local shops and facilities. Barrow Hall offers personal and nursing care for up to 37 people with a mental health problem. The home is owned by Guardian Care Homes, which is a large national company. A choice of single and shared accommodation is available. In addition people who live in the home have access to a range of communal facilities including a dining room, sitting room and recreational area. Twenty-five beds are provided in the main building, a further ten beds are provided in an adjacent building Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home known as The Mews. The Mews consists of ten apartments. Two of the apartments have a separate bedroom, sitting room, kitchen and bathroom. The other eight apartments have an adjoining bedroom, sitting area and small kitchenette. All have separate bathrooms with showers, wash hand basins and toilets. Storage and telephone points are provided in all ten apartments. Two of the apartments have been adapted to accommodate service users with physical disabilities. The remaining two beds are provided in a self-contained house called The Lodge, which is situated at the top of the long driveway. The home has extensive grounds that people who live there have access to and there is ample car parking facilities. The weekly fees currently start from 550 pounds, this is information supplied by the deputy manager during the visit on 21.10.08. 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 Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The inspection was unannounced and took place over eight hours including preparation time. An expert by experience, Rita Hodkin , also assisted in the inspection for four hours. An expert by experience is a person who, because of their shared experience of using services,and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in and use the service. She spoke to nine people Care Homes for Adults (18-65 years) Page 6 of 30 living in the home and some of the staff on duty. The main method of inspection used was called case tracking, which involved selecting four people living in the home and tracking the care they receive through the checking of their records , discussion with them, the care staff and observation of care practices. The premises were looked at and the records of four people living in the home and three staff were examined.The comments and views of people spoken with are included within the this report. An Annual Quality Assurance Assessment document requesting information about the home was sent out before the visit and information from this is also included. What the care home does well: What has improved since the last inspection? What they could do better: The home was flooded earlier in the year and the full refurbishment of the home has not been completed. This has led to the main building home presenting as somewhat institutional and stark in its appearance, lack of pictures, carpet and magnolia walls. The refurbishment needs to be completed and the whole environment made more homely and welcoming. Although aids and adaptations are available throughout the home, there is a lack of ramps or lifts to support people with physical disabilities, leaving them reliant on staff and having to wait for some time to be supported. Training on challenging behaviour for all staff needs to be completed. Similarly staff need to attend training on the safeguarding if adults as not all have completed this. There were some comments about the quality of food provided, although there was evidence in residents meetings records to demonstrate that there had been some discussion and action taken in respect of this. Further action needs to be taken to ensure that people living in the home are provided with a choice of meals that are wholesome and nutritious to suit individual needs. Some of the monitoring in daily records could be improved upon and less judgement, for example describing some one leaving the home as escaping from the home. Care Homes for Adults (18-65 years) Page 8 of 30 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 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 who use the service experience good outcomes in this area. we have made this judgment using a range of evidence, including a visit to the service. The homes assessment process ensures that new people accessing the service are admitted only on the basis that a full assessment of need has been undertaken by people competent to do so, this ensures that the placement is appropriate. People living in the home receive a statement of purpose and service user guide and theses clearly describe what services and support they can expect to receive. Prospective people accessing the service are enabled to visit and sample the home prior to moving in on a permanent basis and this ensures that they are making an informed decision whether to live there. Evidence: During the inspection the the files of four people were examined, this demonstarted that peoples individual needs were assessed before any decision was made as to whether the home could offer them a placement and meet their identified needs. The deputy manager said that the admission process usually involves the receipt of a Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: community care assessment, which is followed by the manager completeing an asssesssment of the individual. this asessment looks at all aspects of personal history, employment, family, previous clinical history including any mental health issues. People are able to visit, have a meal, stay overnight before they make any decision about whether they wish to move in. The homes assessment process ensures that new people accessing the service are admitted only on the basis that a full assessment of need has been undertaken by people competent to do so, this ensures that the placement is appropriate. People living in the home and staff spoken with said that they receive a statement of purpose and service user guide and these clearly describe what services and support they can expect to receive. This was confirmed by people living in the home and professionals visiting the home. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service experience good outcomes in this area. we have made this judgment using a range of evidence including a visit to the service. People using the service have a care plan that fully describes their needs and what support is required. People living in the home are enabled to make decisions about everyday life in the home. The risk management system ensures that the people who live in the home are safe and risks are either eliminated or reduced to a minimum. Evidence: The majority of people using the service have a care plan that fully describes their needs and what support is required. During discussion two people living in the home said that they were unhappy and wanted to move, while the others said they were happy and felt well supported. The care plans of the two individuals were seen, but did not contain any details of how staff should support them in this area or demonstrate Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that they had had the opportunity to air their views at reviews,although reviews had taken place , or express their wishes to move to another care provision. Similarly there was no record of discussion with other professionals in their care about their emotional well being. Other people living in the home are enabled to make decisions about everyday life in the home, evidence of this was seen in care plans and minutes of residents meetings. The risk management system ensures that the people who live in the home are safe and risks are either eliminated or reduced to a minimum. Issues including verbal and physical aggression, medication,communication difficulties, mobility, weight loss, self harming and sexualised behaviour were included in the risk assessment process. Details identifying the risk and how this could be minimised and what action staff needed to take and when other agencies needed to be involved were also included. Staff spoken with explained that new risk assessments or behavioural management plans were discussed at supervision and handovers and that they were expected to sign to show that these had been discussed and they understood the content of them. the care plans are used as a working document and staff had a good understanding and knowledge of the content of these, as well as what support they were expected to offer and the way in which this was expected to be offered. people living in the home and visiting professionals confirmed that they were involved in decisons about their care and any changes were discussed prior to being made. There was evidence to show that care plans are reviewed regularly. The majority of daily recording notes were good, but there were some subjective comments that were seen and need to be improved upon. 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 who use the service experience good outcomes in this area. We have made this judgment using a range of evidence ,including a visits to the service. People who use the service access a range of appropriate activities and education. People living in the home are encouraged to maintain outside links with their family and friends and the routines in the home are flexible , therefore they have their rights respected and their independence promoted. The menu and food on offer is of a good quality and people receive a healthy varied diet. Evidence: People who use the service access a range of appropriate activities and education. Overall, people living in the home are encouraged to maintain outside links with their family and friends and the routines in the home are flexible ,therefore they have their Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: rights respected and their independence promoted. people spoken with said that they are able to maintain contact with their families and some are assisted with this process. They are involved in the planning of activities outings and holidays and enjoy participating in these events. Where people are reluctant to join in, the activities coordinator will work closely withthem to engage them and plan particular opportunities of their choosing to encourage them. Religious services are available within the home, but some people said that they would prefer to have the opportunity to go to church. The menu and food on offer is of a good quality and people receive a healthy varied diet. 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 adequate 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 experience adequate outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who use the service receive an adeqaute level of personal and healthcare support, with most of their healthcare needs being met. The medication policy is adhered to and staff have been appropriately trained. Evidence: A sample of four care plans were examined and interactions between staff and people living in the home observed. Written evidence was in place confirming what health checks and other healthcare appointments had taken place. These included, psychiatrist, optical, dental, G.P. and chiropody appointments , with information about the outcome of these visits. People spoken with said that they has access to all healthcare services that they need and had regular checks. they were also able to confirm who their key worker was and their understanding of what this role involved. the staff were able to describe the health and personal needs of people living in the home and the support that they required. Observations of interactions between staff and peopel living in the home demonstrated that the majority of the staff treated Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: people with respect and maintained their dignity. There were two observations of people seeking support and a staff member dismissing them, but examination of their care plans did not offer advice as to hoew this situation should be managed. Another individual was unkempt in their appearance and had a strong odour of faeces about them, as well as faeces under their nails. daily recording of their care did not indicate that the person had been reluctant in any way to offers of support with personal care. Staff spoken with said that they found that the care plans informative, but that they did experience difficulty in supporting people with more complex needs and felt that they would benefit from additional training in mental health. They also felt that there were times when they were very busy and felt stretched usually when staff called in sick and agency staff were used, which did not help them support people effectively. This is exacerbated with the physical layout of accommodation being split between the main house and the self contained units. Generally when staffing levels were available as per the rota and there was no sickness, staffing levels were considered to be adequate to meet peoples needs. Medication procedures with in the home are well maintained and adhered to. Stock levels and medication records are appropriately maintained. 