Inspection on 18/11/08 for Harborne House

This inspection was carried out on 18th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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Polesworth Group Pooley Heights

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Harborne House 8a Albert Road Harborne Birmingham B17 0AN     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: Donna Ahern     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 30 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 30 Information about the care home Name of care home: Address: Harborne House 8a Albert Road Harborne Birmingham B17 0AN 01214283410 01214283410 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) : Accord Housing Association Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users to be accommodated is 4. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 4 Date of last inspection Brief description of the care home Harborne House is situated in a popular residential area of Birmingham. The Home is close to the amenities offered in Harborne including shops, cafes and bars, sport and leisure facilities and parks. The Home is well situated to access transport links by road and bus. Harborne House was purpose built as a care Home. On the ground floor there are two single bedrooms, a kitchen, Lounge and dining room. This floor has an assisted bathroom and separate W.C. This floor is fully accessible to people without full mobility. On the first floor are two further bedrooms an office and a bathroom with over bath shower. The Home has off street parking for about three cars. There is a private rear garden with seating and raised flower beds. The home is registered for four people with learning disabilities. Care Homes for Adults (18-65 years) Page 4 of 30 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: 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: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The home was previously registered with South Birmingham PCT and has been operating as a registered care home for people with learning disabilities since 2001. Accord took over as the new Providers on 1st November 2008. This is the Homes first inspection with the new provider and the Home was therefore inspected as a new service. The management and staff team transferred over to the new provider. The inspection visit was carried out over one day. The home did not know we were coming. The deputy manager was present throughout the visit and answered questions Care Homes for Adults (18-65 years) Page 6 of 30 and provided us with information we needed to see. After the visit we spoke to the manager on the telephone who provided us with some additional information about the changes in the Home. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. Prior to the visit fieldwork visit taking place a range of information was gathered to include notifications received from the home and a questionnaire about the Home. The questionnaire is called the Annual Quality Assurance Assessment (AQAA). We case tracked three of the people living in the Home. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We met all of the people who live at the home. Due to their communication needs most people who live at the home were not able to comment on their views so we watched the way they interacted with staff on duty. We spoke to four staff, looked at staff files and health and safety records and looked around the building to make sure it was warm, clean and safe. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their relatives would have most of the information that they would need to know so they could make an informed choice about whether they wanted to live at the home. Evidence: There have been no new people recently admitted to the home. All of the people have lived there since the home was first registered several years ago. We saw a detailed admission process that would be implemented in the event of a vacancy occurring. This includes pre admission assessments and the opportunity for visits to the home so that people would have the opportunity to meet staff and the other people who live there. The service user guide and statement of purpose require some updating so that the very recent changes in provider are included. The range of fee levels and any Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: additional charges should also be made available so people know what the fee includes. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the information they need and a good understanding of how to offer care and support to each person, which should ensure peoples needs are met in a way they prefer. Evidence: We looked at three care plans. Care plans explain what each person needs are and the care and support they require to make sure these needs are met. We found that the files looked at gave detailed information about how staff should support the person in order to meet their individual needs in relation to personal care, communication health care and social activities. We spoke to members of staff who support each of the people and we also observed people being supported by staff. The staff demonstrated knowledge of peoples individual needs which was consistent with the information on peoples file. This indicates that staff know how to provide care and support to people so their needs are Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: understood. The home has produced Good Life Plans, which focus on peoples strengths so people can contribute to their care within their capabilities. Photos and pictures have been used to so the plans are meaningful to the individual. We saw risk assessments for accessing the community, using the house vehicle, and safety awareness. These ensure that people could take responsible risks according to their individual needs. Staff spoken with also knew what they must do so people are not put at risk of harm. A risk assessment had been recently reviewed for one of the people so that when people go out in the homes transport any potential risks to themselves of other people travelling with them is kept to a minimum. The people who live there due to their communication needs were not able to tell us about how they are supported to make choices and decisions about their lifestyles. We saw people receiving good support from staff and people were encouraged to communicate their needs by using what limited verbal communication they have or by using gesture and body language to communicate. Staff offered different choices of drinks and supported people to relax in the lounge, go out in the garden, go to their room or listen to music. The AQAA informed us that the manager has identified that the Keywoker system needs to improve so that responsibility for updating peoples care records is shared with the staff team and involves where possible the people living in the Home. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements in place to provide activities do not ensure that all the needs of the people living at the home are met. People are offered a choice of meals to meet their dietary, cultural needs or preferences. Evidence: We looked at care plans and daily records to establish that people are leading meaningful lifestyles and taking part in activities that they enjoy. We also spoke to four staff members and observed care and support on the day. Care plans detail what people like to do. We looked at the daily records across the three previous weeks. The records showed that three of the people had been involved in a variety of trips out including cinema, Harborne High Street shopping, grocery shopping, and lunch at a pub and a visit to a market. However one of the people had Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: only been out once in a three-week period and did not go out on the day of the visit. We discussed this with staff and looked at a recently reviewed risk assessment. The persons opportunities to go out had been limited because of the risk with using the vehicle with other passengers present. The deputy manager present during the visit recognised the need to ensure that all people living there are offered the same opportunities and to explore other ways of accessing the community safely. She also explained that new leisure opportunities are being explored so that people are offered a more varied experience. One of the staff spoke about some leisure classes that she had just got some information about that may be suitable for people to take part in. Three of the people were supported to attend a drumming session and then went out for lunch. Later in the day people went to the local supermarket to do the food shopping for the house. People moved freely around their home accessing their bedroom or lounge or the garden as and when they choose. The care plans and daily records that we looked at showed that where possible people are encouraged to take part in day to day routines of the home. We saw people encouraged to clear their dishes after a meal and help with the weekly food shop. There are some environmental restrictions in place including a locked front door and storage room containing cleaning products. Guidelines are in place to support this practice which is in place to keep people safe from known risks. There are no formal house meeting but staff said people living in the home join part of the staff team meeting when discussions about the day to day running of the home take place. Staffs spoken with said peoples family and friends are encouraged to keep in touch and visit the home and some people regularly visit their relatives. This was confirmed by looking at the care records. We also saw photographs showing relatives involvement in Birthday celebrations. The daily records we looked at indicated that peoples food and drink intake is monitored daily and regular meals and drinks are offered. The records seen indicated that people are offered drinks throughout the day. We saw staff asking people if they would like a drink and also supporting people to go to the kitchen and with support get their own drink. We saw a range of tinned, frozen and fresh food. Menus seen showed that culturally appropriate food is available with a variety of meals including culturally appropriate food. We saw risk assessments and guidelines in place for people who require specific support to eat their meal safely and staff were able to explain what these were. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to meet peoples personal and health care needs. Evidence: Care plans that we looked at had good detail about how to meet peoples personal care needs. We saw that people were dressed in age appropriate clothing and people were very well groomed, this indicates that people are supported to maintain a good selfimage. We met all of the people who live in the home and saw that staff were prompt to offer personal care as needed throughout the day. Care plans looked at had good detail about peoples health care needs. Entries in their health records show that they are being provided with access to healthcare professionals to meet their assessed needs including routine check ups and treatment. Medication is stored in a separate locked storage area off the hallway. The cupboard was found to be clean, tidy and well ordered. The medication administration Records Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: (MARS) looked at were signed indicating medication had been given as required. Copies of prescriptions are retained so that staff can check the right medication has been received from the chemist. The people who live in the home cannot selfadminister their own medication due to their complex needs. There is good information on peoples care records informing staff of how people like their medication to be given. We saw that one tablet had not been given as required the deputy manager was aware of this and the matter was being followed up through the homes procedures. We saw that where possible people had been supported to have their medication reduced with support from health professionals. There was detailed information on peoples care records about how to support them through this change and how to monitor any changes in the persons well being. Staff said they had completed accredited medication training and this was confirmed by looking at the homes training records. The deputy manager told us that eleven of the eighteen staff have been assessed as competent to give out medication. 