Inspection on 19/01/09 for Evergreen Partnership

This inspection was carried out on 19th January 2009.

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

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

Other inspections for this house

Evergreen Partnership 29/01/07

Evergreen Partnership 23/01/06

Evergreen Partnership 22/09/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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: Evergreen Partnership Maple House Woodmansterne Lane Wallington Surrey SM6 0SU     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: David Pennells     Date: 1 9 0 1 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 29 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Evergreen Partnership Woodmansterne Lane Maple House Wallington Surrey SM6 0SU 02082549403 02082549403 dan.maplehouse@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Jaqueline Cook,Maureen Edith Collyer Name of registered manager (if applicable) Daniel Royston Roberts Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Maple House (Evergreen Partnership) is a substantial house set on the southern outskirts of Wallington in Sutton Borough, close to bus stops which can provide transport into the local Carshalton, Purley or Croydon areas. Being situated just off a roundabout, the entrance to the property can easily be missed, but once recognised, there is a driveway, which provides parking on site at the front of the house, for a number of vehicles. The house, which opened as a new service in mid-2005, is Care Homes for Adults (18-65 years) Page 4 of 29 care home 4 Over 65 0 4 Brief description of the care home substantial; providing four good-sized bedrooms for service users, and plentiful communal space (a separate lounge / dining area / sun lounge), and adequate toilets and bathing facilities. There is a large rear garden area, with plans to use some of the garden - which is split into two - for horticulture, which ties in appropriately with the location of the home, as Maple House is close to many market garden / garden centre outlets around the local area. The service is designed to provide for up to four service users with learning disabilities and associated challenging behaviour, aiming to provide (as the Statement of Purpose says): a range of opportunities to support and empower people…to enjoy a fully enhanced quality of life whilst supporting them to make informed decisions and choices about the way they would like to live. The focus will be on fun, choice, good health, enjoyment and comfort, providing people…the opportunity to expand their sphere of experiences and to develop their lives in creative and imaginative ways supported by a highly skilled and experienced staff team. Care Homes for Adults (18-65 years) Page 5 of 29 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: We visited the service from mid-morning to late afternoon on an ordinary weekday Monday. The manager of the service, Danny Roberts, was available to assist us on this occasion, and other staff members and the current people resident at the home were available to meet us and, where able, to add their opinions / a perspective on the service provided. Questionnaire responses concerning the service were also received from those living there (2 of 3), from the relatives / advocates of people using the service (3 of 3), and from staff at the home (2 of 6); all reported back a generally positive reaction, with none seeking to speak about their opinions directly to the inspector. Care Homes for Adults (18-65 years) Page 6 of 29 We are grateful to those who responded to the questionnaires for their responses; and to the people living at the service, the staff and the manager for their welcome, hospitality and cooperation throughout the inspection - for their contributions to the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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 enquirers users can be assured that sufficient information is available, for themselves and other interested parties, to find out about the suitability of the service for themselves prior to admission - through the Statement of Purpose and other documentation. People using the service can be confident that their needs and goals will be assessed using a comprehensive assessment tool, as well as the placing authority being required to provide adequate information, resulting in an accurate assessment of need, stating goals and aspirations, and informing a decision as to whether the home is able to provide a suitable service to the applicant. People can be assured that the process of introduction / familiarisation to the home will be taken seriously, and applied in the most suitable way to encourage induction and integration within the community at Maple House. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: The home has a good Statement of Purpose - describing the premises, the staffing, the aims and philosophy of care and itemising all areas to be addressed and described under Schedule 1 of the Care Homes Regulations 2001 and Standard 1 of the NMS. Documentation for the people resident in the home was examined. The home has its own assessment tool, which had been used, alongside the funding local authority assessment of need - and resultant full care plans and appropriate risk assessments were fully in place. All documents were authenticated by signature and dated. Placing Authorities are currently the London Boroughs of Hillingdon, Wandsworth and Merton. Staff members visit new service users in their previous placements in order to start familiarising themselves with them (and vice versa), and to observe routines. Introductory visits to the house are encouraged when they would serve a useful purpose; the initial placement period is also viewed as an introductory visit sequence to the home. Staff members from previous placements are also invited to visit, this providing a chance for handover of information and to promote a sense of continuity. People using the service commenced their occupancy in July 2005, February 