Inspection on 27/11/08 for John Turner House - Short Break Service

This inspection was carried out on 27th November 2008.

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

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

Other inspections for this house

John Turner House - Short Break... 14/03/07

John Turner House - Short Break... 10/03/06

John Turner House - Short Break... 11/07/05

John Turner House - Short Break... 15/02/05

John Turner House - Short Break... 11/10/04

John Turner House - Short Break... 17/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: John Turner House - Short Break Service Rotterdam Road Lowestoft Suffolk NR32 2EL     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: Kevin Dally     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 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: John Turner House - Short Break Service Rotterdam Road Lowestoft Suffolk NR32 2EL 01502405449 01502405447 Inneka.winser@socserv.suffolkcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Inneka Rae Winser Type of registration: Number of places registered: Suffolk County Council care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: To include one named service user for a period of 6 months. Date of last inspection Brief description of the care home John Turner short break unit is located in Lowestoft on a site shared with other Suffolk Social Services for people with learning disabilities. Within walking distance are facilities for example newsagents, grocers, public houses, parks and the Lowestoft college. The main shopping centre is about 15 minutes walk. John Turner short break is a single storey building and consists of a large kitchen/ dining room, spacious lounge with television and video. A smaller lounge with television and music centre is also available the service users. This room has a patio door leading to an attractive garden with a number of focal points such as a summerhouse and fountain. There are five single bedrooms all nicely furnished. Three bedrooms have rise and fall beds to manage service users needs more effectively. There are three separate toilets, two bathrooms with hoists and a shower room. Wheel chair users are able to access all parts of the building. The sixth bedroom has been turned into an activity room with a Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 5 Brief description of the care home wide range of equipment such as art and craft materials, a drum, jigsaws and optic lights. The cost of care per night is £119 of which clients pay £9.14. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report is based on a key unannounced inspection of the service, which took place on the 27th November 2008. We also checked any other information we had about the service including the information provided by the service in the annual quality assurance assessment (AQAA). This information told us what the service does well, and any areas they have improved in the last year. The inspection was undertaken between 10am and 7pm so we could meet with the service users (or customers, as they prefer to be called) on their return from their day centre, at 4pm. We were also invited by the customers and staff to join in with the evening meal. We spent time with the customers discussing what they thought about the service provided, and some of them showed us around the facilities. We also Care Homes for Adults (18-65 years) Page 6 of 30 received feedback from one of the customers relatives. No surveys were returned from the customers. Mrs Inneker Winser was present for the afternoon and evening, and helped us with the inspection process. The inspection included checking two care plans, two staff files, various records and talking with the staff on duty. 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. Care Homes for Adults (18-65 years) Page 8 of 30 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. Customers can expect their needs to be assessed and considered prior to commencing their stay in the short break service. Evidence: The short stay unit provides customer information about the services they can offer them, and the standards of the service they could expect to receive. This would enable people to make an informed decision on whether to engage their services. This information was available in the John Turner House (JTH) short break booklet, and included the nature of the service, the aims of the service, the range of services available and the business plan. The complaints procedure was explained separately in the Local Authoritys booklet, Having your say, and who to contact, if a customer was not happy. As the customers of JTH short break are people with learning disabilities, the manager should ensure that the information provided by the service is in a more suitable format for the customers benefit. For example by ensuring the use of pictures and large text formats. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The information provided by the service (the AQAA) said, All customers have up to date care plans including individual needs. We checked two customers records and these showed us that the customers needs are assessed before they come to the short break service. This included those who were accepted for an emergency stay, and those customers who staff had planned a visit for. The service had produced an emergency care plan format that could be used which showed the key needs for them. One customers assessment was checked and found to include relevant information, for example around their behavioural needs, social background and risk assessment needs. There was a family/carer self-assessment that allows the customer or their advocate to explain what their key needs are, and how the service can best help them. There was an admissions procedure available which clearly outlined the information and assessments that would be needed, before a customer could stay at the short break service. This included ensuring that an assessment, self-assessment, meeting and care plan, was completed before the allocation confirmation. The short break service showed us that the staff group had received good training, (please refer to standard 35) so that their knowledge, care skills and experience would be suitable to meet the different care and support needs of customers with learning disabilities. The service ensured that new staff were thoroughly inducted based on the Skills for Care common induction standards, which should ensure that new staff would be trained to meet the needs of the customers. Information provided by the agency told us that 5 of 12 support care staff (41 percent) had achieved a national vocational qualification (NVQ) level 2 in care or higher. (Please refer to standard 32). Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Customers can expect their needs to be explained in a support plan and would be encouraged to make decisions and to take risks as part of an independent lifestyle. Evidence: The information provided by the short break service (the AQAA) told us, All customers have detailed care needs in the care plan and we promote independence by using communication aids, personal risk assessments, management of challenging behaviour, and manual handling. Two of the customers support plans were checked and these provided detailed guidance for staff that related to people with learning disabilities. Examples of information found in the support plan included areas around communication, health issues, medication, behaviour issues and social aspects of their support needs. Both support plans included detailed daily schedules for the customers; so staff were clear about their normal daily routines, and could support them achieve their particular Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: goals. One customers support plan outlined the mealtime routine for them, and staff were seen to follow this guidance. Feedback from one relative told us that their relatives care plan had been discussed with them, and provided a record of their support needs. One support plan for a service user who suffered from epilepsy should provide more details about what staff needed to do, should the person have an epileptic fit. While support plans were found to be quite detailed and well written, peoples care plans would be more meaningful and interesting if they are produced in a way, which reflects their needs and wishes, and in a way that they can understand what is written about them. The customers support plans checked also included assessments of any particular risks for them. One example said, the customer can become violent towards others or themselves. A very detailed risk assessment had been provided which included a Unisafe restraint plan and safe techniques to follow as required. The plan also said two staff with Unisafe training was required at all times. The staff told us that this technique had recently been used with one of the customers. Records checked showed that staff had appropriately followed the risk assessment guidance and technique, had completed the restraint form as required, and had reported this to the management. 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. Customers can expect to be included in a range of daily activities, be part of the community and maintain personal and family relationships. Their rights would be respected and they would be offered a healthy diet. Evidence: The short break service offers respite care and support to customers who wish to stay either as a one off visit, or for a number of visits each year. Customers who arrive for a break continue to attend their normal work placements, to ensure continuity of their lifestyles. The care plans checked provided a record of the customers range of care placements and these included The Lowestoft Centre or Aspire Centre, where stimulating events or educational opportunities are provided. The information provided by the service (the AQAA) told us, Customers participate in Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: helping to cook evening meal, and make their own packed lunch. We ensure the unit is represented at the CCPA meeting & reviews; we look at the needs of customers before booking into the unit. Key workers regularly speak to parent/carers about the changing needs of the customer &are invited to the unit. There is lots of space available to customers with a large lounge, activity area & quiet lounge. During the evening, customers were seen enjoying the television, talking with the other residents, or accessing their own rooms. One customer was seen assisting staff with the evening meal preparations, including laying the dining table. Two customers chose to say in the privacy of their rooms, and were not disturbed. Staff were polite and supportive of the customers and showed respect towards them. Customers were addressed by their preferred name. Feedback from one customers relative said, The customers are well care for, and are happy. They have good trips out including a visit to the circus, and an evening at the pub. They are supported to go shopping. The short break service also provided a sensory activities room that was created by the staff. This room was decorated and equipped with sensory, play, leisure and art materials. There was a music centre, jigsaws and painting material. The customers were encouraged to use the room when they were in the short break unit. The customers we spoke with told us that there were always things to do, and that staff take them out. Generally the customers would attend their day centre, or the Aspire Centre. This centre offers educational opportunities for the customers. Customers were also supported to help prepare a menu and help with the weekly shopping. The staff told us that evening or weekend activities were arranged for the customers depending on the availability of staff and the needs of the customers. This would include visits to the shops, pubs, and church. On one occasion, the customers had been taken to a travelling circus. We were invited by the customers and staff to join in with the evening meal. This was a focal point of the day during which time the customers relaxed, enjoyed their meal, and talked with each other, about their day. There was good conversation with laughter and discussion, and customers expressed their views and opinions about the day. The evening meal selected was baked jacket potato, cheese or tuna fish filling with a fresh mixed salad, which was appetising, and very appropriate for the customer group. The daily menu records were checked for the previous two weeks and these showed a good variety and balance of meals. Some examples included cheese and potato pie, pasta bake and garlic bread, sausage, mash and vegetables, roast pork, shepherds pie, or fish and chips. One customer told me their favourite meal was fish and chips, and baked beans, and said I like the meals. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: The menu reflected a choice of food at breakfast time for example toast and cereals. Each customer was responsible for preparing their packed lunch for the following day, and staff would provide support if needed. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. he customers can expect personal support and would have their health care needs met, including support with their medicines when required. Evidence: The two care plans checked showed that the service was aware of each customers daily routines and support needs. Examples were where the daily routines (morning, evening or night time routines) had been fully recorded and agreed with the customer. One customers records included a communication support plan, which included pictures of the relevant support needed. Staff were also seen to support the customers by listening or asking them about their day. The information provided by the service (the AQAA) said, Customers are encouraged to participate fully in managing their own personal care needs. They have ample bathroom/shower space to meet everyones needs, and we provide lockable storage units for customers wishing to self-medicate. Each person has details of how personal care needs are to be carried out. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: During their stay customers had access to a GP, or arrangements could be made to attend any medical appointments. The care plans showed us that customers could attend a GP appointment and a record of those visits was kept. The medication records and procedures were checked and found to be appropriate to the customers needs. The senior carer was designated to administer the medicines, and was also in charge of the shift at the service. When a customer arrives at the home, their medicines are checked in by staff who record the number and totals received, and are secured in a locked cabinet. Medication administration record (MAR) sheets are provided, and medicines were checked out individually and recorded. Any medicines remaining at the end of the visit are returned to the customer, to continue taking at home. One customers medicines (three tablets) were checked and audited, and the totals recorded matched the number that was in the containers. Care plans checked had guidance for each customer around what there medicine requirements were. Care Homes for Adults (18-65 years) Page 19 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. Customers can expect their views to be listened to and action taken, and they would be kept safe from abuse, neglect or self-harm. Evidence: The complaints procedure was checked and was included in the statement of purpose. The complaints procedure was provided by Suffolk Social Care and was entitled Having your say. Comments, Compliments and Complaints. Social Care would investigate complaints directly. Since the last inspection one complaint had been made about how the service had managed one customers medical condition. A detailed investigation had been undertaken, and the complaint was not upheld. A response had been provided to the complainant, and there was evidence to show that they were satisfied with the service provision. The service had also received a number of compliments a selection of which included the following views. Thank you for my card and gift, which was most unexpected, but very much appreciated, or Thank you all for all your kindness and for giving us a break, or To all the staff, we deeply appreciate all your efforts. Staff training records checked showed us that staff had attended safeguarding training, and managing challenging behaviour. Two staff members records checked showed us that these staff had completed this training. Staff members we spoke with Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: said they had received this training. The service was fully aware of the Suffolk multiagency safeguarding policy, and a copy of this guidance was kept at the office for staff to refer to. One customer who was in the service during the inspection presented with the risk of self harming and harming others however there was always members of staff who had been allocated to accompany the person at all times. Customers were also provided with a booklet for called, Say No to abuse, which was in a easy to understand picture format and showed different types of abuse, and who the customer could speak to if they had any concerns. Care Homes for Adults (18-65 years) Page 21 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The customers can expect to stay in a service that is homely, well maintained, safe and clean. Evidence: The service offers a pleasant environment where there are wide corridors leading to the bedrooms, toilets, bathrooms and lounge and dining area. The external door is secured with a keypad therefore ensuring that customers property is protected and when they are in the service that no visitor is able to gain free access to the building. There is sufficient space in the bedrooms with a bed, wardrobe and chest of drawers. The lounge area is substantial, light and airy with a selection of chairs to offer the customers a variety of places within the lounge. The dining area is designed to allow customers to move freely around the tables and chairs and to select where they wish to sit. There were a number of hoists and the appropriate slings to enable staff to move and handle customers around the building and into and out of the shower and baths. The home is carpeted in the communal areas with the exception of the dining area. The service had a number of bathrooms and toilets and on inspection there was appropriate hand washing equipment for example a basin and liquid soap with paper Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: towels. In the kitchen there was a separate hand washbasin in addition to a sink for the preparation food and washing up. There was a dishwasher for the majority of plates and dishes. The entire home was well maintained, clean and tidy, with appropriate fixtures, fittings, and carpets. The home also had good wheelchair access to secure outdoor areas, decks and gardens, and a water fountain. Care