Inspection on 11/02/09 for Esher House

This inspection was carried out on 11th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Esher House 17/08/07

Esher House 29/06/06

Esher House 26/09/05

Esher House 06/04/05

Esher House 09/11/04

Esher House 05/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Esher House 16 Cabbell Road Cromer Norfolk NR27 9HU     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: Debra Allen     Date: 1 1 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 33 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 33 Information about the care home Name of care home: Address: Esher House 16 Cabbell Road Cromer Norfolk NR27 9HU 01263512533 F/P01263512533 info@prime-life.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Lauren Hockett 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: Date of last inspection Brief description of the care home Esher House provides accommodation for up to 13 adults with mental health problems. The philosophy of the home is centred on helping service users to regain/develop social skills with a view to moving on if this is possible. All service users have their own room to which they can retire at any time. Communal accommodation is spacious and one lounge is designated a smoking room. Service users private rooms are located on the first, second and third floors. Service users are encouraged to participate in all aspects of the life of the home and to develop links with the local community if they wish. In this respect the home is well situated, both the town centre and the sea front are just a few minutes walk away. Maintaining and developing contacts with family and friends is seen to be an important Care Homes for Adults (18-65 years) Page 4 of 33 13 Over 65 1 care home 13 Brief description of the care home aspect of the service users overall pattern of care and at their invitation family members and friends are welcome at all times. The home does not provide accommodation for highly dependent service users and all those in residence have to be fully ambulant as there is no lift. The fees are currently £325 per week, which is the basic rate and does not include any additional 1:1 support, chiropody, hairdressing or personal toiletries. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. The fieldwork of this inspection was carried out over a period of five hours, during which time a number of people living at Esher House were observed and spoken with and a tour of the premises was undertaken, which included seeing peoples personal rooms - with their permission. Care Homes for Adults (18-65 years) Page 6 of 33 Discussions were also held with some of the staff on duty and the manager. Various records were looked at in detail, which included care/support plans, staff files and other records relating to health and safety. Meanwhile, an Annual Quality Assurance Assessment (AQAA) was completed and returned to The Commission, as requested, prior to this inspection. Three requirements have been made as a result of this inspection. What the care home does well: What has improved since the last inspection? People living at Esher House have their care plans regularly reviewed and updated as necessary, including input and involvement from significant professionals. Records with regard to any changes to healthcare needs have been maintained appropriately. The staff team is much more stable and consistent and the Home ensures references and clear, enhanced Criminal Records Bureau disclosures are obtained before people start working at Esher House. Staff receive support and supervision on a regular basis, with appropriate records maintained to confirm this. A more formal Quality Assurance process has been established. Risk assessments have been carried out in respect of people who are less mobile using the stairs. Care Homes for Adults (18-65 years) Page 8 of 33 Appropriate risk assessments have been carried out in respect of people smoking within Esher House and the smoking room is regularly checked to ensure ashtray contents and litter are safely disposed of. House meetings take place on a regular basis and appropriate records/notes are maintained from these meetings. 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.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 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with good quality information about the home, so they are able to make an informed choice about living there. People have the opportunity to visit the home and detailed needs assessments are completed before they move in. Evidence: The care plans looked at during the inspection contained copies of pre-admission questionnaires/applications for residency, which also included detailed risk assessments and very descriptive personal profiles, all of which were noted to have been completed prior to people moving into Esher House. Two of the care plans, belonging to people who recently moved into Esher House, also had information which confirmed that they had been able to visit Esher House and stay for a trial period before deciding to move in permanently. Terms and conditions/contracts were seen to have been signed and dated by each of Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: the three people, with copies maintained on their files. Care Homes for Adults (18-65 years) Page 12 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Esher House have their changing needs and personal goals reflected in an individual plan of care, they are able to make decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: Three care plans were looked at in detail, observations were made and individual discussions were held with each person, which helped to confirm that the contents of the plans were accurate. The contents of the care plans included very comprehensive information, to ensure consistency of care and make sure that each person is genuinely treated as an individual and receives the level of support they require. The contents of the care plans were made up of sections such as: Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: Admission Details (which included information about the pre-admission Meet & Greet, application for residency, personal history including hobbies and interests, medical details and requirements, reason for admission, next of kin and religion/cultural requirements. Cleansing/Dressing (this section showed requirements - i.e. with or without assistance and all areas were seent to be clearly completed). Mobility (as above, showing requirements, with extra comments seen to have been added as neccesary - i.e. [name] has a good level of mobility although they have complained of pains in their legs, [name] manages the stairs ok. Staff are to review [name]s mobility monthly and report any concerns to the manager and/or GP as appropriate. Aim/Goal is for [name] to remain fully mobile and staff are to seek advice if there are any concerns. A detailed risk assessment was also seen to support this information. Mental Health (this section contained information in respect of each persons mental health history and requirements). Eating and Drinking (additional comments were noted in this section, which related to individuals health issues such as diabetes or weight management). Behaviour My Life (additional information was seen to be recorded such as [name] has settled well and enjoys making their own breakfast and drinks, also likes to help staff with domestic tasks. [name] often goes into town, either alone or with staff and enjoys a drink or a snack in the local cafe. [name] also enjoy home baking. Social Inclusion. Sleeping (information noted here included details such as preferred time to go to bed and preferred time to get up in the morning). Financial (included details such as: No will or funeral arrangements and has no wish to do so). Letters and Correspondence. Doctors Visits. Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: Observations during the inspection confirmed that the people living at Esher House are genuinely supported and encouraged to make decisions for themselves, take risks appropriately and live their lives as independently as possible. Observations and records also looked at during the inspection confirmed that house meetings have been taking place on a regular basis. All the records and personal information relating to the people living at Esher House was seen to be stored securely in the main office, thus ensuring confidentiality is maintained. The above information provided good evidence to confirm that a previous requirement and recommendation have been addressed and complied with. Care Homes for Adults (18-65 years) Page 15 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Esher House are able to take part in activities that suit them, be part of the local community, enjoy leisure activities as they wish and have good relationships with their family and friends. Peoples rights and responsibilities are respected and recognised in their daily lives. People living at Esher House are offered a healthy diet and enjoy their food. Evidence: Discussions were held with a number of people during the inspection and one person told how they regularly enjoyed walking into town and shopping on their own and observations confirmed people choosing to come and go as they wished, with appropriate risk assessments seen to support peoples independence. Some of the people spoken to also shared information about their hobbies and Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: interests and the care plans that were looked at also reflected this information - such as playing musical instruments, collecting/watching videos, cooking, reading, art, craft, listening to music, trips to London, train travel, visiting museums, cars and gardening. Some of the other activities people said they regularly enjoyed included playing the interactive WII games such as ten pin bowling, golf and tennis (a number of people were observed playing ten pin bowling during the inspection). Some of the recent outings noted included the Thursford Christmas Show and shopping. Great pride and enjoyment appeared to be taken by people in respect of the regular Theme events carried out at Esher House and there was a great deal of evidence to support peoples choice of involvement. Theme projects are usually carried out on a monthly basis and recent themes included Formula 1 (which included going to a car show), Jungle (including a trip to Cromer Zoo), Halloween (comprised a buffet and party), Remembrance Day, Children in Need (a fund raising occasion, which included a table top sale and home baking) and Christmas. A good deal of involvment by the people living at Esher House was also noted in respect of various internl and external fundraising activities. Discussions and records looked at confirmed that people had regular contact with friends and family and they could have visitors whenever they wanted. It was noted, through records and discussions, that food shopping is no longer provided for by caterers, staff and residents go shopping together now to the supermarket and have appropriate choices and a clear budget. In respect of meals and mealtimes, various observations were made throughout the course of the inspection, which showed people choosing what they wanted for their lunch, when they wanted it and where they wanted to have it. A small but pleasant kitchenette was also seen to be is available for people to prepare drinks and snacks as and when they wish. Meal times were also noted to include themes on occasions, such as French, American and Spanish. These occasions were noted to help provide people with the opportunity of trying different food and learning about different cultures, with themed music also being included. It was also noted that a great deal of time and effort has been put into ensuring the Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: menu choices are wholesome and varied with a good integration and selection of diabetic options. Meanwhile, six surveys were completed and returned to the Commission prior to this inspection , four of which stated that they always like the meals and two stated usually. Additional comments written by people living