Inspection on 26/01/09 for Field Cottage

This inspection was carried out on 26th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Field Cottage 31/01/07

Field Cottage 29/11/05

Field Cottage 01/08/05

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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: Field Cottage 17 Harrisons Lane Ringmer East Sussex BN8 5LL     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: Sally Gill     Date: 2 6 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 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Field Cottage 17 Harrisons Lane Ringmer East Sussex BN8 5LL 01273814016 01273814266 louise.eastwood@eastsussex.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): East Sussex County Council Name of registered manager (if applicable) Louise Suzanne Eastwood 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 ot be accommodated is 7 The registered person may provide the following category of service only: Care home only(PC) to service users of the following category: Either whose primary care needs on admission to the home are within the following category: Learning disability(LD) Date of last inspection Brief description of the care home Field Cottage is registered to provide accommodation for up to seven adults with a learning disability and admits people with low to medium dependencies. The home is part of services provided by East Sussex Social Services. The registered manager is Louise Eastwood who has day-to-day control of the home. The premise is a detached house situated in a quiet residential area. There are seven bedrooms all with a wash hand basin and one also has an ensuite shower/toilet. People have access to a bathroom, separate shower room, kitchen/diner and lounge. There is also a laundry. The home is non-smoking. To the rear there is a large garden mainly Care Homes for Adults (18-65 years) Page 4 of 31 care home 7 Over 65 0 7 Brief description of the care home laid to lawn with shrubs and a fishpond. To the front of the property there is a car parking area and a further fishpond and garden. The home is not suitable for wheelchair access. There is limited parking on the car parking area and additional on street parking in the street. The home is situated within walking distance of local village shops and other amenities such as library, bank, swimming pool and public transport links. The staff compliment consists of the team leader (registered manager), senior care officers and care officers. Care staff work a rota with a minimum of two staff on duty during the day although at times there may be three staff on in the morning. One member of staff sleeps in at night. Fees are based on a financial assessment and people make a contribution although this does not reflect the cost of care. Details of the unit cost per person are available from the registered manager. Previous inspection reports are available from the home or can be viewed and downloaded from www.csci.org.uk Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The previous inspection took place on 31st January 2007. This inspection was carried out over a period of time and concluded with an unannounced visit to the home between 09.08am and 4.15pm. The manager and staff assisted during the visit. People that live in the home and staff were spoken to. Observations were made throughout the day. Seven people were living at the home on the day of the visit. Surveys were sent to the home for the manager to distribute to service users, staff and health and social care professionals. Seven were returned from services users, none from staff and two from health and social care professionals all of whom were very Care Homes for Adults (18-65 years) Page 6 of 31 positive about the care and support received. The care of two people was tracked to help gain evidence as to what its like to live at Field Cottage. Various records were viewed during the inspection and a part tour of the home undertaken. The home sent their annual quality assurance assessment (AQAA) to the Commission within the required timescale. The AQAA is a self-assessment picture of how the manager thinks they are doing against the national minimum standards (NMS). Fees are based on a financial assessment and people make a contribution although this does not reflect the cost of the care. Details of the unit cost per person are available from the manager. Additional costs would include some activities, toiletries, clothes, personal items for bedrooms, hairdressing, newspapers and magazines. What the care home does well: What has improved since the last inspection? What they could do better: People and their representatives must have access to clear information both prior to admission and when living in the home such as the service user guide and contract of terms and conditions. The home must maintain records to evidence a robust recruitment procedure protects people. The body of this report highlights some other improvements needed although no further requirements are made. Care Homes for Adults (18-65 years) Page 8 of 31 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 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service or their representatives do not have access to the full information needed to choose a home, which will meet their assessed needs. Evidence: People do not have access to the full information to be sure this home is right for them. A detailed statement of purpose is in place which has recently been reviewed. The terms and conditions of residency document currently doubles as the service user guide. This document must be reviewed, as currently it does not contain all the information required in the service user guide or terms and conditions of residency. Examples include complaints procedure meeting regulation 22, details of fees, breach of contract and insurance details. Each person has a residency agreement in place. The agreements should be between the person using the service and the home not an individual member of staff. Currently there is no place for a signature by either parties or their representatives and none are signed. Four out of seven people surveyed indicated that they were not asked if they want to move into the home and were not Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: given sufficient information prior to moving in. It is acknowledged there have been no admissions since 2003 and under this manager. A requirement is made to have a service user guide and terms and conditions of residency that meet the National Minimum Standards (NMS) and regulations. The Commission is aware that the terms and conditions of residency will change on 1st April 2009 and that the organisation is already reviewing all of the above documents. Previously the manager has discussed the assessment process with the Commission. The Manager reported that a copy of the latest social care assessment would be obtained prior to admission. The details of this assessment would then be tested out through a series of trial visits to assess the suitability of the home and compatibility with the other people who live there. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives and play an active role in planning their care and support they receive. Evidence: People needs are reflected in their my lifestyle plan together with specific review paperwork and a health plan. The paperwork for two people was examined. Generally these were evidenced as reviewed within the recommended six-month timescale. Folders were indexed and information was easily accessible. The documents relating to peoples skills and abilities were very well detailed. Information ensures that staff know what support is required and can consistently promote an individuals independence. The home needs to ensure that the my lifestyle plan document remains fully up to date and a working document. Changes even temporary must be evidenced or cross-referenced to where the up to date/temporary information is recorded. Examples are temporary medications and changes of college/daycentre days. Staff make notes of any significant events, which were detailed. In addition staff Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: sit with each individual daily and record with them whats happened today in their diary. Individuals drive their own reviews. They chose who to invite and where to hold the review. Preparation time is spent one to one with staff discussing support and any goals the person may have. These are then recorded on specific review paperwork. The same paperwork is used to monitored information discussed and agreed at the review. Additional goal plan paperwork is in place but at times it is difficult to track what action has been taken unless it is tracked through numerous notes. The manager advised that people are encouraged to sign their review documents as a sign of their agreement. People feel they are able to make decisions about their lives. All seven people surveyed indicated they always make decisions about what to do each day. In addition to regular one to one time spent with staff regular meetings are held. Minutes and discussions confirmed people have the opportunity to have their say on what goes on and air any concerns they may have. People were observed on the day of the visit to help themselves to drinks and food and choose a place to visit and spend time, as they wished. People are supported to take appropriate risks to enable an independent lifestyle. Risk assessments are recorded including any actions to be taken in order to reduce a risk. Most were reviewed within the recommended timescale. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual expectations. Evidence: People have a range of activities and educational opportunities and lead busy lives. Each person attends a local authority day centre. Most people also attend Lewes College. Activities enjoyed at the day centre include sensory sessions, exploring nature, bowling, animal care, cookery, photography, volunteering at a local railway line, woodwork, drama rhythm and dance and healthy walking. Subjects at the college include social, work and life skills, news and views, music, literacy and books and films. On the one day each individual is not attending college or the day centre they have responsibility for undertaking their household chores and doing their laundry. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: During this day they have one to one staffing and after chores are completed can spend their day as they wish. On the day of the visit the individual choose to go a National Trust garden, which they obviously enjoyed and talked about when they returned. People are able to get out and about in the local community. Records and discussions confirmed people attend a good variety of clubs, groups and venues in the evenings and at weekends. The home has a vehicle that can be used for transport or people have bus passes. Most people also go home regularly at weekends to spend time with their families. Peoples daily routines are detailed in their my lifestyle plan although these are flexible. Staff were observed to interact well with individuals in an enthusiastic but kind and caring way. During the visit it was evident people could choose to spend time alone as they pleased or join in the group discussions and activities. Late afternoon was an active time around the kitchen with people discussing their day, what they wanted to do that evening, making drinks and helping to prepare tea. People enjoy a varied diet. Everyone spoken to said they enjoyed the meals and were able to choose what they wanted. Breakfast is cereals, toast, and porridge or cooked with people helping themselves. Lunch is a light meal, sandwiches or a lunchbox prepared by them. Each day one person chooses the evening meal, which can be cooked, for everyone. In addition three people are loosely following a slimming menu. People who wish to have something different to the above menu choices are offered an alternative. Records showed a range of varied meals on offer. An individual and a staff member were preparing the evening meal of pasta bake or fish fingers, beans and potatoes when the Inspector left. One person said the food is alright. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: People are encouraged and supported to manage their own personal care. The role of staff is primarily to prompt or encourage people as necessary. There is evidence in my lifestyle plan that staff support is offered in a sensitive and respectful manner. Health care professionals surveyed indicated staff always or usually respect individuals privacy and dignity. One professional commented staff are very personal, understanding and most important is the continuity. A key worker system is in place to aid continuity and people spoken to were aware whom their key worker is. Peoples health care needs are met. The manager has introduced health plans since the last inspection which detail peoples health needs. Records evidenced that people have access to a variety of health care professionals to meet their needs. Health care professionals surveyed indicated staff seek advice and guidance and act on this always. They felt individuals health care needs are always or usually met by the Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: service. People are protected by safe medication practices. The manager advised that the medication policy has recently been updated. Records confirmed this had been discussed at a recent staff meeting. The storage and administration of medication were found to be satisfactory. Removing notices relating to medication from the medication cupboard would ensure better safety. Records are accurate and current. Each person has a their own medication file which contains their individual Medication Administration Record (MAR) chart, information about their medication history, potential side affects of their current medication and the criteria for when each medicine should be administered including those prescribed as required. Some handwritten entries on the MAR chart were not signed, dated and witnessed and for good practice should be. The manager advised she has recently obtained further information relating to medicines administered within the home and this is stored in a folder with other medication records. She also advised that the dispensing chemist is shortly to undertake and audit of the medication system. Staff receive appropriate training in the management of medication. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns have opportunities to air their views and concerns, they feel safe living in the home but could have access to a more appropriate complaints procedure. Evidence: People have opportunities to air their views and voice any concerns. This is through regular meetings and planned one to one time with staff. People spoken to confirmed they would speak to staff if they had a concern. An advocate well known to people visits the home every six weeks who could provide impartial support. Records showed that previously an individual has made a complaint. The home has not received any complaints in the last twelve months nor has the Commission. The statement of purpose contains a complaints procedure that meets the regulations. The complaints procedure displayed is a general East Sussex Adult Social Care procedure is not specific to the home and not in a service user-friendly format which would be good practice. People say they feel safe living at the home. The AQAA states that policies and procedures are in place to safeguard people living in the home. Three referrals have been made to the safeguarding team, which the home has managed appropriately. The manager advised that all staff have received safeguarding training, which is updated every three years. Staff spoken showed knowledge of what to do in the event Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: of suspecting abuse. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home, which is homely, clean, comfortable and generally well maintained. Evidence: People live in a home, which is homely, clean and comfortable. A tour of the home was undertaken. The home is generally well maintained and in good decorative order. The manager advised that since the last inspection the hallway has been redecorated and had new carpets together with the stairs. The bathroom has been refurbished and the shower room deep cleaned. The lounge has been redecorated and has a new television and stand. A tropical fish tank with fish has been acquired. One bedroom has also been redecorated. Staff advised that people living in the home have chosen the colours of paint, wallpaper and carpets. The manager advised that since the last inspection in the interest of safety a risk assessment has been undertaken as there are no window restrictors on the first floor windows. During the tour of the home the following areas were discussed. The shower room still has minor mould present and the extractor fan is not working. This should be addressed. The manager advised that the extractor fan is not really up to the job. A blind or curtains could also enhance the bathrooms. The manager advised she is Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: looking into finding something, which will be suitable. One bedroom carpet was stained. The manager advised this is day-to-day spillage and the bedroom carpet is regularly shampooed and does come clean. People have access to a homely lounge and kitchen/diner. The main garden is to the rear of the property, which is mainly laid to lawn with some shrubs and a fishpond. Previously there was a greenhouse and the base has been left as one-person wishes to grown vegetables in this. There is also seating for use in the summer. To the front of the property there is a smaller garden area to the side of a parking area with shrubs, grass and a further fishpond. The gardens are well maintained. People confirmed they are happy with their rooms. All bedrooms are homely, personalised and reflected their interests. People benefit from a warm, generally clean, tidy and hygienic home. People surveyed indicated that the home is always or usually clean and fresh. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive support from a staff team, which is qualified, trained, skilled, and in sufficient numbers to meet individuals needs. Records in the home are unable to evidence people are protected by robust recruitment procedures. Evidence: People are supported by sufficient numbers of staff to meet individuals needs. There is a team of six staff in addition to the manager. The manager advised that the staffing rota is two or three staff during the morning and two in the afternoon. One member of staff sleeps at the home. People surveyed indicated that the staff always treat them well and always listen and act on what they say. People spoken to confirmed they like the staff and felt they were good. Observations throughout the day confirmed people were comfortable in staffs presence. Discussions and observations also confirmed that staff are committed to people who live in the home and put them first at all times. It is a very inclusive atmosphere. There are no recruitment records held at the home. This has been highlighted at three previous inspections going back to May 2005 and a warning letter sent following the last inspection to the organisation. Either copy recruitment documents or an annex 4 form with recruitment information must be held in the home. The requirement