Inspection on 02/03/09 for Glenmar

This inspection was carried out on 2nd March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glenmar 23/04/08

Glenmar 29/05/07

Glenmar 08/05/06

Glenmar 21/11/05

Glenmar 21/06/05

Glenmar 10/02/05

Glenmar 16/09/04

Glenmar 16/09/02

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glenmar 2-3 Charles Road St Leonards-on-sea East Sussex TN38 0QA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michele Etherton     Date: 0 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Glenmar 2-3 Charles Road St Leonards-on-sea East Sussex TN38 0QA 01424436864 01424446425 glenmarjulia@aol.com 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) : Grovestead Limited care home 25 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 25 The maximum number of service users to be accommodated is 25 The registered person may provide the following category 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 category : Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Glenmar provides a service for up to twenty-five adults with or recovering from mental health issues. The home caters for people with low to medium dependency needs. Residents are provided with opportunities for personal, emotional and social development and are supported towards improving their living skills. The home, owned by Grovestead Limited, is located in a quiet residential street, close to the town centre of St. Leonard?s, within easy reach of the usual town amenities and public transport. The building was originally two terraced properties. All bedrooms are for single occupancy, with the exception of one. Some rooms contain ensuite facilities. As the Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home accommodation is arranged over three floors and there is no passenger lift, the home is best suited to those with no mobility problems. Residents have the use of two separate lounge areas on the ground floor (one of which is currently non-smoking) and there are two dining rooms in the basement. The home has gardens to the rear with a seating and lawn area. In addition, Glenmar is situated opposite Gensing Gardens. Kerb side parking is available in the road to the front of the property. The home has an organisational structure, which includes the Manager, the Head of Care and support workers, who operating a roster, provide twenty-four-hour cover. Ancillary staff undertake catering, domestic and maintenance duties. Current fees for the home range between £335.30 and £348.00 per week. Full information about the fees payable, the service provided, the home?s Statement of Purpose and the latest inspection report by the CSCI are available from the Manager. Care Homes for Adults (18-65 years) Page 5 of 32 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: A key inspection of this service has been undertaken, this has taken account of information received about the service and from the service since the last inspeciton and includes an Annual Quality Assurance Assessment (AQAA). The AQAA which we received in time has been completed to a reasonable standard and contains most of the information we need, further improvements in the level of detail recorded would aid the home in illustrating what the day to day operations of the home are like and improvements made to date and planned for. Our inspection has also included an unannounced site visit to the premises on 2nd march 2009 between the hours of 09:45 am and 16:30 pm. For our site vist we had Care Homes for Adults (18-65 years) Page 6 of 32 requested an expert by experience to be present to spend time specifically with residents in the home and to ask them about their experience of living in the home and their future aspirations. We undertook a tour of the premises, interviewed staff on duty, spent time with the provider and manager and examined a range of documentation and records these included, support plans, risk information, medication records and staff recruitment and training records. All key inspection standards have been assessed in addition to the homes progress in addressing shortfalls identified previously. In arriving at our judgement we have tried to be proprotionate in considering complinace with regualtion and outcomes for residents alongside overall risks and impacts of identified shortfalls. What the care home does well: What has improved since the last inspection? What they could do better: The manager and staff team have worked hard since the last inspection to ensure Care Homes for Adults (18-65 years) Page 8 of 32 residents receive a good and appropriate service. However if the staff are to continue to improve the service provided they will need to ensure they maintain a good knowledge and awareness of some key areas that directly impact on residents these are adult safeguarding procedures and moving and Handling of residents. We have also made recommendations for improvements to exisiting practice in regard to support plans, individual resident risk information including moving and handling, the development of behaviour guidelines, improved clarity in recording of quality assurance and how residents feedback influences service development and how quality is monitored in the home. Additionally, we acknowledge that whilst outcomes are in most respects good for residents motivation and expectations among residents can be low, we would support suggestions made by the expert by expereince that use of E- technology should be pursued as a means of engaging residents interests for both personal and educational development and this is also a recommendation of this inspection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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. Prospective residents can be confident their needs will be assessed prior to any decision concerning