Inspection on 24/11/08 for Buttercups & Railway Cottage

This inspection was carried out on 24th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Buttercups & Railway Cottage 12/10/09

Buttercups & Railway Cottage 29/04/09

Buttercups & Railway Cottage 13/11/07

Buttercups & Railway Cottage 02/11/06

Similar services:

Insight - Eastchurch

Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Buttercups & Railway Cottage 8 Ford Road Arundel West Sussex BN18 0BH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Annette Campbell-Currie     Date: 2 4 1 1 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. the things that people have said are important to them: They reflect 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Buttercups & Railway Cottage 8 Ford Road Arundel West Sussex BN18 0BH 01903889643 01903884105 buttercups@consensussupport.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Corich Community Care Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 12. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Buttercups and Railway Cottage is a care home, which is registered to provide personal care for up to twelve service users in the category learning disability (LD) who are between the ages of 18 to 65 years of age. The service has been set up to provide care and accommodation for younger adults with autistic spectrum disorders and challenging behaviours. It is a detached property, which has been extended and adapted for its current use, and is located in the village of Ford. Although it is under one registration it comprises of two adjacent premises - one for three people and the other for nine. The property provides private accommodation to residents in single bedrooms located on the ground and first floors. The bedrooms include ensuite WC and bath or shower facilities. Communal accommodation is made up of a lounge and a dining room in each of the premises; they are located on the ground floor. The smaller Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 12 Brief description of the care home house has its own private courtyard that people living here can use. An enclosed secure garden, which is available to all residents, is located to the rear of the premises. The responsible individual acting on behalf of the organisation is Mr Maarten Vegting who is responsible for supervising the management of the care home. The registered managers post is currently vacant. 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: The previous inspection was carried out on 13th November 2007. Consensus has purchased the home since the previous inspection. The current fees are from 1800 to 2300 pounds per week. Annette Campbell-Currie carried out the site visit over six and a half hours. The registered manager left in August and a new manager was appointed, however he left the home after a month. The deputy manager is currently managing the service. A new manager has been appointed and is due to start work next week. The deputy manager assisted with the inspection and Mr Vegting, the registered person for the company was available by phone. Care Homes for Adults (18-65 years) Page 6 of 30 The previous manager completed an annual quality assurance assessment form (AQAA) before the inspection. The AQAA was not detailed and did not provide very much information to help plan the site visit. We (the Commission) sent surveys out to find out what people think about the home. None of the staff returned completed surveys. The twelve people living in the home returned surveys that had been completed by members of staff due to peoples communication difficulties. During the visit the majority of people living in the home were seen, however it was not possible to find out peoples views about their home due to communication difficulties. Four members of staff were spoken with including the cook. The following documents were read: the case records of four people, the recruitment records for three staff, the complaints records, training records and medication records. The medication storage and administration was also seen. A tour of the building was carried out including the communal areas, the kitchen, laundry room, five bedrooms and bathroom, ensuite shower and toilet facilities. The outcomes for people living in the home have been assessed in relation to twentythree of the forty-two National Minimum Standards for Care Homes for Younger People; including those considered to be key standards to ensure the health and welfare of people living in the home. Six requirements have been made following this inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 30 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs and aspirations assessed before a decision is made about them moving to the home. Evidence: There is a pre-assessment policy and process to ensure that a thorough assessment of need is carried out before a decision is made about someone moving to the home. There have been no new admissions since the previous inspection, when it was found that the assessments included a life history of the person, personal care and behaviour needs, also information about eating and drinking, communication, social skills, sleep and rest patterns, activities and interests, mobility, physical health and family support. An introductory period would be arranged to suit individual need. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed needs are not clearly documented in their care plan and are not always kept under review. People are assisted to make some decisions about their daily lives where they are able to. People are not always supported to be independent within a clear risk assessment framework with risks being kept under review. Evidence: There is a care planning process in place. The case records for four people were seen. There was information about aspects of each persons needs and some detail about the way personal care should be provided. Some guidance had been provided to staff on certain aspects of the persons care. The information was not organised in a way that makes it easy to find key information. Although some of the information identified individual needs the care plans were not person-centred. In some cases there was some key information at the front of the file. It was not clear in all cases that care plans had been reviewed and changes in need Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: documented. Two people have recently had annual reviews arranged by staff from the local authority responsible for arranging the placement. Staff spoken with were clear about the care that people need. Senior staff from Consensus are planning to introduce a new format for care plans and daily recording. The providers have said that this is due to be in place by January 2009. Some staff have attended training sessions on care planning. Mr Vegting said that relatives will be involved in setting up the new care plans as well as the person themselves. Care plans should provide detailed information and guidance to staff and be kept under review to make sure that peoples needs are being met. A requirement has been made regarding this matter. There was evidence that daily records are kept. There is a system for recording daily activities and daily care in separate files; this practice was discussed with the responsible individual who said this would be reviewed to ensure a more holistic approach. A new system of recording has been introduced and two staff said they were not clear about how events should be recorded. There were some gaps in the records that were seen. Mr Vegting said that staff would receive training on recording methods as part of their care planning sessions. There was some evidence to show that people are provided with some choices in their lives, for example the activities that are available. The acting manager said that photographs, symbols and pictures are used to help people make choices. There was no evidence on the case records that were seen to show that peoples level of understanding or ability to give consent had been noted in line with the Mental Capacity Act. The home must document where decisions need to be made on a persons behalf and how these decisions should be made. It was clear that some aspects of risk had been identified and some guidance to staff provided. The risk assessments that were seen were not always clear with detailed guidance to help minimise risks. Not all risk assessments had been reviewed with changes in guidance documented. A requirement has been made regarding this matter. It was evident that there had been behaviour assessments for some people where this need has been identified and clear guidance provided for staff about possible triggers to behaviours, how the avoid to triggers and how to manage behaviours safely should they occur. Assessments and detailed guidance should be in place for all those who may present a risk to themselves or others; Mr Vegting said that there are plans for this to be done so that people living in the home and staff are fully protected. Care Homes for Adults (18-65 years) Page 13 of 30 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 are supported to take part in appropriate activities and to be part of the local community. People are supported in their contact with family and friends. People enjoy a healthy diet. Evidence: There is a programme of activities that is arranged for each person. People are supported to attend college and a local activities centre. During the day two people were going by train to college and having lunch out on the way. Certificates of achievement from college were seen in some case records. Several people were out at the activity centre. A music session was planned for the afternoon with someone from outside the home visiting to facilitate the session. Some people have one to one support in the home and two people were having a hand Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: massage during part of the morning. It was not clear in some cases how the time should be spent with people; one person was spending time alone in his room. There is an activities room that is in the grounds of the home. It is currently being used as a storeroom. Mr Vegting said that there are plans to make better use of this facility. The three people living in the cottage went swimming during the morning and staff said that people enjoy trips out in the minibus and local walks. People are supported to maintain contact with relatives and friends. Events are arranged from time to time; a fun day had been held in the summer and relatives and friends invited to join in. Relatives are involved in annual review meetings when they are held. A number of people who live at Buttercups require close supervision or constant one to one attention for their own safety and the safety of people around them. People are supported to use their bedrooms for privacy and quiet time, sometimes with staff and sometimes on their own. Staff were being sensitive to peoples needs during the visit. Access to some areas of the home is restricted in order to keep people safe, for example the kitchen, the laundry room and office area on the second floor. There is a full time cook who provides a cooked meal at lunch times and prepares food for meals on Saturday before she finishes work on Friday. Information about special diets and allergies are in the kitchen and the cook plans the menu around the food that people enjoy. As people are not always able to express their views about the food they eat it is sometimes only when people do not eat their meals that staff can tell their preferences. The cook said there is an emphasis on healthy eating and there are no restrictions to the budget for fresh fruit and vegetables. There was a choice of meal at lunchtime and a hot snack is provided in the evenings. People usually take their meals in the dining room and staff assist people who need support with eating. 