Inspection on 12/02/09 for The Dales

This inspection was carried out on 12th February 2009.

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

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

Other inspections for this house

The Dales 01/06/09

The Dales 22/02/07

The Dales 01/02/06

The Dales 22/11/05

The Dales 10/03/05

The Dales 13/09/04

The Dales 24/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

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Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dales, The 137 Gillott Road Edgbaston Birmingham West Midlands B16 0ET     The quality rating for this care home is:   zero star poor 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: Kulwant Ghuman     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.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: Dales, The 137 Gillott Road Edgbaston Birmingham West Midlands B16 0ET 01214540197 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Mary Slammon care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 Residents must be aged under 65 years with a learning disability. That the home periodically reviews that it can continue to meet the individuals needs and a record of these reviews are maintained. The home may accommodate one named service user over the age of 65 for reasons of learning disability. Date of last inspection Brief description of the care home The Dales is situated close to Edgbaston Reservoir and Summerfield Park, and within easy reach of local amenities. The large Victorian property has front, off street parking and is well presented. Facilities are provided on the ground, first and second floor reached by a main staircase. Each person living in thehome has a bedroom with wash hand basin and four bedrooms also have showers. There is a large front lounge, rear dining room and kitchen area and laundry facilities. One ground flroo bedroom is available. The house is well maintianed. Furniture and carpets are well maintained. The garden has been developed t include two seating areas with comfortable garden furniture. Paving around the garden allows for short walks. The statement of purpose Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home states that the home will provide service users with a secure, relaxed, homely environment in which their care, well being and comfort are of prime importance. 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: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over two days; the home did not know we were going to visit. The focus of inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. The last key inspection for this home was in February 2007. In February 2008 we carried out an Annual Service Review (ASR). This is where we ask the home for some information and look at any information we have received about the home since the Care Homes for Adults (18-65 years) Page 6 of 31 last inspection. This includes any notifications, things that the home has to tell us that may have happened in the home, any complaints and issues of safeguarding about the home. We also asked the people living in the home about their views about the home. Following the ASR we decided that the home continued to provide a good service. Prior to this visit taking place we looked at all the information that we have received, or asked for, since the last annual service review. This included notifications received from the home and an Annual Quality Assurance Assessment (AQAA). This is a document that provides information about the home and how they think that it meets the needs of people living there. One person living in the home was case tracked. This involves establishing the individuals experiences of living in the care home by meeting them, observing the care they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked around some areas of the home. A sample of care, staff and health and safety records were looked at to make sure that the people living and working in the home were safe. Where people who use the service were able to comment on the care they receive their views have been included in this report. We sent Have your Say surveys to the people who live in the home. We received seven completed surveys from the people living in the home and six from staff working there. They told us that the people living in the home were happy and that the staff felt well supported and received a lot of training. No complaints had been referred to us regarding the home since the last annual service review and none had been received at the home. One safeguarding issue had been raised with us since the annual service review and the investigation into this was ongoing at the time of this inspection. What the care home does well: What has improved since the last inspection? What they could do better: The manager must ensure that information about the needs of anyone moving into the home is received before they move in. This will ensure that the individuals needs can be met in the home. The manager must ensure that the people living in the home have a plan that clearly shows what they like to do and ensure that actions are taken to ensure that these needs can be met. Care Homes for Adults (18-65 years) Page 8 of 31 Risk assessments must clearly show the decisions arrived at and that the people living in the home have been involved in the decision making process. This will ensure that they know if any actions are being taken which they may not agree with but that they are in their best interests. The people living in the home should be involved in menu planning to decide the meals to be served in the home. The manager must ensure that all medicines are stored appropriately at all times to ensure the safety of the people living in the home. There must be adequate records for the management of monies in the home for anyone who is being helped to manage their money or having any assistance in budgeting. This will ensure individuals are safeguarded from abuse. The recruitment procedures must ensure that all the required checks have been received before individuals are employed in the home to ensure that only suitable peole are employed. Staffing levels needed to be maintained at levels that ensured that individuals were gainfully occupied and that ensured both the safety of the people living in the home and the staff. 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.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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is information available for people moving into the home to help them decide if the home is suitable for them but some information is not up to date. People thinking of moving into the home did not have information available to them about how much it might cost to live there. The manager did not always ensure that information about the needs of people moving into the home was received before they moved in. Evidence: There was a service user guide in place and one had been placed on the individuals files. The document was written in a way that made it easy for the people living in the home to understand and included pictures to help those with limited reading skills. The information had not been updated since the last key inspection so that it did not include the correct information about how the people living in the home could contact us if they wished to raise any issues with us. In addition the registered person should ensure that there is information included in it about the fees charged at the home so that anyone thinking about moving into the home would have some information about what the likely costs would be. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: One person had been admitted to the home since the last inspection. We were told by the manager that the individual had come for a visit and overnight stay before moving in however, the documentary evidenced had been archived and we were unable to see it during the inspection. The individual had been admitted on an emergency basis so that the home had not had the assessment and social worker care plan before the person moved into the home. It was several weeks before the information was received by the home and this could potentially leave the person at risk as the staff would not have had all the relevant information about the individuals needs. The manager needed to ensure that people were not admitted without the relevant information to ensure that the individuals needs could be met in the home. There was a contract in place on this individuals file so that the person had access to information about what the fees for living in the home were. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were in place ensuring staff knew how to assist the people living in the home. Some risk assessments were in place but needed to be further developed to ensure that they covered all risks for the people living there ensuring they were safe and for staff to know what actions to take. Evidence: There were care plans in place the purpose of which was to promote a social life, good hygiene and appearance, maintain independence, respect and dignity. The individual being case tracked appeared to be well supported in maintaining his appearance. However, he told us that he was bored as he did not have a day centre to go to but he did go to a club on Friday and Saturday. Areas covered by the care plans included personal hygiene, health and diet, communication, contact with family, personal safety, religious activity, hair and nail care. There was some information indicating what the individual could do for himself and what support he needed, for example, staff to ensure correct water temperature, that they ensured that clothes were Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: changed and a shave undertaken. This showed that the individual was encouraged to do the things they were able to whilst also ensuring safety. There was a communication book available for use with one of the people living in the home. This showed that the home used different forms of communication within the home depending on the needs of the individual. Choices were indicated in the care plans for example, does not want to be checked at night, does not want a key to the bedroom, has a key for locker in the room. People living in the home were involved in daily tasks in the home such as washing up, tidying bedrooms and emptying the bins. More emphasis needed to be put on involving the people living in the home to make decisions and maintain thier independence, for example, deciding the meals to be cooked. This would ensure that the people living in the home were listened to and their views taken into consideration during the running of the home. Care plans were reviewed regularly to ensure that the needs of the people living in the home continued to be met. Risk assessments were in place for diabetes and sight impairments. The risk assessments needed to be further developed to ensure that the staff knew exactly what to do, for example, how they would identify any problems with control of the individuals diabetes. There was not a risk assessment in place for the individual going out in the community although it was clear he was at some risk. The individual had identified that they did not want night checks however, the manager told us that she thought that there should be at least some checks. It was evident that some night staff were carrying out these checks whilst others were not. This issue needed to be discussed with the individual and staff to decide what, if any checks should be undertaken and the decisions recorded. This will ensure that the individual will have a say in his checks and the staff will know exactly what is required of them for the safety of the person living in the home. These decisions must be made in the individuals best interest. Care Homes for Adults (18-65 years) Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Most of the people living in the home had suitable activities to keep them occupied and fulfilled most of the time. The people living in the home were not involved in menu planning but said the food was nice. Evidence: On the day of the inspection there were two people in the home during the day. One person did not have a day centre to go to and the other had not been well so had not attended for the past few days. The person who was not currently attending a day centre told us that he was bored and that he wanted to attend a day centre. He told us that he tended to stay in his room and watch the television. This had been identified as needing to be arranged during a review with the social worker during January 2008. The manager needed to Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: progress this and in the meantime ensure that following discussions with the individual sufficient activities were arranged for the individual to ensure that he was occupied and had something to look forward to on a daily basis. People living in the home could choose whether to attend church, visit relatives and go on holiday. We were told by one person that they had been to Skegness as they didnt like to fly and other people had been to Spain. Another person told us that they had enjoyed their holiday to Spain and were going to Benidorm this year. There was evidence in the monthly meetings held in the home that the people made decisions about where to go on holiday. Other activities such as swimming were also discussed and where they did not happen the reason was discussed at the following meetings. One person told us how they spent time at the weekends with a friend but needed to be back in the home by 9.30pm. They thought that this was a suitable time to return to the home by. This shows that people were able to develop friendships outside of the home and maintain some control of when they needed to return home when they were out alone. People living in the home could access community facilities such as the local shops, parks, pubs, and health clinics like other members of the public. The people living in the home were involved in some aspects of household tasks for example, helping with the washing up, emptying the bins and taking their laundry to be washed. There were records of the food that people were eating. People told us that they did not always know what they were going to eat, that the manager decided what to cook but that it was always nice. The people living in the home should be involved in menu planning to ensure that the meals are to their liking. Diabetic diets were catered for. Care Homes for Adults (18-65 years) Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are assisted to have their health and personal care needs met in a way that suits them and enables them to remain as independent