Inspection on 26/11/08 for Limber

This inspection was carried out on 26th November 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Limber 28/11/07

Limber 31/01/07

Limber 06/03/06

Limber 11/08/05

Limber 21/01/05

Limber 23/06/04

Limber 29/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Limber 49 Church Lane Loughton Essex IG10 1PD     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: Diana Green     Date: 2 6 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. 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 29 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 29 Information about the care home Name of care home: Address: Limber 49 Church Lane Loughton Essex IG10 1PD 02085024533 02085081203 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Together Working for Wellbeing Name of registered manager (if applicable) Mr Ian Jacobs Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: One person, under the age of 65 years, who requires care by reason of dementia, whose name was provided to the Commission in February 2004 Persons of either sex, aged 65 years and over, who require care by reason of a mental disorder, excluding learning disability or dementia (not to exceed 11 persons) Persons of either sex, under the age of 65 years, who require care by reason of a mental disorder, excluding learning disability or dementia (not to exceed 11 persons) The total number of service users accommodated in the home must not exceed 11 persons Date of last inspection Brief description of the care home Limber is a large detached family style house, situated in a residential area of Loughton, close to local shops and transport facilities. The home is registered to Care Homes for Adults (18-65 years) Page 4 of 29 care home 11 Over 65 0 11 1 11 Brief description of the care home provide residential care and support for 11 adults and older people with mental health needs. Limber has a large lounge, a separate dining room, and a small quiet room. Service users are accommodated in nine single bedrooms and one double bedroom. The front and back gardens are maintained and accessible, with a large patio area. The home provides 24-hour care and support for people experiencing mental health difficulties. Although staff do provide support or assistance with personal care where required, the home does not aim to meet the needs of those with a physical disability or illness, and is therefore not equipped to meet such needs (i.e. the home does not have a passenger lift, or other aids or equipment). Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 unannounced inspection took place on the 26th November 2008. All the Key National Minimum Standards for Younger Adults, and the intended outcomes, were assessed in relation to this service during the inspection. The report has been written using accumulated evidence gathered prior to and during the site visit, including the homes Annual Quality Assurance Assessment (AQAA). The Annual Quality Assurance Assessment (AQAA) , a self assessment that focuses on how well outcomes are being met for the people using the service, was completed by the home and returned to us prior to the visit to the home. Information received in the self assessment provided us with some detail to assist us in understanding how the the registered persons understand the services strengths and weaknesses and how they Care Homes for Adults (18-65 years) Page 6 of 29 will take action to address them. The inspection process included some discussion with the manager, staff and residents and reviewing documents required under the Care Homes Regulations. A number of records were looked at in relation to residents, staff recruitment and staff training. 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 29 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People planning to live at Limber can expect their needs will be assessed and they will have an opportunity to visit the home and meet with staff and people living there before their admission is agreed. Evidence: The home had a statement of purpose that included the homes philosophy of care and described the service provided at Limber. A copy of this was seen on display in the home. We were informed that the home also had a service user guide. However this could not be located during the site visit, although a copy was provided following the site visit. The admission procedures were discussed with the acting manager who explained that the referral is received from social services with details of the proposed residents needs also provided in a community care assessment form. Discussions are then held to ensure needs can be met at the home and a trial visits arranged where possible. There had been one admission since the previous key inspection. This person who had Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: lived at the home for six months, confirmed that they had attended the home for day visits and two overnight stays before their admission was agreed. The resident explained that staff had discussed their needs with them and they had been introduced to others living at the home to ensure they would get on together. Care records viewed included evidence of a needs assessment undertaken prior to admission. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to be supported in leading an independent life based on an assessment of their care needs. However without a regular review this cannot always be assured. Evidence: The care plans for three residents living at the home were viewed. All included evidence that their individual needs and care had been discussed and agreed with them. Care plans included guidance for staff on how to meet individual needs. A range of care plans were seen, for example personal hygiene, mental health, physical health, finances, social skills etc. The records confirmed that each person living at the home had an allocated key worker. One resident told us that they go out with their key worker to the shops and for hospital appointments. Two care plans had been recently reviewed and whilst care was evidently being given to meet their needs, one residents care plan was last reviewed on 26/09/07, more than one year previously. The