Inspection on 25/11/08 for Franklyn Lodge 8 Forty Lane

This inspection was carried out on 25th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Franklyn Lodge 8 Forty Lane 24/11/09

Franklyn Lodge 8 Forty Lane 08/06/06

Franklyn Lodge 8 Forty Lane 13/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Franklyn Lodge 8 Forty Lane 8 Forty Lane Wembley HA9 9EB     The quality rating for this care home is:   one star adequate 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: Duncan Paterson     Date: 2 7 1 1 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. the things that people have said are important to them: They reflect 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 30 Information about the care home Name of care home: Address: Franklyn Lodge 8 Forty Lane 8 Forty Lane Wembley HA9 9EB 02089046821 TBC cathy@franklynlodge.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Residential Care Services Ltd care home 9 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: 9 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 Date of last inspection Brief description of the care home 8 Forty Lane was registered in June 2005 to provide accommodation and care support to 9 people with learning disabilities. The home is a detached property located near to Wembley Stadium and the town centre. The home is suitable for people who would benefit from a group living while still maintaining their individualism and identities. The home is not suitable for people who are wheelchair users. Application to live at the home is normally made through relevant social services departments and completion of a multidisciplinary care needs assessment. The home has 9 ensuite bedrooms, a staff room, an office, a dining room, a laundry area, a large open plan communal lounge, an activities room, a kitchen, a separate dining room, and a large garden with storage sheds. Service user accommodation is on the ground and first floors. The fees charged range from £950 per week to £1274.98 per week. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 9 Care Homes for Adults (18-65 years) Page 5 of 30 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: one star adequate 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 inspection took place over two days on 25th and 27th November 2008. Two visits were needed because, on the first day of the inspection, the residents were only at home for a short time before going out to an evening social club. The two days allowed for a period of time with staff and residents observing practice and for time to check records. The Annual Quality Assurance Assessment (AQAA) form, returned to us by the home, was taken into consideration. The inspection also involved a tour of the premises and assessment of a range of the homes records, policies and forms. Care Homes for Adults (18-65 years) Page 6 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Although there are many positive features about the service there is a need for review and strengthening in certain key areas. Of paramount importance is that of safeguarding. The homes safeguarding policy and procedure needs to be re-written so that arrangements are clear when incidents must be reported to the local authority. In addition, a more preventative stance needs to be taken where safeguarding risks presented to residents are identified and minimised. There were a number of other areas where the delegation of some of the management tasks needed to be reviewed to make sure they were being carried out properly. They affected the smooth running of the home and indicated a poor grasp of the need to provide staff and residents with timely information. The staff and resident meeting records had not been typed up for a number of months, the key for the safe where residents money was kept was not immediately available and some parts of the kitchen needed maintenance and cleaning. The building is in need of redecoration with the dining room and kitchen flooring particularly poor. A timetabled plan for the redecoration of the home needs to be drawn up. Finally, further work will be useful to extend person centred planning principles to the service . The manager and staff are aware of these matters and are working on them which is positive. This inspection has highlighted the statement of purpose, the service users guide and care planning documentation as key areas for this work. Care Homes for Adults (18-65 years) Page 7 of 30 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 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. Assessments are detailed and involve key people. Residents are introduced to the home well. Providing pictorial information about the service for residents will give them more information in ways they can understand. Evidence: The statement of purpose sets out the aims for the service. The fundamental aim of the service is to work with people with different levels of learning disability who can be effectively accommodated and supported in this extended family style unit. On the evidence of this inspection the manager and staff have been able to create such a family style atmosphere. There were daily routines, such as day care activities, meal and snack times and relaxation time around which the home worked. The majority of residents spent the day at day centres and then returned to the home in the late afternoon. A small number of residents carried out other activities with one resident preparing to move on to a supporting people service. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The needs of residents vary from a number of people who need a great deal of time and attention and who do not communicate verbally to others who can communicate verbally and will be able to progress, with support, to alternative care settings where there is more emphasis on independent living. During the inspection residents were seen to be living harmoniously together. There is a separate activities / sensory room where residents can spend time quietly and the office was also used by residents during the inspection where they could quietly use computers. Having residents with a variety of needs does mean that staff need to be flexible, adaptable, and multi-skilled, to work with each resident and provide the service that their needs demand. Keyworking arrangements were discussed with the deputy manager and staff. Staff actively keywork residents and staff spoken with were able to explain how they worked. Staff have received relevant training and there are detailed care plans setting out peoples needs as well as evidence that other professionals have been consulted. The assessment information was detailed with a range of documents from sources that knew and had cared for residents before they moved to the home. New residents had had trial visits to allow them to get used to the home. Returning to the