admission, opportunities to visit and try out the service are provided and the views of existing residents are sought. Evidence: The home has revised its assessment form since the last inspection but has not as yet had an opportunity to use it for a prospective resident, whilst there have been referrals to the home the provider considers these have been unsuited to the needs of the other residents and has not progressed them, the provider and manager are also clear that they will not accept emergency placements into the home. From our discussion with the provider and manager we are satisfied that prospective residents will have an assessment of their needs which may involve a trial stay at the home for a few days, during this time the needs of the resident will be assessed further in addition to their interactions with both residents and staff, and their feedback will be taken into consideration when making a final decision concerning Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: admission. Discussion with the provider and manager demonstrated an ability to respond flexibly to the changing needs of residents and to liaise appropriately with health and social care professionals where necessary, however there are environmental limitations which would prevent the home working effectively with residents whose mobility decreased to a level where they could no longer manage stairs. Care Homes for Adults (18-65 years) Page 12 of 32 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. Staff have a good understanding of individual residents needs and preferences but this is not always reflected in support plan information, residents are empowered to make decisions and choices in their day to day lives and the management of risk although positive is not always clearly assessed to ensure residents are safeguarded. Evidence: We looked at care plan information for four residents, the content of these is much improved and the format has changed those viewed provided evidence of reviewing and the content of care plans is recorded by key workers, in discussion with individual staff about some of the people they key work and whose files we viewed it is clear that they have a full and complete understanding of the needs and individual routines of the residents support, but the depth of their knowledge is not always translated into the care plan where we were able to evidence omissions in information that clearly is important in the way residents are worked with, whilst this is not impacting on the way care is delivered to residents on a daily basis due mainly to the continuity of staffing Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: within the home and has therefore been of enormous benefit to residents in maintaining stable mental health and building supportive and trusting relationships with staff it is important that information about resident preferences in their routines is made clear in support plans for all staff to see and ensure consistency of service delivery in the event of staffing changes and we would recommend consideration is given to enhancing the level of person centred detail recorded. Residents lead the life they choose in the home and make choices and decisions about their daily routines and activities, seeking support from staff only as needed. The home is aware that any capacity issues that impact on personal decision making will need to be formally authorized in consultation with local authority staff in keeping with the mental Capacity Act 2005 legislation. Residents are encouraged to lead an active and full life and access the community, its facilities and the management of risk remains positive, in response to previous recommendations risk information has been revised whilst this now reflects on all aspects of the residents daily routines and where specific risks may occur, this continues to lack detail around how risks have been assessed, and whilst we are aware this documentation is evolving we would recommend the service continues to review the content of risk information to ensure residents are safegfuarded. Care Homes for Adults (18-65 years) Page 14 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged and enabled to lead the life they wish and exert control over their day to day routines but would benefit from improved opportunities that will expand their personal skills and provide added stimulation and motivation. Evidence: We asked an expert by expereince to visit the home with us and to spend time with residents to ask about how they spend their time, what opportunities they have for skills development and how involved they are in the household routines. This is what they told us Expert by Experience report of visit made 2nd march 2009 to Glenmar On arrival I was met by a polite member of staff who took me to the managers office Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: where I met the CSCI inspector, who requested that I focus on residents activities, skills development and general participation in the running of the home. I met a resident in the smoking lounge who has been resident for approximately 4 years and enjoys her daily walks. She is hoping her future includes the opportunity to live independently in Eastbourne, an ambition encouraged by her key worker. She looks forward to the organized day trips and the newly introduced musician who visits the home but mentioned that only bingo is available on a regular basis. She is keen to learn new skills. Another resident I met has lived at Glenmar for 7 years and feels that she would respond to the responsibility of supervised self medication and because of her diabetes, should have salad more often and also felt that Money Management could be better. She reads the regularly posted minutes about staff meetings and spoke well of staff. Having given up smoking only a year