at Esher House included: Im happy being here by the sea, Cromer is a nice town. I am very happy at Esher House, my needs are met and its made my life living for me. Care Homes for Adults (18-65 years) Page 18 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Esher House receive personal support in the way they prefer, their physical and emotional health needs are met and they are protected by the homes medication policies and procedures. Evidence: Discussions with some of the people living at Esher House, together with information seen in the care plans, confirmed that peoples individual wishes are acknowledged in respect of the way they are supported, which appeared to be mostly by listening to, encouraging or prompting people with daily or personal healthcare tasks. Some people were noted to require more support than others in respect of health matters and these were clearly described in their individual care plans - i.e. controlling diabetes with a varied diet, goal for [name] is to be involved in planning their diet and to control their blood sugars. Also, supporting another person with their weight management - a comment that was made by this person was that they were pleased with the reduction in their weight and were feeling a lot happier and more confident. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: Numerous individual risk assessments were seen to have been completed and regularly reviewed in respect of peoples physical and mental wellbeing, including mobility and excellent guidance information was seen for individuals with diabetes, in respect of recognising signs of hypo or hyperglycaemic attacks and what action to take. Two people were noted to administer their own medication at the time of this inspection and appropriate risk assessments and personal storage facilities were seen to be in place for this. Meanwhile, the Home was seen to have good and safe practices with regard to the handling, administration and recording of medication and no errors or omissions were noted in the records during the inspection. Other records looked at confirmed that people are supported to have regular and ongoing involvement with various care professionals such as doctor, nurse, psychiatrist, dentist, optician, dietician and chiropodist. In respect of the recent death of a long-term resident at Esher House, excellent evidence was seen of support and comfort being offered and provided to each other person living at the Home, on an individual basis. From discussions and other records seen, it was evident that the ageing, illness and death of the resident was handled with the utmost respect by all concerned. Additionally, information was noted for some people, in respect of their funeral wishes. Care Homes for Adults (18-65 years) Page 20 of 33 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Esher House generally has a clear complaints procedure, both formal and informal, which helps ensure that people feel their views are listened to and acted upon. Staff are well trained in areas such as mental health, adult protection and medication, to help ensure people are protected from abuse, neglect and self-harm as much as is possible. Evidence: A discussion with the manager confirmed that there have been no formal complaints since the last inspection. The complaints book was looked at and, although Esher House generally has a clear complaints procedure, both formal and informal, there is a need for this to be tidied into a more organised and accessible format and to ensure that the up to date procedure is included. Of the six completed surveys that were returned by people living at Esher House only two people stated that they knew how to make a complaint, the remaining four all stated No they didnt. However, it was also noted that five people said they always knew who to speak to if they werent happy, one person responded that they usually did. Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: Meanwhile, one person spoken to individually stated that they were very happy in all ways, living at Esher House, the staff and manager were very supportive and that they could talk to them at any time about anything. Training records were also looked at and it was noted that staff are well trained, particularly in areas such as mental health, self-harm, adult protection and medication. Staff spoken to during the inspection had a clear understanding of adult abuse and protection. Care Homes for Adults (18-65 years) Page 22 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Esher House provides a homely, comfortable and safe environment for people to live in, which is clean and hygienic, although there are on-going improvements and redecoration requirements in a number of areas. Evidence: General observations were made whilst undertaking this inspection, which confirmed that people were very much at home at Esher House and the whole environment was felt to be friendly, comfortable, clean and hygienic. Discussion with the manager, sight of the recent internal audit and a tour of the premises confirmed that, since the last inspection, a number of improvements have been carried out such as: New flooring or carpeting in the office, hallway, room 4, entrance and the smoking room. New furniture for the communal areas has also been purchased, including three new armchairs, two side tables, a coffee table, two sets of furniture and new dining tables and chairs. Other work that has recently been completed included pictures being hung in the Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: corridors, a new fridge purchased and installed, a new dishwasher purchased and installed and the tiling on the lounge fireplace has been completed. Painting throughout the house is scheduled for completion during this year and new vanity units are due to be purchased and installed for two of the bedrooms. One persons bedroom has suffered some damage to the ceiling, following a water leak from the room above. This person was spoken to and they confirmed that Prime Life were very good following the incident and had replaced anything personal that had