remains Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: outstanding and no further action will be taken at this point following a discussion with higher management from the organisation who agreed to have this information in place by 31st March 2009. This will be monitored for compliance. Staff who are trained support people. There have been no new members of staff since 2005. The manager advised of the induction-training programme, which is to Skills for Care specification. The manager advised of training statistics. All staff are trained in all mandatory subjects (fire, first aid, food hygiene, infection control and moving and handling). The manager advised that all mandatory training is updated every three years. One staff members moving and handling and three staffs food hygiene need updating. In addition other training has also been undertaken in the last six months. This includes driving assessments and vehicle checks, equality and diversity, understanding dementia, the mental capacity act, and healthy lives for people with a learning disability, bereavement and understanding communication. Staff benefit from regular supervision and feel well supported. Records examined confirmed that staff have received five or six supervision sessions in the last twelve months. In addition to this they have had an annual appraisal. Staff on duty said they felt well supported. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Day-to-day management of the home is effective but quality assurance systems could be more robust. Evidence: The manager has considerable experience managing the home. She has obtained her NVQ level 4 and Registered Manager Award (RMA) since the last inspection. She has also undertaken all mandatory training. People spoke highly of the manager. One individual said shes alright. Staff comments included she is fair, easy going but will ensure things are done properly, she is a motivator and if you need a push you get it, she is a good team player and has a consistent approach. She is organised, deals with issues well, open to other peoples ideas and listens to service users wants and needs and acts on these. The manager advised she works on shift all but one day per week, which is dedicated to management. If extra time is required this is requested. Day-to-day the home is managed well with good outcomes for people using the Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: service. However it is not acceptable that the organisations management has not addressed one requirement which has been outstanding since May 2005. Internal quality monitoring has not picked this up which questions that systems are not as robust as they should be. The atmosphere within the home is extremely inclusive. On the day of the visit at times things were busy and active although the atmosphere was always calm and everyone remained relaxed. It is apparent all staff put people who live in the home first. People have opportunities to voice their views and opinions. Regular meetings are held with people who live in the home. Records confirmed in addition staff spend one to one time with individuals. People have also completed a have a nice day questionnaire to gather their views. Copies of these are held on file and also given to parents. Those examined were all positive. This could be improved further by analysing results and people receiving overall feedback. The organisation undertakes visits to the home as required by legislation (regulation 26) to check the quality of services provided. One had been completed in December 2008 although prior to this they had not been completed monthly which they are required to be. Copies of the reports were viewed. The new report format recently implimented does not evidence that people using the service have been spoken or staff which would be good practice. The Commission is aware that action has been taken to ensure these visits are now undertaken monthly and therefore a requirement is not made at this time. People confirmed that that they are happy living in the home. Relatives attend reviews and have recently been sent a questionnaire to complete. An Adult Social Care newsletter is sent out monthly which informs people who use the services and their relatives on any news and developments for both the home and the day centre they attend. Staff are regularly supervised. The Commission received a completed AQAA from the manager. This was complete and clear although could have better reflected services provided across all the National Minimum Standards (NMS). Minor improvements are needed to ensure peoples health; safety and welfare are fully protected. The AQAA indicated that equipment is serviced within required timescales. The manager undertakes a regular health and safety audit and staff undertake other regular checks, which are recorded. The fire safety logbook was examined. Alarms are tested regularly. Although the manager advised extinguishers are visually checked each month this is not currently recorded and must be. Emergency lighting was recorded to be last tested in October 2008 and must be monthly. Accidents/incidents are appropriately recorded. Events reportable to the Commission can at times be delayed. Reviewing the system for reporting could speed things up in line with legislation. Care Homes for Adults (18-65 years) Page 26 of 31 Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes R 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 1 34 19 &Sch 2 as amended Staff files to contain the 01/05/2007 information required by the Care Homes Regulations. The information as listed in Schedule 4 to be available at the home for inspection at all times. (Previous timescales of 30 May 2005, 01 October 2005 and 20/01/06 not met) Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 5 The registered person shall have a service user guide in place in accordance with the regulations and NMS To ensure people and their representatives have access to comprehensive information 31/03/2009 2 5 5 The registered person shall have a written contract of terms and conditions in place in accordance with the regulations and NMS agreed with each service user To ensure people and their representatives have access to comprehensive information and are protected by this information 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 29 of 31 No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 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. 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