ago X, a resident of some 2 years informed me that he is quite happy with his home and doesnt want to go out. He prefers his own company and is happy with the activities and very much appreciates the menu. the staff are brilliant and work very hard. I met another resident of 7 years who is happy with the staff but is independent and prefers to organize his own daily activities including eating out. After 7 years of residence another resident said she enjoys the organized trips and feels involved in the running of her home. She has a key to her room where she is able to make tea and coffee and informed me that she has more good days than bad. X has lived at Glenmar for 10 years and told me that he is excellently well looked after. he feels that staff and management are approachable and appreciates their support. I was invited to share lunch and the food was well presented, hot with plenty of vegetables. The menu is well posted and I am assured that individual preferences are accommodated. Certainly the residents all cleared their plates and I was struck by the polite and respectful behaviour of both staff and residents. All of the residents that I spoke with are obviously well cared for and happy at Glenmar but suffer from low expectations as far as learning new skills. The total reliance on outside agencies to provide education means that courses are quite often not available because of lack of funding based on poor attendance. Each resident that I Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: spoke with expressed in interest in E learning and most felt that they would use an available computer. Assistive Technology has a huge role to play in stimulating otherwise stagnant brains, it can help with education, exercise, family contact and socializing. Whilst we are satisfied that for the most part residents lead the life they wish some are clearly understimulated but unwilling to make use of facilities in the community, we would support the observations of the expert by expereince and recommend that the home provides opportunities for residents to have access to a computer and the internet to foster their interest and possible educational opportunities through distance learning. Care Homes for Adults (18-65 years) Page 17 of 32 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 personal, emotional and health care needs of residents are well supported. Evidence: Staff demonstrate a good understanding of individual resident preferences around daily routines although their level of knowledge is not always reflected in the support plan and this has been addressed elsewhere. There is a growing population of residents within the home who are over 65 years of age and consideration will need to be given in respect of staff training, environmental changes and the level of health monitoring undertaken to ensure the needs of this aging group continue to be met. An examination of resident records indicates that health contacts and access to routine health checks are supported, and that the home is responsive to seeking intervention from health care professionals where resident refusals could impact on their overall welfare. Weights are recorded. The continuity and familiarily of the staff team with residents has brought a sense of stability to the majority of residents with the home recording only two mental health Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: breakdowns last year, staff we spoke with thought that their expereince and knowledge of residents gained over a long period of time enabled them to spot early signs of a residents becoming unwell and to ensure appropriate interventions are in place minimising the need for residents to be hospitalised. Moving and handling statements are in place for some residents but these need further development and should be located in individual resident files and subject to review and this is a recommendation. Since the last inspection the home has changed the Pharmacy they receive medications from and this has been very positive, the home feels they receive a much improved service with the pharmacy undertaking independent assessment of medication arrangements in the home, and providing staff medication training. We looked at Medication records and found these to be completed satisfactrily with appropriate use of codes, and receipt of medications and any changes in prescribing instructions clearly signed and dated, the manager tells us that medication is audited monthly. Consideration should be given to the introduction of medication competency assessments for staff. Care Homes for Adults (18-65 years) Page 19 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to express their concerns and feel listened to and systems are in place to safeguard their well being but recording of staff interactions and involvment is limited and would benefit from development. Evidence: Residents feel confident about approaching staff with concerns and feel listened to but these interactions are not always recorded and consideration should be given as to how the home can better record their support in this area. At present their are no specific restrictions in place although some residents are happy for the home staff to manage theitr daily cigarette in take for them, this is not always made clear within support plan information, the provider and manager demonstrate an awareness of the need for capacity assessments and authorisation from the local authority regarding any restrictions on liberty, they report that some local authorities are already in contact to arrange capacity assessments, the home should ensure that these are conducted on all residents who are not self medicating or managing other aspects of their daily routines. When we spoke with staff they indicated an awareness of behaviours from some residents that require