Inspection on 20/08/08 for Hillview

This inspection was carried out on 20th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillview 13/08/09

Hillview 13/12/06

Hillview 07/02/06

Hillview 10/10/05

Hillview 14/02/05

Hillview 31/08/04

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Insight - Eastchurch

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hillview 213 Eastbourne Road Polegate East Sussex BN26 5DU     The quality rating for this care home is:   one star adequate 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: Alexis Reilly     Date: 2 0 0 8 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. the things that people have said are important to them: They reflect 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 29 Information about the care home Name of care home: Address: Hillview 213 Eastbourne Road Polegate East Sussex BN26 5DU 01323488616 01323487508 polegate@regard.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Teresa Murphy Type of registration: Number of places registered: The Regard Partnership Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Hillview is a purpose built bungalow, situated just off the main A22 Polegate/Eastbourne Road. The home shares the same site and Manager as Oak Lodge, another service owned by this organisation. Local shops and public transport links are a short walk away. The home is registered to accommodate six younger adults with learning disabilities. Resident accommodation provides six single bedrooms, a communal lounge and kitchen/diner. Two bathroom facilities are fitted with the necessary adaptations. The site provides a large garden and parking. The Registered Providers of the service are The Regard Partnership. This organisation owns a large Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home number of homes across England and Wales. Information received from the Manager details that the current fees at Hillview range from £938.38 to £1276.56 per week. More detailed information about the services provided at Hillview can be found in the homes Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from The Regard Partnership. Latest CSCI inspection reports are on available on request from the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection began at 11.30am and finished at 4.30pm, as part of the inspection the inspector case tracked three residents in the home, one of these was the last admission to the service. The inspector examined risk assessments, the activities log and the record of accidents and incidents in relation to these three residents. Also viewed during the inspection were the menus in the home and the sheets which record the administration of medication, and the holiday and trips out risk assessments for residents. As part of the inspection the inspector spoke with the deputy manager, and the temporary acting manager of the site. This temporary acting manager is the overall manager for both Hillview and Oaklodge the two services on the one site. A senior manager also arrived during the inspection and also spoken to were two staff members. The views of visiting external professionals were gained. The inspector saw Care Homes for Adults (18-65 years) Page 6 of 29 residents in the home during the morning of the inspection siting finishing breakfast. The inspector also evidenced the Statement of Purpose and the Service Users guide. 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 29 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 29 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Regard Partnership has a assessment process which ensures referrals are processed through a main office and then filtered down to Hillview or the sister unit if suitable. Hillview then carry out their own assessment, and ensure that as part of this prospective residents care managers and family carers are contacted and their views sought. This should then form the basis for a comprehensive assessment. However the quality of this process could not be tested at the time of the inspection as there had been no new admissions into the service, and the assessment document of the last service user could not be produced to view. Evidence: The service has had no new admissions since September 2004. As part of the inspection the inspector looked at care plans for the last person admitted and spoke to the deputy manager of the service, a senior manager and spoke with the overall temporary acting manager of the Hillview site subsequently by telephone. The acting manager and deputy Manager and information from the AQAA showed that the service Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: follows an assessment process for prospective residents and that this is in two parts. Initially a referral goes through to the central department who undertake an initial assessment of all prospective residents, they then obtain a copy of the social care assessment which would be sent to Hillview. Once this had been received Hillview would then carry out their own assessment. As part of Hillivews assessment of the prospective resident the persons care manager and family carer is met. If it is felt the service users is suitable than the home will arrange a visit in order for the person to meet the other residents in the home. The home has updated the Service user guide and Statement of Purpose and these are on display in the main office, each resident has a copy of both of these. However it was unclear from the Statement of Purpose what the night staffing arrangements are for Hillview. The number of staff on duty at night must reflect the needs of the service users placed and these must remain under review. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do have care plans in place and the service is moving over to care plans which are more person centered. However the Manager must ensure that care plans are up to date and contain the relevant information. This would ensure that residents have all their needs met and continually reviewed. The service must ensure they have a clear policy in place for allowing resident to sleep in. Thus ensuring the residents safety and assessed needs are met and kept under constant review. Evidence: As part of the inspection the inspector spoke with the deputy manager of the Hillview site and also the temporary acting manager of the site subsequently by telephone. Two care staff were also spoken with and a senior manager arrived during the inspection. The inspector case tracked three residents, looking at the care plans for each of these and the activities that they follow. The inspector also spoke with external Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: reviewing professionals who have visited Hillview. Evidence seen in the care plans and review documents show that in general each resident has a nominated key worker, they complete key worker meetings and reviews, and oversee that the care plan is implemented on a daily basis. However some of the information in the care plan was found to be conflicting. In discussion with the temporary acting manager, the inspector was informed that senior staff now key work alongside less experienced staff, with service users who have more complex needs . The paperwork in the service showed that they are currently in the process of changing over the care plans to a more person centered approach, and that risk assessment are in place for taking residents on trips and on holidays. However the inspector began the inspection at 11.30 am and four residents were sat at the table finishing breakfast one of the residents had food left on their face. This was wiped away by a carer when the inspector entered the room. In discussion with the deputy manager the inspector was informed that the service allows residents to get up when they wish. This was discussed with the temporary acting manager of the site during a subsequent telephone conversation. They informed the inspector that unless residents had a particular activity they would be allowed to wake up when they wished, but they would obviously be checked during the night and in the morning if ill. The manager was unaware of any particular policy in place to confirm this. Residents do have an annual holiday planned and enjoyed each year, and often one other weekend away during the year. In general the care plans although in the process of moving over to a more person centered approach were large documents, and some had a mix of old and new information in them, which in turn could be confusing. This is highlighted by a comment received from a professional visiting the home. In general care plans had not been completed, evidence of care plans being quite confusing, In relation to one particular care plan the comments received from the visiting professional were On one page it states x knows the food he likes and dislikes and on the next is states x doesnt have the ability to choose his food. Care Homes for Adults (18-65 years) Page 13 of 29 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. Although residents do have an annual holiday, access the community and family links are encouraged, there are activities of little substance on offer in the home. The acting manager must ensure that activities are substantial and person centered, and that a greater emphasis is put on this as part of the overall package for the service users placed in the home. Evidence: During the inspection the inspector spent time with the deputy manager of Hillivew, and subsequently by telephone the overall temporary acting manager of the Hillview and Oaklodge site. During the inspection a senior manager arrived at Hillview and time was spent with her. Two staff were also interviews and the views from external visiting professionals were gained. Information was also taken from the AQAA and care plans and the activity record of the home as well as the pictorial menus in the service. The Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: AQAA and discussion with management confirmed that all residents have the opportunity to attend local college courses, swimming cooking and a day service. All resident have a annual holiday and a short break once a year. Family links are encouraged through regular visits, and families are invited to summer and Christmas parties. A six week menu is in place based around the nutritional requirements as identified by the dietitian, within this each service user is able to choose a meal of their choice once a week. Pictorial menu cards are in use. The inspector was informed that often residents will request a take away, BBQ or pub meal. On the day of the inspection the service users had a takeaway meal for lunch. In relation to the activities on offer in the home, the inspector case tracked three residents and traced through to the individual activities these people completed throughout the week. The inspector also gained the views of the staff in the home and external visiting professionals with regard to the activities on offer in the home. In general it is felt that there is a limited opportunity to participate in activities of any substance in the home. A sample of activities on offer were: looking at old photos and magazines, sticking in scrap book, helping with light chores, gardening, putting bins out, sweeping up, interaction with soft balls, sensory in their room, arts and craft in house, aromatherapy, evening theater trip, picnic dinner, music with Mick, ride out to Ash down forest in the mini bus. Comments received from external visiting professionals were service users were very bored, no person centered activities, not enough stimulation, Issues around access to the garden and also the fence has blown down in the garden. Further comments received were we dont have enough time to do activities with the resident. The inspector also evidence that a fencing panel had been blown down in the garden, in discussion with the deputy manager and the senior manager the inspector was informed that this had been down for a number of months, and was in fact laying on a vegetable patch that the residents had helped to grow. The garden is not secure and leads into the car park of the main building which in turn leads on to a busy main road. This road is fenced and gated, although during the inspection the gate to the main road had been left open. Care Homes for Adults (18-65 years) Page 15 of 29 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. Medication policies are in place in the service. However the temporary acting manager must ensure that any additional applications of shampoo are administered following the guidance from the GP and that this is record in the care plans and individual medicines