Inspection on 21/10/08 for Cornerways

This inspection was carried out on 21st October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cornerways 30/10/06

Cornerways 25/01/06

Cornerways 11/08/05

Cornerways 18/01/05

Cornerways 27/10/04

Cornerways 26/01/04

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cornerways 148-150 South Street North New Whittington Chesterfield Derbyshire S43 2AD     The quality rating for this care home is:   three star excellent 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: Jill Wells     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 31 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 31 Information about the care home Name of care home: Address: Cornerways 148-150 South Street North New Whittington Chesterfield Derbyshire S43 2AD 01246452148 01246452148 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alison Jane Keeton Type of registration: Number of places registered: Enable Care & Home Support Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following categories 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 Date of last inspection Brief description of the care home Cornerways is situated in the village of New Whittington on the outskirts of Chesterfield. Local facilities are nearby, including shops, churches, pubs, a social club and public transport. Cornerways provides personal care and accommodation for up to 6 adults with a learning disability. However, to ensure all residents have single bedrooms, the home currently provides accommodation for 5 people. There is a small 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home garden with patio area. The fees for this home are 358.65. Hairdressing, chiropody and toiletries are not included in the fee. Care Homes for Adults (18-65 years) Page 5 of 31 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: three star excellent 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 quality rating for the service is three star. This means the people who use the service experience excellent quality outcomes. The inspection visit was unannounced and took place over 5 hours. There were 5 people living at the home on the day of the inspection. 4 residents, 1 staff member, and the manager were spoken with during the visit. We also looked at all the information that we have received, or asked for, since the last key inspection on the 30th Oct 2006. This included The annual quality assurance assessment (AQAA) that was sent to us by the service. Care Homes for Adults (18-65 years) Page 6 of 31 The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report. Completed surveys from people living at the home, staff, relatives and professionals that visit. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. 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 31 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 31 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 31 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. Peoples needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. Evidence: There was a statement of purpose available at the service which set out the aims, objectives, philosophy of the home, its services and facilities. The statement of purpose said that the, emphasis is around enabling and encouraging in order to lead as full a life as possible. There was also a service user guide. This had not been given to each person living at the home, but was available in the dining area for easy access. There were relevant photographs in the service user guide to make the document more user friendly. Two peoples records were seen. There had been a full needs assessment completed with evidence that the person had been involved in the process. It was evident from observations and discussions that the home met the needs of Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: people living there. Staff have the skills and experience and demonstrated effective communication with people. Information was available about independent advocacy services and one person said that they were aware of peer advocacy. The statement of purpose made it clear that trial visits were encouraged and people could stay for lunch to meet other residents, and then stay the weekend. One person spoken with confirmed that they had a lengthy introductory visit period. Care Homes for Adults (18-65 years) Page 12 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home were consulted about every aspect of the service, encouraged to make decisions about their own life and participate in all aspects of life at the home. Evidence: Information in the annual quality assurance assessment completed by the manager was that staff support service users to make informed choices, service users are involved in implementing their care plan and reviewing, long-term care plans reviewed monthly and any changes recorded. Staff work alongside multi-disciplinary teams, risk assessment are completed and reviewed to encourage and support independent lifestyles. During the inspection visit two individual s records were seen. Each person had a detailed plan of care in place. Included with this was a personal profile and a pen picture of each person. The plan gave very clear and detailed information that was Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: person centred. For example, tends to rush meals, staff to assist to prompt to slow down and chew food. The plan also highlighted individuals abilities for example, likes to hang out washing and hoover. One record stated, can open own mail but needs assistance to read and understand. .There were records of consultation with people concerning having a lock on their bedroom door, a key to their room, and a key to the front door.This showed that staff promoted peoples independence. There were dietary assessments in place and a record of peoples, likes and dislikes. There was detailed information on each person concerning their communication. For example on records said, has difficulty expressing themselves to people that they do not know well. All relevant risk assessments were in place including moving and handling and risk of pressure sores. There were also individualised risk assessments for example having a wet shave, the kitchen area, wedging fire doors open with objects and inappropriate use of a hairdryer. The