statement of purpose document. This was viewed as well as the homes service users guide. The documents are well written and clear. However, they are not available in alternative formats to assist residents to understand them. This was discussed with the deputy manager who advised that the organisation was considering producing the guides, as well as care plans in alternative person centred formats. A recommendation is given about this. Care Homes for Adults (18-65 years) Page 11 of 30 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. There are detailed care planning arrangements in place and the service is good at gathering together resources to meet peoples needs. Extending person centred planning, arranging advocacy services and taking up communication training will assist staff further to meet the diverse needs of the residents. Evidence: Three peoples care planning records were inspected. These plans were detailed, clearly laid out, with agreed goals and evidence of input from a range of other professionals. There was also evidence that the care plans had been regularly reviewed. Keyworkers spoken with confirmed that they worked with residents to address the stated goals. Observations during the inspection also provided evidence that the care provided matched the care plan goals. For example, individual residents were being assisted to use a computer or to draw. Each resident also had risk assessments which had been completed in the style of one Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: risk per sheet so that additional risks and preventative measures could be added as required. The care plans seen were typed and included use of pictures and symbols. This is useful and residents can follow what has been agreed for them. However, more work in this direction would be useful to fully extend person centred planning for residents. Such an approach will assist the manager and staff with meeting the needs of all residents. Residents needs vary in this home with some leading more independent lives and others requiring more staff input because of challenging or demanding behaviour. The use of advocacy services may also be helpful so that residents can be offered additional support and that staff are not working alone. In addition, there had been a recommendation to the home from a health care professionals that staff receive Makaton and effective communication training. The deputy manager said that this had started. A recommendation is given that all staff receive this training. Having said that, there was evidence that the manager and staff were good at having resources in place for meeting residents needs. A small number of residents had been identified as needing two staff members for support and this was in place. Thought and consideration had been given to equality and diversity issues with residents religions considered as well as their first language. Action had been taken to assist people to go to religious places and to recruit staff with language skills. The manager and staff spoke about the improvements they had made with residents since they came to to the home. Residents meetings are held. However, the record keeping needs improvement. The last recorded minutes of a meeting available was from March 2008. The deputy manager reported that meetings had been held but that the records were not available. The arrangements made to look after residents money were inspected. A review is needed because at first there was no key available to the safe to make checks. The key was later produced after contact with the care worker who takes the lead in this area. A relatively straightforward system is in operation with money held safely for each resident. The overall appointee arrangements for residents should be included in the review to make sure that it is clear who is responsible for safeguarding residents money. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is designed so that residents are given lots of opportunities for activities including leisure and social events. The size of the home and needs of residents mean that daily activities may be carried out as a group although staff can assist with following individual activities. A review of meal arrangements is needed. Evidence: During the inspection the majority of residents went to a day centre during the day. Staff generally work split shifts to take these day time activities into account. That is, when residents are at the day centre and not at the home staff do not work. Staff usually work in the early morning and then in the late afternoon and evening when residents return to the home. This was the case on the first day of the inspection. However, on the second day some of the staff were working during the day supporting residents with day time activities at the home. In the evening of the first day of the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: inspection staff assisted the majority of residents to go to a social club. This daily routine can lend a formal style to the running of the home. However, there were plenty of staff available to work with residents when they returned to the home and there were other activities that residents carried out during the week. In addition, some of the residents lead more independent lives and were out of the home during the inspection. One resident was collected by a relative during the inspection for a home visit. Discussions with staff and residents provided evidence that residents were integrated in the community and enjoyed social events, leisure activities and visits to and from their families. For example, one resident spoke about a forthcoming family holiday, visits home to family and visits to the cinema. The preparation of and serving of the evening meal on the first day of the inspection was observed. Staff efficiently prepared the meal including a vegetarian alternative. The meal looked appetising and tasty. All the residents ate together in the dining room with staff assisting where needed. Staff were knowledgeable about residents food requirements including any special diets. The deputy manager said that staff and residents draw up the menu and a shopping list. She said that the shopping arrangements are to change with residents being more involved in shopping. This is a welcome development and can assist with an increased emphasis on healthy eating and the buying of health ingredients. The deputy manager said that they encourage fruit and vegetables and not fizzy drinks and this could be demonstrated further in shopping trips. In addition, the meal could be made a more enjoyable and integrated experience for all if staff also ate with residents. During the inspection staff helped residents but did not also eat the meal. A jug of tea was seen which was used to serve all residents. This does not allow choice and personal preference for residents