Inspection on 07/08/09 for Haig Road, 22

This inspection was carried out on 7th August 2009.

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

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

Other inspections for this house

Haig Road, 22 09/06/09

Haig Road, 22 19/02/09

Haig Road, 22 23/09/08

Haig Road, 22 24/09/07

Haig Road, 22 28/09/06

Haig Road, 22 07/12/05

Haig Road, 22 29/09/05

Haig Road, 22 02/12/04

Haig Road, 22 13/07/04

Haig Road, 22 17/03/04

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22 Sandown Road

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Park View (15)

Craigmore House

1 Lanark Close

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

Key inspection report Care homes for adults (18-65 years) Name: Address: Haig Road, 22 22 Haig Road Bedlington Northumberland NE22 5AW     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karena Reed     Date: 0 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Haig Road, 22 22 Haig Road Bedlington Northumberland NE22 5AW 01670-531434 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): NTAWT.Haig@nhs.net Northumberland, Tyne & Wear NHS Trust Name of registered manager (if applicable) Ms Marilyn Hay Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 2 residents are over the age of 65 years Date of last inspection Brief description of the care home 22 Haig Road is a semi detached, three-bedroom house located in a residential estate in the town of Bedlington. The home does not provide nursing care but is registered to provide personal care and support to three people with learning disabilities, two of the people are over sixty- five years of age. There is a small garden to the front and a larger garden/patio area to the rear. The home is within walking distance of shops, public houses, restaurants .The home also has its own transport. Each person has their own bedroom and they share the communal areas, which includes a kitchen/dining room and a lounge. One of the ground floor rooms is an office and bedroom for staff on sleepover duty. The premises have not been adapted to be suitable for people who are physically dependent. 22 Haig Road is part of the Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 2 1 1 9 0 2 2 0 0 9 Brief description of the care home residential services provided by Northgate and Prudhoe NHS Trust. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information about the services provided by the home and the relevant charges. Fees payable for living at the home at the time of inspection in August 2009 are £1169.65 weekly. Additional charges are payable for hairdressing, toiletries, Sky television, eating out and taxis. 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: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 0 star. This means that the people who use the service experience poor quality outcomes. We have reviewed our practice when making requirements,to improve national consistency.Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations,but only when it is considered that people who use services are not being put at significant risk of harm.In future,if a requirement is repeated,it is likely that enforcement action will be taken. How the inspection was carried out: Before the visit we looked at information we have received since the last visit in June 2009, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service and their relatives,staff and other Care Homes for Adults (18-65 years) Page 6 of 30 professionals. The Visit:an unannounced visit was made on 7th August 2009 During the visit we talked with people who use the service and staff,looked at information about the people who use the service and how well their needs are met,looked at other records which must be kept,checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since the last visit. We told the person in charge what we found. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 30 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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 of people who are to use the service are carried out before they move into the home to ensure all needs can be met. Evidence: The Statement of Purpose and service user guide were examined. The statement of purpose is a pre-printed document which requires the provider to input individual information about the service. It contained the necessary information as required by the Care Homes Regulations 2001 but at the time of inspection the complaints section in the guide was still out of date. An up dated,accessible complaints procedure however was forwarded to the Commission after the inspection for examination. The documents contain a lot of important information that will help people to make an informed choice about the home. The people living at Haig Road have lived there for a number of years and vacancies do not occur frequently. Records for two people who live at the home showed that when they were admitted to Haig Road an assessment of their care needs had been carried out before their admission by a social worker or health care professional. This assessment is forwarded Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: to the home for the manager to look at to determine if the needs of the person can be met. The manager or senior staff carry out a pre-admission assessment to ensure that the staff can meet each individuals needs. The person living at the home and relevant people are involved in the assessment.These initial assessments are used to create care plans. Any person interested or needing to use the service or relatives are encouraged to visit the home to have a look round and meet the staff. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. A staff member commented: The home is well situated for local services and shops. Service users are happy in their current setting e.g where they live and they are respected by neighbours. Care Homes for Adults (18-65 years) Page 12 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 good arrangements in place to ensure that residents care and support needs are recorded and to ensure that residents are involved in decision making in their lives. Evidence: There are detailed assessments in the residents care plans. Staff are allocated responsibility for a small number of residents and are known as their key worker. The key worker together with the resident are responsible for updating the care plan at least three monthly or sooner if a residents needs change. Care plans are person centred, they do show the amount of support that is required to assist the service user in certain areas. The tasks are broken down to give new staff clear instructions about the amount of care and support that is required to assist the resident to become more independent. Residents are asked individually and consulted about decisions involving themselves and the running of the home. Meetings are held regularly with residents about the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: running of the home, choice of food,activities and outings. The home supports residents to remain independent and take risks in order to live a more fulfilled lifestyle and up to date risk assessments were present in residents care records. Staff commented: The staff provide a good standard of support to service users to achieve a settled and healthy lifestyle. Service users wishes and choices are respected and acted upon. Residents care records all contained statements of confidentiality to remind staff what information could or could not be disclosed about a resident. Care Homes for Adults (18-65 years) Page 14 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. People living at the home have access to a variety of activities which helps them to enjoy a good quality of life. They are also supported to keep in touch with their families. Evidence: Residents records and meeting minutes provided evidence that all residents are consulted and asked their opinion and encouraged to make decisions. Conversation with people living at the home and staff show that residents are provided with the necessary levels of support to help the service users maintain some level of independence and retain some skills to be more self sufficient in aspects of everyday living. People attend some day services if they wish to on a part time basis if they havent retired. Some residents attend a club in the evening, two evenings of the week. Residents are encouraged to pursue their own interests and hobbies and are supported to do so. These include gardening, listening to music, shopping, art, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: cookery and reading. People living at the home also enjoy meals out at local pubs, shopping, picnics,watching television,theatre trips, cinema,car displays and whatever is of interest to the person living at the home. Residents are supported to holiday in this country or abroad and they are looking forward to days out e.g a boat trip down the River Tyne and holidays to Blackpool, Benidorm and Minorca. Staff commented: The home provides well structured activities for service users. There are plenty of opportunities for service users to go on holidays and short breaks. Within the home residents bedrooms are equipped with their own televisions,radios, books,pictures and whatever is of interest to the resident. Residents care plans and case records detail any family involvement. Conversation with a resident and staff also provided evidence that residents are encouraged to maintain contact with family and friends, if they wish to do so, with staff providing any support that may be required. People living at the home are asked individually what they wish to eat each day. A light snack is available at lunch times and a larger cooked meal is served in the evening. On the day of inspection egg and tomato or ham sandwiches were available for lunch and fishcakes and vegetables followed by banana and custard were to be served for the evening meal. Service users have access to the kitchen and are able to prepare snacks and drinks for themselves if they wish . Residents often enjoy meals out at lunch time whilst out shopping. Care Homes for Adults (18-65 years) Page 16 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are poor arrangements in place to ensure that residents health and social care needs are met as the provider has failed to comply with medication training requirements to ensure that staff responsible for administering medication are trained according to the Royal Pharmaceutical Societys latest guidance. Evidence: Two care plans and case records were inspected. The daily records detailed the care and support required for different needs. They reflected the changing needs of service users as they become older. The home respects the wishes of an individual when dealing with their increased dependency. Service users need minimal help with personal care tasks, such as bathing and dressing. Privacy and dignity are respected at all times. Records showed when residents had seen health professionals e.g doctors,community nurses,psychiatrists,psychologists. Residents are referred for specialist health care if appropriate. A staff comment said: There are good liasons with all professional services to provide the best health care Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: possible and care in general. Records also showed when residents had seen opticians and dentists. Staff who have completed training administer medication.The requirement regarding medication training still remains outstanding from previous inspections. Medication training has not been provided yet taking into account the Royal Pharmaceutical Societys latest guidance. Information was received after the previous inspection, as part of the homes action plan, that medication training was to be carried out on July 9th 2009 but this did not take place. Correspondence has been entered into outside of the inspection regarding this medication training. A sample of medication records was examined and they were found to be in order. Clear directions were recorded and each dose of medication was signed for, or a code entered to verify the reason not given. No resident administers their own medication currently. A system could be put in place to oversee the medication of residents if they were able to retain and administer their own medication. The environment is not equipped for the ageing of residents and has not been adapted, there is no through floor passenger lift and a bedroom is not available on the ground floor for a resident if required. Staff have received training to give them more understanding about the ageing process and the needs of residents as they may become incapacitated due to illness and older age. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear complaints procedure and systems are in place to protect people living at the home from abuse. Evidence: There is a complaints procedure that includes what complainants should do if they are not happy with the homes investigation and response but it does not include how to complain as required by the Care Home Regulations 2001. A localized procedure is not available or written in a way that ensures residents understand its contents. Since the inspection an up dated, accessible version has been forwarded to the regulatory authority. Staff have received training about complaints awareness. The home keeps a record of complaints. No complaints have been received since the last inspection. The home has a Whistle Blowing policy and the Trusts Vulnerable Adults procedures. Staff training about Protection of Vulnerable Adults and Prevention of Abuse has been up dated for all staff who were avaible. Residents can deposit money for safe keeping in the homes safe and records are kept Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: of accounts. Care Homes for Adults (18-65 years) Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there and all areas are well maintained,clean,tidy and free from offensive odours. Evidence: There is a programme of redecoration and improvement around the home.Since the last inspection the outside of the house has been decorated, the bathroom suite has been replaced, the bathroom and some bedrooms have been redecorated. The fire alarm has been replaced. The hallway has been decorated, the kitchen is to be decorated.Some curtains, lights and bedding have been replaced. Carpets have been replaced in the hallway. The home was clean, well decorated and well maintained. The home has a lounge and kitchen,diner combined. Residents can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Lighting was bright and domestic in design. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Residents bedrooms were comfortable, well decorated and personalized according to individual taste. There was emergency lighting throughout the home. The home was clean and free from offensive odours. Care Homes for Adults (18-65 years) Page 22 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 adequate 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 for the current needs of the residents living in the home.Staff are safely recruited, however more detailed reference checks would further protect service users from potentially unsuitable workers. Evidence: Examination of staff rosters and discussion with the person in charge showed that the numbers of staff are as follows: 9:00am- 6:00pm 2 -3 staff members 6:00pm- 10:00pm 1- 2 staff members 10:00pm- 9:00am 1 sleep in staff member. Staff numbers include the manager.Staff members carry out cooking and cleaning duties.Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. There is a good level of staff training. Staff members have achieved National Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Vocational Qualifications at levels 2. Staff and their records showed that they also receive training or advice in other areas such as equality and diversity,infection control,food hygiene, complaints awareness, Makaton,person centred planning,diabetes awareness,mental health and older people, challenging behaviour and mental health,dementia care,safe guarding of vulnerable adults. Management training includes recruitment and selection and training the trainer. Staff comments include: The home should keep on improving with training to keep improving services provided. Staff receive regular supervision. Two inspectors visited the Trust headquarters to look at staffing files as part of another inspection their findings are included: As a large employer, the Trust has a centralised team of Human Resources staff. Part of their role is to help with the recruitment of new staff. Inspectors looked at the files of 14 newly recruited staff during the visit. Records showed that staff employed by the Trust only start work once a Criminal Records Bureau disclosure, two written references and a health clearance is received. However, some staff (who had used the standardised NHS on-line application form) had not provided a full employment history. And, the gaps in their employment record had not always been explored with them at interview. It is a vital part of the recruitment and vetting process that a full employment history is obtained and any gaps in working time are fully explored with candidates before they are offered a post. This should include why they have left previous care settings. Care Homes for Adults (18-65 years) Page 24 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust management systems are not in place to ensure the smooth running of the home and to ensure the safety of the people living there. Evidence: Requirements have now been addressed from the last inspections apart from the requirement about medication training for staff as discussed in outcome area 4. The manager is registered for the day to day running of the home.She has several years experience of working with adults with learning disabilities. There is still an issue being followed up with the locality manager outside of this report regarding the medication training requirement. Other requirements have now been carried out in order to ensure compliance and the health and safety of people living at the home however they have not been carried out in a timely manner. The Trusts action plan stated when action would be taken to ensure compliance however they were not actioned according to time scales and in some cases until at least two months later. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Documents detailing fire safety, risk assessments in the environment,water temperatures and maintenance contracts for equipment were up to date. Staff training relating to health and safety was up to date. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 20 18 Staff must receive accredited 30/05/2009 medication training to ensure the health and safety of residents. This will ensure the health and safety of residents. Care Homes for Adults (18-65 years) Page 27 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 20 18 Staff must receive up dated 30/09/2009 medication training to ensure the health and safety of people living at the home. To ensure the health and safety of people living at the home. 2 37 43 Robust management systems are not in place to ensure the smooth running of the home and to ensure the safety of the residents. This is to ensure compliance with the regulations. 30/09/2009 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 33 Staffing levels should be kept under review to ensure the needs of residents can be met at all times and as they become more dependent. Ensure gaps in employment shown on application forms are Page 28 of 30 2 34 Care Homes for Adults (18-65 years) 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 fully explored and this is clearly shown within the record of interview. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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