Inspection on 23/03/09 for Longcroft

This inspection was carried out on 23rd March 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Longcroft 16/01/08

Longcroft 12/02/07

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: Longcroft 34 Swan Lane Wickford Essex SS11 7DD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michelle Love     Date: 2 3 0 3 2 0 0 9 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.cqc.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: Longcroft 34 Swan Lane Wickford Essex SS11 7DD 01268572066 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Veneta Ann Samuel Batt,Tony Brian Batt Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 5 Longcroft is a single story building registered to accommodate 5 persons with a mental disorder. There are 5 single bedrooms all with an en-suite facility. There is a communal lounge area in the home and an open plan kitchen/dining area. The garden area to the rear of the home is pleasant and there is space for 4/5 cars on the forecourt. The home is decorated and furnished to a good standard. The home is situated on the main road into Wickford town centre and is therefore in close proximity of local transport and community facilities. The home is in keeping with domestic dwellings within the area. The homes Statement of Purpose is available upon request from the home. The Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home manager said that the fees were 1000.00 - 1500.00 per week. There are additional charges for items of a personal nature. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection. The visit took place over one day by one inspector and lasted a total of 6.5 hours, with all key standards inspected. Progress against previous requirements and recommendations from the last key inspection were also inspected. Prior to this inspection, the previous manager submitted an Annual Quality Assurance Assessment (AQAA). This is a self-assessment document, required by law, detailing what the home does well, what could be done better and what needs improving. The new manager is concerned that information recorded within this document may not be accurate and is not reflective of how the service was previously run. Care Homes for Adults (18-65 years) Page 6 of 29 As part of the process a number of records relating to residents, care staff and the general running of the home were examined. A full tour of the premises was undertaken, residents, staff and visitors to the home were spoken with and their comments are used throughout the main text of the report. Prior to the site visit, surveys for relatives, staff and healthcare professionals were forwarded to the home for distribution and for people to complete and return to us. Where surveys have been returned to us, comments have been incorporated into the main text of the report. The manager and other staff members assisted us. Feedback on the inspection findings, were given as a summary to the manager. The opportunity for discussion and/or clarification was given. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who come to live at the home can be confident that their needs will be assessed. Evidence: The manager advised that both the Statement of Purpose and Service Users Guide has been reviewed and updated. A copy of the Statement of Purpose was forwarded to us following the inspection, however the Service Users Guide was not accessible. The Statement of Purpose provides specific information about the service so that prospective residents and other interested parties, have the information they need so as to make an informed choice as to whether or not this is the right care home for them. We were advised of the admission process. This involves the management team of the home receiving a referral and other associated documentation e.g. psychiatric report and undertaking a full needs assessment. Although there is a formal pre admission assessment format currently in place, we were advised that this is to be reviewed and Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: updated shortly, so as to provide more in depth information. The care file for the last person admitted to the care home was examined. Records showed that information was received from their previous placement, however there was no evidence to support that the previous management team of the home had undertaken a full needs assessment. Additionally there was no evidence to support that the previous management team and/or registered provider, had confirmed in writing to the resident or their representative that it could meet their needs following the assessment process. The resident was unable to confirm as to whether or not an assessment had been completed prior to their admission. We were advised that a new resident was to be shortly admitted to Longcroft and that a pre admission assessment had been completed, however this was not available for inspection. We were advised that the prospective resident and their representative were given the opportunity to view the care home and arrangements were made for the prospective person to undertake introductory visits to Longcroft. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the care home can expect to have a plan of care, which identifies their care needs and how these are to be met. Evidence: As part of this inspection, one care file was examined in full. Records showed there is a formal care planning system in place to help staff identify the care needs of individual people and to specify how these needs are to be met by care staff. We were advised by the manager that they intend to review the current care planning processes and formats and this will be achieved by mid May 2009. In general terms the care plan was observed to be informative and person centred in parts, however some elements of the document were not completed. Records showed that out of 17 subject areas, 9 were not completed. It was evident from reading the care file that the person has complex needs. The plan Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: of care made reference to staff conducting random monthly drug screening, however there was no evidence to suggest this had been formally agreed with the resident and/or discussed as part of their rehabilitation programme. Additionally there was no information