2006, and September 2008. Documentation examined in the home again showed all necessary paperwork to be in place, all required documents being completed at the point of transfer. Ongoing paperwork was also in good general order. Care Homes for Adults (18-65 years) Page 11 of 29 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. People using the service can be assured that they will be involved with the home in the process of devising their care plan, and will be encouraged to make informed decisions about their lives through person-centred care planning. People can be assured that they will be involved in all aspects of decision-making within the home as suits their capacity. People are well supported to take reasonable daily living risks; such areas being well documented, and shared with the individual. The general assessment format is used to consider all aspects of potential risk initially, and backed up by a specifically individual focus. Evidence: We found full care plans - two of the three being fully person-centred (the third is being prepared) - for all people living at the home; they were related to the day-toCare Homes for Adults (18-65 years) Page 12 of 29 Evidence: day recording, and placed alongside appropriate risk assessments for both generic and any specific areas identified. Care plans evidenced peoples involvement by their signatures, as appropriate, this indicating their involvement with the planning and development process. Monthly summaries are generally maintained by keyworkers - providing a review of progress made by each person, this being a helpful tool for when the formal reviews arise. Risk assessments are in place appropriately for the people currently using the service, these based on the initial comprehensive assessment, and the ongoing observational / experiential assessment made by the home. Assessments span from participation in fireworks display, to the wider, more generic risk assessments. A format is now in place to ensure preliminary counterchecks against all possible or probable avenues of risk for each individual; this ensures that the risk assessment process is as proactive as is possible. Reviews are regular to ensure risk assessments remain up-to-date; they are copied to the staff communication book for information until all staff have seen them. The overall comprehensiveness of meeting this standard again leads us to award an excellent level 4 grading to standard 9. Once the remaining person-centred care planning process is fully in order, this entire group of standards could be highly rated. Care Homes for Adults (18-65 years) Page 13 of 29 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. The home focuses on providing people-centred activities both outside the home and at home; encouragement is provided to engage in locally staged activities, as well as more formal structured day care input, where appropriate. Leisure opportunities are facilitated through staff being familiar with peoples likes and dislikes, and enabling involvement with as much preferred activity as possible. People using the service are encouraged to remain in contact with family and friends through visits, and these people are all made positively welcome at the home. People can expect their rights to be respected and upheld through a relaxed culture in the house, and through choice being promoted. People can be assured of a nutritious and healthy diet - served in line with best catering practice, and they can expect to participate in catering for their own selfdevelopment, independence and enjoyment. Care Homes for Adults (18-65 years) Page 14 of 29 Judgement: Evidence: The higher staffing ratios introduced now there are three people living at the home, have enabled an improved focus on activity. Activities engaged in, through facilitation by the home staff, include: cinema, bowling, visiting cafes and restaurants / pubs and longer outings, if preferred. Staff and people using the service undertake the general food shopping for the home, and also shopping expeditions are enjoyed for personal items. The home continues to make available the idea of local clubs (Mencap, etc.). People also just spend time at home relaxing, as well as engaging in outward-bound activity. Staff members escort people to clubs / events / etc, until such times as confidence is built up, and an independent approach may be taken. People currently using the service may attend formally run day care centres (where and if funded by the placing authority) and such activity can give routine hours out from the home, and provide ongoing contact with peers and friends. Opportunities provided by day care include sports / rambling / games / swimming and free-choice activities. In-house activities are designed to respond to the needs and suggestions of the service user; there are a variety of board games / TV / video and music, and other activity resources provided by the home. Focused communication sessions and 1:1 activities are provided according to each person-centred plan, including specialised training for working with visually impaired people. People using the service confirmed that they do what they want to do at whatever time of the day, though heavily relying to staff to facilitate this at times. Relatives of people using the service have all confirmed that they are made welcome at the home; it is the ongoing intention of the home to support clients to maintain links with both family and friends. Telephone contact is also important, and a portable house phone enables calls to be made, or taken, in privacy. People again confirmed with us that the routines of the house do not obstruct their right to freedom to choice. Having a key to their own room, and staff members knocking doors to show respect for their private space, is a reality. Staff members positively interact with all service users, whilst some enjoy spending time on their own in their own rooms - one with their computers or the television. The kitchen is well equipped and catering is well resourced. Large food stocks remain unnecessary at the