Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 14/10/08 for Hardwick Close (2 and 4)

Also see our care home review for Hardwick Close (2 and 4) for more information

This inspection was carried out on 14th October 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hardwick Close (2 and 4) Holmewood Chesterfield Derbyshire S42 5RL 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: Jill Wells Date: 1 4 1 0 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Hardwick Close (2 and 4) Holmewood Chesterfield Derbyshire S42 5RL No2:(01246)856232 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Enable Care & Home Support Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: Date of last inspection 0 4 1 2 2 0 0 6 A bit about the care home The care home is purpose built and has been open since 1993. There are two interconnecting four bedded units, which provide ground floor, single room accommodation for residents. Each unit has its own kitchen, adapted bathing facilities and a laundry, in addition to communal areas for the residents. The accommodation is homely, spacious and accessible, and has a secure garden Care Homes for Adults (18-65 years) Page 4 of 32 area. Residents who live in the home have high level care and support needs. Some of the staff have known the residents for many years. 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for the service is two star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place over 7 hours. There were 9 people living at the home on the day of the inspection. 4 staff, and the manager were spoken with during the visit. Most residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. We also looked at all the information that we have received, or asked for, since the last key inspection on the 4 December 2006. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. Page 7 of 32 Care Homes for Adults (18-65 years) The previous key inspection report. The previous annual service review completed 18 January 2008. Completed surveys from, staff, relatives and professionals that visit. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. Information from the manager was that the weekly fees are 1299. What the care home does well The home is well managed and run with a competent acting manager and staff team. People living at the home have a good quality of life with their health and personal care needs met as well as appropriate activities provided. The environment is of a good standard, clean, accessible and well maintained. A good standard of training is provided for new and existing staff. A staff member wrote in our survey, excellent training and choice of any other training relevant to service users made me more confident and up-to-date Staff had built up close Care Homes for Adults (18-65 years) Page 8 of 32 relationships with people living at the home and felt that they worked well as a team. One staff member said, I am very proud to be part of this team. New staff members spoken with were clearly enthusiastic and had received good support from the manager and other staff. Although most residents had little or no verbal communication, staff were knowledgeable about their ways of showing emotions, and this was reflected in individual support plans. Two relatives were spoken with. They were generally pleased with the care provided. One person said I am satisfied with the care received. Another said, (name of person) enjoys living there, and gets on well with staff. The acting manager has worked hard to develop the service and staff and relatives were full of praise for her hard work and dedication. Care Homes for Adults (18-65 years) Page 9 of 32 What has got better from the last inspection What the care home could do better The Acting manager has not registered with CSCI and needs to do so as a matter of urgency. The personal planning books were not completed for all people living at the home or kept up-to-date. Care Homes for Adults (18-65 years) Page 10 of 32 The menu could be improved with less processed food provided. The kitchen area is in need of updating and some refurbishment. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jill Wells 33 Greycoat Street London SW1P 2QF 02079792000 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. Care Homes for Adults (18-65 years) Page 11 of 32 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 12 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 13 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 . Clear information was available about the home and everyone had an introductory visit and full assessment to ensure that the home could meet their needs. Evidence: There was a statement of purpose on display in the entrance hall giving clear information about the home. It had the contact details of CSCI so that people could contact us if they wished to do so. It did however have the name of the registered manager who has since left, which could be misleading. Three peoples records were seen as part of our case tracking methodology. These were person centred and highlighted individuals abilities, for example able to put boots on but requires carer to fasten shoelaces. As most people living at the home had no verbal communication there was good information concerning how each person expressed their emotions. There was also a pen picture for each person giving useful background information. The statement of purpose said that introductory visits were always arranged. This Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: included visiting for a meal, overnight and possibly for the weekend to enable everyone to be sure that the placement was suitable. Staff confirmed that trial visits always took place. Each person had a contract within their file that was clear and included the terms and conditions between the home and the service user. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Although most people at the home had limited ability to make decisions about their own lives and participate in the day-to-day running, staff tried to ensure where possible that they took into account peoples needs and preferences using the knowledge that they have about people. Evidence: Information on the annual quality assurance assessment provided by the manager was that everyone had a detailed care plan in place and peoples individual rights and dignity were respected and their preferences and choices were promoted. The key worker plays a role in promoting peoples needs and choices, especially when people were unable to do so themselves. Each of the three files that were seen had a support plan in place. These were detailed and highlighted individuals needs, preferences and wishes. They were regularly reviewed and checked by the manager. Most people living at the home had limited ability concerning making decisions about Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: their own lives and participation in the day-to-day running of the home, however staff tried to ensure that where possible people were involved, for example one person like to stand and watch staff make meals in the kitchen. Staff were aware of the risks involved with this person in the kitchen and would closely supervise them. Relatives and advocates were involved where appropriate concerning decision-making. The support plans detailed how each person expressed their emotions and staff explained that their knowledge of this, helped them to know whether something was pleasing to an individual. Individual likes and dislikes were recorded and information was detailed, particularly for people with non-verbal communication for example, uses a spoon in their right hand and holds a plate in their left. Risk assessments were in place concerning moving and handling, pressure areas, nutritional assessments, risks concerning outings and holidays and use of transport. Individual records were kept secure and staff were aware of the importance of confidentiality. Some but not all records had a personal planning book in place. The ones that had been completed were not always reviewed and up to date. For example one persons book said that they liked to shuffle on the floor, however staff explained that they no longer did this. The manager explained that staff were working with relatives to improve this information. Care Homes for Adults (18-65 years) Page 17 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 . People were encouraged to participate in the local community and have opportunities to live fulfilling lives. Evidence: Information provided in the annual quality assurance assessment by the manager was that staff support people to participate in community activities, encourage friendships of their choice, ensuring that they are not exposed to any form of abuse. On the day of the inspection visit several people were out at a resource centre. Various centres were used, taking into account where people went before they lived at the home and each persons particular needs. Ash Green, which is a specialist service for people with a learning disability is utilised including use of their facilities, a spa and snoezelen, as well as access to specialist professionals including speech therapy psychologists and occupational therapist as required. Community links and social inclusion were encouraged for example 3 people attend the local church supported by Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: staff and some people had attended a performance at the local school. Record showed and staff confirmed that most people either go out or take part in an activity every day. This may include a pub lunch, picnic, shopping, or a take-away brought into the home. Staff said that they try to give everyone an equal opportunity to go out. Two people attend a local tea dance on a weekly basis. Staff said that they try to take account of peoples ages when considering activities. The service has recently employed someone for 10 hours per week at the weekends. They take people out, and do crafts, manicure etc at the home. On the day of the inspection visit people living at the home that had not gone out sat with staff assisting making angels for Christmas out of dough. These would then be hardened and painted. Staff said that the manager encouraged innovative ideas. There were records of communication with relatives and a relatives spoken with said that communication had improved recently. The menus were planned by staff, taking into account peoples likes and dislikes. Several comments in surveys by staff were about the housekeeping budget. One person said, it has been the same amount for the last 9 years and food has gone up. Another person commented, we could improve by more housekeeping for better choice of menu. The menus were checked during the inspection visit. They showed that there was some homemade meals for example curry and liver and onions, fresh and frozen fruit and vegetables were used. However there was also a significant amount of processed food for example Angel delight, fish fingers, frozen chips and pasties. Staff spoken with said the quality of the food depended on which staff member did the food shopping and which did the menu planning for that week. Several people needed their food liquidising and staff explained that this was done separately to make the meal more appetising. Nutritional supplements and thickeners for drinks were used when required. Staff would often take a service user shopping with them. There were records kept in the diary of food provided, although any variation for an individual was not always recorded. Care Homes for Adults (18-65 years) Page 19 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 . People received reliable and responsive personal support and their health care needs were monitored by relevant health professionals to ensure that peoples healthcare needs were met. Evidence: Information in the annual quality assurance assessment provided by the manager was that staff access the local surgery for health issues and liaise with other health professionals in providing all aspects of health care needs. Records show that GPs and other health professionals were contacted when required. Staff said that the manager was very quick to contact relevant health professionals if she thought that it was needed or would benefit an individual. Staff spoken with were very aware in providing