Inspection on 30/09/09 for Four Nevill Park

This inspection was carried out on 30th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Four Nevill Park 09/07/08

Four Nevill Park 31/05/07

Four Nevill Park 29/08/06

Four Nevill Park 08/02/06

Four Nevill Park 29/09/05

Four Nevill Park 04/01/05

Four Nevill Park 13/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Four Nevill Park 4 Nevill Park Tunbridge Wells Kent TN4 8NW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Gary Bartlett     Date: 3 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Four Nevill Park 4 Nevill Park Tunbridge Wells Kent TN4 8NW 01892519520 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: springmeadow@ilg.co.uk Evesleigh (Kent) Ltd care home 24 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 24. The registered person may provide the following category/ies of service only: Care home only - (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 (LD). Date of last inspection Brief description of the care home Four Nevill Park is a large detached Victorian property standing in its own grounds situated in a private road in an elevated position. The home has been developed to offer care for people with a diagnosis of Autism or Aspergers Syndrome. It is located on the outskirts of Tunbridge Wells; the town centre is a short distance away with easy access to public transport. Shops, pubs, post office and church are within easy walking distance of the home. There are large gardens, mainly laid to lawn, to the front and rear of the home and there is car parking available. Although it is registered for 24 service users it is used to accommodate 20 people. It is set out over four floors and is divided into three units. There is also accommodation for Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 24 Brief description of the care home people in semi-independent flats and these are located around the building. The home employs support workers, operating a roster, which gives 24-hour cover. The home has an administrator and there is a maintenance person. The current fees range from approximately £897 to £2036 per week. Full details of these and of any additional charges can be obtained from the Manager. 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: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was at Four Nevill Park from 9.00 a.m. until 3.45 pm. Judgments about quality of life and choices were taken from direct observation and by discussion with the service users, the manager and staff. Some records and parts of the building and grounds were inspected. The organisation had completed an Annual Quality Assurance Assessment, from which a limited amount of information could be used to inform the inspection process. Survey forms were received from six service users, three of their relatives, four staff members and one health care professional prior to the inspection. These indicate generally good standards of care at the home, but there were some concerns about instability within the staffing group of the home. Care Homes for Adults (18-65 years) Page 6 of 29 The Inspector would like to thank everyone involved for their contribution to the inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Two Requirements are made from this inspection. They are in respect of improvements to infection control and staff training. These will better promote service users needs and safety. It is recommended that the home be more consistent in encouraging independence within a risk assessed framework. Risk assessments and reviews should be more consistently recorded to better safeguard people at the home. We again strongly recommend improved facilities for the storage of medicines are provided on the Ruby and Amber units to comply with good practice guidelines. Parts of the home should be redecorated to provide a more dignified environment for Care Homes for Adults (18-65 years) Page 8 of 29 the people who live there and the problems with the hot water supply should be resolved as soon as possible. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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. There are sound policies and procedures in place to ensure prospective service users are properly assessed prior to being offered a place in the home. Evidence: The home has an assessment and admission policy and procedure to ensure each admission is undertaken in a planned way. The Manager described how prospective service users would only be admitted to the home after a full assessment of needs. The forms seen included facilities for the assessments of personal support, health care needs, religious and cultural needs and social interests. This would be inclusive of information received from relatives and health care professionals and is the starting point for service users individual care plans. Further assessments are undertaken after the service user has been admitted to the home. There have not been any admissions to the home since the Manager took post in May 2009. He said there is a current review of the service being provided, taking into Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: account its stated aims and possible development. Therefore, very careful consideration is given to new admissions. Future staff training programmes and the staff structure form part of the review. This is to ensure that staff will have the necessary skills to meet service users specialist care needs. Care Homes for Adults (18-65 years) Page 12 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. The home supports service users in meeting their individual health needs and choices. An improvement to care plans and risk assessments would better show how they are doing this. Evidence: The judgment for this outcome group has taken into account the quality of life experienced by the service users and an assessment of the level of knowledge and