recorded as to what would happen if the outcome of the random drug test proved positive. The plan of care also made reference to them being supported to access drug and alcohol resources within the local community, however no specific information was recorded. The care file also made reference to the person having 1-1 sessions, however little information was recorded as to the rationale, how these were to be conducted, the frequency and how issues raised would be dealt with effectively to ensure positive outcomes for the person concerned. No separate rooms for 1-1 sessions are available within the home environment. Records relating to these sessions were available, however there was no pattern to the frequency of sessions undertaken. As stated at the previous inspection to the home, there were no clear guidelines depicting what actions should be undertaken, should the persons mental health deteriorate. Limited information was available to evidence involvement of the resident and their representative in the devising of their care plan. Not all elements of the care plan had been evaluated, which means that staff working at the care home, may not have the most up to date information. Risk areas were clearly identified, including historical background and current risk elements, however further information is required detailing how risks will be minimised. People spoken with confirmed they are supported and enabled to make decisions about their lives and to participate in the day-to-day running of the home. This includes opportunities to meet up with friends and family, to assist staff with food preparation/snack making, going food shopping etc. Two staff surveys returned to us, recorded that they are provided with up to date information about the needs of the people they support. One survey recorded, I have always been informed immediately of any changes in the care and support needs of any service user in the home. This happens even at times when I am not at work. Two relative surveys returned to us recorded mixed views and these included, If there is anything I might like to know, I am told when I visit, but I have also been telephoned at home on days that Im not visiting and We need to be told more about (name of resident) medication and if they see a GP. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 the care home can expect to have their social care needs met and to receive a varied diet. Evidence: The care file for the person case tracked, recorded them as requiring more social inclusion and a more meaningful lifestyle, for a structured day care programme to be provided so as to prevent boredom and to be given the opportunity to access local leisure facilities and outlets. Records showed the person case tracked was enabled to take part in activities both in house and within the local community and to maintain family links and friendships. It was not clear that issues highlighted during a 1-1 session relating to specific activities had been pursued. The resident was unable to confirm as to whether or not these had Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: taken place, however they stated that they attended church regularly, went out for lunch on occasions, watched films, listened to music and assisted with some house chores. Relatives surveys returned to us, recorded that more structured activities and/or opportunities should be provided. Another person spoken with confirmed they are enabled to maintain intimate personal relationships with people of their choice, can access the community, go clubbing on a regular basis and see visitors in their room and in private. All residents spoken with said their visitors were welcomed. Another person who lives at the care home, works at a local charity shop and opportunities are being pursued for another person to undertake adult education classes. People spoken with were complimentary about the meals provided. The evening meal was prepared by staff on duty and looked appetising and was provided in sufficient quantities. We were advised that people are able to choose what they want at mealtimes and alternatives are readily available. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 the home can expect to have their healthcare needs dealt with promptly, however some aspects of current medication practices and procedures means that they are at risk of not having their health and wellbeing maintained or proactively managed. Evidence: People have access to a range of healthcare services and facilities as and when required. These include GP, Consultant Psychiatry, attendance at hospital appointments, dentist etc. Records showed that people have the option as to whether or not they are accompanied by staff or attend healthcare appointments independently. Consideration should be pursued to enable people to access local peer group support networks. Records showed that people are enabled and supported to manage their own personal care wherever possible, however it is recognised that there may be occasions when support is provided by staff. People confirmed that support is provided in private and that they felt their privacy and dignity was respected at all times. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: Medication practices and procedures at the home were examined. The majority of medication is managed through a monitored dosage system (blister pack). Medication was observed to be stored securely. Records showed there was no record of some medicines having been given to the resident when they were due, as the entries on the Medication Administration Record (MAR) had been left blank and not signed or initialed by staff. Additionally there was a discrepancy for one person in relation to the records and stock balance for one medication. This was checked with the manager and they confirmed the discrepancy. Where packets/bottles of medication are used, the manager was advised that as part of good practice procedures, these should be signed and dated when opened. We were advised that all staff who work at the care home administer medication. Records showed that all staff except the manager, have up to date medication training. No records were available to show that staff are regularly assessed as to their continued competency to administer medication. This requires reviewing. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect their concerns to be listened to and dealt with appropriaetly so as to be safeguarded. Evidence: The complaints procedure was displayed in the entrance hall. We were advised that no complaints have been received since the last key inspection to the home. The manager stated that he has an open door policy, whereby residents, staff, relatives and others can report any concerns. Residents spoken with said that they would feel able to tell staff if they were worried, concerned or had a complaint. Of those relatives surveys received, not all were aware of the procedures and processes relating to complaints. No safeguarding referrals have been raised since the last key inspection. Appropriate safeguarding policies and procedures were readily available and staff spoken with were able to demonstrate an understanding of safeguarding procedures and protocols. Staff training records showed that all staff have up to date safeguarding training. Care Homes for Adults (18-65 years) Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience 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 the care home can expect to live in a home that is comfortable, homely, safe and which meets their needs. Evidence: A full tour of the premises was undertaken as part of this site visit with the manager. The home is furnished, maintained and decorated to a good standard and provides the people who live there, with a homely and comfortable environment. All residents bedrooms were observed to be personalised and individualised with many personal items on display. All rooms have en-suite facilities (toilet/shower). Some rooms were noted to have tea making facilities. People spoken with confirmed they were satisfied with their personal space. Shared facilities included a large lounge, open plan kitchen/dining area and laundry area. The garden area was well maintained and people can access this freely. We were advised that a gym area is to be newly created and a summer house purchased. The premises were observed to be clean and no unpleasant odours were noted. Maintenance is arranged by the registered provider as and when required. A number of Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: maintenance records and service certificates were inspected. Records relating to the servicing of fire equipment, fire risk assessment and weekly testing of the fire alarms were observed to be satisfactory. Although there were records showing that fire drills are undertaken, evidence of who has participated needs to be included. Care Homes for Adults (18-65 years) Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 the home can expect to be supported by sufficient numbers of staff, but not assured that staff will have the skills and knowledge to meet their care needs. Evidence: There were 4 people living at Longcroft at the time of the site visit. The manager stated that staffing levels for the current resident group were 2 staff between 09.00 a.m. to 22.00 p.m. and 1 waking member of staff between 22.00 p.m. and 09.00 a.m. each day. The manager is not supernumerary to the above and generally is on duty between 09.00 a.m. and 17.00 p.m. Monday to Friday. The manager and registered providers are on call and additional sleep-in staff are deployed to the care home as and when required. On inspection of 4 weeks staff rosters, these showed that staffing levels as detailed above had been maintained, however the rota available on the day of the site visit did not accurately reflect the staff on duty. The staff files for 3 people were examined and this included the managers records. Shortfalls in the recruitment procedures were identified and these relate to no recent photograph and no proof of identification for any of the files examined, a full employment history not explored for 2 people and the POVA 1st for one person received after they commenced employment. This was highlighted as a requirement at Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: the last key inspection to the home. Evidence of a comprehensive induction was available for 2 people, however no record of induction was present for the manager. The manager confirmed they had not received an induction. Since the new managers appointment (November 2008), an initial training plan for individual staff members has been devised as there are no clear training records for staff from the previous management team of the home. Records showed that currently staff have up to date training relating to, understanding challenging behaviour and breakaway techniques, safeguarding and medication administration. There was no evidence of specific training pertaining to working with people who have mental health needs e.g. Drug and Alcohol Awareness, Schizophrenia, Mood Disorders etc. This means that staff working at the care home may not have the skills and competence to carry out their role effectively. This was highlighted as a requirement at the last key inspection to the home. Future training planned for support staff includes, Fire Safety and Health and Safety (March 09), Food Hygiene (May 09), Understanding Mental Health (June 09) and Moving and Handling (April 09). The manager stated that it is hoped that all staff will have achieved up to training in core subject areas within the next 3 months and specialist training relating to mental health will be sourced as soon as possible. The manager stated that currently 1 member of staff has NVQ Level 3, 1 member of staff is due to complete NVQ Level 3 in July 09 and 1 person has enrolled to undertake NVQ Level 3. Supervision records for staff were only available for January and February 2009 as records by the previous manager were not available. The manager confirmed that they have not had the opportunity to discuss their practice and development. Care Homes for Adults (18-65 years) Page 22 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that it is run in their best interests. Evidence: The manager has been in post for 5 months. The manager has experience working with both older people and with adults who have a formal diagnosis of a mental disorder. The manager has attained qualifications in BTEC Intermediate Diploma in Care, OCN in Elderly Care, NVQ Level 3 in Health and Social Care and achieved the Registered Managers Award in February 2008. No records were available to provide evidence of the managers updated training and continuous practice. This will be examined at the next inspection to the home. It is evident that since the new managers appointment, many new systems of working and new recording methods have been introduced. Whilst improvements to the service have been noted, including reviewing the care planning processes and formats, devising a training plan for staff, providing training opportunities for staff, ensuring that staff receive regular formal supervision, there is a need for further development. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: As noted within the main text of the report, this relates to ensuring that care plans for individual people are detailed, comprehensive and person centred, structured treatments and programmes are clearly identified where appropriate, medication practices and procedures are improved, staff recruitment procedures are in line with regulatory requirements, training and development opportunities are provided for staff which enables them to undertake their role effectively and staff are regularly supervised. The manager is aware of the shortfalls and is working hard to prioritise areas that require prompt attention and review. People spoken with at the time of the inspection, stated that they felt the new manager was approachable and keen to raise standards. Although an AQAA was completed and returned to us, this was completed by the previous manager to the home. The current manager is concerned that information recorded within this document may not be accurate. The manager advised that the ethos of the service is, for people to come to Longcroft and to be as independent as possible. We were advised that the registered providers classify Longcroft as providing a rehabilitation service. Whilst we recognise this may be the providers beliefs, neither the Statement of Purpose or evidence at the time of the inspection show how this is to be successfully achieved. The manager implemented a quality assurance system at the home in January 2009 and the views of the people who live at the home and their representatives were recorded. Comments included, I feel staff are doing a really good job. They are considerate and really help (name of resident) if they have a problem, staff are very friendly and welcoming, I am happy with staff and residents and enjoy living here and staff are involved with residents and have genuine concern for giving them a healthy enjoyable life despite their disability. The manager advised that surveys will be forwarded to all parties twice yearly. Since the managers appointment there was evidence that staff meetings have been conducted. Records also show that people who live at the home are provided with a formal opportunity to meet collectively with staff and the manager to discuss issues on a regular basis. Regulation 26 visits are conducted by the registered providers and records were available. The health and safety of people who live at the care home are protected by the homes policies and procedures and routine safety checks. Care Homes for Adults (18-65 years) Page 24 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 20 13(2) The home must ensure that 29/05/2009 accurate records are kept in respect of the administration of medication. Previous timescale of 29/2/2008 not met. 2 34 19, schedule 2 The home must ensure that it carries out full checks on prospective employees before they start working at the home, and that full records are kept of those checks. Previous timescale of 29/2/2008 not met. 29/05/2009 Care Homes for Adults (18-65 years) Page 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 5 Ensure that a Service Users Guide is readily available for prospective residents and other interested parties. So as to ensure that people have the information they need to make an informed choice about where to live. Confirm in writing to the resident and/or their representative, that following a full assessment, the needs of the person can be met. So as to ensure that the person being admitted to the care home knows that the home can meet their needs. 01/06/2009 2 2 14 01/06/2009 3 6 15 Care plans must clearly identify individual peoples care needs and how these are to be met by staff. So as staff have the most up to date information. 01/06/2009 Care Homes for Adults (18-65 years) Page 26 of 29 4 9 17 A record to be kept of any 01/06/2009 limitation and/or restriction agreed with the resident and other parties involved in their care and/or treatment. This refers specifically to random drug testing. So as to ensure that people are enabled to make choices. 5 20 13 Residents must be protected 29/05/2009 from harm by having their medication administered safely and in accordance with the prescribers instructions. So as to ensure residents safety and wellbeing. Where the MAR record, records that medication has not been administered, records clearly detail the rationale why they are not and any action taken to address the above. This is to ensure a clear audit trail and to ensure peoples health and welfare. 29/05/2009 6 20 13 7 20 13 Ensure that all staff who administer medication remain competent to undertake this task. This refers specifically to regular competency assessments. So as to ensure that staff remain competent and confident to undertake this task and to ensure residents safety and wellbeing. 29/05/2009 Care Homes for Adults (18-65 years) Page 27 of 29 8 34 18 All newly appointed staff are 29/05/2009 to receive a structured induction. So as to ensure that staff feel supported and able to carry out their role. 9 34 19 Ensure that robust recruitment procedures are adopted at all times. This will ensure that residents and others feel assured that they are safeguarded by the homes procedures. 29/05/2009 10 35 18 Staff receive appropriate training to the work they perform. This refers specifically to core subject areas and those conditions associated with the needs of people who have a mental disorder. So as to ensure that people who work at the care home have the right skills. 01/08/2009 11 36 18 All staff to receive regular supervision. So that staff feel supported. 29/05/2009 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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