Inspection on 03/12/08 for Mar Lodge

This inspection was carried out on 3rd December 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mar Lodge 13/12/06

Mar Lodge 03/11/05

Mar Lodge 26/07/05

Mar Lodge 16/02/05

Mar Lodge 28/06/04

Mar Lodge 23/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Mar Lodge 26 Nottingham Road Melton Mowbray Leicestershire LE13 0NP 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: Chris Wroe Date: 0 3 1 2 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:  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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 35 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 35 Information about the care home Name of care home: Address: Mar Lodge 26 Nottingham Road Melton Mowbray Leicestershire LE13 0NP 01664560302 01664560302 mar.lodge@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Park Care Homes (No 2) Ltd Name of registered manager (if applicable) Zoe Kuzniar Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 care home 7 learning disability Additional conditions: That the home is registered to admit 1 named service user of category SI as specified in Variation Number V000000874 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Mar Lodge is a care home in the town of Melton Mowbray, near to the town centre. The home is within easy access to local shops and public transport. Mar Lodge is registered to provide personal care for up to seven people who have learning disabilities. The home has seven single bedrooms. One bedroom has en suite facilities. The home has one lounge and one dining area and a large kitchen. The fees at the time of our inspection on the 3rd December 2008 ranged from £358 to £712 each week. Care Homes for Adults (18-65 years) Page 5 of 35 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 6 of 35 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 3rd December 2008. The manager was not available on the day of our visit, so we were helped during the inspection by a member of staff. Our visit to the home lasted almost four hours. We asked people to tell us what they think of the home. As part of our inspection, we sent out surveys to the home for people who live there to fill in if they wanted to, so they could tell us what they thought about the home. Six people sent us replies. They all gave us positive answers to our questions, telling us they were happy with the care they received. We also sent out surveys to staff, and we received one response from a member of staff. They gave us positive responses to our questions, and told us they felt supported in their work. One healthcare professional who works alongside the home gave us their views about the home. We asked for information. The main way we do our inspections is using a method we call case tracking. This means looking at the care given to people in different ways. The ways this was done are: - talking to the people who live in the home - talking to staff and the manager - watching how people are given support - looking at written records. We Care Homes for Adults (18-65 years) Page 7 of 35 also looked at the information that the provider (the owner of the home) sent to us. We talked to people about the home. We spoke with two people who live in the home during our visit. People told us that they felt staff were good and helped them. We spoke to two members of staff during our visit to the home, who told us about working in the home and gave us their views. They mainly felt very positive about working in the home. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information in this report is just about what we checked in this inspection. We have kept details about individual people out of the report, to make sure these things are kept confidential. What the care home does well People who live in the home are assessed before they move in, to find out whether staff can meet their needs. The assessment is done over time, so people can take their time to choose about whether the home is right for them. Care plans give information about what each peoples needs are, and how staff can support people. These have some good information in them to make staff Care Homes for Adults (18-65 years) Page 8 of 35 more aware about how to meet peoples needs. Everyone has a person centred plan. People enjoy different activities and have a choice about what they would like to do. There are activities within the home, and people are also able to go out into the community to do what they would like. Some people go to college. People who live in the home are involved in choosing and preparing meals. Staff help people to eat healthily. Good attention is given to helping people to keep healthy and well. Everyone has a GP, and has health check-ups when they need them. We saw that staff treat people who live in the home with respect. There is a complaints procedure in the home. Staff have an understanding of how to keep people safe, and have had training about this. The home is generally clean and tidy, and well maintained. The provider (owner) makes sure that checks are carried out on people who want to work at the home to ensure they Care Homes for Adults (18-65 years) Page 9 of 35 are safe to work with people. Training is given to staff to help them to do their job well. The service uses different ways to find out the views of people living in the home. People who live in the home hold their own meetings, so they can have a say. Staff carry out tests and checks of equipment, and work in safe ways, to make sure peoples wellbeing is looked after. What has got better from the last inspection The manager has improved the assessment so that a lot of care is taken to make sure the home is right for people who come to live there. Everyone has person centred plans, which give good information about what is important for each person. There have been improvements to the living environment in the home, including re-decoration of lounge areas and everyones bedrooms. Care Homes for Adults (18-65 years) Page 10 of 35 There has been different training for staff to bring them up to date in their skills and improve the service. The provider does checks of different things in the home to make sure that everything is running smoothly for people who live there. What the care home could do better It would be good if members of staff were given training in some key areas, such as awareness about learning disabilities, about the mental capacity act, and about how to manage challenging behaviour - so that they have more confidence about meeting peoples needs. Staff must make sure that there are risk assessments in place about the storage and taking of alternative medication, such as homeopathic medicines. It would be good if people who live in the home could have access to social/sexual education and information if they would like it, so that people can have a greater understanding of their rights and choices, and a greater awareness about social and sexual relationships. Care Homes for Adults (18-65 years) Page 11 of 35 The provider must ensure that any serious incidents affecting the welfare of people who live in the home are reported to us. The provider should review staffing levels in the home to ensure that at all times people who live in the home are safe, and that they are given full opportunity to enjoy the lifestyle they choose. It would be good if the provider looks at whether the positions in which staff are employed match the levels of responsibility that they hold. The manager needs to ensure that each member of staff gets individual support and supervision for their work on a regular basis. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 12 of 35 If you want to speak to the inspector please contact Chris Wroe 33 Greycoat Street London SW1P 2QF 02079792000 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 13 of 35 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 14 of 35 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 who live in the home benefit from a safe and careful admissions process. Evidence: We asked people who live in the home whether they had enough information about the home before they moved in. Three people told us they had had enough information, one person said they had not and one person said they could not remember. The manager has told us they plan to make written information (like the service user guide) more accessible, so that people who come to live in the home can have proper information about it. Everyone told us they had been asked if they wanted to move into the home. When we talked to two people who live in the home, they told us they were happy to be living there. We saw that people were supported well by staff. We found that staff had recorded how peoples needs had changed since they moved into the home, and how they gave the right kinds of care for peoples different needs. The manager assesses people who move into the home, to check that staff are able to meet their needs and it is the right place for them. The manager told us this is done Care Homes for Adults (18-65 years) Page 15 of 35 Evidence: very slowly, to give people time to see what the home is like, and whether it is the right place for them. Social workers also give any important information about peoples needs, so the home can give the right support to people. Staff have had different kinds of training so that they can offer the kind of service that is promised in written information about the home. This includes training in handling medication, manual handling (helping people to move safely). But staff have not had training in some areas, which would be useful to help them meet the needs of people living in the home. They have not had training about learning disabilities or about how to manage behaviour which can be challenging. They have also not had training about the Mental Capacity Act 2005, and how this affects people who have learning disabilities. Knowing about these areas could be helpful for staff to more confidently support people who live in this home. Care Homes for Adults (18-65 years) Page 16 of 35 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 who live in the home benefit from receiving good care from staff who are sensitive to meeting their needs. Evidence: We found that the staff keep good written records about people who live in the home, to describe the support they need. There are person centred plans, which are focussed on what each person feels is important for them. The manager and care staff keep care records up to date as peoples needs change. Each person has been given choice about who else can see their care records. When we talked to people who live in the home they were able to show us that they can make choices about what information is private to them. We found that care staff have a good understanding of each persons needs, and how they can best be supported. When we visited, there was a relaxed atmosphere in the home, and people were able to choose what they wanted to do, and make their own choices about when to have lunch. One health professional who works alongside staff at the home, told us they see Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: in the home a warm friendly atmosphere, mutual respect between residents and manager in particular. We also saw risk assessments, which are records to show how people are able to live their life and do things they want to do, whilst being kept safe. We did hear about one incident that had happened, which could create a risk for people. This had not been put into care plans and a risk assessment had not been written. This was put right while we were in the home. Staff were able to tell us about the different risks that each person faced and how they were supported to keep safe. Staff and people who live in the home told us that there are not always so many staff working in the home as there used to be. Sometimes there is only one person working in the home - and this can mean that people do not get as much support or opportunities to do what they want to do. Also, it can mean that it is harder to manage situations where someones behaviour is challenging - as had happened recently in the home. We found that while there used to be male staff working in the home, there are not any now. One relative told us It was and would be nice if there was a male member of staff to deal with male residents. My [relative] appreciated this service and was sad when it ended. People have good access to advocacy support. Most people who live in the home are involved with the group Advocacy in Action and go to their conference every year. Staff support people to manage and keep their money safely. Care Homes for Adults (18-65 years) Page 18 of 35 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 in the home are enabled to enjoy a good lifestyle. Evidence: We learnt from care records and from talking with staff, about the different activities that each person is involved in. Some people go to college. People also enjoy other activities like shopping trips, going swimming, going out for meals and going for walks. Some people go to church each week. Everyone who lives in the home went on holiday this year - two people told us about the good time they had, and we saw photos of their trip. Members of staff go on holiday with people who live in the home. We saw that there is a comfortable, relaxed feel in the home and that