Inspection on 28/11/08 for Dunraven

This inspection was carried out on 28th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dunraven 24/10/06

Dunraven 27/02/06

Dunraven 08/08/05

Dunraven 07/12/04

Dunraven 03/08/04

Dunraven 02/03/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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: Dunraven 12 Bourne Avenue Salisbury Wiltshire SP1 1LP     The quality rating for this care home is:   two star good 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: Alyson Fairweather     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 30 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 30 Information about the care home Name of care home: Address: Dunraven 12 Bourne Avenue Salisbury Wiltshire SP1 1LP 01722321055 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): eoconnormarsh@aol.com Mrs Brigid O`Connor Name of registered manager (if applicable) Mrs Eileen O`Connor-Marsh Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: No more than 15 service users with a Mental Disorder OR with a Mental Disorder, over 65 years of age at any one time. Date of last inspection Brief description of the care home Dunraven House is a privately owned care home, which offers accommodation and personal care to 15 younger adults with a mental disorder or 15 adults over 65 years of age with a mental disorder or a combination of the two age groups. It is one of four registered care homes operated by Mrs OConnor and Mrs OConnor-Marsh in the Salisbury area, which have been in operation since the late 1980s. Dunraven House is a large detached Victorian house, which is located next door to one of its sister homes, Dunraven Lodge. The location of the home is convenient for residents who make use of the facilities and amenities of Salisbury. The administration of all the homes is centred at Dunraven House and staffing is also organised centrally for all three homes. The premises provide fifteen single bedrooms for residents use with four bedrooms having Care Homes for Adults (18-65 years) Page 4 of 30 care home 15 Over 65 15 15 Brief description of the care home on suite facilities. Residents bedrooms located on the first and second floor levels are accessed by use of a staircase with one bedroom located on the ground floor.The homes fees charged to residents for the care and accommodation range from 425 pounds upwards. Information about the care and services provided is available from the home, in written form, by way of its service user guide and Statement of Purpose. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good 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 this service is 2 star. This means the people who use this service experience good quality outcomes. We recently asked the homes manager to complete an Annual Quality Assurance Assessment (known as the AQAA). This was their own assessment of how well they were performing and it gave us information about their future plans. We also sent out surveys to the service users, to staff and to health care professionals, so that we could get their views about the home. Several service users replied as well as two staff members and a health professional who works alongside the home. We reviewed the information that we had received about the home since the last inspection in 2006. We made an unannounced visit in and met some of the residents and met staff as well as the manager and owners. We looked around the home and Care Homes for Adults (18-65 years) Page 6 of 30 saw a number of records, including care plans, risk assessments, health and safety procedures, staff files and medication records. People using the service prefer to be called residents and this is the terminology we use in the report to describe people who live at Dunraven House. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visit. 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. Care Homes for Adults (18-65 years) Page 8 of 30 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 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and families are given enough information to help them decide if they want to move to the home. They have their individual needs assessed before they arrive, so that staff know how best to support them. Evidence: The home, as part of its admission process, always undertakes its own assessment in respect to any prospective resident admitted to the home. Copies of other relevant information including copies of the care programme approach, client history and any risk assessment completed by social services are also obtained, prior to admission. In addition, copies of the care programme approach and previous reviews completed by the mental health team and other relevant information had been obtained. Referrals come usually from the prospective residents Care Manager who will provide the service with a recently completed CPA (Care Programme Approach) assessment and any other relevant information, in order to initially identify whether the service is appropriate for and able to meet the needs of the individual. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Following this, if it initially appears that they are able to offer a service, a visit will be arranged for the person, along with their Care Manager and any other appropriate carer, family member, friend or advocate. Visits are made to for meals and overnight stays so that people can meet existing residents and to spend time socialising and interacting with them as well as members of the staff team. This process is very flexible and can be tailored to meet the needs of the individual. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. They are supported and encouraged to make their own decisions. Residents are supported to take risks where appropriate, and encouraged to be as independent as possible. Evidence: Each person has a care plan, which looks at what they want to achieve and how they can best be supported to reach these goals. The file layout was clear, with sections for the most recent Care Programme Approach (CPA) reports, risk assessments, correspondence, and the assessment information collected before the resident moves in. All plans had been recently reviewed. One person said to us: I would like to continue living here. It is good to have company and feel safe. I am happy to have staff around me to support me and to help me with my daily tasks. Staff are helping me to improve with everything. I am happy with my care plan. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Residents told us that they could always make decisions about what to do each day. One person said: Its very much open to my own ideas, with staff to support me if I need it. We saw that some restrictions on choice and freedom had been recorded on peoples personal files, although house rules appeared to have been kept to a minimum. Some of these restrictions were about the consumption of alcohol and smoking on the premises. Risk assessments were on file, and ways of minimising risks were identified. Risk assessments were also in place to support people who self harmed. Although staff had recorded the date of the last care plan review, they hadnt done so for all the risk assessments. The provider assured us that these were always reviewed at the same time, but agreed that it should be more clearly recorded. It is recommended that these are always signed and dated at the same time as care plan reviews. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Contact with family and friends is encouraged and supported, and peoples rights and responsibilities are recognised in their daily lives. Mealtimes are an enjoyable time, and residents are encouraged to eat a healthy diet. Evidence: The location of the home is convenient for residents who make use of the facilities and amenities of Salisbury either with the support of staff or on their own. Some of the activities enjoyed outside the home include swimming, attending Elizabeth Lodge, (a mental health drop-in centre), doing arts and crafts, woodwork, shopping and going out for a coffee. There is an activities room available for residents, and this is used for games, drawing and arts and crafts. There is a Ladies club on a Wednesday, where manicures and beauty treatments are carried out. There are barbecues in summer and Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: a fireworks night was held recently in the garden. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Some residents visit family and others phone regularly. Individual friendships are encouraged, both inside and outside of the home, and visitors are made welcome. The home places no expectation on the residents to be involved in various daily routines of the home unless specified in their care plan. This is due to their varying abilities, high care needs and their lack of motivation to undertake such tasks. Four people do their own laundry. Currently there are no locks fitted to residents bedroom doors, although these could be fitted if requested by them. Evidence was available in the minutes of a recent residents meeting to confirm this. Residents mail is given directly to them unopened. However, staff will assist them to understand the contents of their mail, if required. Residents can choose how and where to spend their time and this was evident during the inspection. Residents have unrestricted access to the home and grounds and smoking is restricted to one of the Chalets, which is located at the bottom of the rear garden. A satisfactory and varied menu is in operation, which provides a choice at all mealtimes with a cooked breakfast being available at weekends. A cook is employed, and she was aware of individuals likes and dislikes. Special diets are also catered for. Most people tend to eat their meals in the attractive dining room, although they can choose to use another room. Drinks are also available for residents at other specific times of the day and staff would facilitate this. Residents commented very positively about the quality and quantity of food provided, confirming that a choice is provided and they receive plenty. Lunch on the day of the inspection consisted of spring rolls for the vegetarians, chicken curry and rice or plain chicken for those people who did not want spicy food. Birthday cakes are made for each resident when it is their birthday. The kitchen has a milk dispenser as well as a cold water dispenser. There was lots of fresh fruit and vegetables freely available, and these are ordered and delivered weekly. The home has recently had an inspection from the Environmental Health Officer and received four stars, which means that they were pleased with the results in the kitchen. The cook has completed a hazard analysis for kitchen. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. Self-medication is encouraged where possible, although most residents need support with this. Residents are protected by the home’s policies and procedures for dealing with medicines. Evidence: All residents are registered with a GP and there is input from other health professionals as required. All residents attend mental health reviews on a regular basis, and the care plan may be amended at this time. A list of professional visits is kept, and these included psychiatrists and community psychiatric nurses (CPN), as well as visits to the dentist, podiatrist and the optician. The local psychiatrist provides a monthly clinic to see people. One staff member told us that they make every effort to see that peoples health care needs are properly monitored and attended to. The healthcare professional who wrote to us said that the service seeks advice and acts upon it to manage and improve individuals health care needs. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: There are good medication policies and procedures in place. The providers told us in their Annual Quality Assurance Audit (AQAA) that staff know that changes in medication can have an impact on a persons health and that all changes are well communicated within the team. They prompt a review of medication when needed. During our visit, staff had given out lunch time medications, but had not signed the Medication Administration Record (MAR). This may have been because the provider had brought the MAR to me to look at. However, staff are clear that they must sign each time medication is dispensed and should have immediately asked for the MAR. They have been reminded that they must always do this We checked the storage arrangements for peoples medication and found that although no controlled drugs were currently prescribed, there was no secure facility for this should a resident suddenly need them. The law governing storage of controlled drugs has recently changed to incorporate care homes as well as nursing homes and the providers have been asked to make sure that they install this facility. Nobody was fully self medicating at the time of our visit, but some people take responsibility for inhalers, creams, sprays and some liquids. One person who is diabetic has been shown how to draw up insulin and give themselves it via an epipen. One persons medication prescription says that they can be given one or two tablets, but it is not identified whether one or two are given when staff sign to say they have given the medication. It is recommended that they record this. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident has a copy of the homes complaints procedure, and have their views listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. Evidence: The home has a complaints procedure which gives details of the time in which complaints will be investigated, and who will be responsible for making sure it happens. It also gives details of how to contact the Commission for Social Care Inspection (CSCI). All residents are given a copy of the homes complaints procedure when they come to live there. The manager and staff take all complaints seriously, and record the nature of the complaint, any action taken and the outcome. All residents who wrote to us, and those we spoke with, said they knew how to make a complaint if they had to and who to speak to if they were not happy. Visiting professionals are encouraged to raise any concerns with the providers immediately. The home has copies of the local Swindon and Wiltshire No Secrets document, as well as an organisational policy and procedure on responding to allegations of abuse. All staff have had training in prevention of abuse in vulnerable adults. A Whistle Blowing procedure is also available for all staff, and risk assessments are in place for residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Care Homes for Adults (18-65 years) Page 19 of 30 Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. Evidence: Dunraven House is a privately owned care home, which offers accommodation and personal care to 15 younger adults with a mental disorder or 15 adults over 65 years of age with a mental disorder or a combination of the two age groups. It is a comfortably furnished home, with residents bedrooms decorated in a homely way and each containing individual personal items. One person had recently purchased a large screen television for their room. The home has a lounge to the front of the building that is generally known as the visitors lounge. The room is ornately furnished and is only generally used to meet with visitors to the home. A second large communal lounge is located to the rear of the building. This has been divided to provide sitting space as well as an area to undertake activities, and is comfortable and informal. There is also a separate dining room. There is a large well maintained garden to the rear of the property, which is used by residents weather permitting. A chalet is also located to the rear of the back garden which residents use for additional activities and where residents are allowed to smoke. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: There is on-street parking available to the front of the house. The home was clean and tidy when we visited, and there are policies and procedures in place for the maintenance of the building. There is a laundry room located on the ground floor which consists of an industrial washing machine and a smaller washing machine for residents who wish to undertake their own washing, of which there are currently four. Residents clothing is labelled and staff tend to undertake most of the laundry duties. Residents who were spoken with commented that they were happy with the laundry arrangements in place stating that their clothing is suitably returned. When we asked residents if the home was fresh and clean, they said: Always, and one staff member said there was a good cleaning regime. All staff have had infection control training. However, the bathrooms were seen to have various kinds of toiletries lying around, and although the providers were sure that residents did not use them, they have been asked to make sure that all toiletries are kept in individual peoples rooms, and brought to the bathroom when needed. The WCs and bathrooms contained some single use soap dispensers, but also bars of soap and cloth towels. They have been asked to ensure that single use soap and paper towels are used in bathrooms and toilets. These actions will help to prevent any potential cross infections. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by competent staff, most of whom have obtained formal qualifications. Their needs are met by staff who have appropriate training, and they are supported and protected by the homes recruitment policy and practices. They benefit from well supported and supervised staff. Evidence: There were several members of staff with an NVQ Level 2 or above, with some having Level 3 and others having the Registered Managers Award (RMA). Staff were seen to display good understanding of residents mental health needs when working with them. We watched and listened as staff members spoke to the residents who were at home. They treated them politely and listened to them when they spoke. They asked service users for their opinion about everyday matters. Most of the residents we spoke to said that staff Always treated them well, and one said: Usually. On the day we visited, there was a good ratio of staff to residents, and one person was going out shopping with a staff member. One staff member said to us: We dont know the answer to all questions, but will do our best to find the answer to any problem present. The healthcare professional who wrote to us said that the staff were all highly motivated and do their best to support residents. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: All new staff were seen to have had induction training, and training plans are done every year for staff. Some training completed by staff includes protection of vulnerable adults, equal opportunities, fire safety, health and safety, manual handling, pressure care, Boots medication administration, dementia, falls, promoting continence, blood glucose monitoring, managing conflict, care of the diabetic, care of the dying and managing malnutrition in mental health. It is planned to have a series of mental health lectures in the near future. Staff have workbooks from Salisbury College in dementia, infection control and medication. Senior staff have done the Train to Gain course in Management and Communication. All care managers in all the providers homes are doing their RMA. There is a stable staff group who a sometimes work in the sister homes, so are well known to residents. We looked at three staff files, and these showed that the home is following appropriate recruitment practices, including obtaining a full employment history, two satisfactory written references, and satisfactory Criminal Record Bureau enhanced checks. There were records of staff supervision on file, and these meetings were seen to be held regularly. Staff appraisals are held annually. There are regular hand-over meetings as well as staff and residents meetings at which information is shared. All staff members we spoke to said they felt well supported by their manager, and that they would be able to go to her if they had any problems. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home. They know that their views underpin the monitoring and review of care practice. The homes policies and procedures, and the health and safety checks carried out, mean that residents live in a safe environment. Evidence: Mrs OConnor has primary management responsibility for this home, and has considerable experience in the care profession. She was previously an enrolled nurse. She is supported by a deputy manager who has day to day responsibility for the care provided to the residents and has achieved her NVQ Level 4 Registered Managers Award. Staff morale was good and staff commented that they work well as a team and are happy with the training opportunities available to them. Likewise, residents feel able to discuss any issues or concerns with the management or staff and feel these would be suitably dealt with. Residents meetings are held every two months and staff meetings on alternate months. There are also annual surveys given to residents to ask for their Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: comments about how they would like the home to be run. These surveys are not sent to residents families or to other professionals with whom the home work, for example community psychiatric nurses. It is recommended that this is done so that as many people as possible can have the chance to give the home feedback. When we asked residents if carers listened and acted on what they said, two people said: Always and one said: Usually. There were good health & safety records in place, and staff have had training in health and safety and infection control training. There are regular daily, weekly and monthly checks done in the premises. The homes fire extinguishers are serviced on a contractual basis, and there was an up-to-date fire risk assessment in place. Fire drills are done on a quarterly basis, and staff who take part sign to this effect. It is recommended that the initials of all residents who take part are recorded too. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 All medication must be signed for by staff when it has been administered. So staff can be sure residents have had their medication. 24/04/2009 2 20 13 All controlled drugs must be 24/04/2009 stored in a cupboard that meets the current storage regulations (The Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007).Arrangements must be made to store such drugs even if not currently present in the home. So that potentially dangerous drugs can be safely stored. 3 30 13 Single use soap and paper towels must be used in bathrooms and toilets in order to prevent any potential cross infection. 24/04/2009 Care Homes for Adults (18-65 years) Page 28 of 30 To help prevent any cross infection. 4 30 13 Any toiletries belonging to residents must not be kept in the bathroom, but should be kept in the individuals room. To help prevent any cross infection. 24/04/2009 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 1 2 3 9 20 39 Risk assessments should be clearly reviewed at the same time as the care plan. Where tablets are prescribed give one or two the number dispensed should be recorded. The providers should further develop their annual satisfaction questionnaires to include families of residents and any professionals they work alongside, eg psychiatric nurses. Records of any fire drill should contain initials of the staff and residents who take part. 4 42 Care Homes for Adults (18-65 years) Page 29 of 30 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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