understanding displayed by staff when providing care. Each person has a care plan to provide staff with information about the support they need and to help ensure their needs are met in an appropriate and preferred way. The plans of five service users were inspected, three in detail. The home is in the process of introducing a new, more person centred care planning system. This will make important information more readily accessible. The care plans seen are generally up to date although it is not always clear when Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: reviews have taken place. The Manager recognises the necessity for records to be up to date so staff have access to information they need and says he is monitoring the standards of records. The service users spoken with are familiar with their care plans. Of the daily records seen, some are more detailed than others in being descriptive of the days activities and in conveying how the service user has responded during the day and how they feel emotionally. Accurate and detailed information gives a full picture of the persons lifestyle and helps when it comes to reviewing peoples care plans. From reading the care plans and discussion with the staff and service users, it is evident that service users are given support and encouragement to maintain personal contact with health and social care professionals. Each service user has an individual health record which is used to inform staff and can be taken to doctor or hospital appointments for the effective sharing of information. Staff are generally aware that service users have the right to take responsible risks. Staff say that risk assessments are carried out in response to individuals needs and to events which indicate risk management processes are needed. These are not always being promptly recorded. For example we could not find an up to date risk assessment regarding a service user smoking in their flat, but staff were able to give a good description of safeguards in place. These were resultant from a recent case review, the findings of which needed to be written in the care plan. It is recommended that risk assessments and reviews are more consistently recorded to better safeguard people at the home. Service users have regular opportunities to contribute their views and ideas with regard to the running of the home and are supported in this. The home does not act as appointee for any of the service users and there are sound systems for holding their monies and recording amounts of cash held and payments made. There are regular and effective audits of the homes handling of service users finances. Interaction between service users and staff was observed to be good showing respect, friendship and appropriate familiarity with each other. Care Homes for Adults (18-65 years) Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users should be more consistently supported in their individual choices and development of their life skills. Evidence: Views as to whether the home fully supports service users to enjoy individual lifestyles and to develop their life skills are mixed. When asked on a survey form what the home could do better, one service user responded improve on activities. A health care professional stated the home could provide more comprehensive day activities for service users. Whereas a staff members survey says the home plans enough activities for each individual. From speaking with service users and staff and from looking at records, it is evident that the support for some service users to partake in their preferred activities has been adversely affected by the recent instability of the staff group, staff sickness and Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: the impacts of the needs of other service users. This is being addressed now that service users are being reassessed to be sure that Four Nevill Park is the best place for them and by the recent recruitment and training of new staff. The Manager is intending to introduce a revised staff roster so more staff are available at weekends and at key times during the day. He is aware of the sensibilities of those service users who are more dependant on routine but believes the changes, introduced with appropriate care, will be beneficial for all service users. The Manager said he is passionate about promoting independence but, from observation, not all staff members are good at getting a balance between keeping safe and enabling. For example, service users were seen to be consulted about what they wanted for lunch but were not always encouraged to help in its preparation as much as their abilities permitted. Some service users can not independently use a communal bathroom because the taps have had to be removed in response to one service users water fixation. It is, therefore, recommended that the home be more consistent in encouraging independence within a risk assessed framework. Service users spend time in the home relaxing, watching television listening to music or undertaking activities that interest them. If they wish, service users can enjoy privacy in their rooms and the staff respect this. Staff members talk with service users in a friendly and polite way. People living at the home can receive visitors when they choose and have use of a telephone to call family and friends. The staff members spoken with understand the need to support service users in building and maintaining appropriate relationships. Service users participate in planning the menus and those seen show they enjoy a balanced and nutritious diet with a variety and choice. Several service users said they enjoy the food at the home. A staff members survey says the home buys nice food for the service users and plans good and balanced diet. 