Inspection on 22/07/09 for Chelwood Avenue (7)

This inspection was carried out on 22nd July 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chelwood Avenue (7) 24/07/08

Chelwood Avenue (7) 28/06/07

Chelwood Avenue (7) 16/11/06

Chelwood Avenue (7) 20/02/06

Chelwood Avenue (7) 09/06/05

Chelwood Avenue (7) 29/10/04

Chelwood Avenue (7) 22/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Chelwood Avenue (7) 7 Chelwood Avenue Childwall Liverpool Merseyside L16 3NN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Helen Carton     Date: 2 2 0 7 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 33 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 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 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. 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 Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Chelwood Avenue (7) 7 Chelwood Avenue Childwall Liverpool Merseyside L16 3NN 01517222854 01517226502 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.c-i-c.co.uk Community Integrated Care care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 2. Date of last inspection Brief description of the care home 7 Chelwood Avenue is registered to care and offer support to two adults with a learning disability and is run by Community Integrated Care (CIC), a major local not-for profit organisation. 7 Chelwood Avenue is a semi-detached house in a quiet suburb of Liverpool, close to a small parade of shops, the M62 and bus routes to Liverpool city centre. Downstairs there is a large lounge, dining room and a kitchen. Upstairs there are two spacious single bedrooms, a bathroom and a small room that is currently used as a staff sleepin room. The former garage has been converted to an office and utility room There is a large garden to the rear and side of the house. Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 2 Brief description of the care home There is no up to date information available at the home regarding the weekly fees charged to live there. A copy of the most recent CQC inspection report is availble on request from the manager. Care Homes for Adults (18-65 years) Page 5 of 33 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: As part of the inspection process we sent 7 Chelwood an Annual Quality Assurance Assessment (AQAA) document, which was not completed or returned to us prior to our visit to the home. This document was to provide information about the service at 7 Chelwood and to tell us where they felt they had made improvements to the way they support service users and the staff team. As part of the inspection process two surveys were sent to other stakeholders involved in supporting service users none were returned. The last inspection on this service was completed on 24/07/08 We visited 7 Chelwood to enable us to look at records and to discuss how the home supports service users in all aspects of their lives. Part of this process involved speaking with the manager, members of the staff team and spending time with service Care Homes for Adults (18-65 years) Page 6 of 33 users to find out their views on living at the home. We spent approximately 31/2 hours at 7 Chelwood. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: Service users families, friends and other professionals involved in supporting them are encouraged by the staff team to be involved in service users lives and where appropriate to support them in any decision making. Records and discussions with the manager, members of the staff team shows there is a strong commitment to supporting service users to develop and maintain skills including social and independent living skills. This supports them to have some control in their daily lives and to feel a valued part of the house community. We observed members of the staff team supporting service users in an affectionate and respectful manner, service users appeared comfortable and relaxed in their company. Members of the staff team spoken with provided the following comments: The best part of my job is spending time with A they are such good company. Supporting service users to have good days is a great feeling. Records show service users are supported to access health care services such as dentist, opticians, GPs, specialist learning disability services and podiatry. Staff members spoken with demonstrate a good understanding of their responsibilities with regard to safeguarding the people they support. CIC support the staff team to undertake training to enable them to support service users appropriately and safely this includes National Vocational Qualifications in care, crisis intervention training and health and safety training. Members of the staff team spoken with provided the following comments: I enjoy working here and feel supported by the manager. Its very relaxed and the service users dictate the pace of what we do and how we do it. CIC recruit their staff through their regional human resource department. We looked at a sample of records which showed all the required safety checks had been made staff had been issued with contracts and information about their job role. A robust recruitment processes offers service users confidence that they will be supported by people who have the necessary skills and suitable values to work with them. Staff members spoken with demonstrated a good understanding of their roles and acknowledged that as service users needs change their approach and how they offer support is also changing and adapting. This results in service users being able to have confidence that the care and support being offered is flexible and responsive to their changing needs. Care Homes for Adults (18-65 years) Page 8 of 33 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 on page 4. Care Homes for Adults (18-65 years) Page 9 of 33 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 10 of 33 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 11 of 33 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. The statement of purpose and the service user guide provide adequate information about the service and facilities to be offered. However the lack of contractual agreements between all parties leaves service users at risk of having their legal rights as citizens to be ignored or possibly abused. Evidence: The statement of purpose and service user guide which is called the tenants handbook provide basic information about the services to be offered. However service users have not been provided with written statement of terms and conditions or a contract to inform them of what is included in the fee, any liabilities and the care and support to be provided. Resulting in a lack of transparency by CIC who run the home towards service users currently living there. 