Inspection on 04/12/08 for Bridge House

This inspection was carried out on 4th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bridge House 08/01/07

Bridge House 15/02/06

Bridge House 08/09/05

Bridge House 14/03/05

Bridge House 22/09/04

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bridge House 2 Bridgwater Road Taunton Somerset TA1 2DS     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: Gail Richardson     Date: 0 4 1 2 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 29 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 29 Information about the care home Name of care home: Address: Bridge House 2 Bridgwater Road Taunton Somerset TA1 2DS 01823334797 01823353691 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Home First & Foremost Ltd Name of registered manager (if applicable) Mr Gavin Jon Guy Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Bridge House is registered with the Commission for Social Care Inspection to support up to eleven people with a learning disability. It is a large detached property located within walking distance of Taunton town centre. Accommodation is provided over two floors. The home does not have a passenger lift. Peoples bedrooms are arranged over two floors and have full en-suite facilities. There are two lounges, a large dining room and large domestic kitchen within the home. The garden, to the rear of the property is an attractive space made secure and accessible for service users. The Registered Manager is Gavin Guy. 11 Over 65 0 care home 11 Care Homes for Adults (18-65 years) Page 4 of 29 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: This was an unannounced inspection, which took place over 1 day , 6.5 hours, on the 4th December 2008 by Regulation Inspector Gail Richardson. Although there was only one inspector, throughout this report the term we will be used when referring to the Commission. As part of the inspection process CSCI are using Experts by Experience to help inspectors get a picture of what it is like to live in a social care setting. The term Expert by Experience used in this report describes the people who also visited the home during the inspection and who have knowledge about social care. A tour of the home took place and all of the bedrooms and all communal areas were Care Homes for Adults (18-65 years) Page 5 of 29 seen. There were 11 people currently residing at the home which is the homes full occupancy. The inspector spoke to 2 people using the service and 4 members of staff. The Expert by Experience spent time in the communal areas talking with several people using the service. The Registered Manager was available throughout the inspection. The home has provided CSCI with a completed AQAA (Annual Quality Assurance Audit) which was completed by the Manager and gives details of all aspects of the home. As part of this inspection the inspector sent surveys to people using the service and Care Workers to survey their opinion of the home, no responses were received. Records relating to care including 3 care plans, 4 staff files and health and safety records were examined The focus of this inspection visit was to inspect relevant key standards under the CSCI Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are, excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: The registered manager is advised to ensure that all contracts between the home and people using the service are signed as an agreement by the person or their representative. This is to ensure that people are clear about the service they are receiving. The registered manager is recommended to provide people using the service with a timetable or plan of their weekly activities both in and outside of the home. The manager is also recommended to consider how people are informed about the choice of meals. This will enable people to be clear about what is available for them and support their choices and preferences. Care Homes for Adults (18-65 years) Page 7 of 29 The registered manager is required to ensure that all hand transcribed medications are signed by two staff to ensure a clear audit trail. The registered manager is required to review the flooring in some en suite bathrooms. The floorings identified were not well fitted and may pose a risk of cross infection. One wardrobe was identified as not secured and the manager confirmed that this would be risk assessed. The registered manager is recommended to review the use of a staff dependency tool to ensure that staffing levels are sufficient in times of higher dependency such as ill health or increased activities. The registered manager is required to ensure that staff are aware of the Data Protection Act and the need to store records securely to protect the confidentiality of people using the service. 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 8 of 29 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 29 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. There have not been any new admissions to the home since the last inspection. Contracts are provided but were not all signed by the person using the service or their Representative. Evidence: As there have been no new admissions to the home in the last two inspection periods it has not been possible to inspect standards 1 and 4. Three contracts were viewed. Each one contained the details of terms of residency and fee rates. However it is noted that none had been signed by the person or their representative. The manager is recommended to ensure that contracts are signed as agreed with either the person or their representative to ensure that people are aware of the service being provided. Care Homes for Adults (18-65 years) Page 10 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed plan of care, appropriate risk taking is promoted, risk assessments are reviewed and updated and the risks are incorporated into the care plan. People using the service are supported by staff to make decisions, participate in activities and develop some independent life skills. Records are not all stored securely. Evidence: We looked at three care records of people using the service. Each plan of care outlined any specific care needs. The care plans also contain risk assessments and any care plan resulting from that risk. Care records were well maintained and comprehensive