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 are effective systems in place to listen to and respond to complaints about the service. Evidence: The Home has just changed registered provider and was in the process of implementing all the new policies and procedures including complaints, concerns and safeguarding. Policies and procedures we looked at were detailed. The complaints procedure was also available in an easy read version so it was easier for people to understand. The commission has received no complaints about this Home since its registration and no complaints have been made directly to the Home. Some people who live there demonstrate behaviour that determines staff must work with them in a particular way to help keep them safe and well. We saw guidelines on peoples care plans, which explain how staff should support people with these needs. We saw staff following the guidelines several times during the visit, which indicated that staff have read and understand the importance of their role to keep people safe and well. We looked at some of the recordings that staff had completed following an incident involving people living in the Home and spoke to staff about what and where they record this information. We found that staff were not always consistent with the Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: forms they complete following an incident. This could result in incidents not being properly monitored by the Home or reported to other agencies and this may impact on people care. People living in the Home would require significant support to raise their concerns about something due to their communication needs. We spoke to staff who said they would recognise when people are not happy about something. Staff said they monitor people behaviour and changes in behaviour for possible signs that they are unhappy about something. Staff we spoke to demonstrated a general understanding of their duty to safeguard people and how to report concerns on to senior managers. However some staff were unsure about at what point they would alert their manager to a concern. We spoke to staff and looked at training records to determine that training in safeguarding vulnerable adults had been provided. These indicated that updates are required. The manager said that now the new provider has taken over this training will be provided. We did not look at how peoples financial expenditure is managed during this visit. 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. People live in a clean, safe and comfortable home, which promotes their well-being and meets their individual needs. Evidence: Harborne house is located near to Harborne shopping centre with public transport routes close by. There is limited off road parking to the front of the house. To the rear of the Home there is a well-maintained garden that people have direct access to. There are grassed areas with raised flowerbeds and a large patio area with garden furniture. We saw people freely access the garden during the visit. There is access to the front of the building for people who use a wheelchair this ensure there are no restrictions in entry to the building. Aids and adaptations include grab rails in the corridors and assissted bathing facilities. We looked at the shared areas of the Home and the bedrooms of the people whose care we had case tracked. The lounge was welcoming and homely with leather sofas providing a range of seating for people. Pictures, fresh flowers, soft furnishings and lighting features made this a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: lovely comfortable and welcoming area for people to relax in. The kitchen is spacious with lots of storage and worktop space for preparing meals. A hatch opens into the dining room which means meals can be served safely to people. The kitchen was clean and well equipped with adequate space to store fresh, frozen dried and tinned food. There is a separate laundry room, which was clean and organised. We saw substances such as cleaning products that could cause harm to people had been locked safely away. There are bathrooms on the ground and first floor, which ensures that people have easy access to facilities for personal care. The bathroom on the ground floor is to be refurbished and quotes for these works were being sought. The plans for this bathroom will ensure that a new bath will be provided that is suitable for the specific needs of the people living in the home and will ensure they can access the facility safely. Two peoples bedrooms are located on the ground floor and two on the first floor. The bedrooms we looked at were vibrant. People had been supported to personalise their rooms with pictures, photographs, ornaments music centres and televisions. People freely accessed their own rooms during the visit. 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. Recruitment practice is robust and protects the people who live there. The arrangements for staff training and development do not fully ensure that staff have up to date knowledge and skills which could impact on their ability to meet the needs of the people consistently. Evidence: Some peoples communication needs made it difficult for us to talk to them so we watched the way that they interacted with staff on duty. People smiled when staff interacted with them. People sought out staff and sat with them. When we first arrived at the home staff were engaging on a one to one with people and the atmosphere in the home was comfortable and welcoming. Staff were seen to really try and communicate with people using verbal and gesture and encouraged people living there to communicate back. It was evident from what we saw that the staff on duty had made good relationships with the people living there. We looked at the staffing rota for the week of the visit and the previous week. These showed that there is four staff on duty to care for the people living there during the day and two staff at night. The deputy manager informed us that there were two