folder. Good practice guidelines in relation to the administration of medication must be followed to ensure the safety of the residents in the service at all times. The temporary acting manager should review the use of the safe in the medicines cupboard in which to store valuables. Evidence: As part of the inspection the inspector examined the medicines cupboard and the sheets and policies which relate to the administration of medication in the home. Information was also taken from the AQAA, and from discussion with the deputy manager of the unit. Three care plans were examined and records of medication, accidents and incidents checked. In addition the care plan of one particular resident was examined in relation to use of a medicated shampoo. In general residents have written document which identify how individual support is offered, the acting deputy manager informed the inspector that if the need for Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: specialist input is identified then a referral is made to the district nurse, occupational therapy, physiotherapy, or speech therapy unit, residents receive a multi disciplinary review every 6 months, a review of any medication is done in line with the six monthly service review. Each service user has their own personal plan and consent to medication form signed by either themselves or next of kin, there is a protocol for PRN medication in place and policies and procedures are in place for dealing with aging and death. Accidents and incidents were found to be recorded appropriately and if necessary risk assessments updated to reflect any changes in a service users needs. However the inspector found that in relation to one resident who had been prescribed a medicated shampoo for use twice a week this had in fact been used daily from 7/7/08 to 18/7/08 with no record of additional guidance being received from the GP. Also whilst inspecting the medication cupboard additional valuables were found stored in a safe in the same place. Care Homes for Adults (18-65 years) Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have received training in the protection of Vulnerable Adults. The service has produced the complaints procedure in a service user friendly format and this is pinned to the board in the kitchen. However the acting temporary manager must ensure the correct address is on this for the CSCI. Evidence: The inspector evidenced during the inspection that the whistle blowing procedure is on the staff notice board, and that the complaints procedure, and service user guide is displayed in a service user friendly format on the notice board in the kitchen area. However the complaints document had the details of the previous office for the CSCI. Also of concern were in relation to two issues in the service. The first was with regard to the fencing panel in the garden and the second with regard to service users being unable to access their allowance. These were issues which should of been dealt with via the complaints procedure in a timely fashion. The temporary acting manager must ensure that all care managers are notified in writing of the issues with regard to residents inability to access their finances. In relation to the issue with the fence the manager must evidence that this has been addressed and followed through. Evidence from the list of staff training in the home confirmed that staff have carried out training on the Protection of Vulnerable Adults. Care Homes for Adults (18-65 years) Page 18 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well maintained home with personalized rooms. However the access to the garden is not secure and can potentially compromise the safety of the residents placed in the home. Evidence: As part of the inspection the inspector did a full tour of the building including residents bedrooms and the garden. The service has been purpose built for people with complex needs and is a wheelchair friendly environment. There is an adapted bath and shower, disabled toilet facilities and over head tracking hoists in identified bedrooms and also the bathroom, a mobile hoist is also available on the site. Each service user has a personalized room. Evidence from the AQAA and discussion with the manager informed the inspector that domestic chores are completed by staff, with input from the service users if they are willing, night staff are involved in house work completing any jobs which may be unsafe to be carried out during the day such as washing floors. All staff have yearly health and safety training. A separate laundry room is on the site and kept locked when not in use, the washing machine and tumble dryer are industrial, and contain sluice facilities, red bags are in use for soiled clothing. Non slip flooring is in all wash room and bathroom areas. A yellow bag system is in place to collect soiled waste, this is collected by the local authorities every two weeks, a separate sluice Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: room containing an electrical sluice machine to deal with commode pans and urine bottles is in place. Protective clothing is available for staff to wear. In the main the inspector found the environment in good order. However of concern to the inspector was that the fence panel in the garden had been blown down and left on the vegetable patch, and that there is direct access from the back garden to the front car park, therefore compromising residents safety. Care Homes for Adults (18-65 years) Page 20 of 29 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. Staff in the home receive regular supervision and have received training, some staff feel there is not enough time to spend doing activities with the residents in the home. There was also a general feeling of unease among the staff group although some staff stated that they felt things were better now. The acting deputy manager must ensure that staff feel supported to carry out their role and highlight ways to do this, this will in turn provide a more positive atmosphere for the residents who live in the home. Evidence: As part of the inspection the inspector spoke with the deputy manager, temporary acting manager of the site, a senior manager who arrived during the inspection and also spoke with two staff during the inspection. Some of the comments made to the inspector were I dont feel there