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Inspection on 02/10/08 for Magnolia Cottage
Also see our care home review for Magnolia Cottage for more information
This inspection was carried out on 2nd October 2008.
CSCI found this care home to be providing an Good 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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
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: Magnolia Cottage 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG 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: Judith Last Date: 0 2 1 0 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. They reflect the things that people have said are important to them: 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: ï· Put the people who use social care first ï· Improve services and stamp out bad practice ï· Be an expert voice on social care ï· Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information
Document Purpose Author Inspection report CSCI
Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 36 Information about the care home
Name of care home: Address: Magnolia Cottage 26 Sydney Road Spixworth Norwich Norfolk NR10 3PG 01603897764 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care Management Group Ltd (trading as CMG Homes Ltd) Name of registered manager (if applicable) Mr Martin Edward Rendle Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: Date of last inspection 2 5 0 9 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home Care Management Group Limited, whose registered office is in London, owns Magnolia Cottage and four other small homes in close to Norwich. Magnolia Cottage provides personal care and accommodation for up to 4 younger adults with a learning disability. People may also have a physical disability. The home is located in a residential area in the village of Spixworth, and close to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow. All bedrooms are single. No one has to share a room. Care Homes for Adults (18-65 years) Page 5 of 36 There are gardens to the side and rear of the building, with parking available at the front of the home. Care Homes for Adults (18-65 years) Page 6 of 36 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 Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home We visited the home unannounced and spent just over three and a half hours there. Before making our visit we reviewed all the information we have about the home and looked at detailed information that the manager was asked to send to us. Care Homes for Adults (18-65 years) Page 8 of 36 We also wrote to people before we visited to ask what they think about the service. We had letters from two people working at the home, two people living there and two relatives. While we were there we spoke to two people who live at the home (although we were not able to get a lot of information directly from them). We also spoke to two people who work at the home, to the manager, and briefly to the team leader. Care Homes for Adults (18-65 years) Page 9 of 36 We used a method of inspection we call case tracking. This is used to see what records say about peoples needs and to find out from observation and discussion what happens in the daily lives of those people and the outcomes they experience. We looked at and listened to what was going on while we were at Magnolia Cottage. We used this information and the rules we have, to see how well people were being supported in their daily lives. Fees for the service range from 1062 pounds to 1514.83 pounds per week according to peoples needs. What the care home does well Care Homes for Adults (18-65 years) Page 10 of 36 People live in a comfortable and safe home. They have a comfortable sitting room and their own bedrooms. They can decide how they keep their own rooms. Staff work hard to support people with their health care needs and keep clear records about appointments and the outcomes of these. This means that people are supported to stay well. There are meetings with residents where any changes or ideas are discussed and explained. This helps people express their views and also to be reassured about any changes that are taken place so that they can deal with them better People have busy lives with a variety of things to do. Staff at the home support people with outings and accessing classes Care Homes for Adults (18-65 years) Page 11 of 36 They also support people to join in the domestic routine such as making drinks, simple meals, tidying their rooms or doing their washing. This means that people are able to learn new things and to practice and develop skills. One relative says that I have nothing but praise for both the company and staff involved in (X)s care. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 12 of 36 The home has been redecorated and is brighter than it used to be. More permanent staff have been taken on so that agency staff are not needed. This has meant that people have more consistent care and have not had to cope with so much change. This is good because people have been less anxious and distressed and so more calm in their behaviour. The manager has been trying, with the support of headquarters, to make sure everyone can get their own bank account opened. He is still working on this and told us after our visit that some more progress has been made. Care Homes for Adults (18-65 years) Page 13 of 36 What the care home could do better There are two things that need to happen by law and are to do with the way medicines are managed. Staff must follow the proper procedures for checking medicines they dispense against the directions to make sure that they do not miss anything. This is so people can receive all of the medication they need to keep them well, and have been prescribed, at the right time, in the right dosage. Care Homes for Adults (18-65 years) Page 14 of 36 The manager needs to check with the doctor and chemist, the guidance about medicines that are only needed occasionally. Sometimes what is written down for staff does not match what is on the label as prescribed by the doctor. These things need to be clarified to make sure people are not at risk. The manager told us after our visit that he has been making progress with this. There are some other things that the manager could think about doing that would be good practice and he would be able to tell you about these. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Judith Last 33 Greycoat Street London SW1P 2QF 02079792000 Care Homes for Adults (18-65 years) Page 15 of 36 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 16 of 36 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 17 of 36 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 thinking about moving into the home would have their needs assessed and they (or their representatives) would be given time to decide whether they wish to move in. Evidence: The manager is aware of the importance of assessment in making sure that the home is suitable to meet someones needs. He says that he has recently carried out an assessment of a prospective service user, but felt the persons needs could not be met at the home. Assessments of the needs and abilities of people currently living at the home have been kept up to date and used to develop their support plans. The manager says that anybody considered suitable for admission would have a gradual introduction to the home, including visits for meals and overnight stays. This would help to ensure that the home would be able to meet their needs and that the person would get on with those already living in Magnolia Cottage. Care Homes for Adults (18-65 years) Page 18 of 36 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. People are involved in decisions about their lives and are able to have some participation in planning the support they receive. Evidence: Each person has a support plan that sets out how staff are to meet peoples needs. They also take into account personal goals and show progress towards these over time. One has signatures of the person concerned showing that the plan had been discussed and explained to them. Everyone has a keyworker and residents meeting notes show that any changes are discussed with them. They also show that staff had tried to explain what a keyworker would do to help support them. One person says I like the staff, both people we spoke to say yes that they have keyworkers. Two people who wrote to us say the staff always treat them well and listen to them There are photographs to help people discuss their care. Keyworkers record every month what has been going on for the person. However, these records do not yet
Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: show that the allocated keyworker time involves discussion with people about their progress and needs. Support plans are reviewed regularly and show the progress that people are making towards their goals. One relative who wrote to us feels that staff usually give the person they support they expect but goes on to day that at present the home is doing well at most levels. One relative says the person always receives the support they need and says we are more than happy that (residents name)s every need is being cared for. Risk assessments have been simplified so that staff can follow them and one staff member told us that they felt reading the plan had been helpful in assisting them to understand one person and their behaviour, and in knowing how to support people properly. The manager is still in the process, of trying to open individual bank accounts for people so that they will receive interest on any savings. He has correspondence showing the difficulties with this and progress made. We have said this needed to happen before but can see that he is trying, with head office, to address the requirement and is still making progress. Care Homes for Adults (18-65 years) Page 20 of 36 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 are supported to have a fulfilling lifestyle that suits their needs. Evidence: Support plans show people developing skills in their daily lives, such as preparing simple snacks, drinks, doing their laundry and tidying their rooms. Photos are used to show these tasks and help as a reminder for the people concerned. The reviews show that people are making progress towards increasing their skills. We saw people encouraged to go to the kitchen and make their own drinks while we were visiting. They also made use of the lounge or went into their rooms. This means that people are able to move around their home freely and make use of facilities. Each persons plan shows how they communicate and also records particular words or phrases that might show whether anxiety or distress is increasing and how staff are to respond. Records show one person likes to spend time in the garden when they feel
Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: anxious. This shows that staff are alert and sensitive to problems and have guidance about how to respond in a manner that should help to resolve issues rather than escalate them. Although no one has chosen to go to church regularly, one support plan does show that the person enjoys the peacefulness of churches when there are no services in progress and that staff will support them with this. One persons support plan shows that they have opportunities for further education and letters from a tutor who is please with their progress. Photographs and written records show some of the other things that people do, including visits out to places of interest and playing snooker. Two people we spoke to say that they have lots to do. There is a vehicle at the home to help people get around and staff say a larger one will be coming soon. This is because one person does not respond well to being crowded. This will help the person have their needs met in the least distressing or risky manner. Feedback from relatives shows that people are supported to make contact. One person told us they see their family and can talk to them on the telephone. People say they like the food. One person has been helped to lose weight successfully based on their support plan. There are photographs in the kitchen to help people make decisions about what they want to eat and about healthy eating. No one needs help to eat although there is guidance about encouraging people not to eat too quickly because of the adverse effect this has on them. This shows that people are supported with good nutrition and to enjoy their meals. Care Homes for Adults (18-65 years) Page 22 of 36 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