staff Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: vacancies and these were in the process of being appointed to. The deputy manager explained that the new providers recruitment procedure is being implemented and potential employees will now get the opportunity to visit the service prior to being offered a position. The new provider is in the process of reviewing all staff files to ensure they meet the required standard and all staff are required to complete a new CRB check as part of the transfer over. We spoke to four staff during this visit who demonstrated that they had a good understanding of peoples individual needs. We spoke to staff about the training they had received and they said that they had completed training in studio 3 physical intervention, safeguarding, medication, health and safety, first aid and fire. Staff said they are due refresher updates and this was confirmed by speaking to the deputy manager and looking at records which indicated that staff do require updates in a number of areas so that staff continue to have the up to date knowledge and skills required to meet peoples individual needs. The AQAA informed us that the manager has identified staff training and development as an area for improvement. He stated in the assessment that progress has been hampered by the change of provider with the transfer over date delayed. Now that this change has taken place he is optimistic that training updates will take place as required and an improved system of staff supervision and appraisal will be implemented so that the team receive the support they require to do their job well. The AQAA informed us that ten staff have achieved and five staff are working towards a National Vocational Qualification in care. This should contribute towards ensuring that the staff team have effective knowledge of social care. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements in place ensure that people who live in the home are protected from harm and live safely in a home that is comfortable and meets peoples needs. Evidence: This is the homes first inspection with the new provider. The manager and staff team all transferred over to the new provider. The manager has significant experience of working with people who have a learning disability and challenging behaviour. The deputy manager was present during the visit and fully assisted with the inspection as the manager was on a training day. There are quality assurance systems in place including a detailed auditing system. However it was not possible for us to explore these on the day as the new provider had only just made these available to the manager so they were not yet implemented. There are also systems in place for regular visits and audit checks to be completed by senior managers to ensure the home is run in the best interest of the people living there. The last audit report was seen which reports on the standard of care provided. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We looked at records to see that peoples health and safety is being promoted. The fire alarm system had been tested and serviced on a regular basis. Individual fire risk assessments should be developed for each person so staff know how to support people safely in the event of the firm alarm being activated. This had been identified in the Homes own work place fire risk assessment. New policies and procedures were in the early stages of being implemented when the visit took place. The Home was still waiting on a computer to be installed so that it is linked to the new providers systems. We found some shortfalls with the recording of incidents in the home. In a conversation with the manager after the visit, he confirmed to us that new accident and incident recording and reporting procedures are being implemented by Accord. We were informed that all staff will be attending an induction day soon with the new provider and this will include an overview of the policy and procedures so staff have an understanding of what these are and how peoples best interests are safeguarded. Staff do require some training updates on health and safety, fire, first aid, manual handling and basic food hygiene so they can ensure a safe environment is provided for people. There are quality assurance systems in place including a detailed auditing system. However it was not possible for us to explore these on the day as the new provider had only just made these available to the manager. There are systems in place for regular visits and audit checks to be completed by senior managers to ensure the home is run in the best interest of the people living there. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 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 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 2 1 1 The statement of purpose and service user guide should be update to include the changes of provider. The details of fee levels should be included in the service user guide so people know what the fees cover and the details of any extras. All people living in the home should be supported to take part in valued and fulfiling activities that meet their needs. Arrangements must be made to ensure that staff have a clear understanding of adult protection and whistle blowing procedures. This is to ensure that people are not at risk of harm. Arrangements must be made to ensure that the right documentation is completed by staff following an incident. This will ensure that accurate records are kept and any follow up action required is taken. Staff must receive training updates in mandatory areas so they have the up to date knowledge and skills to support people safely. Staff should receive supervision at least six times per year so thay have the support they require to do their job. 3 4 12 23 5 23 6 35 7 36 Care Homes for Adults (18-65 years) Page 28 of 30 8 9 39 42 Quality assurrance systems based on seeking the views of people living in the home should be fully implemented. Individual fire risk assessments should be developed so staff know how to support people safely. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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