Inspection on 12/06/09 for Gladstone Road, 31

This inspection was carried out on 12th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gladstone Road, 31 10/07/08

Gladstone Road, 31 31/07/07

Gladstone Road, 31 15/05/06

Gladstone Road, 31 14/12/05

Gladstone Road, 31 01/07/05

Gladstone Road, 31 04/03/05

Gladstone Road, 31 23/09/04

Gladstone Road, 31 01/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gladstone Road, 31 31 Gladstone Road Bootle Liverpool Merseyside L21 1DG one star adequate service The quality rating for this care home is: 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: Lorraine Farrar Date: 1 2 0 6 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Gladstone Road, 31 31 Gladstone Road Bootle Liverpool Merseyside L21 1DG 01514761964 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Expect Limited care home 3 Number of places (if applicable): Under 65 Over 65 3 3 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Up to a maximum of 3 service users in categories MD or LD may be accommodated. Date of last inspection 1 0 0 7 2 0 0 8 A bit about the care home 31 Gladstone Road is a terraced house in a family area of Bootle. It provides support for three adults who either have a learning disability and or who need support with their mental health. It is run by Expect Ltd, a local organisation who provide support to people within the local area. The people living there Share :A lounge and a craft room An upstairs bathroom and toilet. A downstairs bathroom. There is also a back yard where people can sit. Everyone living there has their own bedroom. There is some parking outside the house and public transport near by. There is one member of staff in the home 24 hours a day, at night this member of staff sleeps in. An extra member of staff often works for several hours a day. This means people can get out and about if they want to. 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 How we did our inspection: This is what the inspector did when they were at 31 Gladstone Road. Before we visited we sent a question form to the manager. This gave her with the chance to tell us about:the areas the home are doing well in any improvements they have made and plans they have for future improvements. It also told us about Staff Health and safety How they support people. We a looked at any information we have been given about the home since our last big inspection. This helped us to plan our site visit and in writing this report. We visited the home on12th June 2009. They did not know we were visiting. During our visit we met the three people living there and two members of staff. We also met with two senior managers from the organisation. We spent time:reading records looking at the environment observing the support provided to the people living there. After our site visit we talked to the manager and a relative on the phone to get more information. It costs between three hundred and three pounds and three hundred and fifty one pounds each week to live at 31 Gladstone Road. This may be more if the person needs more support from the home and staff. What 31 Gladstone Road does well The people living at 31 Gladstone Road get lots of support to spend their time doing the things they enjoy. They can go out and about with support from staff. When they are at home they can spend their time how they choose. People are able to make decisions for themselves. They can decide everyday things like what to do each day. They are asked their opinion about bigger things, such as if someone new is moving into their home, or what is written in their care plan. People know who to talk to if they are unhappy or if they have a complaint. They have confidence that staff and Expect will listen to them and help them. The people living there like the staff team. They told us staff listen to them and give them the support they need The house is an ordinary house in a family area. It is clean and comfortable and the people living there can choose how they want to decorate it. What has got better from the last inspection. Expect have started a service users forum. This gives people the chance to give their opinion on how things are run. They can help to plan any changes or improvements they would like to see. A small craft room has been set up in the house. This gives people space to follow their hobbies. It also means people can choose to spend their time together or doing different things, when they are at home. What 31 Gladstone Road could do better. Staff need to make sure that when someone new moves in they have an up to date assessment. They need to use this to write a care plan saying how they will meet the persons support needs. This helps to make sure everyone if aware of the support people need. It helps to make sure that they are getting all of the support they need with things like their health and personal care. Support should be offered to people to eat a healthy diet most of the time. This will help people to stay as healthy as possible. Staff should make sure that peoples tablets are locked away safely. They should also make sure that records of medication people are taking are up to date. This will help to stop any mistakes happening. Staff should have more training. This training should cover basic things such as moving and handling people and protecting vulnerable adults. They should also have training around the health and support needs of the people living in the home. This will help to make sure they can support people safely and well. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact. Lorraine Farrar Northwest Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA Phone 03000616161 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 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 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 . Sufficient information is given to people before they move into 31 Gladstone Road to help them decide if it is the right place for them to live. However the information obtained about people is not used to plan the support they need in sufficient detail. This could lead to people not getting all of the support they require in a way they need and prefer. Evidence: The people living at 31 Gladstone Road told us that they like living there. One person told us, its nice here whilst another explained, I like living here, nice people. An information pack is available for people considering moving into the home, with a copy kept in the hallway for people living there to look at. This gives people information about how the home works and the support they can expect. There are also leaflets about how to raise a concern or complaint and information about Expect, the organisation who run the home. The information uses pictures and is written in a way that is easy for people to read. This helps people to understand as much as possible about their rights and the support they can expect to receive. We looked at records for one person who had recently moved into the home. In discussion with a relative they confirmed that before the person moved in they and their relatives were invited to visit the house and meet the other people who live there. We also read records of a house meeting which evidenced that the other people living in the house were kept informed about plans for someone new to move in and asked their opinion. This is good practice as it ensures people are as fully involved, consulted and informed as possible, about what is happening in their home. Evidence: An assessment had been carried out for the person who had not long moved into the home. However the assessment and care plans for this person had not been fully updated to reflect their changing support needs and the environment at 31 Gladstone Road. This could lead to people not getting all of the support they require as staff do not have detailed guidance to follow. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . A lack of up to date care planning and risk assessments could lead to people not receiving all of the support they need, as safely as possible. Evidence: Individual care files are in place for all of the people living at 31 Gladstone Road. One of the people living there told us that they are aware of their care plan and its contents. They explained, my key worker tells me whats in it. The organisation have recently drawn up new care plan documentation and this is being introduced within the home. This uses an easy to understand format including the use of pictures and photographs. This is good practice as it helps to ensure people are as aware and involved as possible in the support they receive. Plans are clearly sectioned and cover the things the person does and does not like, their chosen lifestyle and the support they need with their health and personal care as well as the things they can do more independently. We looked at care plans and files for all of the people living at 31 Gladstone Road. Two contained sufficient information about the persons support needs and choices to guide staff. However a third care file had not been updated to reflect the environment at 31 Gladstone Road or to provide sufficient guidance for staff to support the person. For example recent changes to their health care needs were not identified and plans advised that the person uses equipment that is not available within the home. We also found that two care plans contained up to date risk assessments for people. These identified areas of risk to the person and gave guidelines to remove or minimise that risk. This helps to make sure that people are safe and their lives are not unduly Evidence: restricted. However risk assessments for a third person had not been up dated to reflect the environment at 31 Gladstone Road. For example no risk assessment was in place for the use of the stair lift, or to reflect current changes to their health. This could lead to people not being supported as safely as possible. The people living at 31 Gladstone Road told us that they are able to make decisions for themselves. For example they can go out and about and can decide when to get up or go to bed. Their involvement in their care plan also enables them to have input into the support they receive. It was evident during our visits that people are supported to make their own choices and to be as independent as possible. People were seen to spend their time doing things they enjoyed as well as making full use of shared areas of the home. Information about local advocacy services, that help people to speak up for themselves is readily available in the home. In addition the organisation have recently started a service user forum that provides people with a formal way to give their views and influence the services they receive. 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 people living at 31 Gladstone Road receive support to live a lifestyle of their choice. Evidence: Discussions with the people living at 31 Gladstone Road and with staff evidenced that people receive support to do the things they enjoy and spend their time how they choose. For example one person explained that she had been attending a local community centre, but wanted to go elsewhere. Staff supported her to find different leisure classes to attend. Another person explained that they like to spend time in their room watching TV and they are able to do this with staff taking time to sit and chat with them. Records showed that people receive plenty of support to go out and about if they wish to do so. For example in the past few weeks one person had been out for lunch several times, been shopping, for a walk and to visit family. We spoke to another person who had not long moved into the home. They explained that they have several hobbies and we noted that these were identified within their care plan. During our visit people were spending their time in different ways as they choose. One person was attending a local centre, whilst another was out with staff, then spent time chatting and watching TV at home. The amount of space available means that people can choose whether to sit together or spend time watching their favorite TV or listening to their choice of music. Staff were seen to spend time at the home Evidence: socialising with the people living there as well as supporting and meeting their everyday needs. A couple of the people living at 31 Gladstone Road enjoy arts and crafts and staff have recently decorated and furnished an upstairs room to accommodate this hobby. Records showed that people are engaged in household tasks such as cleaning and shopping for food and this was confirmed in discussions with one person who explained, I make a cup of tea and that. Make my own toast. Another person confirmed that if they want something to eat or drink they, just ask and staff will support them with this. Individual records of menus are kept for each person, however we found that these are not always completed. This makes it difficult to establish if people are being supported to eat a healthy meal. Of the completed records we looked at for one person, ten meals or snacks were recorded. Of these only two portions of fruit or vegetables appeared to have been offered. If people are not supported to eat a healthy diet most of the time, this could have a negative impact on their overall health. The people living at 31 Gladstone Road are supported to maintain contact with their family and friends. They also have plenty of opportunities to meet new people via their use of local community facilities and community centres. Routines in the home are flexible and people told us they can choose how they spend their time. They are able to have a key for their front door or bedroom if they wish and can spend time in communal areas or their bedrooms as they prefer. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people living at 31 Gladstone Road receive support to meet their personal care needs. However practices around managing their medication are not as safe as they should be. This could lead to an error occurring which could impact on their health. Evidence: The people living at 31 Gladstone Road told us that they get support with their health and personal care needs. One person explained, If I am not well they take me to the doctors. They also explained, I can have a shower when I want, at night as well as in the day. In meeting people it was evident that they had received support to maintain their personal care and appearance in a way they prefer. For example one person explained that she had recently gone with support from a member of staff to have a pamper day. As identified earlier in this report care plans for two people contained up to date information about the support and guidance they require, including with their personal care and health. However care plans for a third person did not fully reflect changes to their health or the use of aids and adaptations available within home. Training records and discussions with staff evidenced that staff have not had training in understanding and fully meeting peoples individual health care needs. This could lead to staff not having sufficient guidance to support people as safely as possible. Lockable storage for medication is available in the home. However one person was keeping equipment used for their medication in their bedroom. A lock should be provided for this drawer in order to ensure it is stored as safety as possible. The majority of medication was stored correctly. A locked box was in use for some medication requiring refrigeration. However other medication was stored in the kitchen Evidence: fridge door, next to an open packet of food. This included some eye ointment that did not need storing in the fridge as well as a bottle of ointment that stated it had been opened in August 2008 and which was not clearly named. A senior manager from the organisation rectified this during our site visit. People told us that they get their medication on time and staff were able to explain any preferences people have with regards to their medication. Systems are in place for recording medication given and for checking stock regularly. However a record sheet did contain a record for one medication that the person was not using. Staff had not given this and were able to explain that it had been stopped. However regular checks should be made to ensure records are up to date and reflect any changes, this will help to lessen the risk of a mistake occurring. The home and organisation have recently supported one person who passed away. In discussions with staff and with the people living there, it was evident that this support had been provided sensitively in a way that took into account the support the person needed, as well as the impact it would have on everyone living in the house. For example other people were offered the opportunity to go on holiday to provide privacy for the person and their family. The people living in the house were supported by staff to talk about their feelings and discuss how they wanted to remember the person. In addition the organisation have been aware of the impact on staff and offered local counseling services for them. This is all very good practice as it helps people to get the support they need at a difficult time in their lives. 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 . The people living at 31 Gladstone Road are confident that any concerns or complaints they have will be listen to and acted upon. Evidence: The people living at 31 Gladstone Road and a relative told us that they know how to raise any concerns or complaints they may have about the service. One person told us they would talk to staff as, they help me. They also explained that they know who the senior staff are within the organisation and would talk to them if they had a concern or complaint. No concerns or complaints have been raised about the home since our last big inspection. However the organisation have polices and procedures in place to deal with any that may arise. This is made available to the people who live there via their information pack. Not all staff have had training in the protection of vulnerable adults. This means that they may not be fully aware of how to recognise potential issues and the actions they should take. The systems in place at 31 Gladstone Road for supporting people to manage their money are clear and well recorded. This helps to ensure peoples money is safely managed and can be clearly audited. The open approach to concerns and complaints helps the people living at 31 Gladstone Road to feel safe and that they are listened to. 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 . 31 Gladstone Road provides a comfortable and homely place for people to live that meets their needs and choices. Evidence: 31 Gladstone Road is a terraced house located in a family area of Bootle. It has good links to local transport and facilities. Both inside and outside it has the appearance of a family home and has a welcoming atmosphere. The people living there all have their own bedroom, one of which is located downstairs. They share a large downstairs lounge, small dining room, kitchen, enclosed backyard with seating and a small upstairs craft room. The house has an upstairs bathroom, which has a bath and an accessible shower. A separate toilet and basin are also available upstairs. Downstairs there is a small toilet and sink. There are no bathing or showering facilities on the ground floor. A ramp to the front door provides easy access to the house for people who have difficulties with their mobility. In addition grab rails and a stair lift are available to support people. During our visit we noted that all area of the house were clean and tidy. Some areas are looking tired and would benefit from refurbishment. For example the bathroom suite is quite old and the kitchen cupboards are beginning to chip. However the manager told us in the self assessment form, that in the past year the lounge had been decorated and new carpets bought for parts of the house. She also told us that they plan to improve the rear yard by adding new furniture and painting it. During our visit the people living there told us that they are involved in choosing the decor and furnishings for the house. People told us that they chose the colour and decor for their bedrooms and one person explained they recently chose new curtains for the lounge. We also observed that plans to improve the yard were underway with new furniture Evidence: helping to provide a pleasant, private space for people to use. Suitable equipment and facilities are provided to enable staff to prevent or quickly deal with any outbreak of infection. 