and gave staff a clear and detailed plan of care. They also included health and social care input, the persons preferences with regards to their care and activities, daily records, monthly summaries, review notes and cash records. Any people who require behavior management guidelines have clear and detailed instruction made available to Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: staff and these work together with the As required medication. Daily progress sheets detail activities undertaken, nutrition, moods and behavior, time up and dressed and returning to bed, GP visits and body mapping as required. The homes AQAA states that, Each individual has an individual support plan which details their needs and choices in 14 key areas of their life. Bridge House promotes person centered active support and ensures all service users are encouraged to participate in all aspects of their daily living to ensure every day tasks have meaning to them. Care plans identified areas where people using the service could participate in daily tasks incorporating any disability and how staff supported people to be part of the day to day running of the home. These activities included cooking and some domestic tasks. One person was seen to be delivering laundry and staff told us that meetings take place for people using the service. One staff member has the role of organizing the menus with the input of people using the service. The Home has implemented meetings for people using the service to be able to be involved in some aspects and decision making of the running of the home. Some peoples records were not stored securely and were found to have been left in the lounge. This may compromise a peoples confidentiality and the registered manager is required to address this situation. No individuals currently manage their personal finances and appropriate records are kept on behalf of the person by the staff and family. Financial records were seen with receipts and all Care Homes for Adults (18-65 years) Page 12 of 29 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. Choices are available for people to take part in age, peer and culturally appropriate activities and participate in the local community, how that choice is informed requires further review. Appropriate personal and family relationships are promoted. Residents are treated with dignity and respect. People are encouraged to help plan menus and a healthy diet is promoted. Evidence: The homes AQAA states , Each person is supported to undertake some regular activity and their preferences of hobbies and leisure activities are recorded in their care plan. The daily record for each person records the activity undertaken. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The Expert by Experience spent time with people talking about how they spend their day. The people told the Expert by Experience The residents go to the Albemarle Center in Taunton. here they were making Christmas decorations and Christmas Cards. The staff who take them there stay with them and bring them back. When asked if they like it there ,they said it was a good idea to go there. The people using the service said that apart from going to the Ablemarle Center theres not much going on during the day except they go shopping. Some of them went out during the evening to the local pub within walking distance or cinema. One person enjoys football on TV in their room and the staff are encouraged to support people with their preferences. One person and their key worker were decorating the persons room with football related decor. Another resident does knitting while watching TV in the lounge. There was a guitar, table football and table top games which the Expert by Experience was told If people want to play they can, this was however not seen to be used on the day. One resident said I have a lot of jig saw puzzles, I like doing jig saw puzzles. The Expert by Experience asked them what they are doing for Christmas , they were told that the residents will be going to a pantomime if they want to. Several of the homes get together and go to the pantomime as a group, they hire a hall for a Christmas get together with residents from the other homes, this allows them to see their friends. The following week there will be a coffee and mince pie morning and residents from the other houses will be invited. The residents can choose where they want to go on holiday, nine of the residents went on holiday and stayed in a cottage. The staff support each person as needs apply. The residents have the meetings when they ask for them or when they need to discuss things. This is also an opportunity to choose menus. One resident has a flask of hot water in their room at night so they can make a drink. The other residents said we have to ask staff for drinks we were told that I have asked and got a drink. The Expert by Experience asked the residents what is good about living here, people responded People coming, I get letters and parcels, it’s nice and Ive got some friends. The people using the service did not know what activity was planned for them each week. They were aware of activities outside of the home but not in house and their choice in participating was not clear. The registered manager is recommended to Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: review this and formalize a way that people know what their activity choices are and the plans for them for the week ahead. This would identify if enough activities were provided for each person. People using the service are supported with contact with families and friends and some people regularly go home for periods of time. Some people using the service do not have family contact and the manager confirmed that although they do not use any advocacy service to support people, they can access one if needed and there is a key worker system in place. There is some flexibility around meals and mealtimes to fit in with activities. On the day of inspection breakfast was seen to be taken at various times to support peoples preferences for getting up early or late. Lunch is cooked by the staff and was king prawn stir fry. There was a planned lighter snack in the evening of eggs on waffles. A healthy diet is promoted and monitoring of weight is maintained. People are supported to eat in the dining