manager told us that this was because their key worker had left and a relief worker Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: had been allocated as their key worker. The manager informed us that most residents had a relative or representative to support them and help them make decisions. One person also regularly attended a day/advocacy centre. Another resident spoken with said their relative visited them twice per week and helped them manage their money. Information on advocacy services was also available in the home. One social care professional told us the service encourages the residents to live an independent lifestyle. Risk assessments were seen in the care files viewed. These included individual risks for various identified risks, for example smoking, alcohol, going out, financial abuse etc. demonstrating that risks were minimised as far as possible and provided guidance to staff on how risks were to be managed. This showed us that people living at Limber were enabled to take risks as part of an independent lifestyle. A social work professional told us that the service encourages joint working with other services involved with their residents needs and that the service encourages residents to live an independent lifestyle. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to experience education and occupational activities as able, to be part of the local community and be supported to maintain appropriate relationships with friends and family members. Evidence: The manager told us that several residents were in paid employment and one worked as a handyman as they enjoyed fixing things. Three residents worked every Monday making clips for an ECG (electrocardiograph) machine; this was also confirmed from discussion with a resident. A health care professional told us my clients mental and physical well-being has improved since becoming a resident of Limber. X is no longer isolated, is in paid part-time employment and feels a valued member of the local community. We were told that another resident also worked in an hotel kitchen. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The records included details of residents going out with staff and relatives for shopping, to the pub and visits to their relatives. We were informed that one resident had planned to go to Amsterdam to a museum but due to ill health this had been cancelled. The same resident was an artist and had the use of an external building where they were able to keep their resources (paints, pencils, paper, easels etc) and spend time painting and sketching. Some of their art work was seen on display and we were informed that some paintings had also been exhibited in local events. A health care professional told us the residents are encouraged to be an integral part of the local community. Residents spoken with said they received regular visits from their relatives. This was also confirmed from the records viewed. One resident was observed to have had their hair done the morning of the site visit ready to go home for a birthday party with support of a staff member who had been employed for that purpose. Staff were also seen helping them with their personal care to look their best for the outing. One resident told us they sometimes went out to the pub. We were also informed that another resident went to a Day Centre for Recreational Activities for people with mental health needs. These visits needed to be planned with the social worker and relied on the resident also having the motivation to take part. The kitchen was domestic in size and design. The menus were viewed. These comprised a free choice at breakfast and lunch. Weekly meetings were held with residents to discuss the menus. The main meal of the day was sweet and sour chicken with rice or pie and mash with gravy and vegetables with a vegetarian option. Several residents shopped for themselves including one who ate a vegan diet. We were told that each week a takeaway meal was arranged where resident were each given 5 pounds and encouraged to make their own choice, thereby supporting their social skills. Residents were seen cooking for themselves under supervision and one told us they liked to cook their own meals. The records viewed confirmed that nutritional needs were assessed on admission and nutritional intake monitored. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to have their personal and healthcare needs met and to be safeguarded by the homes medication policy, procedures and practices. Evidence: The daily routines of the home were seen to be flexible. Some residents were seen to get up later and others were at work. One resident told us they preferred to get up at 9am, have breakfast then watch television but some days went out with their key worker to the shops and to the post office to get their money. All residents had a key worker that was known to them and had responsibility for taking care of their general needs. Personal care was observed to be provided in private with the assistance of staff as indicated by need following assessment. Two residents who completed surveys told us they could do what they wanted to do during the morning, in the evening and at weekends and one said they would like to stay up later in the evenings. From discussion with staff, residents and an inspection of the records it was evident that residents had access to GPs, community psychiatric nurses, opticians, dentists, chiropodists and attended outpatient appointments for physical and mental health Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: needs as required. Daily records were detailed and showed good monitoring of health problems with prompt action taken as appropriate. A completed survey from a healthcare professional stated that my clients physical well being has improved since residing at Limber due to their excellent care. The medication systems for the home were discussed with senior staff. Medication was supplied in dosset boxes and individual containers from the supplying pharmacy. Those prescribed by the psychiatrist at outpatient appointments were provided by the hospital pharmacy. Policies and procedures for ordering, receipt, storage, administration, recording and disposal of