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 . The people living at 31 Gladstone Road have confidence in the staff team who support them. However a lack of training for staff could lead to people not getting all of the support they need to remain healthy and well. Evidence: The people living at 31 Gladstone Road told us that they like the staff who work there. One person explained, I am happy with the staff here. Theyre easy to talk to. Listen to me whilst a second person told us staff are good. A relative explained that they find the staff team, friendly, welcoming, nothing is too much trouble. During our site visit it was clear that the people living there felt comfortable with the staff team. Staff we spoke with had a good understanding of the support people need and of how they like to spend their time. One member of staff is available in the home twenty four hours a day. During the night this member staff sleeps in. Most days there is a second member of staff working for several hours. This provides the opportunity for the people living there to get support to do the things they enjoy. For example during our visit one person was out and about with a member of staff, another was attending a local centre and a third was spending time at home watching their TV and chatting with staff. There are clear systems in place within the organisation for recruiting new staff. This includes obtaining written references and a Criminal Records Bureau check. These checks help to ensure that staff are suitable to work with people who may be vulnerable. A member of staff confirmed that they attended two interviews with the organisation. The second involved visiting several of the houses where they provide support, including 31 Gladstone Road. This provides the people living there with opportunity to meet potential staff and have some input into the recruitment process. The organisation has a training department for staff that provides training throughout Evidence: the year in a variety of areas. We saw a training calendar from the organisation that contained dates for training in a variety of areas including, equality and diversity, protection of vulnerable adults, medication and health and safety. Staff working in the home have undertaken some training, for example they have had an induction to working in care. In addition some staff have had training in other areas such as supporting people with their medication or 1st aid. However records showed that not all staff in the home have had training in basic areas of care practice. For example of the staff records we looked at none had received training in moving and handling people or in food hygiene and only one had received training in the protection of vulnerable adults. Staff have not had more specialist training to meet the needs of the people living at the home. For example where people have specific support needs due to their health, staff have not received training in how to support them safely and help them to manage their health. A lack of up to date training in these basic and more specialist areas of care could place the people living at 31 Gladstone Road at risk, as staff may not have the up to date knowledge needed to support them safely and well. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Systems are in place at 31 Gladstone Road to ensure that it is safely managed for the people living there. However these are not always sufficient to ensure that identified improvements to the service are followed through in a timely manner. Evidence: Jane Hughes is the appointed manager of 31 Gladstone Road. She is experienced in working with adults who have learning disabilities and is currently working towards qualifications in care and management. The people living there told us that they have confidence in Ms Hughes with one person explaining she is great. You can really talk to her. Staff echoed this telling us they find her, approachable, open and that she provides them with advice and guidance if needed. There has been no registered manager at 31 Gladstone Road for some time. The process of managers registering with ourselves (Care Quality Commission) helps to ensure that managers are suitable and experienced people to manage a care service. There are several systems in place at 31 Gladstone Road for checking the quality of the service they provide. These include an audit carried out in June by a senior manager and an audit carried out in December 2008 by a director. Both of these audits look at a variety of services provided by the home, including health and safety, the support provided to people and records. They then identify areas for improvements needed within the home. However although both identified that further training was needed for staff, we found that this training had not taken place or been arranged, which could place the people living there at risk. Records and certificates showed that regular checks are carried out on the Evidence: environment and equipment in the home. This includes regular checking of the fire system, water, fridge and food temperatures and gas and electrical supplies. These checks help to ensure that 31 Gladstone Road is a safe place for people to live work and visit. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 37 8 An application to register a 30/11/2008 manager for the service must be made to the Commission for Social Care Inspection. This will help to ensure that the home has a suitable manager in place. Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 2 14 A system must be 03/08/2009 implemented to ensure that a full assessment of a persons support needs is carried out before they move in to the home. Once the assessment is completed a care plan detailing their basic support needs must be put into place. This will help to ensure that people receive all of the support they need and that staff have clear guidance in how to provide that support. 2 20 13 Systems must be put into 03/08/2009 place to ensure medication is safely stored at all times. Systems must be put into place to ensure changes to peoples medication are clearly recorded on their records. This will help to ensure medication is managed as safely as possible and reduce the risk of an error occurring. 3 35 18 03/08/2009 A training plan must be compiled and implemented for all staff working at the home. This must cover training in basic areas of care as well as training to help them understand and support peoples individual needs, including their health. This will help to ensure that people receive all of the support they need to remain as healthy and safe as possible. 4 37 8 An application must be made 03/08/2009 to register a manager for 31 Gladstone Road. This will help to ensure that a suitably qualified and experienced manager is in place. 5 39 24 A system must be 03/08/2009 implemented to ensure that any actions identified through quality assurance checks are implemented in a timely fashion. This will help to ensure that the home provides a safe service for the people who live there. 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 17 Records of menus should be fully completed. They should also be regularly reviewed to ensure people are being offered the opportunity to eat a healthy diet. This will support people to maintain their health. Helpline: Telephone: 03000 616161 or Textphone : or 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) 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. 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