room or their own rooms. One resident has food appropriate to their religion. It was noted that the home does not display its menu choices and is recommended to review this with a view to menu boards or some means of visual indicator. Care Homes for Adults (18-65 years) Page 15 of 29 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 using the service receive personal support as they require. All areas of physical and emotional need are assessed and a care plan is in place to ensure staff have the information required to meet those needs. Clear systems are mostly in place to ensure that medication is safely managed and administered. Evidence: The homes AQAA states, Each service user has an individual support plan that clearly highlights the health care and personal care support required for each individual and what level of support the team need to provide.The team are involved in ensuring the very best service is available to an individual. Monthly reviews with the GP, regular dental, optical and chiropody checks are arranged to ensure if any change is required in an individuals routine it is made as soon as possible with their consent. Care plans have been updated to provide clear information and guidelines about personal care routines. Risk assessments were implemented where a need was identified and care plans put in place to support that risk. There was evidence that Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: peoples choices had been identified with reference to routines and clothing choices. Where the input of a visiting health professional was required this had been recorded. Body mapping is used and records maintained for all wounds and health care. Equipment has been supplied where a need has been identified. We observed that people were assisted with personal care in private and people receiving aromatherapy massage were supported to receive this is their own rooms. The staff team is both male and female, which enables any preferences with assistance to be met. All staff have had training in the care of medicines. No people using the service are currently managing their own medication. Medication is appropriately stored and managed and a monitored dosage system is in use. There are clear protocols in place for staff to follow when giving PRN medication. The management of medications was well organized and monitored however, the registered manager is required to ensure that all hand transcribed medications are signed by two staff. This will provide a clear audit trail and reduce the risk of the medication information being incorrect. Care Homes for Adults (18-65 years) Page 17 of 29 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 using the service and their representatives have access to the homes complaints procedure. Policies, procedures and staff training are in place to protect people using the service from abuse. Evidence: We spoke with four staff members who were all clear about the procedure to be followed if a concern was raised with them or if they wish to make a complaint. Staff told us they were confident that any concerns raised would be acted upon appropriately. Two complaints have been recorded at the home since the last inspection and both had been addressed in writing within the agreed timescale. CSCI have not received any complaints about this service. The homes AQAA told us, Our organization have a clear and effective complaints policy. Any complaint would be investigated in a sensitive professional manner. All staff undergo an induction training programme that includes POVA, this is completed on the first week of employment. The company policy very clearly explains how to respond to any suspicion of abuse and on the staff members first day the whistle blowing policy is explained.As part of Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: the extensive training programme the organization provide, the support team complete the Crisis Prevention Institute course entitled Non Violent Crisis Intervention. This is a 2 day course where support staff are trained in the skills to respond appropriately to an individual given the situation, and aim to reduce the number of instances where a service users behavior accelerates. By following the principles of the course this respects and protects individuals we support by promoting their care welfare safety and security. All staff have completed the POVA training including all new members of the team. Care Homes for Adults (18-65 years) Page 19 of 29 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. Bridge House provides a homely, comfortable and safe environment. It is decorated and maintained to suit the people living there’s needs and lifestyles. The home provides equipment as identified and the standard of hygiene is good. Evidence: Bridge House is a large converted older building. It provides accommodation over two floors with bedrooms having en-suit facilities. Upper floor access is by stairs only. All bedrooms, communal areas, kitchen and laundry were visited during the inspection. The living areas include a communal lounge and a quiet lounge. There are TV, games and Karaoke facilities and there was evidence of some of them being in use. There is also a spacious dining room and all areas appeared comfortable, suitably decorated and furnished. Bedrooms and en-suites had adaptations to meet the mobility needs of their occupants. Each bedroom was individual and the decor reflected the interests of the occupant. The kitchen and laundry were well organized and the home was maintained in a clean condition throughout. Protective equipment and materials were observed for the control of spread of infection. Hazardous substances are safely locked away and COSHH sheets are in use for all relevant substances. The homes AQAA said, The Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: support team ensure that the high standards of cleanliness is maintained at Bridge House with the continued involvement of service users. The registered manager advised that some redecoration is planed to brighten some areas of the home. The dining room has recently been painted and the manager discussed the further development of communal space. Some en-suite facilities were noted to have flooring which is in need of repair to ensure that there is no risk of cross