Inspection on 29/09/09 for Chatting Independently Orchard View

This inspection was carried out on 29th September 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Chatting Independently: Orchard View 42A Wimblington Road March Cambridge PE15 9QN Lead Inspector Alison Hilton Key Unannounced Inspection 29 September 2009 08:50 th Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Chatting Independently: Orchard View Address 42A Wimblington Road March Cambridge PE15 9QN 01354657444 01354650767 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Chatting Independently Anthony Robertson Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Physical disability - Code PD The maximum number of service users who can be accommodated is: 6 New Service Date of last inspection Brief Description of the Service: Chatting Independently Ltd. is situated in a converted bungalow at Orchard View, 42a Wimblington Road, March which is a private road near to the town centre. The service is designed to cater for 6 people with a physical disability, who will be learning how to use Augmentative Alternative Communication (AAC), which is an electronic device to assist people with speech and communication problems. There are six single rooms and residents share the kitchen/dining area, bathroom and lounge facilities. There is a lift to the bedrooms upstairs. There are sleeping-in facilities for the staff. The fee levels vary depending on the needs of individuals accommodated and can be requested on application. On the day of inspection there were four people in residence. There is a second home owned by Chatting Independently Ltd in March and this has the same manager and responsible person. It is registered separately and is therefore inspected in its own right. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 star. This means that people who use the service experience poor quality outcomes. We, the Care Quality Commission (CQC) carried out a key unannounced inspection at Chatting Independently, Orchard View, on Tuesday 29th September 2009 between the hours of 08:50 and 16:30. This report makes judgements about the service based on the evidence we have gathered. Staff (including night staff); people who live at the home and the manager were spoken to. An Annual Quality Assurance Assessment was completed and returned to the Commission prior to this inspection. A number of records were seen, together with staff files and two files of people living in the home. There were four people in the home with two vacant beds. What the service does well: What has improved since the last inspection? What they could do better: Staff must follow the protocols of the home when recording, handling, safekeeping, administering and disposing of medication to ensure the health and safety of those living there. Care plans need to contain enough information for staff to care for those living in the home, and risk assessments need to be completed where necessary. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 6 Care plans need to be kept in the home to ensure they are available for staff to read. There must be enough suitably qualified, competent and experienced staff on duty appropriate to the needs of those living in the home. Staff need to undertake appropriate and updated training to ensure best practice. Staff must receive regular supervision to maintain good working practices. Where staff have whistle blown the manager must follow his own policy and procedure to ensure staff are kept informed of action taken. 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 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. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 People using the service experience good quality outcomes in this area. People are encouraged to visit the home to ensure the staff and environment can meet their needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Information provided in the AQAA showed that a three day assessment is undertaken by a physiotherapist, speech and language therapist and the registered manager who assesses independent living skills. A report is written about the assessment detailing the amount of time required for each therapy and the cost of this provision. During the assessment they stay at the home so have an understanding of it before a final decision is made about moving in. In the future an occupational therapist and wheelchair specialist will also take part in the assessment. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 People using the service experience adequate quality outcomes in this area. Information in the care plans does not reflect the changing needs of people in the home which means their needs may not be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that the philosophy of the home is to encourage those living there to become more independent. This has to be done with staff commitment and understanding of their role in the process and the manager is putting together an action plan that will summarise the main points. Further information showed that during induction and supervision staff are given instruction on how to enable and encourage people in the home, but there was no evidence of up to date supervision in staff files and no detail of Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 10 what was contained in the induction. The manager was heard telling staff why they should encourage people in the home to do their chores, but this was not recorded and was part of a general conversation. Some areas of the plans contained good information and were explicit in how the needs of the individual are to be met, however other areas did not contain enough detail to enable a person to provide the necessary care. Some files had risk assessments but these were not personal or detailed enough. One person’s care plan was in the other Chatting Independently home as it had recently been re-written. We discussed with the manager that all care plans must be in the home the person resides in so that those who provide the care have the information they need. Care plans are not reviewed at least six monthly and this was discussed with the manager who said plans would be reviewed and updated as soon as possible. There are timetables in each file on the activities to be undertaken. The information was not up to date. One person should have physiotherapy regularly and from the daily notes it appeared this had not happened, but staff said it had taken place on 28th September. People spoken to during the inspection said they were involved in their care plans and some signatures were seen on file to confirm that. Staff said they were involved in enabling people in the home to handle their own finances. Some transaction sheets were seen and there was evidence that there had been a minor discrepancy noted for one person but there was no further investigation in the paperwork seen that showed how this had occurred or whether the money had been balanced. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12,13,15,16,17 People using the service experience good quality outcomes in this area. People have the opportunity to take part in activities to enhance their lives. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that people can decide what courses they want to undertake and this was confirmed by those living in the home. They can go into town shopping, to visit the pub, attend church or travel on the train to larger cities such as Peterborough or London. Staff accompany them on a 1-1 basis. People living in the home have to learn to budget, choose menus, shop for the ingredients and use staff support to cook it. This means they can choose when and what to eat. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 12 The AQAA also states that the home could better enable people to go to bed and get up when they want. In discussion with some people in the home it was evident there were times when the staffing levels meant people could not get up or go to bed when they wanted. (See Staffing in section 7.) Chatting Independently has another home across the road from Orchard View and this has a hydrotherapy pool available for use by those living in both homes. Staff informed us that people have taken holidays abroad as well as in the UK and one person is due to go away next week. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People using the service experience poor quality outcomes in this area. Poorly completed medication records mean that people who live in the home may not be given their medication as prescribed, putting them at the potential risk of harm to their health. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that people are able to express themselves and how they want to be treated. They have the appropriate communication systems to enable them to make their wishes known and this was evident during the inspection. There were details on file of specialist input from a variety of professionals such as dieticians, GP and physiotherapists. The AQAA also stated that one member of staff had been appointed to be responsible for the ordering of medication, checking MAR sheets and signing the correct amount of medication is used. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 14 We looked at the medication for two people living in the home and the medication administration record (MAR) charts linked to them. We found the following:• Ear drops prescribed by the GP (11/09/09) had not been entered on the MAR sheet and therefore staff were unable to tell us if the person had had them administered as required. • There was no consistency in recording medication that had been refused. • One person received two Cetirizine 10mg tablets in one day when the MAR sheet clearly states one tablet daily. • Mar sheets had been signed that medication had been administered when the tablet was still in the blister pack including Tegratol 100mg, Pregabalin 100mg, Pregabalin 200mg, and Cetirizine 10mg. • MAR sheets had not been signed to show medication had been administered when the blister pack was empty including Gabapentin 300mg • Sodium Fluoride toothpaste to be used ‘as directed’ (twice a day) had been used seven times since 7 September according to the MAR sheet. • A continuing balance of medications in the home was not kept therefore staff were unaware how many tablets there were on site. For example Diazepam 5mg showed 40 tablets from the last prescription but there were 133 tablets in the home for this person. Baclofen 10mg showed 112 received, 100 tablets had been given and there were 78 left in the box. Pregabalin 200mg 56 received, 38 given and 51 in the box. We discussed these issues with the manager who said he was arranging medication training for 6th November (administration of medication in a care home) and he may (in the future) have specific staff allocated to administer medication in each home. He also said he would check all medication and MAR charts. People living in the home have a safe in their room so they can keep their medication there. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People using the service experience adequate quality outcomes in this area. People do not feel their views are listened to meaning they do not comment on the running of the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The Commission has received no complaints about Chatting Independently, Orchard View. The AQAA showed that any problem or concern is handled through the complaints procedure, but no complaints have been made and so this could not be tested. Although the AQAA shows that ‘staff and residents feel free to come to the managers to speak of concerns and know they will be listened to and they will have a response within the agreed time frame’, this was not evident on the day of inspection when staff said they had complained to the manager but were not aware of the outcome of the issues they had raised. Some of the issues should have been raised as Safeguarding of Vulnerable Adults, but this had not been done. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 16 People who live in the home stated that they did not feel there was any point complaining and were frustrated with the management of the home. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,29,30 this area. People using the service experience good quality outcomes in People in the home have a safe and comfortable place to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Details in the AQAA showed that the premises are well maintained and things replaced when necessary. Risk assessments are in place to deal with infection control and health & safety. The Environmental Health Officer has given the home 3 stars for food hygiene. We spoke to the new maintenance person who provided information about the aids and adaptations in the home. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 18 The home is furnished and decorated in a way that produces a homely and comfortable environment. This means people can relax and feel at home. A variety of aids and adaptations are available to meet their needs and these are checked regularly. The lounge, kitchen and dining area are domestic in style and are comfortably furnished and well equipped. The residents all have their own rooms, arranged and decorated to suit their particular interests and tastes. There is a lift to allow access to the bedrooms upstairs and people were seen to use it unaided. Checks are completed on all equipment in the home and records were seen. One person was having difficulty with his wheelchair and was in some discomfort. Staff said this had been a problem since he had his new wheelchair. No-one was sure if this information had been passed to senior management to look into. It was suggested that this be checked to ensure the safety and wellbeing of the person. The home was clean, fresh and generally well maintained; there were no mal odours. Staff follow appropriate procedures to maintain hygiene and prevent the risk of infection by using hand wash lotion regularly. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 People using the service experience adequate quality outcomes in this area. The number of staff available does not always meet the needs of people living in the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Three files were inspected and the information they contained was difficult to sort as there was no order to it. They did have application forms but the dates of previous employment only had years not months and gaps in employment did not appear to have been checked. References were on file but some gave very little information about the person or their aptitude towards a career in care. This was discussed with the manager and the possibility of obtaining a third reference and/or ‘phoning referees who may provide better information. Some had no interview information. Two people had details of issues raised but neither had been dealt with under the safeguarding protocols laid down in the home. The manager said that staff had been part of disciplinary action and were on final warnings, but some of that information was stored on the Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 20 computer, which is only available in the other home. The manager stated we could access this if necessary. On the day of inspection there were two staff in the home when we arrived. One person had completed a sleep-in and was due off at 10am and the other due off at 1pm. Two further staff arrived at 9:30am. Chatting Independently owns Orchard View and another home across the road. Both homes use the same staff group and although each person living there is supposed to have a dedicated staff member each shift, (called a facilitator) when one home is short or needs a driver, staff from the other home are called upon to fill the gaps. This means that there are times when a different facilitator appears to provide the care for someone in the home and this has an unsettling effect on that person. People in the home felt they were expected to accept a change with no discussion and that this was not right. We understand the philosophy of the home is to promote independence and part of that is interacting with different people but those we spoke to felt the process was unfair and those who were ‘easy to get on with’ had more changes of facilitator because of that. People who live in the home said staff were fantastic but “we are short of people, day and night”. This affects the activities they can take part in and it is “difficult for the facilitator”. “We need more people (staff) because dangerous if emergency; no good”. Some felt the manager “don’t care”. The manager agreed that the service is short staffed and there are three full time and three flexi time posts that need to be filled. Staff files seen during the inspection show training that is out of date such as Fire Safety October 2006, Epilepsy 2007, statutory courses October 2006 and the manager could not provide more up to date information. Some staff said they had been given extra responsibilities but had no time to do them because of the lack of staff. They felt this undermined their roles within the home. Supervision is not being given regularly to staff because of shortages. The last dates on the files seen were 22/6/07 and 10/12/08. For one person this is significant as they have had some disciplinary action taken but no support given through supervision. This was discussed with the manager who is aware of the requirement to supervise staff. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 People using the service experience adequate quality outcomes in this area. The ethos of the home is excellent but the management structure does not underpin it to ensure people feel supported. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The philosophy of the home and the staff understanding of it cannot be faulted. The AQAA shows that the manager is well qualified and has managed his own staff from the age of 18 yrs. He has the same physical and communication Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 22 issues as those living in the home and can empathise and understand things from a similar viewpoint. He has City and Guilds Registered Manager of a Care Home and is about to start his NVQ Level 4. Staff said they do not feel supported and that the leadership in the home is not strong enough to deal with issues in relation to staffing. They said they do not feel their views are listened to or acted upon and this has affected staff morale. People who live in Orchard View like the home but say there are a lot of problems. There are irregular staff and resident meetings, which means people do not have the opportunity to raise issues. A caretaker has been appointed and he overseas all aspects within the two homes. He showed us the records he keeps and these were well presented. The hot water temperatures in the sinks need to be dealt with so that staff are not scalded. People in the home are not able to use the sinks independently because of their disabilities. There was some evidence that fire drills are undertaken, but no list of the staff or those living in the home, who have taken part. This means the manager cannot be sure that everyone has taken part. Staff spoken to during the inspection had taken part in fire drills and were aware of the action necessary. The manager has not yet completed any quality assurance assessment of the service, but understands that this is necessary to ensure the service is reviewed and progressed in a positive way. He is also aware that this should include the views of staff, people living in the home, families and other stakeholders. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 2 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000073077.V377871.R01.S.doc 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 1 x 2 3 2 X X 3 X Version 5.3 Page 24 Chatting Independently: Orchard View N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 14 Requirement Care plans must be kept under review and revised when there is a change in circumstances. This means there is always up to date information about the provision of care for a person living in the home. Accurate records of medication administration must be kept to ensure the health and wellbeing of people living in the home. Arrangements must be made for the recording, handling, safekeeping, and disposal of medicines received into the care home to ensure an audit trail is available. The manager must inform people what action is to be taken after a complaint is made so that they are aware of the consequences. There must always be enough suitably qualified and experienced staff on duty to meet the needs of those living in the home. Staff must receive training appropriate to the work they are to perform to ensure the safety and wellbeing of people living in DS0000073077.V377871.R01.S.doc Timescale for action 30/09/09 2 YA20 13 30/09/09 3 YA20 13 30/09/09 4 YA22 22 30/09/09 5 YA33 18 30/09/09 6 YA35 18 30/11/09 Chatting Independently: Orchard View Version 5.3 Page 25 the home. 7 YA36 18 (2) Staff must be appropriately supervised to ensure continuing best practice. 30/11/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The manager must establish a system of reviewing and improving the quality of care. Chatting Independently: Orchard View DS0000073077.V377871.R01.S.doc Version 5.3 Page 26 Care Quality Commission Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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