Inspection on 09/09/09 for Leahurst

This inspection was carried out on 9th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Leahurst 18/11/09

Leahurst 15/08/07

Leahurst 06/02/07

Leahurst 01/01/06

Leahurst 25/08/05

Leahurst 12/01/05

Leahurst 07/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Leahurst Coronation Drive Widnes Cheshire WA8 8AZ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Maureen Brown     Date: 0 9 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.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: Leahurst Coronation Drive Widnes Cheshire WA8 8AZ 01514951919 01514233513 HRHLEAHURST@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hilton Residential Homes Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 26. Date of last inspection Brief description of the care home Leahurst provides personal care for twenty-six adults with enduring mental health needs. The home has two double bedrooms but uses these for single occupancy. There are two buildings, the main building with a first floor independent three bedroom flat and the lodge a three bedroom detached property. The flat and the lodge have their own kitchen, bathroom and living areas. The main building has twenty bedrooms one of which is en-suite. Other facilities include a residents kitchen, dining room, main lounge, conservatory and smoking lounge. The home has a patio area to the rear of the property with a large area of lawn, where Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 26 Brief description of the care home service users can sit. There is car-parking area at the front of the property. The home is close to local shops and a mile away from Widnes town centre. It is on a local bus route and close to two railway stations. 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: We carried out an unannounced visit to the home on 9 September 2009 and this lasted seven and a quarter hours. It was done by one inspector. The report will say we when referring to what was done and found at this visit, as it is written on behalf of the Care Quality Commission. The visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to some of the people living at the home and staff to find out their views about the home and service provided. Other information received about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of three people who live at the home, to see how their needs were being met. We looked at the files of three staff members to check on the recruitment processes Care Homes for Adults (18-65 years) Page 6 of 30 used by the home. We spoke to people living at the home, the manager, the senior care assistant and other staff members who were on duty. They all gave their views about the home. The fees for the home are from £397.00 to £437.61 per week. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: Two requirements and seven recommendations were made at this visit. Although supervision sessions and appraisals had been completed since the last visit these had not been maintained. Appraisals should be carried out annually and staff should have regular supervision sessions with their line manager to give them an opportunity to discuss their work practice and future development. Each person living within the home must have a up to date care plan and risk Care Homes for Adults (18-65 years) Page 8 of 30 assessment and these should be updated regularly and as required in line with the individual persons change in well-being. Care plan reviews should be completed regularly to make sure that they continue to provide correct up to date information to meet peoples needs. A plan of refurbishment and redecoration should be provided by the home to ensure that the environment is improved for the people who live at Leahurst. It was suggested that satisfaction surveys should be developed for relatives and other stakeholders so that a full view of the home is obtained. Also an analysis of information received should be produced and shared with the people living at the home, other interested parties and the commission. It was recommended that copies of the accident reports be kept on the individual persons file, not in one file, to comply with data protection requirements. Also that a copy of the electrical hard wiring certificate be kept at the home to show that the home is safe for the people who live there. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.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. People receive enough information about the home for them to make an informed decision about moving in and their needs are assessed before they move in so they know that these can be met at the home. Evidence: A copy of the information that tells people who is the service is for, the statement of purpose and service users guide, had been updated in April and May 2009. Information in these included facilities and services, information about the home, other services, complaints procedure and quality assurance process. Details of the manager Mike Moran staff, other people from the company and management structure were also included. These documents were written in plain English and provided in standard print format. They were also available in large print on request. Copies of these documents could be found in the entrance hall. The previous recommendation had been met with regard to looking at other formats. The manager said that providing the documents in standard and large print met the needs of the people living at Leahurst. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: There was a document available for staff to use with people before they move into the home, to check on what their needs are. The document contains information on the person, their next of kin and GP, all personal care and daily living needs. This is used with the information gathered from local social services about the persons needs. The staff confirmed that all this information is available in the staff room for staff to look at before somebody moves into the home. This would help them to be able to provide support for the person as soon as they moved in. 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. Peoples care plan and risk assessment records were not up to date so that their assessed and changing needs were not being met. People who live at Leahurst are able to make choices about their lifestyle and their privacy is respected. Evidence: We looked at the care plans of three people who live at the home to check on the care they were receiving. Out of the three plans, one persons assessment documentation and care plan was missing. The manager and staff team on duty tried to find this during the day of our visit but were not able to. There was other evidence to suggest that these documents had been available but were not there when we looked at the files. A requirement was made regarding this. The other two care files we saw contained care plans indicating each persons needs. Also included were reviews from the local mental health team and social services reviews. The previous recommendation about social service reviews being monitored by the manager had been met. Two of the three care plan reviews were not up to Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: date; they need to be kept up to date to make sure that the staff have relevant information about the persons needs and how these should be met. People who live at Leahurst are encouraged by the staff to do what ever they want to do. Of the three risk assessments we saw one was two years old and the other one was not dated. A requirement was made regarding this because it was not possible to see if these risk assessments were up to date and still relevant. The risk assessment document covers fire risk and areas relating to mental health issues such as self harm, potential harm to others, substance abuse and self neglect. 