and the practice should be stopped. Care Homes for Adults (18-65 years) Page 15 of 30 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. Residents are generally well looked after in terms of personal care and healthcare. However, advice from healthcare professionals must be followed to make sure residents are safe and have the correct equipment. Medication arrangements are carried out properly. Evidence: There are good relations between staff and residents as well as positive keyworking arrangements. Staff know residents well and were able to describe how they worked with residents. In addition, observations were made of positive and flexible work with residents. For example, there is a sensory room where staff were working on a one-toone basis with a resident. In addition, a resident used the office to work with a computer. The extended family style of the home works well here with staff relaxed and sociable with residents. The healthcare arrangements are generally well organised. The records of healthcare seen were clear and there was evidence of the input from a range of healthcare professionals. However, a recent safeguarding issue has highlighted the need for the Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: home to follow the advice of healthcare professionals. This had not been done for one resident where there was a need for specialist equipment. During the inspection it was clear that this type of care provision was unusual for this home. It is not set up or geared to providing care for residents with mobility needs. There is no hoist, for example. However, a requirement is given that advice from healthcare professionals be followed. The medication storage arrangements and recordings were inspected. Medication is stored within a small locked office on the ground floor. There are relatively small amounts of medication currently prescribed for residents and the storage and recording was being carried out properly. There had been no change to the medication storage cabinet since the last key inspection. At that time a recommendation had been given for a larger cabinet. However, the actual medication in use since then has reduced and therefore the cabinet is suitable. However, a new larger one will be required if more medication is prescribed. There was a variety of records recording the receipt into the home of medication which is good practice. There were also records of audits which had been carried out by the supplying pharmacy. Care Homes for Adults (18-65 years) Page 17 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints information for people is adequate and will be enhanced when there is an updated pictorial service users guide. The safeguarding arrangements are currently inadequate. Evidence: No complaints have been received by the home since the last key inspection. There is an adequate complaints policy and procedure which is available within the service users guide as well as separately. Producing a pictorial service users guide, as already discussed, should provide residents with more information about how to complain. Work is required to boost the safeguarding arrangements and make them more robust. The safeguarding policy and procedure was inspected. Although it provides details about safeguarding matters it does not provide adequate information about reporting safeguarding matters to the local authority. Specific details about reporting to the local authority and the fact that it is the lead authority for safeguarding must be provided. The homes policy and procedure must be rewritten. On the plus side, records were seen which provided evidence that staff had received safeguarding training in 2007. Just before the inspection there had been a safeguarding matter and following the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: inspection another safeguarding matter was reported to the local authority and us. These incidents indicate the need for a more preventative strategy to be developed by the home. Possible safeguarding risks to residents should be considered and plans to address these risks drawn up. Such plans will assist staff with providing a preventative service for residents. A recommendation is given about this. Care Homes for Adults (18-65 years) Page 19 of 30 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. Residents are provided with a large comfortable home. However, it could be much better for residents if it is redecorated and a range of photographs and pictures displayed. Evidence: A premises tour took place and a number of bedrooms were visited as well as the communal rooms. The home is in a large detached building with a large garden as well as a choice of communal rooms. However, the decor is now looking a little worn and needs re-decoration to restore some freshness to the environment. The kitchen and dining room are particularly in need of redecoration and renewal. The dining room carpet is stained and unwelcoming. The kitchen floor is also worn and marked and needs a deep clean or renewal. The kitchen equipment needs renewal including some broken fridge handles and a particularly stained oven hood. An overall requirement is given about providing the physical standards with an upgrade. There are some nice features to the home. Bedrooms are spacious and provide a pleasant, private space for residents. There is a large communal lounge with lots of seating and there is a sensory room where residents can relax. There is also a large garden which will be very useful for residents in the summer months. There was a Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: loose patio stone in the garden and this must be secured to avoid residents or staff tripping. Consideration should also be given to the display of photographs and pictures around the home. There were few of these which is a pity as a display of photographs of residents can provide a lively feature as well as a record of peoples lives together. Care Homes for Adults (18-65 years) Page 21 of 30 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. Residents can be sure that the staff are well supported and trained to meet their needs. There are good staff relations and staff are motivated. This will be enhanced by some additional training and more effective staff meeting arrangements. Evidence: All the staff on duty were spoken with during the inspection, some in more detail than others. There is good staff morale. All staff, including agency staff, said that they liked working at the home. One member of staff said that the staff team was good as was the manager. They have been very helpful, said the staff member. The manager had assisted staff with time off for medical appointments so that work was not affected. This was appreciated by staff. Similarly, another member of staff said that, there is a good rapport with the manager and the owner. Many of the staff have worked at the home for many years. All the staff have at least NVQ Level 2 qualifications. The training records were viewed and these provided evidence that staff received a range of relevant training. This included health and safety, fire, manual handling and first aid. Staff confirmed, when they were spoken with, that they had received this training. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The training plan for 2008-2009 was seen which outlined plans for provision of other training including medication, epilepsy and food hygiene. The deputy manager said that Mental Capacity Act training was planned for early 2009. A recommendation is given that staff received the makaton and effective communication training, as described earlier. A recommendation is also given about Mental Capacity Act training as there are new Deprivation of Liberty safeguards which become law from 1 April 2009. Staff need training and guidance in this area. Staff recruitment records were not assessed as the records are held at the organisations head office and not at the home. There are currently two vacancies which are being covered by agency staff at the moment. A sample of staff supervision records were inspected. There was some variation in the frequency but the deputy manager said that was explained by some staff sickness and leave arrangements. Other than that the records provided evidence that staff were being provided with regular supervision which addressed care practice issues as well as training and development matters. The staff meeting records were inspected. The most recently available minutes were from April 2008. The deputy manager said that there had been meetings, including a very recent one, but that they had not yet been typed up. Such a situation does not help the manager or staff as important information may not be communicated to staff. Meeting minutes should be typed up and circulated to staff much more quickly. Care Homes for Adults (18-65 years) Page 23 of 30 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 manager is experienced and well liked. She is able to bring her skills to bear in providing a well run home for residents. This will be improved by a review of delegated tasks so that residents can be sure that such tasks are being efficiently carried out. Evidence: The manager has many years of experience and has been running this home since it opened three years ago. She is respected by staff and there are good relations in the staff team. Many staff have worked for the organisation for a number of years and have a positive approach to their work. This inspection has identified some areas where attention is needed that may be indicative of the need for more robust management. For example, the slowness to type up and distribute staff and resident meeting minutes. Another example is the arrangements to look after residents money with the key for the safe not being immediately available and a third example was the slowness to improve the kitchen facilities. The manager may wish to review the delegation of some of these areas so Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: that the work is effectively carried out. Quality assurance records were inspected. There had been a recent survey of relatives and a report of the findings had been drawn up. This is good practice and demonstrates an openness to the service. The report concluded that, there could be improvements and mechanisms put in place to enable residents to live more independent lives. This was discussed with the deputy manager who said that there were plans to develop person centred care plans and that these issues would be addressed during that process. A sample of policies and procedures were inspected. The approach taken by the home is to review their policies and procedures annually. The last review being in April 2008. The health and safety records, risk assessments and certificates of servicing were inspected. These were available and up-to-date. However, the fire safety arrangements need to be reviewed as it was noted that some of the fire doors within the home did not shut properly and one was held open by a sofa. Care Homes for Adults (18-65 years) Page 25 of 30 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 30 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 19 15 The manager and staff must follow the advice of healthcare professionals to provide equipment to assist in meeting residents needs. Specilaist equipment can sometimes be needed to best meet residents needs. 01/01/2009 2 23 13 The homes safeguarding policy and procedure must be updated. Reporting details to the local authority must be included. The homes policy must be compatible with the local authority to provide adequate safeguards for residents. 01/02/2009 3 24 23 A timetabled plan for the redecoration of the home must be drawn up. The plan to include the renewal of equipment where required. 01/02/2009 Care Homes for Adults (18-65 years) Page 27 of 30 The home must be well maintained so that residents have a good quality of environment. 4 24 23 The loose patio stone must be secured. A potential trip hazard will be removed. 5 35 18 All staff must be provided with makaton training and training in effective communication. Such training will equip staff to work more effectively with residents including those who do not communicate verbally. 6 42 23 The fire safety arrangements 01/01/2009 must be reviewed with fire doors checked and repaired as required. Maintaining fire doors is essential for the safety of residents and staff. 01/04/2009 01/01/2009 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. No. Refer to Standard Good Practice Recommendations 1 1 Consideration should be given to producing the homes statement of purpose, service users guide and care planning documentation in alternative formats to assist residents to follow the aims for the service and their care provision. Consideration should be given to offering residents advocacy services and to developing person centred care plans further. Consideration should be given for staff to eat meals with 2 6 3 17 Care Homes for Adults (18-65 years) Page 28 of 30 residents to produce a more homely, integrated feel for mealtimes. The use of jugs to serve tea should be stopped. 4 5 6 7 23 24 35 36 Consideration should be given to drawing up preventative safeguarding plans for residents. Consideration should be given to displaying more photographs and pictures around the home. Staff should be provided with Mental Capacity Act training. Staff meeting minutes should be typed up and circulated to staff much more quickly than at present. Care Homes for Adults (18-65 years) Page 29 of 30 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 © (2008) 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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