home (due to the low number of people resident), and going out Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: for shopping for what is preferred enables the active participation and engagement of those using the service. Food records are kept, and again indicated a broad approach to nutritional assessment, with items served with chips being interspersed with more healthy salad meals and other styles of cooking (omelettes / roasts / pasta, etc.). Care Homes for Adults (18-65 years) Page 16 of 29 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. People using the service can be assured that the home provides personal care in an individually focused and sensitive way, and will seek to promote each persons health and wellbeing through ensuring appropriate contact with health care professionals, and also through the home managing any medication regimes, where appropriate. Evidence: Personal care is provided by staff who do encourage people who use the service to self-care as far as is practicable. Relatives commented on the culturally appropriate service provided to individuals who needed specialist skin and hair care. Staff also confirmed that they receive adequate information to about the needs of people they work with. Health Action Plans are also now in place for each of the three people living at the home. Healthcare support is generally provided from the Shotfield Health Centre in Wallington, and the Stafford Pharmacy provides the medication and also the Pharmacy inspection / advisory visits. Access to other paramedical services such as opticians and dentists is accessed as much as possible from ordinary community services, unless a Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: specialist focus is advised. Psychology, Psychiatry and Speech & Language input is provided from the Integrated Community Learning Disability Team at Orchard Hill. Medication is provided in monitored dosage system blister packs, ensuring a safe method of administration. Medication storage and the records kept for the each persons medication were examined, and found well maintained. Medication profiles are in place for each person, enabling the home to record their medication / prescription history. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be sure that any complaints and comments will be taken seriously, and that their opinions are respected and taken into account. The home is equipped to ensure the protection of people using the service from the possibility of physical, material or financial abuse or harm, and has robust procedures to respond to any allegation or suggestion of such acts. Evidence: All relatives confirmed they knew how to maker a complaint about the care provided at the home; the written procedure being provided to them. There has been one formal complaint received since the last inspection visit, which was a concern from a relative concerning staffing levels. The home has increased staffing levels since then to address the issue. With regard to adult protection, an issue of concern had been raised through the local authority safeguarding procedure, and fully investigated, rightly ensuring that the exploration of any issue of abuse is openly and transparently investigated. The allegations were unfounded. The home has it own policy regarding Complaints and an Abuse / safeguarding policy, and the current Local Authority Safeguarding Adults guidelines are strictly acknowledged and adhered to. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Financial recording was again found in good order, with people being involved in signing for their personal allowance monies, where it is possible. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can expect to reside in a well-maintained, clean, hygienic and comfortable environment, the premises being homely and very suited to the Statement of Purpose of the home. The home and service is designed to encourage independence, privacy, and the maximisation of each individual lifestyle. Evidence: Maple House is a very pleasant well-furnished environment in which to live; each person has access to extensive well prepared communal areas, as well as a pleasant single bedroom each. The general standard of furnishings and decoration remains very high. All bedrooms are over 12 sq metres in dimensions; two of them now have an ensuite shower. The ground floor has the fourth single bedroom, with a shower-room and toilet close by. On the first floor, also, there is a separate toilet, a bathroom with toilet and Jacuzzi spa bath, and the office / staff room. The lounge, sun lounge, and kitchen are all off the front hallway; the dining area is off the kitchen area, closer to the back door and overlooking the back garden. Garaging, close to the back door, is generally used for storage. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The home has a fully integrated fire alarm system, and other health & safety precautions, such as thermostatic mixer valves on hot water outlets which are fitted as standard. Some items of personally owned furnishings identified at the last visit, which were inadequate to the point of being hazardous, have been replaced with more satisfactory items. The majority of the house remains at a high level of cleanliness and general decorative order. As people using the service decorate and furnish their own space, and take over the communal areas, they will become increasingly different, once pictures and posters appropriate to the individual characters are introduced. Care Homes for Adults (18-65 years) Page 22 of 29 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. People using the service can expect staff members to be competent and suitably trained and qualified, and provided at the home in sufficient numbers to fully meet the needs of people using the service. People can be assured that recruitment practices are fair, will ensure their protection and safety, and that appropriately trained staff will be provided to meet their identified needs. The staff are more consistently supervised, supported and appraised through