. The health and personal care that people receive is based on their individual needs, but medication management presents minor concerns. Evidence: Support plans set out the kind of support people need with personal care and how staff are to do this. For example, one plan set out a goal to encourage the person with their bathing. This shows some progress in recent reviews, showing people are encouraged to develop skills with their own personal care. Records show that there are flexible times for people getting up and going to bed. There are three male residents and half the staff are male so people can have some choice of who supports them, subject to the constraints of the duty roster. The bathroom has a suitable bolt so that, when staff are assisting people others will not inadvertently breach their privacy. There are grab handles in the bathroom that were the result of an occupational therapy assessment for one person. These will be removed now the person no longer lives at the home, but do show that additional
Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: specialist advice is sought about peoples care when needed. Staff and the manager acknowledge that the level of agency staff needed in the past have presented problems in delivering consistent care and resulted in people living at the home experiencing more difficulties. However, staff, relatives and recorded improvements show this situation is much improved. Every one living at the home has a health book. These have been completed with a full range of information about everyones health care and the support they need with this. They show input from health professionals such as dentists, chiropody and consultant psychiatrist. Support plans also take into account peoples mental health and emotional wellbeing and how they might communicate problems. They show professional advice is taken when this is needed. Records show that staff have accredited training in the management of medicines, delivered by the University of East Anglia. They also show that the manager assesses the competence of staff to administer it. This means he tries to make sure that systems for administration are as safe as possible for people. People living at the home would have difficulties understanding their medication and some would have serious implications if mistakes were made. No one manages their own medicines. We found when we looked that one tablet for occasional use is shown on the medication administration record chart as to be given at night when it is needed. This is not consistent with the guidance for staff, which suggests it can be used through the day should behaviours escalate. (In practice it has not been used recently.) No correspondence from the consultant or GP was available to support the change from what was recorded on the chart. This means guidance is not clear. One medicine not in the monitored dosage system showed 56 tablets had been received. Records show 43 doses have been signed as given but 14 remain. This is a surplus of one tablet and shows that proper procedures for checking, administration and recording have not always been followed. This means people may not always get the medication that has been prescribed to keep them well, in the correct dose. The manager says a medication cabinet is on order that would allow storage of controlled drugs should these be prescribed. This means that people would be able to receive any such medicines if they were prescribed and that they would be stored appropriately. Care Homes for Adults (18-65 years) Page 24 of 36 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 (or their representatives) can be sure their concerns will be taken seriously and addressed. There are measures in place to help protect people from abuse. Evidence: Two people who wrote to us say they know who to speak to if they have concerns and how to complain if they need to. One person says they would talk to Martin (the manager). Information about how to complain is on the noticeboard in the hall and with pictures to help make it more accessible. The two staff who wrote to us say that they know what to do if someone raises a concern about their care and both relatives know how to complain if they need to. We looked at the complaints record and this showed one person had complained since our last visit, on behalf of a service user. The manager has subsequently had a letter thanking him for his prompt response and thorough investigation. This shows that concerns or complaints raised by people are taken seriously and addressed. Staff say they have training in recognising and responding to abuse. They say this happens soon after they start work and they know who to report to. There is also guidance explaining the process. Longer standing staff have experience of behavioural difficulties and how they are managed, although incidents have, they say, decreased since there is a more stable
Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: team of permanent staff. Relatives who wrote to us, recognise consistency and stability as important in minimising problems and that things have improved. Checks on complaints and finances are made at visits on behalf of the registered providers. These show that personal monies held at the home on behalf of people living there, are checked against receipts to make sure there is no misuse and people are protected. Care Homes for Adults (18-65 years) Page 26 of 36 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 live in a comfortable, safe and clean home, which suits their needs. Evidence: The home has been redecorated in the last two years and floor coverings have been replaced. Staff say the home looks brighter and better than it used to. It is in keeping with others in the area. There are ramps to both doors with handrails. This acts as a reassurance to anyone living, working or visiting the home, who might be unsure on their feet. One person has their own en-suite, level access wet room. The bathroom is shared by two people at present (and will be three when the vacancy is filled). They do not need aids or adaptations to use the bath. People living at the home have access to a vehicle. This allows them to get out and about in their community and further afield. There are recorded checks on the safety of the home, carried out regularly by the manager. Fire detection and call points are tested regularly and staff are trained in fire safety so that they would be able to ensure peoples safety as far as possible, in the event of a fire.
Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: Four out of five staff have training in infection control and there is guidance about food safety. This shows that there are measures in place to help reduce the risk of infection for people living and working in the home. There were no unpleasant smells associated with difficulties with continence, showing that issues arising from a complaint have been addressed satisfactorily. Care Homes for Adults (18-65 years) Page 28 of 36 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
. People have their needs met by skilled and effective staff who are working to increase their competence. The increase in stability and consistency of the staff team has had a positive effect on the care people receive. Evidence: Staff say that training is good and one staff member recently appointed says that they have a lot more courses lined up. The two staff who wrote to us say that they have training that keeps them up to date and helps them to understand peoples needs. We confirmed with one staff member that they have a national vocational qualification (NVQ) level 2 and are progressing to level 3. The manager says that three other staff have gone forward for enrolment. This will help to ensure that all staff have the underpinning knowledge they need to support people effectively. Both staff who wrote to us say that their induction covered what they needed to know to do the job very well. One staff member we spoke to said that they had lots of support from other members of the team when they first started and while they were getting to know the people living at the home. Staff and a relative confirm that staffing is now more consistent and no agency staff have been needed to cover shifts recently. There are two staff on duty to support
Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: people. The manager and a staff member says that turnover is now much less. This has been of benefit to people living at the home in ensuring that records about their care are more organised and kept up to date, that people have got to know the staff who work with them, and difficulties with behaviour have reduced. There remains one vacancy for a part time support worker. The training matrix shows a range of different courses are on offer to help staff meet peoples needs effectively. This includes dignified management of challenging behaviour to help staff de-escalate situations and keep themselves safe. We asked one staff member about the need to intervene physically with people in order to prevent immediate danger. This has happened in the past but not recently. None of the staff has training in this. Staff meetings take place regularly so that the team can ensure they are continuing to work effectively. We saw records of these and one was taking place at the home when we arrived. We looked at the recruitment file for two people taken on recently within the last year. These show that checks and references are taken up before people start work, to ensure that they are suitable to work with vulnerable people. There is a checklist that the manager completes to ensure none of the records the law says must be there, is missed. We also saw that there are probation reports on file for new staff showing that their performance and understanding is monitored through appraisal as well as induction. Staff confirm that they have supervision regularly and records confirm this. This provides another opportunity for the manager or team leader to iron out problems and ensure staff have a good understanding of their roles and responsibilities. One relative says I have nothing but praise for both the company and staff involved and describes the staff as caring, adaptable, patient and kind. Care Homes for Adults (18-65 years) Page 30 of 36 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service
. The home is being effectively run by a competent and skilled manager, in a manner that promotes the safety and welfare of people living there and takes their views into account. Evidence: The manager is registered with the Commission and has completed his registered managers award. He has also participated in other training on offer to ensure that he keeps his knowledge up to date. He says this training has included Mental Capacity Act training. He does not currently have responsibility for budgets that are devolved to individual homes so that he could prioritise his own expenditure. (Computer equipment would also aid him in the performance if his duty, in ensuring things can be updated more promptly rather than needing to wait for the availability of the companys administrator to produce documentation - including the things we ask for.) The organisations systems for monitoring service quality include monthly visits by another manager to check quality, and which provide for discussion with staff and
Care Homes for Adults (18-65 years) Page 31 of 36 Evidence: service users. The regional director also visits once every three months in order to report on the quality of the service. We know from previous visits that annual surveys about quality are carried out. The manager is currently awaiting for questionnaires to come back from relatives and other interested parties. He says these will be analysed by the administrator so he can see what areas for improvement have been suggested. Records show staff also talk to people living at the home during residents meetings, to see whether people have ideas and suggestions for the home. The information we asked for about the quality of the service, was completed on time. It used a range of appropriate evidence to support the managers assessment of the service and the quality of outcomes for people living there. The manager carries out audits of safety monthly and these are monitored by the organisation. There are also checks on routine maintenance and testing of equipment to make sure it remains safe to use. The manager showed us records indicating that two overruns on timescales for servicing or training that affects peoples safety, have been dealt with promptly. Temperatures of fridges and freezers are monitored to ensure that they do not present concerns for the safe storage of food and are working effectively. Training is available to staff on health and safety so they understand how they can contribute to this and their responsibilities. Care Homes for Adults (18-65 years) Page 32 of 36 Are there any outstanding requirements from the last inspection? Yes ï£ No ï 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 33 of 36 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 Description 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 Description Timescale for action 1 20 13 The manager must take 29/10/2008 steps to ensure staff follow the correct procedure for checking, administering and recording medicines (including those not in blister packs). This is so people are protected from error and can be sure they will get the medicines they have been prescribed in the right dose at the right time. 2 20 13 The manager needs to take steps to verify prescribers intentions about medicines used occasionally and to ensure directions on the administration records are consistent with this. 29/10/2008 This is to make sure that guidance for staff is consistent with the
Care Homes for Adults (18-65 years) Page 34 of 36 prescribers intentions, so that people are not at avoidable risk of error, misuse or misunderstanding. 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 7 Keyworker sessions should show the efforts made to discuss what is in the records with the people concerned. This would help increase evidence of the efforts made to involve people in making decisions. The manager should keep under review whether training in safe holding techniques might be necessary for staff in future, in order for them to keep others and themselves safe. 2 35 Care Homes for Adults (18-65 years) Page 35 of 36 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.
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