been damaged. It was also confirmed that the room is scheduled to have the ceiling fully repaired and the room to be redecorated. Meanwhile, some of the people living at Esher House were happy for their rooms to be seen and each of these were noted to be very individual, with peoples personal belongings around them. Care Homes for Adults (18-65 years) Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Esher House has robust recruitment procedures and staff are well trained, with more than 50 holding a minimum of NVQ2. Evidence: Three personnel files were looked at in detail during the inspection and each of these was found to be well organised and contain comprehensive information, which confirmed that Esher House has a robust recruitment procedure. Some of the documents seen in the staff files included: Employment checklist, professional and character references, confirmation of a clear enhanced Criminal Records Bureau (CRB) disclosure, application form, job offer letter, job description and contract, identification, support and supervision records, appraisals, training records including induction. With regard to training and qualifications, more than 50 of the staff currently working at Esher House are trained to a minimum of NVQ2. In addition to the induction and Prime Lifes Early Days Learning the records seen provided evidence of staff being trained in areas such as: Fire Safety, Moving and Handling, COSHH, Food Hygiene, Mental Health, First Aid, Managing Challenging Behaviour (NAPPI) Medication Care Homes for Adults (18-65 years) Page 25 of 33 Evidence: Handling and Administration, Care Skills and Depression. Observations during the inspection showed a warm and friendly staff team, who interacted regularly and naturally with the people living at Esher House and staffing levels appeared to be more consistent in accordance with the needs of the people living at the Home. Some of the people spoken with on the day confirmed that they knew who their keyworker was and any specific roles/areas of responsibility that staff had. Discussions with staff indicated that they were supported well by the management team, as well as each other, and some made specific comments about really enjoying working at Esher House. From records seen in the staff files, together with discussions held with staff and the manager/deputy, it was confirmed that staff receive regular support and supervision both formally and informally. Meanwhile, three surveys were completed and returned by staff and each of these contained mostly positive responses and contained additional comments such as: We have daily hand-overs and can always read up on daily care records. We have support and supervision every six to eight weeks and have regular appraisals. I know if I ever need to talk to management they will always make time to talk. The home provides well for all the needs of the residents. Esher House is a home to many people and a holiday to others. We, the staff, try to promote independence and we will always assist residents when needed. A couple of the comments that were noted in the area what the Home could do better included: Treat all staff with respect and reward, where appropriate, for things they do well. Treat staff better. Care Homes for Adults (18-65 years) Page 26 of 33 Care Homes for Adults (18-65 years) Page 27 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Esher House is a well run home and the people living there benefit from good quality leadership and day-to-day management. The people living at Esher House also know their health, safety and welfare is promoted and protected. Evidence: The current manager has been registered with the commission since December 2007, during which time it has been noted, from the evidence available for this inspection, that the stability and consistency of care, record keeping and staffing levels at Esher House has improved greatly. The manager currently has a diploma in care and is working towards her NVQ4 in care and the Registered Managers Award (RMA). One person living at Esher House commented that although the previous manager was excellent, the current manager has that little bit extra, she is very kind, very supportive and you can talk to her anytime about anything! Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: Comments from staff both during the inspection and from the surveys received also confirmed that they felt supported by the manager. Residents house meetings take place on a regular basis now and appropriate records are maintained. People are also regularly invited to give feedback regarding the home, including visitors, relatives and other health/care professionals. Health and safety is promoted well at Esher House and records looked at confirmed that fire alarm and safety tests are carried out on a regular basis. Cleaning materials/hazardous chemicals were seen to be stored appropriately and staff training in areas relating to health and safety was seen to be up to date. Overall, the atmosphere during the inspection was cheerful and relaxed and observations confirmed that people were genuinely in their own homes, with their best interests, health and happiness being absolute priority. Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 22 22 The complaints book/folder 17/08/2009 needs to be tidied into a more organised and accessible format and the up to date procedure must be included. To ensure each person living at the Home is aware of the procedure for making a complaint if required. 2 24 23 The scheduled redecoration works throughout Esher House must be undertaken and completed as soon as possible. To ensure the ongoing safety and comfort of the people living at the Home. 15/10/2009 3 25 23 Urgent attention must be paid to the total repair of the ceiling and the redecoration of room 4. To ensure the ongoing comfort and safety of the person using the room. 15/10/2009 Care Homes for Adults (18-65 years) Page 31 of 33 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 24 25 . . Care Homes for Adults (18-65 years) Page 32 of 33 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!