Inspection on 19/12/08 for James Court

This inspection was carried out on 19th December 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

James Court 01/08/07

James Court 17/07/06

James Court 27/02/06

James Court 06/09/05

James Court 01/03/05

James Court 28/09/04

James Court 03/03/04

James Court 26/11/03

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: James Court 6 St Pauls Square Burton On Trent Staffordshire DE14 2EF     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: Peter Dawson     Date: 1 9 1 2 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: James Court 6 St Pauls Square Burton On Trent Staffordshire DE14 2EF 01283740411 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jamescourt6@hotmail.co.uk Mr Sivasubramaniam Kathirgiamathamby Sathianathan,Mrs Perpetua Jasmine Sathianathan care home 12 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 1 learning disability Additional conditions: Date of last inspection Brief description of the care home 12 James Court is a residential home located in the centre of Burton, Staffordshire. The home provides a service for up to twelve male or female adults who have a learning disability. The large Victorian detached property provides six single occupancy bedrooms and three shared rooms. The home has a lounge, dining room and a quiet room/music room located on the ground floor. There is a large domestic kitchen that has recently been upgraded. Bathrooms and toilets are located throughout the building and are in close proximity to bedrooms and communal areas. The home is not registered for people with a physical disability and would not be suitable for individuals who are wheelchair users; grab rails are provided through parts of the home. The location of the home is accessible by public transport and is very close to the town centre and all local amenities that are within a short walking distance. Limited parking space is provided within the grounds. Current fee levels are 315- 1819 pounds per week. Residents pay for their own personal items, including toiletries, magazines, holidays and chiropody Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home 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: 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: The last inspection on this service was completed on 1st August 2007 The AQAA (Annual Quality Assurance Assessment) is a self-assessment legal document required to be completed annually by each service - reviewing and stating the levels of service provided. This was returned to us prior to the inspection and some information from the AQAA is included in this report. The unannounced key inspection was carried out by one inspector on one day from 8am - 5.30 pm. The Registered Manager was on duty and provided all the required information for the inspection. The 2 Deputy Managers were also present and all provided helpful and detailed information about the service. Care Homes for Adults (18-65 years) Page 6 of 30 All people in the home were seen, with the exception of one who was in hospital. The majority of people were spoken with where possible, some needing communication interventions by staff. There was an examination of records including care plans, risk assessments, staffing rosters, medication records and staff files and other documents relevant to the inspection. All communal areas of the home were inspected and also a sample of most bedrooms. No visitors were seen during the inspection and written feedback was not received by us due to the fact that we were not able to request the information in time for the inspection. People in the home able to express a view said that they were happy at James Court, many have been here for several years and are clearly settled. There have been no new admissions since the last inspection. There was a relaxed atmosphere in the home, staff sat with people spending time and engaging positively. People spoke positively about life at James Court, they were clearly used to visitors and talked about daily events and holidays in particular, insisting that the holiday photo albums were shown and they recalled the good times evidenced in the holiday photographs. What the care home does well: What has improved since the last inspection? What they could do better: Some aspects of medication record keeping must be improved. It is important that the prescribers instructions are mirrored on MAR sheets ensuring the correct dose and Care Homes for Adults (18-65 years) Page 8 of 30 timings reflect the prescribers instructions. A reducing count of all medication will also ensure that an ongoing audit of the system is possible. Privacy screens should be provided in all shared bedrooms, ensuring the occupants have the option to protect their privacy and dignity. Strip flourescent lighting in bedrooms is unsuitable and alternatives should be provided. Finances held by the home are carefully and accurately monitored. Additionally it is recommended where possible, that people should sign for the monies they receive or expend as a means of furthering independence and empowerment. Other areas of empowerment include - allowing people a role in the provision of their care -is to consider giving them the opportunity of being involved in staff recruitment. It is recommended that the system of providing a paid chiropody service for all is reviewed. Evidence of agreement by people using the service/their representatives, is advisable. Once established, the option of reverting from a private to free NHS service becomes remote. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Adequate information enables a considered choice of home and pre-admission procedures ensure successful placements. Evidence: The home have a Statement of Purpose and a Service Users Guide which they call the Residents A - Z. A recommendation of the last report was made to improve the format and presentation of the latter and present it in an easier-read form. This has been done and produced in large print with revised pictorial features. Information relating to CSCI in the A - Z requires updating to include the current address and telephone number. There have been no new admissions to the home since the last inspection. Previous admissions have been handled well with pre admission assessments carried out and gradual introductions to the home involving day visits, meals, overnight stays and weekend visits prior to placement. The home always insist upon a multi-agency Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: assessment co-ordinated by social services prior to admission. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improved care planning ensures needs are known and met. Individual consultation and involvement could be further improved. Evidence: The home previously switched to a new care planning format which they have adapted to meet the needs of this group of people. The format contains a mixture of tick-boxes for ease of compilation and information with boxes for text to record more detail of needs and how they can be met. Five recommendations relating to care planning information were made at the last inspection and the home have worked hard to apply those recommendations. A sample of care plans seen contained adequate information about the personal, health and social care needs of people. Plans contained detailed information where Consultant Psychiatrists are involved with diagnoses and treatment adequate recorded. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Some challenging behaviours presented were documented with instructions to staff about actions to be taken to deal with those behaviours. Risk assessments were seen in relation to visiting the community, road safety, bedrooms, electrical and water hazards. These are reviewed on a 6 monthly basis or sooner if circumstances change. Reviews held 6 monthly were documented together with annual reviews by sponsoring local authorities. People and their families are involved in reviews. A large picture format is available and used with care plans. This enables a better understanding for people, of the aspects of the care plan being reviewed. Behavioural and communication support plans contain more information about the needs of people and the inputs required by staff to give greater support. Many improvements have been made in this area. Participation in the daily running of the home is by means of residents meetings and annual quality assurance questionnaires to people and their families. The home are considering the involvement of possibly two people in the process of staff selection in the future. During the inspection staff were seen to stimulate and seek the views of people in the home, although in one instance a persons views were not appropriately supported and this was later discussed with the Manager. Staff generally had good engagement with the people they support. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities provided offer opportunities for social enjoyment and enhance quality of life. Evidence: A range of internal and external activities are provided. Four people attend external day centres run by local authorities that provide continuity of relationships and activities in their lives. One person sponsored by Derbyshire social services attends a day centre there on 2 days each week, others attend local day centres. Four people do not attend day centres and a daily activity programme is provided for them within the home but with daily visits to the community. Since the last inspection the home have further developed links with community social Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: groups. There are 4 groups accessed each by 3 people on different nights, they include groups run by church, MIND and other voluntary organisations. People said that they enjoyed attending the groups saying we have a good time and have made friends there. One group was suggested by a parent and now 3 people from the home attend regularly. Two people attend different churches at weekends. The social and communication skills of people are extended in accessing the community facilities mentioned. Independent living skills in the home are limited to input into menu planning but no food preparation. Some people do attend shops with staff who purchase food. Some people are encouraged to change their beds, hoover and tidy bedrooms with staff, but not involved in laundry. Ongoing records of all daily activities including family visits, home visits, phone calls, outings and internal and external visits are kept in individual daily communication sheets. James Court is very close to the Burton town centre allowing easy, swift walking access to the shops and a wide range of community facilities All have an annual holiday. This is planned in advance by people in the home. They were more than keen to talk about their regular holidays in the Isle of Wight and other places, presenting numerous photographs clearly recording the good times that they enjoyed. The group said that they had decided to go to another resort this year and were talking in detail about their plans. In 2008 all 10 people went on holiday for a week supported by 4 staff members. This is clearly a joint, preferred option enjoyed by all. When asked people said that they enjoyed the food at James Court and said we have what we want, the food is good. Menus supported a varied and nutritional diet. The dining room is well-decorated and furnished with tables and chairs. The area is very plain with restrictions upon the homely additions to soften the area due to the reported unpredictable behaviours that can be presented. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The healthcare needs of people are met. Improvements in the accuracy of medication records will ensure people receive the correct medication. Evidence: Care plans seen gave adequate information about the level of support required by staff to meet personal care needs. Only one person has mobility needs and has a ground floor bedroom with appropriate grab rails in place for toileting/bathing. Care plans contained diagnosed conditions and detailed healthcare plans identifying their healthcare needs. All have a learning disability, some have mental health needs and others emotional care needs. Some people present challenging behaviours, although restraint is not required and in difficult situations other people are effectively moved from the scene to ensure their safety. Two people have communication needs, one with no verbal communication. Specialist Learning Disability nurses and Consultant Psychiatrists are involved and also Community Psychiatric Nurses to assess and advise on how best to meet the specialist needs of people in the home. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: All have regular annual medical and medication reviews with the GP and services for dental and optical care accessed in the community. the home reported a good service and positive working relationships with 5 different GP practices. This was confirmed in written feedback from a GP and other healthcare professionals. A Consultant Psychiatrist provides an ongoing service to 5 people at James Court with regular reviews and direct access in the event of any specialist advice being needed. A private chiropody service is provided for all people in the service for which they pay 16 pounds approximately every 6 weeks. This was established in the absence of a satisfactory NHS (National Health Service) provision. The Manager said that families were happy with this arrangement, although there had been no written consents. It is recommended that this service is reviewed - some people may not be able or willing to pay for what should essentially be a free service. The medication system was inspected and showed some shortfalls. There is no self-medication in the home at this time. MAR (medication administration records) sheets showed some inaccuracies. The information on MAR sheets did not reflect the instructions of the prescribing doctor. In one instance chlorpromazine PRN (as required) was prescribed once a day but the MAR sheet recorded twice per day. It is important to check instructions on MAR sheets which must reflect the prescribers instructions. Medication on some MAR sheets had been handwritten and it is recommended that these are checked and countersigned by another member of staff to ensure their accuracy. It was also noted that the numbers of tablets provided in bottles had not been recorded on MAR sheets, this should be done to ensure an audit of the medication system is possible. All staff administering medication have had appropriate training. The Manager carries out competency tests on an ongoing basis to ensure continued safety. 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. A complaints procedure is in place and staff have knowledge and training to ensure the protection of people. Evidence: There is a copy of the complaints procedure available in the home. There is a also a copy with the service users guide that all people have a copy of. The contact information for CSCI needs to be updated. The procedure available to people in the service is in pictorial form. There have been no complaints to the home or to us since the last inspection. There is information available to staff in the form of policy documents - Recognition and Prevention of Abuse and there is a copy of the Staffordshire/Stoke on Trent Vulnerable Adults Procedures (Multi-agency procedures). The Manager has provided abuse training for staff and some have had external training. Sample questionnaires for staff were seen relating to this topic. Staff meeting minutes dated November 2008 evidenced some training in Safeguarding at that meeting. Supervision records also showed discussions also. The AQAA (Annual Quality Assurance Assessment) completed prior to the inspection by the Manager stated that further random testing for staff during supervision was carried out to ensure Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: knowledge and understanding of Protection issues. A recommendation of the last report was made to provide staff with training in the management of challenging behaviours. This has been done and evidenced in staff training records. The home holds finances for all people in the service. Some appointeeships to receive benefits/payments are held by the home but the Manager says these are being transferred to Social Services. A sample of financial records and cash balances held by the home were inspected and all had the correct current balance. Financial records were detailed and included 2 staff signatures for transactions with receipts obtained wherever possible. It is recommended that where people themselves are able to sign to confirm transactions, this could be done as part of greater empowerment. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and secure place for people who would also benefit from improved screening and lighting in bedrooms. Evidence: Since the last inspection many areas of the home have been upgraded. The kitchen has been completely re-fitted at considerable cost providing a spacious, modern, wellequipped area. The hall, landing, stairs and 2 bedrooms have been re-carpeted improving the presenation of the home. The home is generally well-maintained and re-decoration is ongoing. The maintenance log was seen and all items entered had been actioned swiftly. The area now requiring attention is the external paintwork which the Manager said was to be actioned next year. There is some damp around internal window areas which the Manager said would be remedied after the winter. Windows are wooden sash-type, apparently Upvc cannot be installed because of planning restrictions on this Victorian villa. A sample of bedrooms were seen and were generally personalised, reflecting the individuality of the occupants. There are 3 double bedrooms one presently shared by two ladies, but there is no privacy curtain. There is a rail for the curtains but they are Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: not hung. The reason given was that the occupants did not want the curtains in place. Another shared bedroom on the ground floor similarly does not have curtains. There have been two young men occupying the room until recently, the remaining man said that the curtains were not used when someone shared the room with him. He talked about being disturbed in the night due to the needs of the other person and did not wish to share again. The reason given for not using the privacy curtains previously was health and safety issues relating to mobility. It is important to ensure the privacy and dignity of people sharing bedrooms, that privacy screening is in place, used by staff and people encouraged to use it to ensure their dignity. It was noted in 4 bedrooms seen that all had large flourescent lights, fitted to the ceiling and was the sole form or lighting. This provides a stark and inappropriate form of lighting in bedroom areas. The lights should be replaced with domestic lighting, or diffusers fitted and bedside lamps provided as a less severe and more ambient means of lighting at night time. There are 2 lounge areas providing comfortable seating along domestic lines. The large lounge will easily accommodate up to 10 people the smaller lounge, is a quiet lounge used individually by people or to receive visitors in private. Both areas are comfortable and homely. This visit was made in the week prior to Christmas people had been involved in decorating the home and together with the large Christmas tree provided a warm, homely feel to the communal areas. Standards of hygiene throughout the home were good. There is a large, pleasant, secluded garden area with good seating which is used considerably during the summer months and allows a place for people to use at other times. This is particularly important as none of the people in the service are able to leave the home unescorted. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and experienced staff group ensure a good level of support to people in the home. Good recruitment procedures ensure the protection of people. Evidence: There have been no new staff appointed since the last inspection, allowing continuity of care. There are generally 3 staff on duty during the day increasing to 4 often as required. There were 4 staff on duty on the morning of this inspection plus the Manager. The staffing rota confirmed there were adequate numbers of staff, generally the weekly staffing hours are 436 (including the Manager). One person has funded 1:1 staffing for 16 hours throughout the day and included in the figures stated. There is 1 waking night support worker and 1 Senior sleeping-in and on call. Although there had been no recent staff appointments, a sample of staff files showed that appropriate police and other checks had been carried out prior to employment, with 2 references obtained and other documents required by regulation were also present. People in the home are not presently involved in staff selection. The Manager has plans to involve at least 2 people in the staff recruitment process. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff training records showed that statutory training had taken place for all staff and additional service-specific training had also been provided. This included training in the management of challenging behaviours particularly relevant to the service at this time. Although there have been no staff induction needs since the last report, it was confirmed that induction standards are now to Skills for Care common induction standards. The home has a good record of NVQ training, only 1 person (65 years) has not been involved in NVQ training. All have completed NV2 training, many progressing to NVQ3 and the deputies have undertaken NVQ4 training including the Registered Managers Award. NVQ training far exceeds the required minimum levels. Generally good engagement and positive established personal relationships were evident between staff and people in the home, although there was one exception that was discussed with the Manager during the inspection. Three staff meetings have been held this year, minutes were seen and evidenced an open agenda and discussion. Supervision records showed that efforts to provide 4 sessions per year had been achieved in 2008. 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 home is well-run and managed with positive leadership and an experienced staff group. The health, safety and welfare of people is promoted and protected. Evidence: The Registered Manager is also a provider (owner) of the home. She originally qualified as a learning disability nurse. She has considerable experience and has operated the home since it was established 13 years ago. She continues to update her professional practice and skills. She takes a positive lead in the home and has an open and meaningful working relationship with staff. This was confirmed in a Christmas card seen, which was recently sent by all staff to the Manager and also in written feedback from staff. Conversations with people in the service and staff further confirmed this. There are 2 Deputy Managers presently studying NVQ4/Management who also take a positive lead in care provision. There is a Quality assurance system in place which includes the usual internal audits of Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: aspects of the service including Health and Safety and general risk assessments. Annual surveys are solicited from people in the home, their relatives and external professionals involved with the service. Comments included Friendly, well informed staff, adequately trained to meet the complex needs of residents (Consultant Psychiatrist). Well managed and organised home. Residents appear very happy (Specialist Learning Disability Nurse). I have been impressed by the general standard of care - (General Practitioner). There were positive comments from relatives on behalf of people in the home. These comments were made in late 2008 following the recent annual survey initiated by the home. Two recommendations of the last report relating to these outcomes were made and have been actioned: Support plans have been revised/extended to contain all necessary information required by staff to support people and the Fire Officer has confirmed that the fire risk assessments relating to evacuation of 2 people were satisfactory. Following discussions between the Fire Officer and the Manager, it was recommended that additional fire sensors would provide additional protection of the building. This work has been carried out although it was not a statutory requirement. 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 1 20 13 Review arrangements for the recording, handling, safekeeping and safe administration of medicines. This will ensure people have the correct medication prescribed for them. 09/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 Review arrangments for payment for private chiropody service to ensure all people are willing and can afford to pay. It is recommended that where possible people should sign for transactions relating to their personal finance. This will ensure the involvement and empowerment of people. The option of privacy screening must be provided in all shared bedrooms. This will ensure peoples privacy and dignity are respected and protected. Strip fluorescent lights are not appropriate in bedrooms and should be fitted with diffusers or replaced with domestictype lighting. Bedside lights should be provided in all bedrooms. Page 28 of 30 2 23 3 25 4 26 Care Homes for Adults (18-65 years) 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. 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. 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