Inspection on 09/12/08 for Fern House

This inspection was carried out on 9th December 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Fern House 07/12/06

Fern House 14/03/06

Fern House 08/11/05

Fern House 01/03/05

Fern House 07/09/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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: Fern House 28 Accrington Road Burnley Lancashire BB11 4AW 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: Pat White Date: 0 9 1 2 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 34 Information about the care home Name of care home: Address: Fern House 28 Accrington Road Burnley Lancashire BB11 4AW 01282451950 01282451950 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Shaun Martin Brelsford,Mrs Amanda Jane Brelsford Name of registered manager (if applicable) Mrs Joann Whittaker Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Fern House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for six adults 18 - 65 years with a learning disability. People who live there are encouraged to follow their individual interests in order to learn further life skills and to take part in fulfilling leisure activities. The home is a mid terrace property and is close to Burnley town centre and all its amenities. There are six single bedrooms, none of the rooms have an en suite facility, and the shared space consists of two lounges and a dining kitchen. There is a yard area at the rear of the property and a garden at the front. The home has a written service user guide with information about the home, the staff and its facilities and services. This provides useful information to residents and visitors. Care Homes for Adults (18-65 years) Page 5 of 34 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 Care Homes for Adults (18-65 years) Page 6 of 34 How we did our inspection: This is what the inspector did when they were at the care home A main inspection which included a visit to the home, was undertaken at Fern House on the 9th December 2008. This included checking important areas of life in the home, and checking what had been done about the things that needed improving from the previous inspection in 2006. Another person visited the home for part of the day to help the inspector. This person has experience of using services for people with learning disabilities (called an expert by experience), and he helped the inspector to decide whether or not people were happy living in the home and with what they did each day. For the inspection we talked to people living and working in the home, looked round the house, looked at residents care records and other documents and talked to the manager. Also some written information from the home was given to us before the visit which told us about the home, and gave us some information about the residents and what they did each day. Questionnaires were also sent to all the residents and some staff to try and get a bigger picture of life in the home. At the time of writing this report all the residents had completed and returned the questionnaires with help, and 3 staff had returned completed questionnaires. Some of the views of all these people, including the expert by experience, are Care Homes for Adults (18-65 years) Page 7 of 34 included in the report. What the care home does well The residents were given useful information about the home, which had some pictures in it to help people who could not read understand. Before people went to live in the home the staff found out what care and support they needed. People could also spend some time in the home before making up their mind that they wanted to go and live there. There was also some written information about the residents likes and dislikes and what they liked to do each day. This helped to make sure that Fern house was the right place for people to live and that the staff understood them. The residents were well looked after and had some interesting and enjoyable things to do. Residents could go to college and day centres if they wanted to, and could do hobbies and social activities, such as going to a luncheon club and going to social events. One resident said I love it here, and another said Its really nice here. Residents could see family and friends if they wanted to and visitors were welcome in the home. Residents said that they could choose what they wanted to do each day and choose some of the things in the house, Care Homes for Adults (18-65 years) Page 8 of 34 such as their favourite meals and the colours for their bedrooms. They all told the inspector and the expert by experience that they enjoyed the things they did during the day and at the weekends, and all said that they enjoyed the meals. The residents and staff seemed to get on very well and the inspector and the expert by experience both thought there was a nice feeling about the home. Residents said in their questionnaires that the staff were good to them. They also said that staff listened to what they had to say so they felt their views were important. The staff made sure that the residents stayed as healthy as possible, and that they saw the doctor and the nurses and went to hospital when they needed to. They were well looked after when they were ill. Staff were as careful as they could be to make sure that the residents were kept safe from harm so that they were happy and contented, and residents said that they knew who to speak to if they were not happy with anything. The house was homely, clean and comfortable and was a pleasant place for people to live in (see below). The staff were having the right training to help them know how to look after people properly. The manager also had the right training and qualifications to be the Care Homes for Adults (18-65 years) Page 9 of 34 manager of a care home. She knew all about the residents and worked hard with the staff to try and make sure they were well looked after and happy. What has got better from the last inspection What the care home could do better The written information about some of the residents, and the care and support they needed, was still not as up to date as it should be, and there was some information missing from some residents written plans. How decisions were made about what Care Homes for Adults (18-65 years) Page 10 of 34 residents could and couldnt do for themselves, such as whether or not they could keep their own medicines and their own money, was not clear. This should be thought about again and the reasons for residents not being able to do things for themselves should be explained and written down. Staff need to give medicines correctly, and make sure that the records they keep of this are accurate and written in the right place and the right time. The medicines and the records need to be frequently checked by someone in charge to stop mistakes from happening. Some other parts of the home needed to be improved. The floor in the kitchen and in the hall needed repairing or replacing, and some of the bedrooms were too dark and needed to be made brighter so that it was more pleasant for residents. The checks made on the home by the owner could be better and cover more things. This would help