their line management, this leading to a more focused and developing service. Evidence: The staff team continues to develop, with currently six full-time staff members employed at the home permanently, with two appearing on a bank basis. Staffing levels never fall below two, and often there are at least three staff available during the working day. Two staff are available throughout the night. Supplementary agency hours was declared as 85 hours used within the past three months. Criminal Records Bureau checks are obtained for all staff; all have full CRB / PoVA Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: checks undertaken by the managing company. All other necessary references and checks are completed before staff members start employment. Staff confirmed they had received adequate vetting and induction at the start of their employment. Staffing qualifications currently held included five of the eight staff members having a NVQ at Level 2 in Care, with two qualified and one completing their level 3 qualification. Two of the support workers are undertaking their Level 2 NVQs, which will bring the percentage of staff who are qualified up to more than three quarters. Training was due to be provided in Lone Working, Handling Violence and Aggression, Risk Incident, Reporting and Food Hygiene. Staff members were up-to-date with First Aid training, this ensuring all shifts were covered by qualified staff. Staff members were positive about training opportunities at the home. Senior staff have undertaken a Person-Centred Planning Facilitators Courses and two have engaged with Health Action Planning training. All staff members have been trained in Autism & Challenging Behaviour, and all have undergone Adult Protection training. Some staff members have attended Mental Health & Learning Disability training. Staff have also undertaken the intermediate level Course in Care & Control of Medicines. Supervision records evidenced over the long-term some gaps in maintaining regular two-monthly sessions with all staff - more recently, however, the pattern appears to have improved, with appraisals started in early 2009, and it is hoped that this pattern of improvement will continue. The registered providers should remain vigilant in this regard. Staff confirmed that they received support through regular meetings on a regular basis. Care Homes for Adults (18-65 years) Page 24 of 29 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. The home is well organised and run on a basis of positive leadership, with a competent manager - supported by the encouragement of the registered providers. The views and opinions about the service expressed by people using the service are noted and positively taken into account by the registered providers, and acted upon. The health, safety and welfare of people is generally well protected, with all safety provision, maintenance and servicing being up to date. Evidence: The registered manager, Daniel (Danny) Roberts, has a more than ten-year history of working in this field of social care; he is now in the final stages of completing his Level 4 Registered Managers Award which will consolidate his caring experience with management skills to the required level approved by this Commission and Skills for Care. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Quality assurance mechanisms continue to be focused on the 1:1 basis of relying on reviews and feedback from interested parties. Verbal communication and feedback from people using the service, family, advocates and interested professionals are heavily relied on. Due to the profoundly different natures of the communication skills of the people at the home, this 1:1 focus continues. It is beholden on the manager to ensure that as the service grows, suitable and adequate mechanisms are put in place to regularly assess the service from stakeholders feedback. The service users at the house were all seemingly happy with the service, one reporting again that she could engage well with staff and felt that her opinions / preferences were heard and acknowledged. All three people using the service have relatives who reported through our Questionnaire that they were generally happy with the service being provided, and that they were positively welcomed at the home, notified about events relating to their loved-ones, and involved with decision-making in respect of their loved one. Some relatives felt that a management presence at the weekend shoudld be more obvious, with concerns about the focus of staff on these days withoiut the manager to guide them; this idea is carried into a recommendation in this report. The Commission Annual Quality Assurance Assessment form, which providers are required to complete annually was duly returned in good time, and evidenced required details about the service in general and maintenance and servicing contracts in particular, all of which have been satisfactorily evidenced to us. Fire Drills and associated fire alarm testing provisions were checked and are regularly carried out and recorded. There were, eventually, no significant outstanding issues relating to health and safety on the day of the inspection; missing certification relating to gas testing, and the electrical installation and emergency lighting testing was provided by the contractor a few days after the inspection visit - showing and confirming that checks had been completed prior to the visit. General house-focused risk assessments have also been completed and reviewed. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 36 That the registered providers should, on their monthly recorded visits, ensure that staff support through supervision is being conducted by management on a regular and consistent basis That management could occasionally work a shift across the weekend to provide a presence and guidance for staff in these two important days of the working week. 2 38 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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 29 of 29 - 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!