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. Overall people who use the service are protected from possible harm or abuse,as the home only employs staff after appropriate employment checks have been completed. not all staff have undertaken the Safeguarding of Vulnerable Adults training,so may not be fully aware of their responsibilities should an incident occur. Evidence: The home has a clear complaints procedure and discussion with people living in the home and staff showed that they have an understanding of these and who they should go to raise a concern or complaint. Staff spoken with during the visit showed a good understanding and awareness of the procedures and what their responsibilities were within this. Examination of the staff training records showed that not all staff have received training in the safeguarding of Vulnerable adults, a requirement was made in respect of this in February of 2007 and will remain ongoing until all of the staff team have completed this training. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service experience adequate outcomes in this area. We have made this judgment using a range of evidence including a visit to the service. The Main Hall provides a clean environment, but lacks personalisation and homeliness, while The Lodge and Mews provides more homely accommodation. Appropriate aids and adaptation are available within the home, but further assessment is required to ensure that all individuals independence is promoted. Evidence: A tour of the building was completed and found to be clean and odour free. There are some areas of the home which would benefit from further redecoration and the addition of some homely touches, while others present as more homely and comfortable. Overall the bedrooms were personalised and homely and people spoken to were happy with the facilities provided. However, the new split level dining facility dining caused concern to both staff and people living in the home. The people living in the home commented that it was noisy and cramped, while staff expressed concern that the open banister and staircase may present further risks during any challenging situations. A requirement was made for a risk assessment to be completed to identify how these risks could be reduced. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: People living in all of the areas commented that they were happy with their accommodation and the facilities on offer. People were observed involved in different domestic tasks,washing, tidying their rooms and preparing drinks and snacks. Although there is a good range of moving and handling equipment in the home, there are areas where there are only stairs for access, making it difficult for people with physical disabilities to maintain their independence. There are stairs to the main office which is situated on the first floor and stairs halfway along the corridor of the main building. The home has a maintenance plan in place, this was seen and confirms that further work is in progress to improve the environment and make it more homely after the flooding last year. Records of health and safety checks are also maintained including, fire checks and water temperatures. Care Homes for Adults (18-65 years) Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support from staff who have been properly selected and recruited. The health and safety of the people living in the home could be compromised as staff have not received or updated the mandatory training. Evidence: The home has a large staff team consisting of trained RMN nurses, care assistants and domestic staff. From discussion with the deputy manager it was confirmed that since the last inspection the staffing hours have been increased to a total of 1106 .5 hours. From speaking to staff and people living in the home it was apparent that the staffing numbers were sufficient to meet the basic needs of the residents. Staff said that there had been a problem with sickness earlier in the year, which had caused some difficulties, but the levels were okay currently. The home has five care staff and two trained nurses RMN on duty at all times, the manager, administrator, chef, domestic staff, handyman and activities coordinator is in addition to this. During the night there are 3 care staff and 1 trained nurse .From speaking to the deputy and the activities coordinator it was clear that the activities plan offers a variety of activities, opportunities and outings to the people living in the home. Staff meetings occur regularly and written evidence was seen confirming this. During the inspection visit two staff personnel flies were looked at and this confirmed Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: that the home undertakes appropriate checks including Criminal Records Bureau disclosure and two references prior to staff commencing work. One person spoken to during the visit confirmed that people living in the home are involved in the interviewing process.The home demonstrates a commitment to involving the people who live in the home within everyday decisions and procedures, therefore promotes inclusion and equality. Internal induction records were available and the manager assured the inspector that induction training to Skills for Care Standards had been carried out with new employees, the records for these are now kept in the home and evidence of this was seen. One new staff member was spoken to the during the inspection visit and it was evident that an in-house induction commences on the first day of employment. Since the last inspection there has been some improvement with regard to the training offered to staff, but records showed that not all staff was up to date with mandatory training, for example, infection control, mental health, challenging behaviour,health and safety and safeguarding adults. This remains an outstanding requirement from the previous inspection and must be addressed without delay. During the last inspection the training records showed that some support workers had undertaken training in relation to mental health and challenging behaviour. However, the manager must ensure that all staff receive training on mental health and challenging behaviour. This is required to ensure that staff have the skills needed to meet