individual risks had been clearly considered and appropriate action taken with consultation with the individual to minimise the risk. There was a behavioural plan for one person that had challenging behaviour. This had been written with involvement from a specialist behavioural nurse. Staff were recording on each occasion the reason for the behaviour if known and were following the plan. They were recording how effective this had been to minimise the challenging behaviour. Each person had a personal planning book. This was completed with the individual and signed by them if possible. It included a record of important people in their life with photographs, what they liked to do, their life story and things they like and dont like. One person wrote in their book, Im fond of all the staff. People living at the home kept their own book in their bedroom. There was evidence in files and through observation during the inspection visit that people were encouraged to make decisions about their own lives. Advocacy was used when required if additional support was needed. Any restrictions had been clearly explained to the person and staff had sought their agreement. For example one person when left in the bath alone had attempted to get out and had fallen on several occasions. The individual had agreed that staff would not supervise them but would knock on the door and check at regular intervals that they were okay. People living at the home managed their own finances with support and tuition if needed. People participated in all aspects of life in the home. For example people were encouraged to undertake household tasks including cleaning their room and making Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: their bed. Some people enjoyed additional tasks around the home, supported by staff. Individuals assisted staff with the food shopping and helped plan menus. A new outside table had recently been purchased. The manager explained that people were asked if they preferred a glass or a wooden table, and were shown pictures. They chose a glass table, and this was purchased. A new kitchen and change to the layout is planned. People living at the home had been fully involved with this and had chosen the type of kitchen that they preferred. Staff spoken with were aware of the importance of confidentiality. Individual records were kept secure and confidential. Care Homes for Adults (18-65 years) Page 15 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were fully supported to develop their full potential, be actively involved with the local community, and have a full, rewarding life. Evidence: People had opportunities to maintain and develop independent living skills. Everyone was encouraged to participate in the daily life of the home including household chores, taking into account their wishes and abilities. Four of the five residents had chosen to attend various day centres. One person did not wish to do so, preferring to accompany staff in day-to-day tasks. On the day of the inspection visit they hoovered and walked to the local chemist with a staff member. Staff spoken with said that everyone enjoyed the various day centres that they attended, taking part in various activities for example baking, flower arranging, gardening and outings. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Several people went to the local church on a weekly basis. Staff support people to become part of and participate in the local community. People regularly went to the pub and local shops. If a service user sees any events taking place that they wish to attend, staff will make every effort to ensure that they can do this. Examples, well dressing and local concerts. Two people had asked to see Foster and Allen and had gone with staff to purchase the tickets. The service has their own transport facilities, and each person has their own bus pass. People were supported to pursue their own interests and hobbies. One person had asked if they could grow tomatoes, and had done this successfully. They had also requested a bird table for Christmas and enjoyed feeding the birds. Some people liked to spend time in their rooms listening to music, the radio or TV. An annual holiday had been organised this year to Ibiza. They were supported on holiday on a one-to-one basis. A grant was provided from the provider for this. Four of the five people had wanted to go. Staffing arrangements were made for the fifth person that chose not to go. This evidenced that the service was fully flexible and avoided putting pressure on individuals to go to a holiday or events if they did not wish to. The statement of purpose said, apart from outings to the coast activities are spontaneous when residents are willing and able. Daily records showed that residents mostly enjoyed outings at the weekend. One record stated, at service users request went out to the pub, two people enjoyed game of pool. Another records said, as the weather is beautiful this p.m., all service users wanted to go a ride out and they asked to go to Matlock. We had a walk, had fish and chips and sat in the park. Informal discussions were recorded for example a discussion about ideas for an outing at Christmas. Everyone wanted a meal out for Christmas and the venues were discussed with people. There was also a record of non-verbal responses from people that had no verbal communication. This shows that everyone was fully involved in decision-making. Minutes of residents meetings also showed that people were consulted. They had asked to go to Blackpool illuminations and staff were now planning this. Again nonverbal communication from individuals was recorded. The statement of purpose said that routines and regimes were avoided, mealtimes were flexible, working around residents and people could eat when and what they wished. This was evident during lunch. Staff asked the two people remaining at the home what they wanted for lunch. After lunch one person was seen helping Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: themselves to a yoghurt from the fridge. Another person said that they wanted a cup of tea. The staff member asked them if they wanted to make this, which they did. This shows that people were encouraged to be independent. The manager said that people living at the home were fully involved in menu planning, shopping, and occasionally people wanted to help with food preparation. A staff member said that the food budget had not been increased for a number of years. The manager hoped that this would be reviewed when she requests this. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support was flexible, and individualised and peoples physical and emotional health needs were well met. Evidence: Staff spoken with were aware of the importance of providing sensitive and flexible personal support to maximise peoples privacy, dignity and independence. Examples were one person that preferred a wet shave but needed to be regularly reminded not to talk or move around while they were doing this to minimise risk of cuts. This was recorded in their plan of care. People were supported to have baths and showers in private with minimal support, taking into account their needs and wishes. Staff said and residents confirmed that times for getting up and going to bed were flexible. One persons plan said that staff were to discourage the person from staying up very late when they were due to attend day centre the next day. One person had chosen to remain in bed for the morning of the inspection visit. Each person had a designated key worker to ensure consistency and continuity of support. Peoples preferred routines, likes and dislikes were recorded. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: People were supported to attend GP, hospital appointments and involvement with other health professionals were arranged as required. Peoples health was monitored and records showed that problems were identified and dealt with at an early stage, including prompt contact with the GP or other relevant specialist. A relative wrote in our survey, the well-being of (name of relative) is very important to all who care for them. The nurse advisor for challenging behaviour completed a survey and commented that, the manager and staff appear to work tirelessly to improve the health care needs of service users. Staff demonstrate an awareness of individual service users rights to privacy and dignity. There was a record of compliments made. This included a compliment from the dentist who said that, there has been a marked improvement in this persons oral care. The GP also commented that they were very pleased with all aspects of the service users care. Medication was stored in a medication trolley, that was secured to the wall. There was a photograph in place of each person. Medication records were checked and found to be in good order. Medication administration records were handwritten by the manager and checked by a second person to minimise errors. There was a good recording system for ordering, receipt, and returns of any medication. One person had been prescribed medication when required. There was a care plan in place giving guidance to staff as to when this medication should be given. This medication was to manage behaviour. It was evident from records that staff did not give this medication unnecessarily, preferring to use their skills and knowledge about this person to minimise any difficult behaviour and would only use the medication as a last resort. There was no evidence that individuals had been risk assessed as to their ability to self administer, with support if necessary or keep their own medication. Care Homes for Adults (18-65 years) Page 20 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected by the, policies, procedures and practices at the home. Evidence: A complaints procedure was in place that was in pictorial form. This was in peoples files that they could access at any time. There was a complaints record. There had been no complaints since 2006. The manager said that during residents meetings service users were asked if they had any complaints and were reminded of the complaints procedure. Minutes of this meeting demonstrated this. One person wrote in our survey, I would speak to my key worker if I was not happy but I like it here. Another person said, staff listen to me. A relative wrote in our survey, I have no reason to think that anyone would be left out or discriminated against here. Training record showed that staff had attended safeguarding adults training. Staff member spoken with were aware of the whistle blowing policy and safeguarding adults procedures. The manager had recently taken the revised safeguarding adults policy to the staff meeting and gone through this with staff, asking them to sign that they had read the new document. One persons challenging behaviour may at times put other residents at risk. The manager was working alongside a challenging behaviour nurse specialist and social services, to minimise this risk. Care Homes for Adults (18-65 years) Page 21 of 31 Care Homes for Adults (18-65 years) Page 22 of 31 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 good 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 safe, well-maintained and comfortable environment, which encourages independence. Evidence: The premises were accessible, safe and well maintained. Maintenance records showed that any maintenance issues were quickly reported and seen to. Four bedrooms are on the ground floor and the fifth bedroom was an attic room on the first floor. Everyone has a wash hand basin. There are two bathrooms, one is a walk in shower. The second bathroom has recently had a new bath and bathing equipment. This bath is up against the wall which may not make supporting someone with bathing easy for staff, however staff spoken with said that this wasnt a problem with the present people living at the home. There was not a call system at the home for people to contact staff when they are in their rooms, although one person with their bedroom on the first floor has a bell system. Other people have not been risk assessed concerning lack of any call system. There was a lounge, dining room and kitchen area which was open plan. The kitchen Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Was due to be refurbished. The layout was also due to be changed to make the area a kitchen dining room area. People living at the home were encouraged to use the kitchen with support and supervision from staff. There was a utility room with domestic laundry facilities. There was also a fridge and freezer in this room which was not ideal. The manager said that these will be removed and