her to pick up some of the things that needed doing and make sure they are quickly sorted out. Care Homes for Adults (18-65 years) Page 11 of 34 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Pat White Unit 1 Tustin Court Port Way Preston PR2 2YQ 01772 730100 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 12 of 34 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 13 of 34 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 . Residents were provided with useful information about the services and facilities in the home. Residents needs were properly assessed before people were admitted to the home Evidence: There was written information to inform residents, potential residents and relatives about the service and this was written in a form that some of the residents would understand. The service user guide had also been updated since the previous inspection and some outdated and incorrect information had been corrected. This information was in peoples bedrooms so they could refer to it if they wished. There had been no residents admitted since the last inspection visit two years ago, but the records viewed showed that residents had been asssessed and admitted properly in the past. Also following the previous inspection the documentation for assessing peoples needs had been improved and extended. Also some of the old assessments had been updated, so staff had more accurate information about peoples current needs and from which to update care plans (see next section). However not all the assessments had been updated and in particular the assessment of one resident did Care Homes for Adults (18-65 years) Page 14 of 34 Evidence: not reflect the health changes and needs they had gone through with illness, treatment and recovery. However there was evidence that inspite of this residents were receiving the care and support they needed. Through talking to staff and residents, and from those who completed questionnaires, it was clear that the needs of the residents were met and that staff had a good understanding of how to support them. Care Homes for Adults (18-65 years) Page 15 of 34 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Not all the care plans reflected the changing needs and capabilities of the residents in all relevent matters. Residents were supported to make choices and decisions about their lives but the decisions made were not always clearly explained or underpinned by risk assessments Evidence: All residents had a care plan, but these were not always based on the assessment (see previous section). Care plans were reviewed and some had been completely revised since the last inspection. However some were incomplete and had not been updated in all important matters. There was no written information to guide staff on how to care for the resident referred to in the previous section, who had been ill, and required care and support for this. This meant that the the care and support in the home was not always underpinned by accurate written instructions to guide staff. This potentially means that residents might not receive the right support, though there was no evidence that this was the case at the time of our visit. Also some residents were described as having challenging behaviour, but the support and management strategies were not underpinned by a useful written assessment of the risk, or Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: information about who was at risk and when. The staff were assisiting residents to develop person centred profiles which helped staff to find out about the residents likes and dislikes and preferences. There was also a multidisciplinary process to help residents express their wishes and hopes for the future. Discussions with the residents and staff, and the responses in the questionnaires showed that residents had choices in their every day lives, about what to do each day and at the weekend, and that staff mostly listened to what they said and acted on this. As stated above their was information about their preferred routines and likes and dislikes. Residents meetings, that were held regualrly, also helped residents to express choices and be involved in the running of the home. Residents were encouraged to be independent, and take some responsible risks. Some residents were relatively independent; one attended college and another worked at a luncheon club. However neither they, or the other residents, were said to be capable of managing their own medication or money, though some residents had some skills in these respects. There were no written explanations or risk assessments to support the decisions made, or to demonstrate the capabilities and limitations of the residents, so it was not clear how or why these decisions had been made. Care Homes for Adults (18-65 years) Page 17 of 34 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 . Residents had good opportunites to take part in a range of appropriate activities and maintained links with their families. They enjoyed positive relationships within the home. The meals served were healthy and varied and appeared to suit individual preferences. Evidence: Residents attended college courses and day centres in line with their interests and capabilities and which included learning life skills. This gave them a chance to develop relationships out side Fern House. However some had given up going to the day centre through choice or because of their age. One resident worked at a luncheon club that was attended by the other residents. When residents were at home they were given the opportunity to go shopping or to help prepare snacks and meals. People were encouraged to use the local leisure facilities, and the information supplied to the commission by the home showed that they were encouraged to have meals in restaurants, go to shows, parties, swimming, shopping and church activities. Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: Residents spoken with spoke enthusiastically about their holiday in Scotland and a recent turkey and tinsel weekend in Blackpool. They were looking forward to the Christmas festivities and all the associated activities. Residents also told the expert by experience that they were happy in the home and enjoyed all their activities. Residents were able to keep in touch with families if appropriate. Relatives and friends were able to visit the home at any time and several residents had regular contact with their relatives. The staff encouraged and supported these relationships when at all possible. Both the inspector and the expert by experience felt that the home was friendly and welcoming. Discussion with residents and staff showed that routines were flexible enough to suit residents preferences, and some of these preferences were recorded on the care plans. Residents were encouraged to participate in some household chores such as cleaning and tidying their bedrooms, preparing food and washing up. Information had been sought from the learning disability nurse and the dietician regarding healthier eating, and menus had been revised according to their advice. Residents had been involved in this development, and spoke positively about the changes