the changing needs of the people in their care. This requirement will remain outstanding until all of the staff have undertaken the training. The home has a separate training budget and there is a programme of in-house training, as well as external courses available to staff. Supervision records were looked at and staff were spoken to, it was confirmed that supervision is offered to all staff, all but one staff were receiving this on a regular basis. Staff commented that the manager is approachable and he listens, but did not feel fully supported by the new organisational higher management. Staff were observed interacting with the residents throughout the visit, this was done overall in a sensitive and respectful way. From speaking to the people who live in the home it was clear that they had developed good relationships with the staff and manager . A visiting social care professional was spoken during the visit and commented That the staff are are welcoming and that they had done a good job in supporting their client. Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience 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 experience good quality outcomes in this area. We have made this judgment using a range of evidence including this visit.People live in a home that is run in their best interests and their health safety and welfare is promoted and protected. Evidence: The care management systems have improved and in particular the reviewing of care plans and medication administration systems to protect people using the service. The satisfaction surveys show people and their relatives have the opportunity to comment on the quality of care and services provided. The Quality Assurance Action Plan shows the home is prepared to listen to what people say and change the way things are done as a result of their comments. This was supported further by visiting professionals to the home who commented on the experience and knowledge of the home manager and their ability to work well with other professionals for the benefit of the people living in the home. he was also considered to be an excellent advocate for Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: them too. People are protected by the way their finances are dealt with as three peoples finances were checked and found to be correct, kept safely and recorded properly. Peoples health, safety and welfare is promoted and protected as the maintenance records show that proper checks are carried out on emergency equipment, hoists, and safe water temperatures are maintained. Staff training records show they have Health and Safety, Moving and Handling, Food Hygiene, and First Aid training. Care Homes for Adults (18-65 years) Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 23 13 & 18 Staff must undertake training 22/02/2008 in relation to safeguarding vulnerable adults, this would ensure that staff are aware of their responsibilities and the protection of the people living in the home would be maintained. (Previous timescale - 25/02/07 not met) 2 32 18(1) c, 12(4) Staff training and 22/02/2008 b development programme includes specialist subjects around mental health problems, challenging behaviour or difficult to help residents and all other mandatory training including infection control, health and safety, food hygiene and first aid must be undertaken to ensure that people using the service are supported by a well-trained staff group who can ensure their health and safety. (Previous timescale 30/12/06 not met) Care Homes for Adults (18-65 years) Page 26 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 18 The Registered Provider should ensure that all staff are given appropriate training in the understanding of Mental health Conditions and the mental capacity Act. This would ensure that staff would have a better understanding of how individual needs can be met and sensitive and personal support can be provided to enable people living in the home to maximize their privacy, dignity ,independence and control 31/03/2009 2 23 13 The registered proviider must ensure that all of the staff team undertake training in relation to safeuarding vulnerable adults. This would ensure that staff are aware of their responsibilities and the 31/03/2009 Care Homes for Adults (18-65 years) Page 27 of 30 protection of people living in the home would be maintained. 3 25 23 The Responsible Individual should ensure that an Occupational Therapy assessment of the Main hall is completed and the necessary equipment put in place to allow people with physical needs to access all areas of the home independently. This would allow the individual to freely access the home independently and not be reliant on staff for support to access areas of the home. 4 32 13 The Registered Provider should ensure that all staff receive appropriate training in mental health problems, Challenging behaviour and difficult to help people,and other Mandatory training including infection control. this requirement is ongoing from December 2006 This would ensure that peopel using the service are supported by a well trained staff team, who can promote individuals health, safety and well being. 5 32 13 The Registered Provider must ensure that every member of the staff team receive training in the Safeguarding of Vulnerable 31/03/2009 31/03/2009 31/03/2009 Care Homes for Adults (18-65 years) Page 28 of 30 Adults. Ongoing from February 2007. This will ensure that staff are aware of their responsibilities and the protection of the people living in the home would be maintained. 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 Further information and guidance needs to be added to two care plans to include how staff can offer emotional support to these individuals when they are distressed. Where subjective comments are made within care plans, this needs to be adressed with the individual to promote dignity for people living in the home and guidance offered as to what is appropraite terminology. Consideration should be made as to how people can be given the opportunity to atttend the church that they wish to attend. The menu should be updated to show the selection of food offered in addition to the main choices available on a daily basis. Staff should be offered training in how to record information about individuals in an objective, rather than subjective manner. 2 6 3 13 4 17 5 18 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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