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. The home supports service users in meeting their health care needs and promotes their privacy and dignity. Evidence: Staff spoken with have a good understanding of the preferred routines and varying requirements of each service user. The improved care plans being introduced will better show that staff are made aware as to the type and nature of the support required for individuals personal and intimate care needs. Through discussion with the staff and assessing the three care plans, it is evident that service users have ready access to health and social care professionals and are supported with any specialist appointments and interventions. Staff described how they provide flexible support to service users based on individual choice and personal care is provided in private to promote their dignity. This was confirmed by the service users spoken with and by observation. Guidance regarding personal hygiene is recorded in the care plans. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: A procedure is in place for the administration of medication by the home, which aims to protect service users. Records show that all staff administering medications have been trained and signed off as being competent to do so. It was recommended in our last report that the facilities for the storage of medicines on Ruby and Amber should be reviewed. Improvements have still not been made. Whilst clean and well maintained, they are cramped, without hand washing facilities and have limited ventilation. The latter makes it difficult to always store medicines at the recommended temperature. Commendably, the Manager has been in contact with the pharmacist regarding this. We again strongly recommend improved facilities for the storage of medicines are provided on the Ruby and Amber units to comply with good practice guidelines. 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 who use the service are protected by clear policies and procedures. They are able to offer comment or complaints. Evidence: The home has a clear, up to date complaint procedure that is readily available. The procedure is also available in a pictorial format for service users. Records are kept of complaints, their investigations and outcomes. The AQAA indicates the home has received seven complaints in the last twelve months, all of which were dealt with in a timely manner. The Manager described how these are used to inform future practice. The Care Quality Commissions statutory remit is to assess compliance with the Care Homes Regulations; it is not empowered to investigate complaints. So, when we received an anonymous complaint about the service, we passed the details to the provider to undertake the investigation. The allegations could not be substantiated. There are procedures for protecting service users from abuse and the staff is required to attend training in this. The members of staff spoken with have a good understanding of the protocols to safeguard adults. There have been 2 Safeguarding Adults alerts in the last 12 months, both of which have been closed. Care Homes for Adults (18-65 years) Page 19 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples quality of life and safety would be enhanced by improvements to the environment in which they live. Evidence: Four Nevill Park is a large detached Victorian property standing in its own grounds situated in a private road in an elevated position. The property has four floors and has been arranged into three units, Amber, Emerald and Ruby. Alongside these units there are a number of semi-independent flats Although the AQAA mentions ongoing redecoration, some areas inside the home look shabby and do not provide a dignified environment for the people who live there. This is particularly so on the Ruby and Emerald units. Some areas have worn or damaged surfaces, plasterwork, and wall coverings. In high infection risk areas such as kitchens, dining areas and bathrooms; this compromises the health of people at the home. These areas must be improved to better promote infection control. The standard of cleanliness around the home is variable. In some bathrooms, we saw cobwebs and dusty surfaces in the high parts of them. The Manager undertook to arrange for the home to be cleaned throughout and for cleanliness to be better maintained. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The home was free from offensive odours with the exception of one persons bedroom, where soiled bed linen had been left on the floor and the mattress covering was still visibly wet. Although a staff member was aware of this, it was not being addressed with the promptness necessary to ensure a hygienic, dignified and homely environment. The Manager took immediate action in regard to these issues. Accordingly, we did not issue an Immediate Requirement Notice. Since the last inspection, clinical waste bins have been provided to better maintain infection control. Our last inspection noted that some of the sash windows were difficult for service users to operate and had to be wedged open. This has been partly addressed by the fitting of sliding bolts to the window frames to keep the windows open without having to use wedges. Some furniture is worn and stained. The Manager undertook to replace an easy chair that had a loose frame and was potentially dangerous. Although some staff members must have been aware of this, it is not evident they had reported it. We recommend the home does an audit of all the furniture and arrangements for replacements to be made where necessary, with priority being given to health and safety. The hot water supply in some parts of the home is inadequate, with only tepid water being available. The Manager explained this is an ongoing problem that the organisation is aware of. It is strongly recommended this be resolved as soon as possible. The home benefits from having a very competent maintenance person who operates good systems for monitoring health and safety in the home, within the resources available. There are large gardens, mainly laid to lawn, to the front and rear of the home that can be used by service users. At the time of our inspection, the grass in the front garden was very overgrown. Consequently, the outlook from the home in this direction, particularly from the Emerald lounge was unattractive. It is recommended the garden be better maintained. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment processes are followed to ensure only properly vetted people work at the home. Staff members are caring, but the home must be more able to readily show they have the necessary skills to meet service users care needs. Evidence: The last year has been very unsettled for the home with constant changes in management and a high turnover of staff. This has stabilized in recent months with the appointment of a permanent manager and new staff. Robust recruitment processes are followed to ensure only properly vetted people work at the home. People applying to work at the home have to complete an application form, provide two references and have a POVA and Criminal Records Bureau (CRB) check and attend an interview. New staff have to undertake an induction programme. Staff members speak of training and there are some certificates on their files. However, the training matrix is not up to date. The Manager said he is intending to collate the information necessary to update it. Until this is done, it is not evident that all members of staff have had the necessary training for them to have the skills to Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: meet service users care needs and to comply with current legislation and good practice guidelines. This is particularly necessary in view of the recent changes to the staff group. The Manager said he is reviewing the deployment of staff and is looking to change the staff rosters. This is to make more staff available at weekends and at key times during the day for the support of service users. Staff members spoken with are apprehensive about these changes. Service users indicate they like the staff and find them approachable and kind. Throughout the site visit there was evidence of good relationships between staff and service users. Conversation and activities were inclusive and service users were given time to express themselves. Care Homes for Adults (18-65 years) Page 23 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 benefits from a manager who is experienced, qualified and understands where changes need to be made to improve the standard of service. Evidence: The Manager has worked at Four Nevil Park since May 2009. He has extensive experience of working with people with learning disabilities in residential settings, was previously the registered manager at another home and has achieved the Registered Managers Award. Until he took post, there was a succession of managers and concerns about the lack of continuity of the management of the home were expressed in two surveys returned to us by relatives. Indeed, there has not been a registered Manager at Four Nevill Park since early in 2007. This is not compliant with the Care Standards Act 2000. We are pleased to see that the current manager has recently applied for a CRB check, the first step in the process of making an application to be registered as the manager of the home. The standard of cleanliness in the kitchens and surrounding areas is satisfactory. Food packaging is not always being dated when opened as a matter of good practice. We Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: had sight of records that showed the Manager is aware of this and has been reminding staff of their responsibilities, so did not issue an Immediate Requirement Notice. Staff are careful to ensure COSHH requirements are complied with to safeguard service users. There is a sound system of holding and recording service users cash, which is regularly checked as part of an audit process. There are very good systems for the regular checking of fire safety systems. Staff members spoken with have a good understanding of emergency procedures. The organisation undertakes monthly visits to the home to monitor the quality of the service and there are regular meetings and surveys to request the views of service users, their relatives and external agencies. Whilst the monthly reports seen show a robust check of the homes records, they do not record what service users say to the visitor about the service; what the outcomes are for them. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 30 13 The registered person shall 30/11/2009 make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. The registered person has a legal responsibility to prevent infection, toxic conditions and the spread of infection at the care home. High infection risk areas such as the bathrooms, kitchens and dining areas must be made good, where necessary, to promote infection control and maintain adequate hygiene standards. An action plane for the completion of this, with timescales, must be received by the Commission by the given timescale. 2 35 18 The registered person shall, having regard to the size of the care home, the statement of purpose and 30/11/2009 Care Homes for Adults (18-65 years) Page 27 of 29 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 numbers and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform including structured induction training. It is a legal responsibility to ensure the staff group has the knowledge and skills to meet service users needs. A detailed training analysis must be made for every staff member. A copy of the analysis and details of training courses attended and booked, including details of the training providers and any accreditation they may have, must be received by the Commission by the given timescale. 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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