medicines were in place for staff guidance and were seen to be appropriately followed. All medication was stored in a wall cupboard in the office and keys were held in a separate locked cupboard. Systems for monitoring of room and refrigerator temperatures was in place ensuring that medicines did not deteriorate due to being inappropriately stored. Medication was given by two staff who had undertaken appropriate training, minimising the risk of error. A list of staff signatures and initials was held to enable appropriate follow up in the event of an error being made. However this had last been recorded in 2005 and should therefore be updated. No residents were self medicating. A healthcare professional told us that this may be arranged when it is felt appropriate and safe practice is adhered to. The medication supplies and administration records for three residents were inspected. Photographs of each resident were present to ensure accurate identification. All medication was present and records were well recorded with no omissions evident. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to have their concerns and complaints listened to and to be protected by the homes safeguarding procedures. Evidence: The home had a complaints procedure that included the timescales complainants could expect for a response. The procedure was seen displayed in the entrance hall of the home. Three residents who completed surveys stated they knew who to speak to if they were unhappy and knew how to make a complaint. The manager said that staff were made aware of the complaints procedure during their induction when they were familiarised with the policies and procedures of the home. One complaint was recorded in the complaints record and the AQAA informed us that five complaints had been received since the previous key inspection. From discussion with the manager it was evident that all had been investigated appropriately in line with the homes procedures. Minutes from the residents meetings included evidence that residents were able to express their views on any issues of concern and action would be taken to address these where possible. The home had a safeguarding adults policy and procedures and local Essex procedures to be used in the event that an allegation is made. The manager explained that staff were provided with an individual booklet explaining adult abuse that was provided by Essex County Council. There had been no formal allegations made. However one Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: resident had made a complaint regarding staff attitude that had been appropriately referred within the organisation and to the local authority and was under investigation. The records confirmed that staff had received training on safeguarding on 17/04/07. We were informed that the manager had arranged to attend a course on No secretscurrent practice during the following week which would be cascaded to staff to update their skills and knowledge. The systems for dealing with residents monies was discussed with the manager. All residents had their own bank account which some of them managed with support. The finances of three residents were inspected. Each had their own cash box which they had access to that was kept in a locked filing cabinet. All expenditure was signed for by the resident and a staff member and receipts were held. The amounts for the three residents were checked and found to be correct. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to live in a clean, comfortable, well maintained and homely environment that is appropriate for their needs. Evidence: A tour of the premises was undertaken during the site visit. The manager explained that the premises are owned by the local Primary Care Trust and services are commissioned jointly with social services. The premises were observed to be secure with a CCT camera, burglar alarm and door entry security system in place and were located in a residential area close to shops and local amenities. The home was clean and communal rooms were comfortably furnished in keeping with the client group. The home had a planned programme of repair and maintenance in place with action taken as appropriate and confirmed from the record seen. Records viewed confirmed that fire safety equipment was appropriately maintained and fire safety practices were in place to meet the requirements of the local fire service. We were informed that since the previous key inspection several toilets and bathrooms had been upgraded including one that had been also been provided with a shower. A third bathroom on the first floor was in need of refurbishment and the manager said that there were also plans to upgrade this bathroom. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The premises were clean and free from malodour throughout. Staff hand washing (liquid soap and paper towels) were provided in key areas where personal care was carried out to enable safe practice and to minimise the risk of infection. The training records also confirmed that staff had received updated training in infection control. The laundry room was domestic in size and was fitted with two washing machines and a drier that were confirmed to be in good working order. The manager said that residents each had a set day for doing their personal laundry with assistance from staff. Two residents were therefore planned to use the laundry each day. One resident who was laundering their sheets and personal clothing said they felt able to manage to do their laundry with help from staff. A resident who completed a survey told us its a very nice place to live. Another resident who had recently moved into the home told usI like my room and being able to listen to my music and watch TV. I also like the food and the company. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to be cared for by skilled and experienced staff who are well supported through a programme of training and development. However a lack of evidence that recruitment checks are robust does not provide assurance they are appropriately safeguarded. Evidence: Staff were observed to be friendly but respectful towards residents during the site visit. One resident spoken with said I like it here. I like to watch TV and I like going out with my key worker. The manager confirmed that there were three staff with NVQ level 3 qualification and one with NVQ level 2 from a total of six permanent staff. A further person was currently being recruited who had NVQ level 3 qualification. A healthcare professional who completed a survey told us my observation is that all staff at Limber have the necessary skills amid experience required. In addition to the manager there was one senior care assistant and two care workers on duty for eleven residents. The manager informed us that additional staff are employed when needed, for example one extra care assistant was on duty specifically to assist a resident prepare to go home for a birthday celebration. Shifts had also been reviewed to ensure staff were available to accommodate activities at various times Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: including weekends. The manager told us that one student placement had been funded by the university and the money utilised for activities. The recruitment records for three new staff were viewed. All three included evidence of identification, full employment history and health declaration. However one file did not include evidence of a Criminal Records Bureau check having been undertaken and there were no references held on file. The manager said that two satisfactory references were obtained prior to appointment and were held at the Organisations Head Office. Arrangements for training were discussed with the manager. Each staff member had a training and development file and those viewed confirmed that induction was provided in line with the Common Induction Standards. The manager told us that the organisation have a learning and development booklet and a very comprehensive range of both statutory and mental health courses were seen to be available for staff to access. The training records were viewed for the three recently employed staff members. All were registered on the Skills for care induction. Training had been provided for each in emergency first aid, health and safety, fire safety, food hygiene, manual handling, infection control, and Control of Substances Hazardous to Health (COSHH) and evidenced from the certificates held in the file. The manager told us that arrangements for supervision had been further developed and all staff received supervision by himself or a senior care worker. The records viewed were comprehensive and confirmed that supervision was undertaken monthly where practice and training needs were discussed. This ensured that staff were supported in developing their skills and practice to enable them to care more effectively for resident. In addition all staff received an annual appraisal. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Limber can expect to live in a well managed home with good standards of health and safety that protects them and the staff who care for them. Evidence: The management arrangements of the home were discussed with the manager who confirmed that an application to register had been submitted to CSCI. The training file viewed also confirmed that he had a BSc degree in Psychology, a qualification at NVQ level 3 in Promoting Independence in Mental Health and had commenced training to NVQ level 4 demonstrating that he had the qualifications and experience to manage the service. The manager told us that it was the prime responsibility of the manager to deliver the Well Being Agenda (the philosophy of the organisation). Several residents were observed to speak freely with the manager during the site visit and to access the office to seek reassurance from him showing that he operated an open door policy. We were told that the deputy manager post was vacant and was currently being covered by a senior care worker. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The quality assurance programme for the home was discussed with the manager. This comprised a quarterly monitoring report undertaken by the Area Manager, a monthly report based on the National Minimum Standards and quality of partnerships (local agency and community). An annual audit was also undertaken. Care coordinators, who are external to the project and who could be an advocate or a community psychiatric nurse or relative, meet with residents in private to seek their views on how the service/project is meeting their needs. All the information is then collated to produce an annual report and annual plan which is shared with the commission. Records held on behalf of residents were seen to be in the main kept up to date and stored safely in secure facilities in a lockable office in accordance with the Data Protection Act 1998. Records viewed at the inspection included care plans, medication records, statement of purpose, policies and procedures, quality monitoring reports, staff recruitment and staff training, maintenance and fire safety records. The home had a health and safety policy and procedures for manager and staff guidance. The records viewed showed that new staff received health and safety training and regular updated training there were was also provided. Evidence of a sample of records showed there were systems in place to ensure the servicing of equipment and utilities (e.g. gas, electrical safety certificates, annual PAT testing etc.) and there was evident of appropriate weekly and monthly internal checks being for the carried out (for example on fire safety equipment, fire alarms and emergency lighting etc.). Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 The care plans for people 31/03/2008 living at the home must be reviewed and updated to reflect their current assessed needs. Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 A copy of the service user guide should be available in the home. This will ensure prospective residents and their representatives have full information about the home prior to making a decision. All residents should have their care plans reviewed at a minimum of six monthly intervals to ensure they meet their changing needs. The list of staff signatures and initials should be updated to ensure it is current. 2 6 3 20 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!