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 receive personal care in the way they prefer and require. People have their physical and healthcare needs met however the records are not always clear. The policies and procedures regarding medication protect people who live in the home, however the policy regarding covert administration of medication was not being followed. Evidence: Personal care needs are documented in care plans. The case records that were seen showed that some guidance was provided to staff about the way that care should be provided. Newly appointed staff follow an induction programme that includes information about providing personal care. It was clear from case records that people are supported to see the GP and other health care professionals as required. There was some information about peoples healthcare needs but this was not always clear and sufficiently detailed to make sure that peoples health care needs are being monitored. There was some indication that people are supported to see the optician, the dentist and chiropodist when they need Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: to. The medication records that were in case files were not always up to date, this could cause confusion and records should be updated when prescribed medication is changed. None of the people living in the home are able to self medicate. An audit of the home carried out by senior staff from the organisation highlighted the need for each person to have a health action plan and that an annual medication review should be recorded, this was not evident on the care plans that were seen. The storage facilities, records and administration of medication were seen. The acting manager said that the home has recently changed to using a different pharmacy and the company is providing staff training and guidance to the home. The acting manager said that none of the people in the home are currently prescribed controlled medication; if this situation changes the home must provide storage facilities that meet the Royal Pharmaceutical Societys guidance. The storage and records were in order. Guidance should be sought and the companys policy followed regarding the practice of covert administration of medication. The agreement of the GP should be sought in writing where it is agreed that this practice should be followed. A requirement has been made regarding this matter. Staff who administer medication have all attended training in medication issues. 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. It was not clear that all complaints are recorded to show that they are appropriately investigated and necessary action is taken to address them. People have not been fully protected at all times. Evidence: There is a complaints policy and procedure that is given to relatives of people living in the home who are not able to make complaints for themselves. There is a book for recording complaints. No complaints had been recorded in the past twelve months although at least two relatives have raised concerns and complaints recently that have been investigated under the West Sussex safeguarding protocols. There was no record of these issues, the acting manager said that head office has the records however there should be evidence in the home that complaints are listened to, recorded and investigated appropriately. A requirement has been made regarding this matter. The home follows the West Sussex multi agency policy and procedure for safeguarding vulnerable adults. Three incidents have been investigated under the safeguarding protocols in recent months. Two of the incidents had not been reported to social services at an early stage. The outcome of the investigations was that the home had been negligent in some aspects of care. Since the investigation all care staff have Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: attended training sessions about adult abuse and alerting procedures to make sure that measures are taken to protect people living in the home. There are systems in place to support people with their daily finances and to make sure their money is protected. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable environment that is in need of some refurbishment. The home is usually clean and hygienic. Evidence: The communal areas, the kitchen, laundry facilities, a communal bathroom and five bedrooms were seen. There were areas of the home that are in need of repainting and some flooring in bathrooms and shower rooms should be replaced to prevent the risk of cross infection. Mr Vegting said that there is a plan for refurbishing the home and extending the dining room and lounge to provide more communal space. There is an activities room in the grounds that is currently used as a storeroom. As the communal space is limited this would provide additional space and opportunities for a wider range of activities. Mr Vegting said that there are plans to make this room warm and suitable for use. There is a cleaner employed to keep the home clean on a daily basis. The need for some of the flooring and shower rooms to have a deep clean as required was discussed with the manager. Arrangements should be made for this to be done to prevent the risk of cross infection. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The laundry room is in the basement and not accessible to people living in the home. A member of staff is employed on a part time basis for laundry duties and care staff take on laundry duties at other times. There is a procedure for dealing with soiled laundry. Staff are provided with gloves to help prevent the risk of cross infection. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who have the knowledge and skills to do their job. People are protected by the recruitment policy and procedure. Staff have not been receiving the supervision they need to make sure they have the support they need to do their job. Evidence: The previous manager said in the AQAA that eight of the twenty-six care staff have achieved the National Vocational Qualification (NVQ) at level two or above. This does not meet the target of 50 of care staff achieving this qualification. There were sufficient numbers of staff on duty during the site visit. Seven staff were on duty with an additional person employed for one to one time with someone who needs this level of support. There were eight people on the afternoon shift and three waking night staff; one person in the cottage and two in the main house. One member of staff said that numbers of people on duty have increased recently which means that more time can be spent with individuals. The staffing rota was seen and showed that this is the case. Twelve staff have left in the past twelve months and recently agency staff have been Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: employed to cover shifts. The acting manager said that the agencies try to send staff who have been to the home before to provide consistency. There has been a recruitment drive; one newly appointed person began work recently and three people are due to begin work soon pending Criminal Record Bureau (CRB) checks. The recruitment records for three staff were seen and showed that people had completed application forms, two written references had been obtained and people had not started work until a CRB or POVA First check had been obtained. There is an induction and training programme in place. The acting manager said that all newly recruited staff follow an induction programme that meets the Skills for Care guidelines and includes aspects of specialist training for working with people who have a learning disability. A training programme has been set up including sessions in mandatory topics including health and safety and moving and handling. Senior managers from Consensus are planning to provide training in person centred care planning, communication, working with people with autistic spectrum disorders and challenging behaviour active support and report writing. Training in adult abuse and reporting procedures has recently taken place. Not all staff have attended updated training in all mandatory topics. None of the staff have had annual appraisals to identify individual training needs; this is partly due to the fact that the home has been without a registered manager for four months. There has been no system in place for providing supervision for staff to make sure they have the support they need and any shortfalls in performance are noted and appropriate support given. A requirement has been made regarding this matter. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not currently managed by someone registered with the Commission. It is not clear how peoples views and opinions influence the development of the home. There are measures in place to protect the health, safety and welfare of people living in the home and of staff. Evidence: The registered manager left in August. A new manager began work in September and left a month later. Since then the deputy manager has been managing the service with support from senior staff from Consensus. A new manager has now been appointed and is due to start work next week. In order to ensure the business is run efficiently and effectively meets with the regulations then good support must be provided to the manager and an application submitted for registration. It is difficult for people living in the home to express their opinions about the service due to communication difficulties. There was no clear system for ensuring that those who are able to indicate their wishes are supported to do this. The acting manager said Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: that questionnaires are sent to relatives to find out what they think about the service although there was no evidence of this. Senior managers in the organisation carry out Regulation 26 visits each month and provide a report of their findings. An audit was carried out in February with a follow up visit in August and November. The issues that were noted in February have not yet been addressed and a further monitoring visit is planned for January. Senior managers drew up an improvement plan for the home in October and progress that is being made is being monitored. The previous manager in the AQAA indicated that equipment is serviced as required and measures are in place to protect the health and safety of people in the home and of staff. There are policies and procedures in place that have been read and signed by staff. Incidents are recorded and monitored by the manager. As previously discussed risk assessments for individuals in the home should be clear and detailed to make sure that there are clear measures in place to protect people living in the home and staff. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered provider must ensure that care plans provide clear information about peoples needs in respect of his or her health and welfare and how they should be met. Care plans should be kept under review to ensure that peoples changing needs are met to make sure that people are receiving the care that they need. 31/01/2009 2 9 13 The registered provider 31/01/2009 must ensure that risk assessments provide detailed guidance about how to avoid unnecessary risks and these should be kept under review so that there are measures in place to protect people living in the home. Care Homes for Adults (18-65 years) Page 28 of 30 3 19 17 The registered providers must ensure that staff are provided with guidance about recording key information so that there are measures in place to protect people living in the home. 31/01/2009 4 20 13 The registered providers 31/01/2009 must ensure that medication policies and procedures regarding the covert administration of medication are followed to make sure that people are kept safe. 5 22 22 The registered provider 31/01/2009 must ensure that a record of complaints is kept in the home to show that complaints are listened to, appropriately investigated and acted upon. 6 36 18 The registered provider must ensure that people working in the home are appropriately supervised to make sure that staff have the support they need to do the job and any shortfalls in performance are identified and addressed. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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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