as possible. People living in the home received their medicines as prescribed but some areas of medicine management needed to be improved. Evidence: It was evident that the people working in the home knew the people living there very well. The people living in the home were encouraged to take responsibility for their personal hygiene but were given support when needed. The people seen by us on the day of the inspection all looked to be well groomed and wore clothes that were suited to the weather and their own styles. There was evidence that peoples health care needs were being appropriately met. There were health action plans in place that included information about who was involved in individuals care, when they visited professionals such as dentists and opticians. One person attended the diabetic clinic every three months. All appointments attended were recorded in an appointments diary. This also included Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: some details about the outcomes of these visits. This information should be recorded in the individuals file to ensure confidentiality. The weights of individuals were monitored to ensure that they were not gaining or losing too much weight. Where it was identified that individuals were putting on too much weight they were assisted to manage this by providing a healthy diet. The management of medicines in the home was generally good ensuring that people living in the home received their medicines as prescribed for them. There had been a recent inspection by the pharmacist and it was noted that no problems had been identified with the management of medicines. On the day of the inspection there was a small problem with the management of painkillers. It appeared that some tablets had been carried over from the previous month but not recorded on the medication chart. The majority of the medicines were dispensed via a monthly monitored dosage system which was easy to manage and audit. The records showed that the people living in the home always took their medicines and there were no gaps or refusals identified on the records. No one living in the home was able to manage their own medicines and there were no controlled medicines in use. One person was insulin dependent. We were told that the manager and deputy had been trained so that they could administer this during the week however district nurses administered it at the weekends. Records seen indicated that the district nurses had been involved in showing them what to do. There needs to be some evidence that the nurses review their techniques on a regular basis. The storage of the insulin was not safe as it was kept in an unlocked cupboard in the kitchen leaving the syringes and insulin in use easily accessible. Care Homes for Adults (18-65 years) Page 18 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home were not always protected by the recruitment procedures and practices in the home. People were listened and issue followed up appropriately. Evidence: There was evidence that the people living in the home were listened to and actions followed up on their behalf. One individual had identified an issue occuring at a day centre which the manager had followed up on their behalf. The completed surveys we received and the people spoken to during the inspection told us that they would speak to the manager and staff if they were unhappy about anything. The adult protection policy was seen and found to be comprehensive including signs and indicators of abuse ensuring that the staff knew what to look out for. One safeguarding issue had arisen at the home concerning the actions of a member of staff. The matter was being investigated at the time of this inspection and the manager had taken the required steps to safeguard the people living in the home. The recruitment procedure was not robust as not all the checks were in place before Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: people started to work in the home. Some people were being supported with managing their monies. The records for the management of these monies were not robust. They did not show the monies that had been received for the individuals, what had been taken out for fees and what had been given to the individuals. The receipts for monies being withdrawn from the post office for one individual were not being kept as evidence to show the actual amounts being withdrawn. Records that were being maintained at the last key inspection were not being completed. Lack of adequate records meant that it could not be determined that people living in the home were being safeguarded. Records must be kept for any lotteries that the people living in the home put money towards. Care Homes for Adults (18-65 years) Page 20 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. The home provided a comfortable and homely environment for people to live in. Evidence: The home continues to be maintained and run as a large family home. It is furnished and decorated to provide a homely environment for the people to live in. The AQAA told us that the internal appearance of the home was bright, clean and there had been new furnishings. There were single bedrooms and people had been encouraged to personalise them. The mood and atmosphere was pleasant and the environment was safe and clean. This was confirmed during the inspection. We did not look at all the bedrooms in the home but the lounge, dining room and kitchen were seen to be clean and comfortable. Three bedrooms that were seen were found to be very comfortable and the people occupying them said that they liked them and they had been involved in the choosing the colour schemes. There were televisions and music systems in bedrooms. At the last key inspection it was noted that there were adequate bathing and toilet facilities in the home. The AQAA told us that these facilities had been further Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: improved. The home was suited to people with good mobility as there was no stair lift or passenger lift to take people to the bedrooms on the first and second floor. The only adaptation in the home was the emergency call system. The home was clean, tidy and hygienic and provided a comfortable environment in which to live. Care Homes for Adults (18-65 years) Page 22 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels and recruitment did not always safeguard the people living in the home. Evidence: The AQAA told us that there were two staff on duty throughout the day and that the staff team were made up of family members. At the time of the inspection there was only one person on duty in the home with two people who lived in the home whilst the other person was out at a private appointment. This meant that in an emergency there was no one available to assist the lone worker. The staffing rota seen was not accurate. The person due to come on duty, according to the rota, during the afternoon did not come on duty. The rota did not identify anyone as being allocated to the night duty. The manager stated that the rota needed to be changed to accurately show who was on duty. On the first of February it was known that one person carried out a 12 hour shift as a lone worker. This was an unsatisfactory situation leaving both the people living in the home and the staff at risk. The people living in the home would all have to do the Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: same things unless they were able to go out alone. There would have been times when the people living in the home would have been left to their own devices as the lone worker was involved in cooking. There was no opportunity for the lone worker to have a break and they would have been alone if there had been an emergency. The files of two staff were looked at. These showed that the staff had received training such as adult protection, medication, nutrition, infection control, fire training and first aid. We were told that all but two of the staff had completed NVQ 2 training and some were doing further training. This meant that the staff had the basic information but it was important that they had training regarding awareness of learning disabilities, mental health and diabetes so that they know how these issues may impact on how they care for the people living in the home. The recruitment procedure showed that not all the required checks were in place before the individuals started their employment. These checks must be in place to ensure the safety of the people living in the home. Supervision was undertaken on a regular basis to ensure that staff were up to date with information about the needs of the people living in the home and to provide the opportunity to discuss issues that may have arisen. There was very little staff turnover at the home and this made for good continuity of care for the people living in the home. It would be good practice to ensure that there are more advocates involved in the home so that the people living in the home have the opportunity to speak to people outside the family group. It would also be good practice to widen the pool of employees so that related individuals were not always working together and to promote equal opportunities in employment. Care Homes for Adults (18-65 years) Page 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home was adequate although some aspects had fallen short of the required standards since the last inspection. This meant that the people living in the home were not always safeguarded. Evidence: The manager of the home is also the owner and has many years experience of running a home and caring for people with a learning disablity. The people living in the home appeared to be comfortable in her presence. She demonstrated that she had a good knowledge of their needs. The home tried to achieve high standards and these were achieved in some areas such as the environment however, in other areas the standards had not reached the required levels. This was particularly in the protection of the people living in the home and the management of some records particularly the finances and recruitment. The home also needed to develop ways in which the people living in the home could be Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: assisted to make more choices and lead individualised lives. Health and safety was well managed with all the equipment being serviced regularly and fire checks being carried out regularly. There was no specific quality assurance system in place and this needed to be developed. There were regular staff and house meetings to discuss issues arising in the home. Care Homes for Adults (18-65 years) Page 26 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 27 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 1 6 12 All the people living in the home should be supported to be more involved in decision making within the home. This will ensure that the people living in the home are assured that they are valued and their views taken into account. 14/05/2009 2 9 13 The risk assessment process 14/05/2009 must be robust identifying all risks and management plans. This will ensure that the people living in the home are safe and there is consistency within the staff group when managing the risks. 3 20 13 Syringes and medicines must be stored in a locked cupboard suitable for the storage of medicines. 14/05/2009 Care Homes for Adults (18-65 years) Page 28 of 31 This will ensure that medicines and needles are kept safely secured out of reach of vulnerable adults. 4 20 13 The records for the 14/05/2009 management of medicines must clearly show that people have been given their medicines as prescribed. This will ensure that the people living in the home receive their medicines as prescribed. 5 23 17 Adequate records must be maintained in the home to safeguard the people living in the home where they are assisted with any aspects of management of money. This will ensure that the people living in the home are safeguarded from abuse. 6 34 19 All recruitment checks must be in place and assure that the individual is suitable for employment before they start working in the home. This will ensure that the people living in the home will be safeguarded and be supported by suitable individuals. 30/04/2009 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 31 1 1 The manager must ensure that people thinking about moving into the home have all the information they need to make an informed decision about moving in. The manager must ensure that information about the needs of people moving into the home is received before or as soon as possible after someone has moved in so that the staff know what the needs are and how to meet their needs. Individual activity plans should be developed depending on the likes and dislikes of the people living in the home. This will enable each person in the home to live a fulfilled life. The people living in the home should be involved in menu planning to ensure that individual preferences are included in the menus. All information about individuals health appointments should be recorded in their individual files to ensure confidentiality. Staff who have been trained by health care professionals to carry out specific tasks in relation to administeration of medicines must be regularly reviewed to ensure that their practices continue to be as required. This will ensure that the people living in the home are kept safe. The manager should widen the sources from which staff are employed. This will ensure the best people are in post and that equal opportunities is promoted. The manager should ensure that there are adequate numbers of staff on duty at all times. This will ensure that the people living in the home are not restricted in what they can do and there is backup available in the event of an emergency to ensure the safety of the staff and the people living in the home. The staffing rota should be an accurate record of who is on duty at any time. This will ensure that the people living in the home know who should be on duty and staff know that they can be held accountable for anything that happens in the home. Staff should taking training in the conditions of the people living in the home. This will ensure that the people living in the home are being supported by staff who understand their conditions. An effective quality assurance and quality monitoring system based on the veiws of the people living in the home should be put in place. This will ensure that the home can show an ongoing improvement of the service and development of the people living in the home. Page 30 of 31 2 2 3 14 4 17 5 19 6 20 7 33 8 33 9 33 10 35 11 39 Care Homes for Adults (18-65 years) Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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