to their diet. There was a good choice of meals and snacks and fresh fruit was available. The menus showed a variety of healthy dishes. Care Homes for Adults (18-65 years) Page 19 of 34 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Personal support was provided in a manner which respected peoples rights to privacy, dignity and independence. The residents physical and emotional health was monitored and health needs addressed. Residents medication was in general given correctly but some procedures could be improved including that of self administration. Evidence: Residents received the personal support and supervision that they required according to their individual needs and in a way that promoted dignity and independence. The registered manager and staff ensured consistency and continuity of support and this was enhanced through the key worker system. A record was also kept of likes and dislikes and preferred routines as part of the person centred planning process. Through talking to residents and staff, and through the residents survey questionnaires, it was evident that staff upheld residents rights to independence, privacy and dignity. Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: The records and discussion with staff and the learning disabilty nurse showed that the residents physical and emotional health was monitored and health problems addressed. The learning disability nurse said that the health care in the home was excellent, and that staff worked cooperatively with the team in an ongoing way, and sought their support appropriately. Records showed that residents had the necessary support and health care from the hospital, psychologists, physiotherapists, dentists and opticians. There was also evidence that problems associated with ageing, such as mobility and deterioration in memory were being assessed and action taken. The checking of policies and procedures, and of 3 peoples medication records and medicines, showed that some practices and procedures had improved since the previous inspection. However some written procedures were still inadequate such as those for self administration, the recording of medication received into the home and homely remedies. Whether or not residents could manage some or all of their own medication was not underpinned by an assessment of the risks (see earlier section). Also some errors were seen on two Medication Administration Records (MARs) looked at which indicated that staff were not following correct procedures when giving out medication. One medicine to be given every night had not been signed for a number of weeks though there was evidence that this had been given. Another medicine was to be given at night but was signed as being given in the morning. The manager investigated immediately and gave assurance that the medications had been given as prescribed and that the errors were in the signing of the MARs. This showed that staff were not following the correct procedures of recording in relation to the administration of medication, and that the manager was not checking and auditing the medication practices. Immediately after the site visit the manager provided evidence of the action she was going to take to prevent such errors happening again. This included daily checks of records and medication and action to be taken against staff who do not follow correct procedures. We are confident that this will be implemented and will ensure that correct records are kept and also that residents receive the correct medication at the right time. In addition, though the manager was now recording all the medicines being received into the home, this was not being done according to the Royal Pharaceutical Guidelines and did not include enough information to give a satisfactory audit trail of the medicines. This was rectified immediately after the site vsit and we were provided with evidence of the new system set up. We were also informed that those staff that had not undertaken accredited medication training were booked on to a course early in 2009. Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: Care Homes for Adults (18-65 years) Page 22 of 34 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 . Residents concerns were taken seriously and acted upon. There were satisfactory policies and procedures to help protect people from abuse. Evidence: The home had a complaints procedure to which residents had access, and which included pictures to help those who could not read understand who to speak to. Residents also spoke freely to staff and their key workers about any concerns or worries they had. In the survey questionnaires residents indicated that they knew who to speak to if they were not happy with anything in the home. All stated that they were happy with every aspect of life in the home. The information supplied by the home to the commission before the inspection visit stated that no complaints had been received since the previous inspection. None had been made to the commission. Since the previous inspection the home informed us of one incident that was potentially an allegation of abuse as a resident said that another resident had caused a bruise on her face. Investigations showed that this was caused by an accident in the shower. Satisfactory records were kept that showed the conclusion of the investigations. There were satisfactory polices and procedures to help protect people from abuse and all staff were to attend Protection of Vulnerable Adults training again early in 2009. Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: This should further help to protect people. Care Homes for Adults (18-65 years) Page 24 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home was clean, comfortable and homely and in keeping with the residents age group. The residents bedrooms suited their needs and lifestyle. Evidence: A tour of the premises showed that the premises were homely and comfortable and that some repair work and decorating had been undertaken since the last inspection. The information supplied to the commission before the site visit told us what parts of the home had been improved and what still needed doing, such as replacing the kitchen floor. The residents had personalised their bedrooms with their own possessions and items such as televisions and music players. Those spoken with confirmed that they had chosen colours and some furnishings for their rooms. However two bedrooms were dark due to small windows, partly obscured by furniture, and the use of energy saving light bulbs. This made the rooms look gloomy and could affect the residents vision and well being. The expert by experience also felt that some parts of the home looked gloomy. The premises were safe had been made safer since the last inspection visit. The gas boiler had been repaired in line with requirements from the fire service. The hot water tested randomly at outlets was within an acceptable and safe range. Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: The home was clean and without any unpleasant odours. To help ensure good standards of hygiene, staff had undertaken an infection control course. Care Homes for Adults (18-65 years) Page 26 of 34 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 . Staff were qualified and competent and delivered a good service to the people living in the home Evidence: Discussions with the manager, the information supplied by the home before the site visit, observation and talking to staff, showed us that staff were caring and competent, and that most (four out of six) had the relevent National Vocation Qualifications for people working in care. The inspection methods showed that the staff training programme ensured that staff qualifications were being updated as required, such as in first aid and safe handling of food. Staff were undertaking training in Person Centred Planning, to enable them to identify residents individual needs and aspirations, and Protection of Vulnerable Adults training was scheduled for early in 2009. The learning disability nurses also worked with staff to increase their understanding and help them develop support plans. New staff completed a comprehensive induction that was in accordance with Government guidance for staff working with people with learning disabilities. At the previous inspection there was a concern that sometimes there were not enough staff on duty particularly at the weekends. The manager informed us that this had improved and that staffing numbers were rostered on duty according to the needs of the residents. For much of the time there was only one member of staff on duty but 2 Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: staff would work if need be, such as for activities at the weekends, and if a particular resident needed additional support through illness or medical appointments. The staff members spoken with said they felt there were enough staff on duty and that there was satisfactory support for staff working alone. In the questionnaires one member of staff said that there were always enough staff on duty since more staff had been recruited. Records of the staff meetings were viewed and showed that these meetings were held every few months. This assisted communication within the staff group and staff who completed the survey questionnaires felt that communication about residents needs, and changes in the home, was effective. The records of a member of staff recruited since the last inspection were looked at. These records showed that the necessary checks were undertaken, but that this person had started work in the home with the Protection of Vulnerable Adults check and before the full Criminal Records Bureau check had been obtained. Extra checks then had to be done in order for the management to be assured of this persons suitability and valuable time and resourses were taken up with this. Care Homes for Adults (18-65 years) Page 28 of 34 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 was managed by a competent and qualified manager who ran the home in accordance with the residents best interests. The health and safety of the residents and staff was promoted Evidence: The home was run by a competent, experienced manager who had been in the role for a number of years. She had the relevant qualifications for the manager of a care home. She was considered by the staff team to be committed to the home and supportive to both staff and residents. One of the owners carried out monthly unannounced monitoring visits to the home as required under the Care Homes Regulations. However copies of these reports that were seen showed that they did not cover all areas of life in the home, such as staff and residents records or medication audits. More thorough checks by the owner should help to identify some mistakes and shortfalls in the meeting of the National Minimum Standards. There was evidence that the home was run in the best interests of the residents. There were frequent residents meetings, and one to one meetings of individuals with their key worker. In addition monitoring questionnaires were sent to residents and families Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: and visitors including the learning disability nurses. All were very positive about all aspects of life in the home with no complaints. Records and the information supplied by the home to the commission prior to the site visit showed that the home was a safe place for residents and staff and that their health and safety were promoted. The installations and appliances had been appropriately serviced and maintained and the homes fire precautions were satisfactory. There had been a fire safety inspection in July following a problem with the gas boiler. The boiler now met the fire regulations and no further problems were identified. The information supplied to the commission before the site visit told us that there had been no accidents in the home requiring medical intervention. This further indicated that the residents were safe. Care Homes for Adults (18-65 years) Page 30 of 34 Are there any outstanding requirements from the last inspection? Yes  No  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 31 of 34 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 Description 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 Description Timescale for action 1 20 13 Staff must sign the Medication Administration Records correctly and these records must be checked regularly so that errors such as the one referred to in the report are identified. 02/01/2009 So that there are accurate records which show whether or not medication has been given as prescribed and demonstrate that staff are giving medication correctly 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 All the current assessments should be updated when needs change so that staff have written information from which to update the care plans The care plans should be fully completed and updated and Page 32 of 34 2 6 Care Homes for Adults (18-65 years) should be based on the assessment. Care plans should also reflect the changes in peoples health and the changing support required because of this. 3 9 Decisions about whether or not residents can manage some or all of their medication and finances should be supported by a written explanation and risk assessment that demonstrates the capabilities and limitations of the residents and any support required. Residents ability to manager their own medication should be subject to a risk assessment which demonstrates whether or not they are capable of managing some or all of their medication. The medication procedures should be reviewed and developed according to the Royal Pharmaceutical Guidelines of Great Britain All parts of the home should be bright, including the lighting in the bedrooms identified, to improve the appearance of the home and the vision of the residnts. It is recommended that staff do not commence work in the home until the full Criminal Records Bureau check has been received. The unannounced monitoring visits by the registered provider should cover all areas of life in the home to help identify areas for improvement and errors in procedures. 4 20 5 20 6 25 7 34 8 37 Care Homes for Adults (18-65 years) Page 33 of 34 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. 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