Homes for Adults (18-65 years) Page 23 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. Customers can expect to be supported by staff what are competent, qualified and trained to meet the customers support needs. The services recruitment policy and practices protect the customers. Evidence: Two staff members records were checked and found to include the recruitment information and checks needed to ensure the protection of younger vulnerable adults. The records checked showed the agency had obtained appropriate documentation which included application forms, criminal records bureau (CRB) checks, protection of vulnerable adults (POVA 1st) checks, reference checking, a photo, proof of identity, and a declaration of health for staff members. Application forms included the employees previous work history, and relevant care experience to ensure their suitability for the job. The agency provided all staff with mandatory training, and new staff with induction training based on the guidelines provided by Skills for Care, which should ensure that staff could meet the needs of the service users. Induction training is provided which includes safeguarding, moving and handling, medicines training, care topics, infection control and Unisafe training for people with challenging behaviour. Foundation training Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: follows and includes 6 core subjects, as recommended by Skills for Care, which are completed within the first 12 weeks of employment. Two staff members records checked showed us that the agency had provided detailed training for these workers. Feedback received from staff members told us, We receive good training. Information provided by the agency told us that 5 of 12 support care staff (41 percent) had achieved a national vocational qualification (NVQ) level 2 in care or higher. This was slightly lower than the previous inspection which was around 55 percent. The service therefore needs to consider how it will again meet the recommended standard of 50 percent staff NVQ trained, to ensure that it has sufficiently qualified staff to meet the customers needs. Job roles were described within staff job descriptions, which each staff member had received. Staff spoken with and records checked showed us that regular supervision continued for staff. Further, staff said they felt supported by the management, and any problems could be discussed with their supervisors. Care Homes for Adults (18-65 years) Page 25 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. Customers can expect to benefit from a well-run service and can be confident their views are sought. Evidence: The manager confirmed that there were suitable management arrangements in place for the effective operation of the short break service. The manager provides 18.5 management hours a week in addition to the senior support worker, who provides the remaining 22 hours. Mrs Winser had around 23 years experience in care work and commenced working in John Turner House in 1997. She was appointed as the manager of the service in 2004, and has an NVQ 3 supervisory management, and an NVQ 4 registered managers award qualification. The manager told us that the service has appropriate quality assurance systems in place to ensure feedback from the customers, so that it can continually review and improve the service. At the end of each stay, customers are invited to provide feedback via a pictorial questionnaire, or at a review meeting held each year. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Customers records checked showed that these customers had been asked about the service, and had provided good feedback to the service. One customer said, I like to water the plants, and watch T.V., and I like my bedroom when staying in the short break. Another customer said, I like the food here, and I eat well. Feedback from one residents relative told us that the home was very friendly, and that there was A nice atmosphere at the home. Further, that they considered the service was like a home from home for their relative. A check of the regulation 26 records (a report about the quality of the service by the provider) showed us that these had not been completed for some months. These reports must be completed monthly by the provider to evidence ongoing quality and monitoring of the service. However, this was raised by the manager, who told us that the Local Authority was addressing this issue, and that checks would be started again this month. The health and safety information was kept in the service office where the relevant policies and procedures were available. There were risk assessments in place for all customers including manual handling and the environment. Accidents and incidents records were maintained and kept in the office. Additional health and safety policies included infection control, substances hazardous to health (COSHH) and fire precautions. The fire records were checked and seen as up to date, and the service had a fire risk assessment in place. Staff records checked showed that these staff had attended appropriate health and safety training, which would ensure they understood their responsibilities in relationship to health and safety. Care Homes for Adults (18-65 years) Page 27 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 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Information for customers should be provided in a more easy to understand format. This is to ensure that people with learning disabilities can make choices about the service they want. One support plan for a service user who suffered from epilepsy should provide more details about what staff need to do, should the person suffer from a fit. This is to ensure that staff are aware of the procedures in the event a customer has a medical emergency. Peoples care plans would be more meaningful and interesting if they are produced in a way, which reflects their needs and wishes, and in a way that they can understand what is written about them. The service should review how it proposes to meet the recommended 50 percent staff achieving a national vocational qualification (NVQ) level 2. This is to ensure that the service has a suitable number of staff trained to meet the customers needs. 2 6 3 6 4 32 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. 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