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. People who live at Leahurst were able to take part in a range of activities and receive support to live their chosen lifestyle. Evidence: Activities are provided for people who live in the home and these include cards, dominoes, giant crosswords, quizzes, jigsaws, football, gardening, chess, drawing and bingo. Many people go out and about into the community on their own. One person has a voluntary job locally and another person is supported independently from the home to get out and about in the community. The people who live at Leahurst are consulted on what they want to do individually and during residents meetings. People who live in the home are offered choices in various ways, such as the time they get up or go to bed, what they wear and what they do each day. Also by deciding on whether or not to join in activities and also by how they wish to be addressed. This Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: gives people some control over their own lives and helps them to stay as independent as possible. The home has a four-week menu plan which is predominately a traditional menu that the people who live in the home prefer. At present the menus are being reviewed and some changes are being made following discussions with the residents at a recent meeting. There are three choices available at each meal time and the main meal is served at lunch time. During discussions with the cook she said that there were several types of diets that people required including diabetic, weight increasing and low fat. Records were kept of the temperatures of the hot food, fridges and freezers to ensure that foods are stored at the correct temperatures. The cook also said that a new cooker and water urn had been purchased recently and that these were working well. 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 health care needs of the people who live at Leahurst are met by the staff team in a way that promotes the persons independence, privacy and respect;, however staff do not have adequate records to help them to meet the needs of the people who live at Leahurst. Evidence: Visits from health care professionals were recorded and we saw from the records that visits to the GP, dentist, chiropodist, optician and district nurse were attended by the people who live in the home. Visits from social workers were recorded as well. It was confirmed that health care professionals would also visit people at the home if required to make sure that they remain well. From discussion with the people who live at the home it was clear that personal support is carried out as each person prefers, so that choice and respect are maintained. However the lack of up to date information in peoples care plans and risk assessment records means that staff have to rely on their own knowledge of each person and verbal information to address each persons individual needs which can potentially put the carer and the person living at the home at risk. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The medicines for people who live at the home are supplied in a monitored dosage system, as this helps to make sure that medicines are given correctly at the right time and as prescribed. Medication is stored securely in a locked medicine trolley. Medication administration record sheets were completed when medication was given. We looked at a sample of the records and these were completed correctly to show that no errors had been made in giving out the medicines. The senior care assistant said that the system was good and that the procedure worked well. 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. The homes procedure for complaints and safeguarding are effective so that the concerns of people who live at Leahurst are listened to and they are protected from abuse and harm. Evidence: We looked at some of the staff files and saw that they had completed training on safeguarding adults. The manager confirmed this and showed that he was aware of the policy, procedure and guidance on safeguarding. Other policies were available regarding the protection of vulnerable adults including restraint, management of aggressive behaviour, harassment and whistle blowing. No safeguarding referrals had been made by the home over the last year. The complaints procedure was satisfactory and contained details of how to contact the commission. The home had not received any complaints since our last inspection and the commission had received one complaint which was investigated and resolved prior to this visit to the service. People who live at the home said they would speak to the staff or the manager if they had any problems. Care Homes for Adults (18-65 years) Page 19 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. Leahurst is a clean and safe home for people to live in. Evidence: We had a look around the home during our visit and saw all the shared (communal) areas and some of the bedrooms. There are two double rooms which are used as single rooms and also eleven single rooms. Bedrooms had been made more homely by the people living there. They had pictures, furniture, TVs and other equipment that they either brought with them or have purchased since moving into the home. The overall standard of the decor was adequate, however many of the doors and woodwork generally were damaged and would benefit from redecoration. The manager said that decoration is renewed on an as and when needed basis. The previous recommendation with regard to a refurbishment and redecoration plan had not been met and was made again. The home was clean and had no unpleasant smells. The home employs one cleaner and she maintains the hygiene standard of the home with some support from the staff team. Since the last inspection a new cooker and urn has been purchased for the main kitchen and a new call system has been installed. One bedroom has been Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: redecorated and the residents kitchen has a new cooker and kitchen units. Care Homes for Adults (18-65 years) Page 21 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. The recruitment procedures are thorough and staff have completed a range of training so people who live in the home are protected from poor practices. Evidence: The staff rota showed the staff on duty over the week. The staffing levels appeared to be sufficient to meet peoples needs. People who live in the home confirmed they were usually enough staff around to help them and during the visit we saw that staff were attentive to peoples needs. We checked three staff files to see how the staff had been recruited. All the necessary pre-employment checks had been carried out and these included Criminal Record Bureau checks, health checks, identity checks, references and application forms. The files were in good order and it was easy to access the relevant information required. The training staff had completed included an induction course based on person centred approaches, medication awareness, moving and handling, food hygiene and infection control, safeguarding, health and safety and fire safety. Other courses staff had undertaken included risk assessments, first aid, mental health basic awareness and supervisory development. The previous recommendation with regard to refresher training had been met. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Excellent progress had been made with National Vocational Qualification (NVQ) level 2 in care training. Nine out of eleven staff had obtained this award. This means that a very high percentage of staff have a nationally recognised qualification in care to help them provide good quality support for people who live at Leahurst. Day to day supervision of the staff team was good. Following previous requirements being made these had been brought up to date. However, supervisions had lapsed with only four of the staff team having one formal session during 2009, the other seven staff having supervision during 2008. All appraisals were out of date, having not been completed over the year before this visit. Recommendations were made regarding supervisions and appraisals to be brought up to date again. Care Homes for Adults (18-65 years) Page 23 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. A settled, competent and well trained staff team provide a package of support for the people living at Leahurst. Evidence: The registered manager is a qualified nurse with twenty-seven years experience in mental health nursing. He has managed the home since 1993. He stated that he is in regular contact via email and phone with the responsible individual who resides in America. The quality assurance process for the home includes meetings for people who live and work at the home, questionnaires completed by the people who live at the home and by compliments received by the home. Satisfaction surveys had been completed in March 2008, December 2008 and June 2009. Each time a different survey is sent out to focus on different areas such as the home, staffing and general information. comments from these surveys included, The home is very good, All the staff are good, The food is fantastic and The staff treat me well. Other comments included I am looked after well, Very pleased with the home and the food and Very well Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: cared for. Previous recommendations about sending surveys to relatives and other professionals and producing an analysis of the information received and sharing it with people who live in the home and other interested parties had not been addressed. These recommendations were made again. Meetings for residents are held on a regular basis with records kept. Also staff meetings are split into senior team and staff meetings. These also are held on a regular basis with records kept. A range of compliments had been received at the home by note, letter and cards. These showed the appreciation of the care and support by the staff and the home. Comments included I dont think my relative could be in a better home and Many thanks for everything. People were supported with their finances at Leahurst. Each person had their own personal finance record sheet and their own bank account. The manager stated he audits the money kept at the home each week. A sample of cash balances were checked and found to be in order. We saw that safe working practices were in place with in the home. There were up to date safety checks on the homes gas installation and portable appliance tests. The electrical hard wire certificate could not be found. The manager said that he would fax a copy of this over once it is found but it had not been received prior to this report being written and therefore a recommendation was made that the certificate be obtained. The accident book was kept up to date and records seen were stored in one file. We suggested that these be kept on individuals files but the manager told us that he had been told by Health and Safety to store the records together. The fire safety equipment test log book was up to date and completed appropriately. A range of policies and procedures were available in relation to health and safety and these included dealing with hazardous substances, health and safety, fire safety and food safety. A range of policies and procedures were seen and appropriate for the home. The smoking policy stated that smoking is not permitted in the bedrooms, but that people who live in the home can smoke in the designated lounge and that staff must use smoke outside. The policy of gifts and presents from clients states that staff are to decline any gifts as we are not permitted to accept gifts. It also goes on to say that staff must not sign or witness any legal document. It did state that if a resident was getting agitated about a refusal of a gift then the staff member could provisionally take the gift and leave it in the office until the manager could be consulted. A written Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: record would be kept of any gift kept by a staff member. 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 7 15 Each person must have a care plan that is up to date and reviewed regularly. This is to make sure that staff have sufficient information to support each individual living at Leahurst. 23/10/2009 2 9 13 Each person must have an up to date risk assessment that it is reviewed regularly. This is to make sure that staff have sufficient information to support each individual living at Leahurst. 23/10/2009 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 24 A plan of refurbishment and redecoration should be produced to ensure that the environment is improved for the service users. Staff should receive regular supervision sessions with Page 28 of 30 2 36 Care Homes for Adults (18-65 years) 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 record kept so that well- supervised staff support the people who live at Leahurst. 3 36 Staff should receive annual appraisals with records kept so that they can discuss their work practice and training and development and so that well- supervised staff support the people who live at Leahurst. Satisfaction surveys for relatives and other stakeholders should be developed to ensure an overall view of the home is obtained. An analysis of the survey information should be produced and shared with the people living at the home and other interested parties to show that their views have been included and taken into account. Copies of accident reports should be stored within each persons individual files to ensure they are kept in line with the data protection legislation. A copy of the electrical hard wiring test certificate should be kept at the home so that people can see that the home is safe for the people who live there. 4 39 5 39 6 42 7 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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