is enough time for activities in the home. Some staff expressed that they felt demoralized and had not had sufficient support with regard to a incident in the sister home. This was confirmed by a visiting professional to the home who stated that staff had appeared anxious during their visit. However staff did state to the inspector that they felt things were better now. There had been an issue with regard to residents accessing their allowance as staff who were the signatures for the accounts had left. The inspector was informed that this issue has now been resolved and new staff have been appointed to sign for residents accounts. The home Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: has the following staff on duty, three staff in the morning and three staff in the afternoon, one waking night and one sleeping night staff a deputy manager in the home and a overall temporary acting manager on site. This temporary acting manager is shared between the two services Hillview and Oaklodge. Staff supervision is carried out every 6 weeks, and mandatory staff training is up to date in the home. This was confirmed by looking at the record of supervisions and training matrixs in the home. Staff recruitment files were not checked as part of this inspection, no new staff had been recruited and all staff files are kept at a central office. Care Homes for Adults (18-65 years) Page 22 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a management structure in place, and as of the date of this inspection had kept the CSCI informed of any proposed changes in this. It has amended and reviewed the way it carries out the internal audits of the home. However in discussion with the overall manager of the site they were aware they would need to work further on the care plans and the activities in the home. This will in turn ensure the residents placed in the home enjoy a fuller life. In tandem with this the management of the home needs to ensure that staff feel supported and put systems in place to ensure this support continues. Evidence: Hillview shares the same site as its sister home OakLodge, the site has one overall temporary acting manager for the two services and a deputy manager is placed at each home. The inspector spoke with the deputy manager, the overall temporary acting manager subsequently by telephone and a senior manager arrived during the inspection. The inspector also spoke with staff working in the home. The home is in the process of reviewing its policies and procedures however the temporary acting Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: manager could not inform the inspector of a policy which is in place to allow residents to wake and stay in bed in the morning. This has particular relevance to some of the individual residents in the home. The home is also in the process of changing over the care plans to a more person centered approach, and the home must address the lack of significant activities on offer for residents placed in the home. There have been a number of changes in the sister home with regard to staffing and this appears to have affected how the staff at Hillview feel. Some staff in the home have in the past felt unsupported but can recognize that there is now an improvement. This was confirmed by comments received from visiting professionals staff were shaking when they showed us round,they were asking if service users would be removed. The organization has changed its procedure with regard to carrying out its own internal audits of the service and these are now carried out on a rota system by managers from the other homes. Care Homes for Adults (18-65 years) Page 24 of 29 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 25 of 29 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 1 4 The Registered Provider must ensure that the statement of purpose states the aims and objectives of the care home, and includes a statement as to the facilities and services which are to be provided by the registered person. To ensure that service users are protected and their needs met. 01/02/2009 2 6 15 The Registered Provider must ensure service users have a written plan. This will ensure residents needs are met including health care, and that care plans are based on clear guidance and policies within the home. 01/01/2009 3 12 16 The Registered Provider must ensure that service users are consulted about and offered a program of activities in the home that 01/02/2009 Care Homes for Adults (18-65 years) Page 26 of 29 met their assessed needs and the service provides facilities in relation to recreation, fitness and training. This will ensure that the residents, have a full and active lifestyle 4 17 16 The Registered Provider must assess the benefit of using take away food and the quality and nutritional benefit of take away food in the service. This will ensure residents receive a healthy balanced diet. 5 20 13 The Registered Provider shall make suitable arrangements for the recording, handling, safekeeping and administration and disposal of medicines received into the care home. safety 6 24 23 The Registered Provider 01/01/2009 must ensure that a risk assessment is carried out on access to the garden by the residents and the danger of in coming traffic. This will ensure residents safety when using the garden and accessing the front of the home. 01/01/2009 01/02/2009 Care Homes for Adults (18-65 years) Page 27 of 29 7 38 10 The Registered Provider must communicate a clear sense of direction and leadership. This will ensure the staff in the service feel supported and able to fulfill their role. 01/01/2009 8 40 12 The Registered Provider 01/01/2009 must ensure that ll relevant policies and procedure are in place and that all staff are aware of these. This will ensure that residents health, safety and best interests are protected. 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 3 20 22 23 The Registered Provider is to review the position of the safe and also its use. The Registered Provider must ensure all complaints are dealt with in a effective speedy manner. The Registered Provider must ensure the correct contact details of the CSCI are available on the complaints leaflet. Care Homes for Adults (18-65 years) Page 28 of 29 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. 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