the freezer integrated into the new kitchen. The garden area was pleasant and had recently been improved with a decking area and new outside furniture. Care Homes for Adults (18-65 years) Page 24 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment practices and staff training programme were good and ensured that people were protected by competent, well-trained staff. There were sufficient numbers of staff to support the people who use the service. Evidence: Information provided in the annual quality assurance assessment was that they provide staff who are competent, there is a low turnover of staff therefore they can provide good continuity of care. They have above the 50 percent minimum standard of staff with NVQ 2 Care and several staff have NVQ 3 which should be commended. Staff spoken with were aware of the aims and values of the home. A staff member spoken with said, we always try to put residents first and make sure that care is right for the individual. Several positive comments were received from staff in surveys. These included communication between staff is very good, we are a small, close team and, we are good at person centred care, communication and respecting and involving service users. Training records showed that staff had attended relevant mandatory training including fire safety, health and safety, moving and handling, first aid, safe administration of Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: medication and safeguarding adults training. One person wrote in our survey, my induction was for two weeks but I was very highly supported when working as a full team member. The induction was thorough and very helpful. Staff said that they received regular supervision every 2 months and felt supported by the manager and their colleagues. Two staff files were seen. These showed that recruitment procedures were thorough and included all relevant checks. They showed that staff did not receive a starting date until a criminal record bureau check had been received. Equal opportunities information was sent with her application guidelines. Identity checks were completed at interview. People living at the home were complimentary about staff and said that they liked all of the staff. A relative wrote in our survey, the team could not be more helpful and supportive. They are well trained staff. A service user supported by a relative wrote in our survey, staff are kind, helpful and supportive. The rotas were inspected. It was found that staffing was flexible dependent on how many people were at the home at any one time. There were times when there would be one staff member and one service user. Two staff on duty at any one time was the norm. This would increase if required, for example if outings or activities needed additional staff. There was one staff member on duty at night. The manager said that if everyone living at the home went out, there would be four staff to support them. Care Homes for Adults (18-65 years) Page 26 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed, with effective quality assurance systems, ensuring that people are listened to and the home continues to develop and improve. Evidence: The manager explained that she had completed the work for the Registered Managers Award, and was waiting to be assessed. She made sure that policies and procedures were implemented by discussing them at staff meetings and monitoring staffs work. The registration and insurance certificate was displayed. Staff spoken with said that the manager was very approachable and, you can talk to the manager, she will listen and support you, but she can be tough if she needs to be. One person wrote in our survey that, the manager is a lovely person, always has the interests of service users first and foremost. A relative wrote in our survey, we have a good, open relationship and good communication with the manager. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: There was evidence that questionnaires had been completed with support from an advocate and key workers. They showed a high level of satisfaction from people living at the home and relatives. The manager had completed an analysis of these questionnaires. All of the records were in place required by regulation. The manager encouraged service users to access their records and information held about them. Individual records were secure, up to date and in good order. The manager was supported by the service manager responsible for the home. The service manager undertook monthly unannounced visits. The report showed that they spent time talking to service users and staff, checking the environment and records. There was a business plan which included completion of the new kitchen in 2009, re carpeting of communal areas, new curtains and decorating when this had been completed. It also highlighted achievements which included ensuring regular staff and service user meetings, improvements to the garden and a holiday to Ibiza with one-toone staffing. The manager made sure that regular reviews took place involving social services care managers. This was an opportunity for anyone to voice concerns or ideas about improvements to individuals care. Health and safety records showed that all relevant checks were being undertaken concerning fire safety. Fire drills and evacuation was done monthly. Any issues were recorded, for example a service user did not leave their bedroom on hearing the alarm. Record showed that they they were reminded of the importance of fire drills. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 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 2 17 20 The food budget available for the home should be reviewed to ensure that it is in line with price increases. People should have written risk assessments to consider their ability to self administer their own mediation with support or keep their own medication in their room in locked storage to promote independence. Individuals should be risk assessed concerning the need for a call bell system to assess any risk involved when this is not provided. Consideration should be given to providing a call bell to anyone that may be at risk from not having this. 3 26 Care Homes for Adults (18-65 years) Page 30 of 31 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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