infection. This is required to be reviewed and repaired or replaced. The outside and garden areas are attractively laid out and well maintained. Some people have direct access from their rooms to the garden area. People told us that they used the garden when the weather permitted.The home is within walking distance of local amenities. An undercover smoking area is provided for any people who wish to smoke. An alternative staff smoking area is provided. Care Homes for Adults (18-65 years) Page 21 of 29 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 home provides a staff team who know the people using the service well. The level of staff is not measured to ensure appropriate staffing numbers are available. Staff are well trained and appropriately supported. The recruitment procedures are robust and protect people using the service from the risk of harm. Evidence: On the day of inspection seven staff members were on duty, from 3pm to 6pm,6 staff were available and from 6pm that number reduced to 4 staff with 2 staff on waking nights. We discussed with the manager how the level of staffing was calculated and it is evident that the dependency of people is not reviewed and therefore adjustments to meet increased dependency for example for ill health or activities, could not be identified. The inspector spoke with staff on duty. They showed a good knowledge of operations in the home, of their role and that of others. All staff showed a good understanding of peoples needs and it was observed that staff interacted well with people using the service. Staff appeared relaxed and confident in the management of the home. All staff spoken with told us that they have received a good induction and sufficient Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: training in all mandatory areas. The manager stated that the induction is a company based plan which is based on the Skills for Care Common Induction Standards. Staff training is ongoing and the manager confirmed that 80 of staff have completed a NVQ qualification. The majority of training is done in-house. There is a clear staff raining matrix that enables the managers to identify any staff whose training is out of date. There are clear records that staff receive regular supervision and staff told us that this takes place and is an opportunity to discuss training needs and any issues they may have. Recruitment procedures are robust and all staff have CRB (Criminal Record Bureau) and POVA (Protection of Vulnerable Adults) checks prior to commencing employment. Not all records were available as they are maintained at a head office. There was a record of when all the documents had been received and the manager confirmed that he has access to all recruitment checks prior to staff commencing employment. Care Homes for Adults (18-65 years) Page 23 of 29 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 continues to provide effective leadership to the staff team. The home is organized and the people using the service benefit from the management approach of the home. The health, safety and welfare of residents is promoted and protected. Evidence: The registered manager is Gavin Guy. He has recently completed the Registered Manager Award. Mr Guy is currently dividing his time between two homes, providing 20 hours at each placement. This is a short-term measure and during this period Bridge House is being supported by the Deputy Manager. Regulation 26 visits are completed each month and the company undertakes an annual audit to review the quality of the service provided. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: Health and safety records inspected included the fire log, servicing and checking of fire equipment and systems, of gas and electricity and of portable electrical equipment. All records seen were well organized and up dated. One room was observed to have a wardrobe that had not been secured to the wall. The manager confirmed that a risk assessment was to be provided to ensure the safety of the person using the room. There is an annual training plan for staff that covers H&S updates including fire training and moving and handling training. Accidents are now monitored monthly to promote prevention. The storage of records has been previously noted under the outcome group Individual needs and choices As previously stated the storage of records in the lounge is not in line with the Data Protection Act and may compromise confidentiality and is required to be reviewed. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 13(2) The registered manager is required to ensure that all transcribed medications are signed by two staff. This is required to ensure that there is a clear audit trail of medications received and sufficient checks have been made to ensure correct transcribing. 14/01/2009 2 30 13 13(3) The registered manager is required to ensure that the flooring in bathrooms identified at inspection is repaired/replaced. This is required to ensure that the risk of cross infection is reduced. 25/02/2009 3 41 12 12 (4)(a) 14/01/2009 The registered manager is required to ensure that all records are stored confidentially in line with the Data Protection Act. Page 27 of 29 Care Homes for Adults (18-65 years) This is required to ensure the privacy and dignity of people using the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 5 The registered manager is recommended to ensure that all contract are signed as agreed by the person or their Representative. The registered manager is recommended to review how activities are planned and provide a plan to each person of their activity program for activities planned both in and out of the home. The registered manager is recommended to look at how the format for the choice of menu is made available to people. The registered manager is recommended to ensure that the dependency levels of people using the service meet the staffing levels in place and identify how this would be reflected in times of higher dependency for example periods of ill health. The registered manager is recommended to ensure that the one wardrobe identified as unsecured,is risk assessed and appropriate action taken to reduce any risk of injury. 2 14 3 4 17 33 5 41 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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