7 Chelwood is owned by a housing association meaning service users are tenants they currently have no tenancy agreements. It is unclear legally what legal role CIC has to advocate on behalf of service users when raising concerns about the maintenance of the building. This lack of clarity may result in service users rights as citizens not being Care Homes for Adults (18-65 years) Page 12 of 33 Evidence: promoted or safeguarded. Before a person moves in to the home information is gained from them, their families and other professionals who may have been involved in supporting them. Following this assessment a decision is made as to whether the person is invited to move in, records show this process happens. Care Homes for Adults (18-65 years) Page 13 of 33 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. Care plans are in place which offers the staff team information to be able to support service users appropriately. However risk management strategies are not robust leaving service users at risk of receiving inappropriate or unsafe care. Evidence: Care plans provide detailed information about the care and support to be provided with some good information about preferred routines and lifestyle choices. However the care files are disorganised with lots of historical information mixed in with current care needs. This may result in confusion for any new members of the staff team and a reliance on verbal information passed from one member of staff to another. We discussed this with the manager who acknowledged care files need to be reviewed and information streamlined. Service users families, friends and other professionals involved in supporting them are encouraged by the staff team to be involved in service users lives and where Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: appropriate to support them in any decision making. We looked at a number of risk assessments and found that some routines and activities had not been fully risk assessed with the advice and input from other professionals involved in supporting service not being sought. The manager acknowledged this and said he would carryout detailed risk assessments following multidisciplinary meetings. This is to ensure actions taken by the staff team to minimise risks are in the best interests of service users. Care Homes for Adults (18-65 years) Page 15 of 33 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. Service users are proactively supported to engage in meaningful activities and to maintain positive relationships in their lives to promote a sense of wellbeing. Evidence: Records and discussions with the manager, members of the staff team shows there is a strong commitment to supporting service users to develop and maintain skills including social and independent living skills. This supports them to have some control in their daily lives and to feel a valued part of the house community. Service users rights to maintain their religious beliefs is supported by the manager and the staff team. Service users are supported to maintain positive friendships and family relationships. Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: Service users are supported to take part in activities and social events they enjoy and are meaningful to them as individuals. We observed members of the staff team supporting service users in an affectionate and respectful manner, service users appeared comfortable and relaxed in their company. Members of the staff team spoken with provided the following comments: The best part of my job is spending time with A they are such good company. Supporting service users to have good days is a great feeling. We looked at the food stores which had quite a lot of pre made meals we discussed with the manager the need to ensure service users receive a balanced and nutritious diet. This is to make sure every effort is made to support service users to develop and maintain healthy lifestyles. The manager told us homemade meals are provided but a supply of ready meals are stored to use as alternatives if activities take longer than expected. Care Homes for Adults (18-65 years) Page 17 of 33 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. Service users personal care needs are met in a skilled and sensitive manner. However on occasions their healthcare needs are not being fully met resulting in service users being provided with an inconsistent service. Evidence: We looked at a sample of care plans which provided information about how service users wish to be supported with their personal and intimate care needs. These plans provide good information to enable the staff team to support service users sensitively and appropriately. However the way the information is stored is disjointed with the most up to date information mixed in with historical information. This could lead to service users receiving inconsistent care and an over reliance by the staff team on verbal information passed between them. Records show service users are supported to access health care services such as dentist, opticians, GPs, specialist learning disability services and podiatry. With records kept of the outcomes of all medical appointments. A sample of service users medication and the accompanying medication administration Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: record sheets were looked at and the following issues were discussed with the manager: On occasions medication is mixed with food to help service users swallow medication. There is no risk assessment in place nor is there evidence that this practice has been discussed with GPs, the dispensing pharmacist or other professionals involved in supporting service users. The manager stated tablets are not disguised just placed on a spoon with some food we acknowledged this. However we advised that to ensure this practice is in service users best interests and is safe it must be formally discussed and agreed upon. We noted that one regularly prescribed medication did not have clear dispensing instructions documented on the medication administration record and that staff members had written a dosage on from verbal information given to them by a healthcare professional. We advised the manager to seek clarification of this issue to ensure service users are receiving the correct dosages of their medication. Care Homes for Adults (18-65 years) Page 19 of 33 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. Service users views and opinions are sought and acted upon. The homes policies and procedures promote service users wellbeing. Evidence: Service users their families and supporters receive information about how to complain and raise concerns about the service they are receiving in the Statement of Purpose and tenants handbook. We discussed with the manager the need to look at ways to produce complaints and concerns information in a format that is more meaningful to service users. The home has a record of complaints and concerns which details the action carried out to resolve these issues. There are also detailed policies and procedures for the staff team to refer to if they witness or are told about incidents of abuse. This also includes a whistle blowing policy. We discussed with the manager the need to review the contents of some of the guidance provided by CIC as it is not reflective of the service provided by the home and would require the staff team to undertake specialist training. The manager agreed to discuss this issue with his line manager and remove the guidance. Staff members spoken with demonstrate a good understanding of their responsibilities Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: with regard to safeguarding the people they support. The companys induction process involves attending safeguarding vulnerable adults training. Care Homes for Adults (18-65 years) Page 21 of 33 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. The home is not being well maintained resulting in service users not always living in a homely, comfortable and safe environment. Evidence: A tour of the building highlighted the following concerns: There is evidence of damp on the chimney breast wall of the lounge the manager stated this is an ongoing problem that the housing association who own the property are aware of. An e-mail was received from the manager on the 2/08/09 stating work had commenced to rectify this problem. The flooring in the lounge was dirty and damaged and in some areas looked unsightly. Some of the stair carpet treads were worn and damaged if remedial work is not carried out they could become a tripping hazard. The bathroom flooring was badly stained, the blind was dirty and the wood around the bath was damaged. The toilet and sink were dirty as was the inside of the window. There was food debris in the kitchen cupboards and on the floor, work surfaces were Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: stained and dirty. The manager acknowledged this and stated he would ensure all areas of the home were thoroughly cleaned. Furnishings throughout the home were of a good standard with new curtains and bedding having been purchased for service users bedrooms. Care Homes for Adults (18-65 years) Page 23 of 33 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. Service users are supported by a trained and competent workforce resulting in positive outcomes with regard to them receiving individualised care and support. Evidence: CIC support the staff team to undertake training to enable them to support service users appropriately and safely this includes National Vocational Qualifications in care, crisis intervention training and health and safety training. CIC and the manager have organised refresher training in medication procedures and safeguarding adults training which is booked to take place in the coming months. Members of the staff team spoken with provided the following comments: I enjoy working here and feel supported by the manager. Its very relaxed and the service users dictate the pace of what we do and how we do it. CIC recruit their staff through their regional human resource department. We looked at a sample of records which showed all the required safety checks had been made Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: staff had been issued with contracts and information about their job role. A robust recruitment processes offers service users confidence that they will be supported by people who have the necessary skills and suitable values to work with them. I observed staff supporting service users sensitively and affectionately. Staff members spoken with demonstrated a good understanding of their roles and acknowledged that as service users needs change their approach and how they offer support is also changing and adapting. This results in service users being able to have confidence that the care and support being offered is flexible and responsive to their changing needs. The staffing roster shows staffing levels are flexible to offer service users support at times they need and want. Care Homes for Adults (18-65 years) Page 25 of 33 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. Current management systems are not adequately robust enough that service users can be confident their health, safety and welfare is promoted and safeguarded at all times. Evidence: The manager has worked at the home as a support worker for over ten years and was appointed manager at the beginning of the year. An application to register the manager with CQC has not been received. However we were told an application has been completed and CIC are awaiting the return of a criminal records bureau check required before sending the application to the commission. The manager intends to commence the NVQ Level 4 Managers Award in September 09. As part of the inspection process an AQAA document is sent for completion by the manager or a representative of the organisation. This document allows the home to provide information about what they believe they are doing well, plans they have to develop the service and areas they feel they can improve in. A completed AQAA was not received prior to the visit being made to the home or completion of this report. Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: The area manager visits once a fortnight and carries out Regulation 26 visits monthly, there is no other service specific quality assurance systems in place. We discussed with the manager the need to engage with other stakeholders in the service to ensure the service being offered to service users meets their needs and expectations. A number of health and safety issues were raised during the inspection visit with utility safety and maintenance checks not being carried out within the required timescales. The manager acknowledged this and stated he would ensure all required safety checks and risk assessments were carried out as a matter of urgency. Care Homes for Adults (18-65 years) Page 27 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 2(b) Care plans must be kept 31/08/2008 under review to demonstrate that people?s changing care needs have been identified and effective measures taken to meet those changed needs. The registered person must 30/09/2008 ensure that a registered manager is appointed and an application to register the appointed manager is made with CSCI. Unmet requirement from 30/10/07 2 38 8 Care Homes for Adults (18-65 years) Page 28 of 33 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 1 37 10 An application to register the 30/09/2009 manager must be received by CQC within the required timescale. completed application form to register the manager with CQC must be This is to ensure service users health and wlfare is promoted and protected. 2 39 24 Service specific quality assurance systems must be put in place. This is to ensure the opinions and views of service users, their relatives and other stakeholders are actively sought and acted upon. 30/11/2009 3 39 24 The AQAA dataset must be completed and returned to the Commission within the required timescale. This is to ensure quality assurance systems are robust and identify good practice and acknowledge areas requiring improvement. 30/06/2010 4 42 23 All health and safety checks required to be carried are done so within the required timescales. This is to ensure service users live in a safe and hazard free environment. 30/10/2009 Care Homes for Adults (18-65 years) Page 29 of 33 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 5 5 Each service user must be provided with terms and conditions in respect of accommodation and care to be provided, including as to the amount and method of payment and overall fees. This is to ensure service users rights as citizens are respected and protected. 26/10/2009 2 6 15 Information held in care plans must be reviewed This is to ensure current information is easily accessible for the staff team. Enabling them to offer the most appropriate and safe care at all times. 30/09/2009 3 9 13 Where a risk has been identified a detailed risk assessment must be put in place. This is to ensure any restrictions placed on service users are in their best interests. 30/09/2009 Care Homes for Adults (18-65 years) Page 30 of 33 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 4 20 13 Clear instructions regarding 07/09/2009 the administration of service users medication must be sought from the prescibing healthcare professional. This is to ensure service receive the correct dosage of their medication to maintain the health and and wellbeing. 5 20 13 A risk assessment must be 30/09/2009 carried regarding the practice of placing tablets on a spoon with food to administer medication to service users. This is to ensure this practice is safe and in service users best interests. 6 23 13 Policies and procedures in place to promote service users safety and wellbeing must be relevent to the service being provided. This is to ensure service users receive safe and appropriate care at all times. 30/09/2009 7 24 16 The stair carpet must be 30/09/2009 maintained and made free of tripping hazards. This is to ensure service users health and safety is maintained. Care Homes for Adults (18-65 years) Page 31 of 33 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 8 27 16 The flooring in the bathroom 30/10/2009 is damaged and must be replaced. This is to ensure service users live in a well maintained and pleasant environment. 9 30 16 All areas of the home must be kept hygenically clean. This is to ensure service users health and safety is maintained. 07/09/2009 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 1 17 The use of pre made meals should be reviewed regularly to ensure service users are being supported to develop and maintain healthy lifestyles. The way in which healthcare information is stored should be reviewed to make sure the most recent information and guidance is easily accesible to the staff team. This is to ensure service users receive approprite and safe support at all times. Work should continue to ensure damage caused to plasterwork through damp penetration are rectified. This is to ensure service users live in safe and healthy environment. The flooring in the lounge is damaged and in some areas unsightly it should be replaced within the next six months 2 19 3 24 4 24 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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