intervention by staff, these usually consist of providing distraction, or responding in a particular manner, staff familiarity and continuity has Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: enabled the staff team to manage these incidents well but examination of support plans indicates a lack of detailed behaviour guidlines to inform staff practice and we would recommend these are implemented to ensure consitency in delivery of support. Staff demonstrate an awareness of safegfuarding issues and their responsibilities to report but their understanding of local protocols is not well developed, they have received training but this now needs updating and we have issued a training requirement elsewhere in the report. One adult safeguarding alert was referred to the local authority last year but this has not been progressed by them and no contact made with the home concerning this matter. Care Homes for Adults (18-65 years) Page 21 of 32 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. Residents benefit from ongoing improvements to the environment they enjoy living in a comfortable clean home in which they are encouraged to personalise their own space and have their own possessions around them. Evidence: The home provides a spacious and confortable environment for residents and benefits from a rolling programme of upgrading. A maintenance person is employed to undertake minor repairs and redecoration and external qualified contractors are used for larger works, attention needs to be given to the standard of completion of some of these works and we have drawn the provider attention to pipework on the top floor of the building which we consider has been poorly finished is unsightly and vulnerable to tampering which may pose a risk. Some unscheduled but important works have had to be undertaken and this has therefore taken priority and funding from some of the planned redecoration and refurbishment. A visitors book has been introduced since the last inspection and all visitors are now asked to sign this. The Home tells us that they are considering the installation of a CCTV camera at the front door of the home as a securty measure and they should ensure that residents are consulted for their views regarding this. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: We were able to view several bedrooms during our visit with resident permission, these were in good order and individually furnished and decorated to reflect the tastes and interests of the resident. Some residents have their own kettles in their bedrooms. All residents have keys to their rooms if they want one. Fire alarm equipment has been serviced and staff receive regualr training in fire drills and evacuations, the provider should ensure that night staff in particular have partcipated in drills a minimum of twice annually and preferably four times annually. The home is not accessible to residents who develop mobility issues affecting their use of stairs and as one third of the present resident group are now over 65 years of age consideration must be given as to how the needs of an aging group of residents will continue to be met. The home is maintained to a good standard of cleanliness, we found one toilet which although refurbished throughout retains an unpleasant odour that the home has been unable to establish the cause of and will continue to ensure this is explored. Paper towels are not used within the home because of previous issues concerning blocked toilets, currently cloth towles are used and staff we spoke with confirmed these are changed regularly to support good infection control. The home has a small but adequately equipped laundry, whilst the management of soiled laundry is not common within the home staff spoken with a good understanding of safe management of this separately to normal laundry. Care Homes for Adults (18-65 years) Page 23 of 32 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. There are enough staff on duty. Recruitment procedures protect residents and a programme of training is in place for staff, some shortfalls in key training areas must be addressed Evidence: The AQAA tells us that all the current staff team have achieved NVQ2 and the home is to be commended for this. Staffing levels remain unchanged with three care staff the care manager and the provider on duty during the day time shifts,staffing turnover is minimal with all the staff members spoke with during our site visit having been employed in the home for more than 10 years. Staff spoken with thought that the staffing level was satisfactory to enable them to offer support to those residents who need it staff support is flexible and responsive to changes in need and staff were able to give examples of how this might be increased for individual residents from time to time particularly when they may be becoming unwell. There has been no significant recruitment since the last inspection with only one new staff member taken on, as this was a reappointment of a previous staff member the Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: home as the sole employer has been unable to seek an employment reference, they have conducted vetting and checks although a second reference character reference is outstanding and the home has been urged to pursue this. The provider and manager demonstrated an awareness of skills for care Common indication standards and must ensure this is implemented for all new staff. We looked at the mandatory training of staff and found that whilst there is clearly an active programme in place staff training in respect of adult safeguarding and Moving and handling have not been updated for most staff within the expected intervals and we have required the service to provide staff with this training within the timescales given. Staff said they could approach the manager and provider