personal support in a way that respects peoples privacy and dignity. Staff were keen to ensure that peoples clothes, and hairstyle reflected their personality and age as there was a wide age range of people living at the home. Relevant equipment was in place for people that needed this, including hoists and profiling beds. People were supported to attend outpatient and other appointments. On the day of the Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: inspection visit the manager took one person to a hospital appointment. People received regular health checks and their medication was regularly reviewed. There was a separate system in each property for storage and recording of medication. Both systems were checked during the visit. There were safe systems for receipt, storage, administration and recording of medication. The record of controlled drugs did not have the name of the person that the medication had been prescribed for. At the time this was not a significant concern as there was only one person that had been prescribed a controlled drug. The record being used may not comply with the Royal Pharmaceutical Guidelines. Care Homes for Adults (18-65 years) Page 21 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 . Complaints were taken seriously and people were kept safe by the policies, procedures and practices within the home. Evidence: Information provided by the manager in the annual quality assurance assessment was that the home provides a pictorial complaints procedure and any complaint is handled professionally, confidently, with consideration to all involved concerning confidentiality. There was a copy of the pictorial complaints procedure in the entrance hall and in peoples files. The manager was keeping a record of all complaints received. There had been a complaint made earlier in the year from a neighbour concerning noise levels. Record showed that this was dealt with sensitively and appropriately. CSCI had received an anonymous complaint concerning the behaviour of a member of staff. Although this was referred to Social Services under safeguarding procedures, they did not feel that it was a safeguarding matter and requested that the service deal with this under their disciplinary procedures. The member of staff no longer works at the service. Staff spoken with were aware of the whistle blowing policy and procedure and the importance of keeping people safe. Training record showed that staff had received training in protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 22 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 . People live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: The premises were accessible, safe and well maintained and met peoples needs in a comfortable and homely way. There was a lounge and separate dining room in each house. Everyone have their own bedroom with a sink. Toilets and bathroom were shared. Improvements had recently been made to one bathroom and had now been made into a wet room. Staff spoken with said that this was a great improvement for staff and people living at the home. New furniture and curtains had recently been purchased and redecorating was due to take place. Staff spoken with said that since the manager had come to the home she had made sure that the environment was of a very good standard. The kitchen areas were in need of refurbishment due to chipped work surfaces and cupboards. The manager said that this was being looked at but was taking some time. The building is rented from a housing association. The home were very aware of the importance of hygiene and control of infection. There were hands sanitizers in the entrance hall, kitchen and bathrooms and alcohol gel in the toilets. Staff used protective clothing when appropriate. One person had a monitor on their chair in the lounge area as a result of being Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: assessed as at high risk of falls. There were call systems around the home. Staff explained that although people living at the home were unlikely to use these, staff would use them to call for assistance. The utility room had an industrial washer and dryer and was away from where food was repaired and stored. Although there were storage in bathroom areas, incontinence pads were on display on the shelves and in peoples bedrooms which did not respect peoples privacy and dignity. Care Homes for Adults (18-65 years) Page 24 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 . The recruitment practices and staff training programme were good and ensured that people were protected by competent, well-trained staff. There were usually sufficient numbers of staff to support the people who use the service. Evidence: Information from the manager on the annual quality assurance assessment was that all staff are vetted prior to employment, staff are aware of their roles and responsibilities, receive induction and training and are competent to support people in their home. The manager said that they have a good ratio of staff to support people. Four staff were spoken with during the inspection visit. Some were very experienced and had worked at the home for many years. Others were newly appointed but seemed competent, enthusiastic, and had received a good level of support. It was evident that staff had developed good relationships with service users that they supported and were aware of individuals needs. Relevant knowledge and experience was observed including staff showing interest, being motivated and committed and good communicators. Although the service had not yet reached the National minimum standard of 50 of staff holding NVQ 2 qualification, 6 staff had recently agreed to be registered on the course. Staff spoken Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: with were very positive about working at the home, one person said it is a brilliant staff team, very supportive, its a lovely home. Another staff member said, I dont feel Im at work, its like being part of the family. Someone wrote in a survey that there is an, excellent staff team that care is very much. I am very proud to be part of this team. Staff training records were seen. Relevant training