people enjoy spending their time with each other and staff. Two relatives commented in our surveys that they felt people who live in the home are well looked after. One commented: The care home provides a family home and Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: atmosphere for their residents. They also told us The home provides a good service and staff are looked upon as friends not only to residents but also to relatives and friends of the residents. Another relative said to us: I always feel it is family friendly. We were told by people who live in the home and by members of staff, that there are less staff working at times in the home than there used to be. Sometimes there is only one member of staff on duty - especially in the evenings and every other weekend. People told us that this sometimes means that they cannot go out and do the things they want to do. Care staff are also responsible for doing cooking and cleaning in the home, and they tell us that when there is only one member of staff on duty, it means they have less time to support people to develop their own skills and to do things with them, because they have jobs to get on with. One health professional who works with the home also commented to us: Could be better staffed at weekends and evenings to support community visits, leisure etc. This is something the Provider (the owner of the home) should look at, to make sure people who live in the home continue to have a good lifestyle (see Staffing section of report). We found that people who live in the home have family contacts, who come to see them or who they meet up with. The manager and care staff are supportive in enabling people to see relatives when they want to. Some people are involved in relationships, although we found that people could be given more support in getting social/sexual education or information to increase their understanding and awareness. We saw menus, which showed that people who live in the home have varied nutritional meals, including healthy pack-up lunches when they go to college. Care staff make sure that each resident has a good diet, and care plans show where attention needs to be given to someones diet. People who live in the home make choices about what they would like to eat, and make their own meals or assist in the cooking of main meals for everyone. Care Homes for Adults (18-65 years) Page 20 of 35 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 who live in this home benefit from good attention to personal and healthcare needs. Evidence: We looked at care records, we talked to staff and we looked at what goes on in the home. We found that good attention is given to making sure that people who live in the home are supported to keep healthy. People are given support to look after themselves and to be as independent as they can be. Each person has a health action plan, which tells about what is important for them in keeping them healthy and well. Six people who live in the home told us that staff always treated them well. One member of staff told us they feel they are given the right skills, experience and training to meet the needs of people in the home. One relative told us: My son always seems to be well cared for by well experienced staff in a well managed home. People who live in the home have access to GPs and other healthcare services. We saw that people have control over their health and wellbeing. The home has good contact with other services. One health professional told us that the care service works well Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: with them: Good communication when necessary... We looked at a sample of medication and records to check how medicines are stored and given to people who live in the home. Stocks are kept safely and good records are made. We saw that one person had good understanding of the medication they were taking and knew about the need to keep medicines safe. One person uses alternative therapies and medicines. We did find that there was no risk assessment to describe how these sorts of medications were to be used and stored safely - and this should be put in place. Care Homes for Adults (18-65 years) Page 22 of 35 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 who live in this home are protected from harm and enabled to raise any concerns they have. Evidence: We saw that there was a good relationship between people who live in the home and staff, which led to people being able to say what they needed and wanted. Everyone told us in our surveys that they know how to make a complaint - one person told us they tell the manager if they are not happy. Everyone told us they feel the staff always listen to them and act on what they say. Two relatives told us that feel able to raise concerns if they need to. One said: My [relative] has been in care at Mar Lodge for about 14 years and only once have I had a concern. Another person said: Had to use this service only once, and the matter was dealt with quite quickly and a satisfactory solution was found. We saw that there is a complaints procedure up for people to read and use if they want to. People in the home have good involvement with advocacy services. Staff have had some training to help them to keep people who live in the home safe from harm. More training was to be given in December, after our inspection visit. There had been an incident in the home recently, which could cause some risk. Staff and the manager followed the procedures that tell them how to manage situations Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: where people might be at risk of harm. But there is no record that information about this was passed to us, as the home is supposed to do. We also had some concern that although care staff are left in charge of the home, they do not have access to all the information they might need to keep people safe or to report incidents. The manager told us this is something the provider is looking to change. Staff have also not had training about how to manage situations where peoples behaviour may be challenging or potentially harmful. Care Homes for Adults (18-65 years) Page 24 of 35 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 in the home benefit from having a good living environment. Evidence: People who live in the home told us that they found the home to be always fresh and clean. When we visited, we found this to be so. There has been some re-decoration in the home, and one health care professional told us: The environment is now beginning to be improved i.e. painting and decorating and furniture replacement. This was long awaited. It is good that the provider is improving the living area of people who live in the home. We saw that people are comfortable, and that it is very much their home. People are able to personalise their bedrooms with their own things. The manager makes sure that maintenance of equipment is done, and that tests and checks of equipment are carried out to make sure the home is safe and comfortable for people. A food hygiene inspection was carried out by the environmental health department in February 2008, and the home got 3 stars (for a good service). There is a laundry for people to use to do their washing. People who live in the home do their own washing and ironing, with support from staff. The laundry area is fit for purpose, and there are cleaning rotas in place in the home. Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: Care Homes for Adults (18-65 years) Page 26 of 35 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 in the home benefit from having a committed and trained staff group. Evidence: Everyone who lives in the home told us in our surveys that staff look after them well and treat them well. Two relatives told us they were also happy with staff in the home. One member of staff answered our question about what the home does well: Treat everyone as an equal. Staff told us that the provider carried out checks on them before they started work in the home, and that they had induction training, to help them learn about the job at the start. Staff told us they get training to help them do their job well. Training includes fire safety, moving and handling, safe handling of medication. Some staff have done National Vocational Qualification (NVQ) Level 2 training, and others are working towards this. One member of staff told us they would like to do their NVQ level 3. We have talked about some gaps in training in other parts of this report. We have also discussed the staffing levels. Having less staff on duty at some times would seem to be preventing people who live in the home from having their needs fully met. Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: Staff who work in this home carry some responsibility on their own, when they are working alone in the home. But each member of staff is in a support worker role, rather than as a senior carer, or team leader (as in the providers sister home). Given the level of responsibility staff are given, the provider could consider making sure staff are properly equipped in the right role to make the decisions they need to make. The manager told us this is something the provider will be looking into. We found that staff have occasional supervision, but that some staff feel it would be helpful to have more one-to-one support from the manager. Staff told us that they have team meetings but do not always feel able to raise everything with the team. As staff are on their own in the home, it is important that they receive the proper support to carry out their role effectively, and the manager said she will aim to make sure this happens. Care Homes for Adults (18-65 years) Page 28 of 35 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 who live in this home benefit from having good management systems. Evidence: The home now has a registered manager in place, who has experience and qualifications. Staff told us that they find the manager approachable and are able to talk to her. One healthcare professional commented to us: The manager is very committed and works very hard to give a consistent service to individuals. The provider has an audit team which carries out checks of the home to make sure that everything is running well. Checks are carried out of different things relating to the care of people who live in the home. The day before we visited, a check of finances was done, to make sure that peoples money is being looked after. People who live in the home hold their own meetings every week and can have their say about how the home is run. Staff have training to help them to understand how to work safely in the home. There are also written policies in the home, which tell staff how to carry out their work safely. Staff check equipment to make sure it is still safe for people to use. Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: Care Homes for Adults (18-65 years) Page 30 of 35 Are there any outstanding requirements from the last inspection? Yes  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 Care Homes for Adults (18-65 years) Page 31 of 35 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 provider must ensure that there is a risk assessment in place relating to the safe use and storage of homeopathic and other alternative medications. 31/01/2009 This is to ensure that people are kept safe from any risks relating to medication. 2 23 37 The provider must ensure that any serious incidents affecting the welfare of people who live in the home are reported to the CSCI as required. 31/01/2009 This is to ensure that people are safeguarded from harm. 3 33 18 The provider must review 28/02/2009 staffing levels in the home to ensure that at all times Page 32 of 35 Care Homes for Adults (18-65 years) residents and staff are safe, and that residents are given full opportunity to enjoy the lifestyle they choose. To ensure that there are enough staff to enable residents to have a good lifestyle and live to their potential. 4 36 18 The provider must ensure 28/02/2009 that one to one supervision and support is given to staff on a regular basis so that they feel supported in their work and enabled to develop professionally. To ensure that staff are fully supported and equipped to carry out their role 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 3 It is recommended that staff who work in the home have training about learning disabilities and about the Mental Capacity Act 2005, so that they are more confidently able to meet the needs of people who live in the home. It is recommended that the provider arranges for people who live in the home to have access to social/sexual education and information if they would like it, so that people can have a greater understanding of their rights and choices, and a greater awareness about social and sexual relationships. It is recommended that the staff are provided with training Page 33 of 35 2 15 3 23 Care Homes for Adults (18-65 years) relating to managing challenging behaviour so they can be more confident and skilled in keeping people safe from harm and responding to situations. 4 32 It is recommended that the provider considers whether the positions in which staff are employed are appropriate to the levels of responsibility that they hold. Care Homes for Adults (18-65 years) Page 34 of 35 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 35 of 35 - 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!