at anytime and feel confident about raising issues, staff said they receive appraisals and the provider and manager report these are provided usually at two monthly intervals. Care Homes for Adults (18-65 years) Page 25 of 32 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 is generally well managed in the best interests of the residents. Evidence: The home has responded well to previous requirements and recommendations and has a history of general compliance with regulation, improvements in previously identified shortfalls are noted. There has been no change to the management structure of the home and the provider remains actively involved in the day to day running of the service. The AQAA was sent to us on time and provided us with most of the information we needed this will continue to benefit from some additional information and detail to illustrate fully the working of the home on a day to day basis and the improvements made and planned for. The Home is now notifying us appropriately of incidents that occur in the home and fall under the criteria for notification, although timescales for doing so are still to be Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: improved upon and should aim to be within 24 hours of the incident occurring. The home has advised us within the AQAA that all health and safety checks and servicing have been completed and a sample examination of records during our visit confirmed that gas and electrical installations have been serviced and that fire alarm and emergency lighting has also been serviced. The home was visited by Environmental Health on 11/2/09 when no required actions were issued all was found to be satisfactory, with a recommendation in regard to kitchen equipment. Further clarification from the local environmental health office is needed in respect of smoking legislation and the provider and manager have been urged to pursue this. Residents have opportunities to be consulted and to express their own views, residents meetings are held and residents are able to attend staff meetings, and two residents were recently in attendance at the last staff meeting. A comments and suggestion box has been provided for residents and visitors use. In response to a previous requirement in regard to quality assurance a report has been developed which highlights what the home undertakes to quality assure in the service but fails to make clear how this is to be Monitored, and is in need of further development and clarity. Surveys of residents and other staewkholders are conducted by the home and feedback from these is analysed and may influence service development but this is not made clear within the quality assurance report how and if this occurs, the manager was able to cite examples of where feedback from residents has directly impacted on the way the service is offered. We discussed with the provider and manager ways in which the home could make clearer within quality assurance reports how residents have influenced the development of the service and how the home evidences how quality assurance is monitored and this is a recommendation. We checked the home Insurance which is in date. Fire safety training is provided to staff four times annually and this includes an evacuation drill, it is important that all staff participate in a minimum of two fire drills annually at evenly spaced intervals and this should be more frequent for night staff, and that records of staff attendance are maintained. We examined the accident records and noted there has been a low level of accidents recorded, the last serious incident between residents occurred some years ago, and we discussed with management their responsibilities to ensure all appropriate agencies are informed of such incidents under adult safeguarding guidance should similar events happen again today. Care Homes for Adults (18-65 years) Page 27 of 32 Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 35 18 The provider must ensure 01/06/2009 that staff have attended up to date manual handling and adult safeguarding training. New staff must complete the Common Induction Standards if they have not already done so Regulation 18(1)(c)(i) The Registered person shall having due regard to the size of the Care Home the Statement of Purpose and the number and needs of service users (c) ensure that persons employed by the registered person to work at the care home receive -(i) Traiing appropriate to the work they are to perform; and (ii) suitable assistance, including time off, for the purpose of obtaining further qulifications appropriate to such work Care Homes for Adults (18-65 years) Page 30 of 32 To ensure all staff have the necessary knowledge and skills to residents appropriately and effectively 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 6 care plans would benefit from improved detail in respect of the personal preferences of residents around their daily routines to better inform staff Individual resident risk informaiton needs further development to make clear risk reduction measures in place The home should provide residents with a computer and access to the internet to aid the development of their knowledge and skills in keepijng with the mainstream population Moving and handling assessments to be further developed and maintained in individual resident files and subject to regualr review The provider should ensure that behaviour guidleines are developed in regard of individual residents to inform staff and bring consistency to the delivery of support. The provider should be able to evidence how service user feedback influences service development and also make clear within quality assurance information how service quality is monitored. 2 9 3 12 4 19 5 23 6 39 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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