was provided including moving and handling, first aid, fire safety, safeguarding adults and health and safety. New staff received an induction followed by completion of the Certificate in Working with People with Learning Disabilities. A new person working at the home had not yet undertaken moving and handling training, however she was very clear that she was not to undertake moving and handling tasks unless supervised until this training had been completed. Staff were very pleased with the training provided. Comments in surveys included, we get very good training and updates on a regular basis and, they are a good employer and treat staff well. Two staff files were seen of staff that had recently been appointed. Safe recruitment procedures had been followed. There was evidence to show that people did not start until they had received a criminal record bureau check. The staff rotas were seen. These showed that there were two staff on duty at night and usually four people on duty in the daytime, two in each house, occasionally five people, although there were occasions when staffing was reduced to three people due to sickness that could not be covered. Information received by survey from a relative was that staffing sometimes was a problem, staff were ill or on holiday on a regular basis. The manager explained that staffing had recently improved due to recruitment of new staff. Staff spoken with confirmed that staffing had improved. One staff member said, the staffing levels have never been better here. Record showed that staff received regular supervision. Supervision records showed a good level of support and guidance for example one record advised the staff member to watch the epilepsy video available and gave them information on the General Social Care Council code of conduct, there was also a record of discussion concerning male staff members not bathing female residents. Comments in staff surveys confirmed that staff felt well supported. Records of staff meetings showed that they were regular and were a good balance of information sharing and advice and opportunity for staff to voice any ideas or concerns. Care Homes for Adults (18-65 years) Page 26 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 very well managed, with an atmosphere of openness and respect and safe systems in place to ensure that people living at the home are safe. Evidence: The registered manager had left the service and there was an acting manager in place. This person had not registered with CSCI. She had completed the registered managers award and undertaken a performance management course. She had also recently undertaken training in the Mental Capacity Act. Information from surveys and talking to staff confirmed that the manager was competent, organised and created an open, positive and inclusive atmosphere. Comments received about the manager included, the manager is brilliant, and she helps everyone and if anything is wrong with a resident shes always quick to try and sort it out. Someone wrote in a survey, the manager involves all staff and values their input and, an excellent manager, supportive, sympathetic and caring. The manager was present during the inspection visit and was found to be very organised and knowledgeable. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: The manager said that all policies and procedures were in place. Some that were seen had recently been reviewed including the safeguarding adult policy. The policies and procedures were accessible to staff. Individual records and home records were secure, up to date and in good order. Safe working practices were taking place to ensure that people were safe including regular fire tests and drills, safe storage of hazardous substances, maintenance and servicing of relevant systems including gas, electric appliances and water testing, and accidents were recorded and reported when required. A recent food hygiene inspection had been undertaken. The outcome was that the premises and practices were found to be satisfactory. The senior manager responsible for the service visited regularly, attended staff meetings and completed reports after unannounced visits. The manager said during the inspection visit, its about working together with staff and relatives, you cant do it on your own. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 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 Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 37 8 The manager must apply to register with CSCI. 16/12/2008 To comply with the Care Standards Act 2000 and Care Home Regulations. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The statement of purpose and service user guide should reflect the management changes so that accurate information is provided. There should be a personal planning book in place that is accurate and reviewed regularly so that staff have up to date information about peoples wishes, and what is important to them. The food budget should be reviewed to ensure that good quality food is provided at all times and menus should be monitored to ensure that fresh, nutritious food is always provided so that people are always offered a healthy diet. 2 6 3 17 Care Homes for Adults (18-65 years) Page 30 of 32 4 17 Where an individual is provided with an alternative to the planned menu, this should be clearly recorded in every instance so that each persons diet can be monitored. The manager should check with the pharmacist or other relevant professional as to whether the record being used for controlled drugs meets the Royal Pharmaceutical Guidelines. The record needs to include the name of the person that the medication has been prescribed for to minimise risk of errors. Ongoing plans should continue with regards to the kitchen being refurbished due to chipped work surfaces and cupboards, to maintain the environment to a good standard. Incontinence pads should be stored in a way that respect peoples privacy and dignity. Staffing levels should not be reduced to a level that does not meet the needs of people living at the home when staff sickness and holiday occurs. 5 20 6 24 7 8 27 33 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!