Inspection on 27/10/08 for Meadows

This inspection was carried out on 27th October 2008.

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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadows 16/11/06

Meadows 20/03/06

Meadows 21/09/05

Meadows 14/03/05

Meadows 17/11/04

Meadows 15/12/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Meadows Fairy Hall Lane Rayne Braintree Essex CM77 6SZ     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: June Humphreys     Date: 2 7 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. 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 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Meadows Fairy Hall Lane Rayne Braintree Essex CM77 6SZ 01376340714 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): a.ohene@btinternet.com Mr Alex A Ohene Name of registered manager (if applicable) Mr Alex A Ohene Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: One named person, over the age of 65 years, who requires care by reason of a learning disability and who also has a learning disability Persons of either sex, under the age of 65 years, who require care by reason of a learning disability who may also have a physical disability (not to exceed 6 persons) The registered person is required to undertake training with regard to adult protection policies and procedures and ensure that staff employed at the home are trained in this area, within three months of the date of registration. All new staff appointed must receive training in adult abuse as part of their induction. The total number of service users accommodated in the home must not exceed 6 persons Date of last inspection 0 6 Over 65 1 0 care home 6 Care Homes for Adults (18-65 years) Page 4 of 32 Brief description of the care home Meadows is a fully detached, domestic style, single storey bungalow situated on the edge of Rayne village. The property is fully in keeping with other properties around it. The home is registered for six people with learning and physical disabilities, accommodated in four single and one shared rooms. Communal space comprised a lounge, with a dining area at one end, and a separate kitchen with a second dining area. The fenced rear garden was large, well maintained and accessible to residents. There was also an enclosed patio area at the rear of the home. Limited visitor car parking is provided on the driveway. Regular community access is provided to residents by the use of a vehicle based at the home. There was also a public transport link available in the centre of Rayne, via an hourly bus service to Braintree. Information from the home confirmed that weekly fees vary according to the care package agreed with the placing agency. Past inspection reports are available from the home, and from the CSCI internet website. Care Homes for Adults (18-65 years) Page 5 of 32 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: The quality rating for this service is one stars. This means that the people who use this service experience adequate quality outcomes. This was a routine unannounced Inspection. One Inspector visited the home on the 27th October 2008. The people who live at the home were spoken with, and observed being supported and talking to the staff on duty. One of the service users showed me around the building, so that I was able to look at the facilities and the environment where people live. I talked to the staff and the Manager about what service users do during the day,and what they do when they are at home. Information was also gained from sending Care Homes for Adults (18-65 years) Page 6 of 32 surveys to both relatives and professionals who also visit the home. The manager completed the Annual Quality assurance Assessment form (AQAA) which is a self assessment which indicates how the home considers it is meeting the National Minimum standards, and what improvements they will make in the next 12 months. Information from this document is used within this report. A sample of records maintained in the home was looked at to ensure the health and safety of service users is considered at all times; including a sample of care plans, supervision records, the staff rota, complaints, medication and accident records. 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.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 8 of 32 Care Homes for Adults (18-65 years) Page 9 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 32 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. Service users are not provided with up to date information relating to the current service, and therefore it is difficult to make a decision about the suitability of the service prior to trying it out Evidence: No new service users have been admitted to the home since February 2004. The assessments completed prior to the above date were looked at as part of the inspection, and provided sufficient detail to ensure the persons individual needs could be met by the service. A service users guide, and the homes statement of purpose was available, but had not been updated for sometime. The service users guide was dated 2003, and the statement of purpose dated January 2005. The manager explained that an audio version of the guide had been developed since then and had proven more beneficial. A copy of this version was not available on the day of the site visit. Both the Statement purpose and service user guide must be updated as soon as possible to ensure that the documents clearly outline the current service available. The service user guide would benefit from being offered in a format that would be Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: considered suitable for service users with a learning disability to fully understand, without considerable assistance. The manager advised that any future admission would be subject to a full needs assessment, and then a series of introductory visits would be arranged to enable the prospective service user to try out the service to see if they liked it. This would also enable current service users to get to know the person, before reviewing the suitability of the placement. Care Homes for Adults (18-65 years) Page 12 of 32 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. The service supports and encourages individuals to make life decisions, and provides opportunities to take risks as part of daily life, but consistency cannot be guaranteed due to the lack of up to date information and recording. Evidence: All service users has an individual care plan, and an allocated key worker to support them in the home. Three care plans were examined, and contained a good level of detail regarding peoples personal and social needs. The care plans looked at had not been frequently updated, some service users had been reviewed but the old documentation remained. The Manager advised that changes had been made where necessary, and behavior management guidelines were in place for a service user that had experienced some difficulties within the home. Evidence was available to confirm this, and staff spoken to were aware of the guidelines, and applying these within the persons daily support routine. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Most Service users do have relatives and friends who visit. The manager stated that visitors were made welcome, and this was echoed by relatives who were spoken to. One relative said we are always informed of what is happening, and the Manager is very on hand, and approachable. Another person said I am happy here, and the staff are helpful. There is a small separate room located in the garden area that can provide greater privacy if required when service users have visitors. The Manager stated that service users and relatives are involved in the running of the home where possible, but there is currently no advocacy input to the home, and evidence of regular service users meetings was limited. The service users lead reasonably independent lives according to their varying levels of ability, and Staff understand the importance of allowing them to take sensibly evaluated risks in order to enjoy a range of opportunities. Evidence of a number of risk assessments were on file, and mostly related to areas of significant risk i.e. when two staff needed to work with a person on certain tasks. Care Homes for Adults (18-65 years) Page 14 of 32 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. Service users enjoy their life experiences both inside and outside the home, but would benefit greater from improved recording. Evidence: There was evident from discussion with two staff, the manager and a service user that the home enables and encourages service users to participate in the community, and to make use of the facilities available on a regular basis. The manager said that many of the service users attend the local college, and the range of activities has recently been reduced. The manager has organised to have tutors come into the home to facilitate groups, and staff access the community via the use of the homes minibus. One service user talked about her activities, describing how she liked to go to college, and enjoyed going Swimming. Despite the discussions held there was very limited up Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: to date information on file about what activities each person was involved in. Several activities plans were shown as examples but they had not been updated and were not current. Recording of activities was also limited, with some mention of activities within individual care notes i.e. that a service user had taken part in an activity. Throughout the site visit staff were observed to interact appropriately with service users, the atmosphere was relaxed, but friendly and supportive. Service users comments were they look after me well, I like the food, good here, its happy, I like the staff. Menus checked showed that service users are provided with an interesting and varied diet. Food stocks in the fridge and cupboards were seen to be varied and service users said that there was always a choice. Care Homes for Adults (18-65 years) Page 16 of 32 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. Service users receive personal support in the way they prefer which adequately meets their needs, but the current storage of medication requires review. Evidence: The home is small accommodating only six service users. There is usually two members of staff on duty. The care provided to service users is tailored to meet each persons individual needs, with service users choices and preferences being promoted wherever possible. The manager stated in the AQAA that the service does well because, the staff are able to respond appropriately and sensitively in all situations involving personal care. Ensuring all personal care is conducted in privacy. Personal support is flexible, consistent and responsive to each individuals needs. There had been concerns relating to the provision of personal care to an individual in the home which the manager said he had resolved, by working on shift himself when female staff were on duty. This was until further male staff has been employed. The care plans do provide basic information regarding peoples physical and emotional health, but additional monitoring forms used to monitor certain health conditions had not always been accurately kept up to date. These forms are integral in supporting people who Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: have complex needs, and impacts on the daily support, that needs to be provided. One example was a person who regularly had their weight monitored by the dietitian. This had clearly happened, but was not recorded in the daily notes, or on the appropriate monitoring form. A medication policy and procedure is in place to support the safe administration, storage and receipt of medicines. However concerns were raised about both the administration of, and the storage of medication. No service users currently living at the home retained or administered their own medication or were prescribed controlled drugs. There is no secure facility to store controlled drugs should they need to be administered in the future. The Manager advised that the current system for storing medication in an ordinary kitchen cupboard was introduced, to enable medication to be administered as normally as possible, usually at breakfast or tea time. Whilst the ethos being promoted is understood, a kitchen is far from an ideal place to store medication of any type due to usually high temperature and humidity. The key was also an ordinary cupboard key, placed on the main bunch of keys. Again this limits the security of the stored medication. The medication records seen were in order. Several MAR sheets (medication administration records) were sampled and staff had signed on each occasion that medication had been administered. Most medication is stored in blister packs, but a few items were available in boxes, which demonstrated that the outstanding amount of medication in the box, related accurately to the recording sheets. There was a query in relation to staff training relating to administering medication as records had not been kept up to date, and therefore evidence was not available for the sample of staff selected in relation to this area of training. Care Homes for Adults (18-65 years) Page 18 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff respond appropriately when listening to any concerns or complaints, and do protect service users from abuse, although some further training would be beneficial to both staff and service users. Evidence: The homes complaints procedure is available to all service users, and a copy is provided on admission. There is both a written and audio version available. Service users have regular contact with their allocated key worker, and concerns are addressed immediately wherever possible. Service users spoken to did appear to know how to make a complaint, and staff said that they actively encourage people to express their views. Relatives also said that the Manager and staff team listen to Service users, and act on their requests. No complaints have been received since the last inspection in November 2006. Appropriate documentation to record complaints is available should the need arise. A number of staff had received safeguarding training; but there was no evidence that new staff had attended. A Vulnerable adults training pack dated 2006 was shown as current training by the manager, and also abuse of adults was also included in the Learning disability TOPPS pack completed as part of staff induction. Two new members of staff were interviewed and both stated that had covered information regarding safeguarding as part of induction. However the induction packs that were completed Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: were not available on the day of inspection. A concern had recently been raised through a Service users review, and evidence was available to demonstrate that the service had responded quickly and appropriately. Care Homes for Adults (18-65 years) Page 20 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in a comfortable environment, which is homely but in need of some improvements, which can sometimes impact on residents safety. Evidence: A tour of the premises was completed as part of this inspection. The accommodation is in need of some re decoration. Certain repairs were in the process of being completed, and evidence was seen of quotations and agreement to start work. The bathroom opposite the office was seen to look worn. The toilet had been replaced, but this had left gaps in the flooring. The flooring was of poor quality, and torn around the bath area. The bath panel was worn, and cracked which could be hazardous when service users are bathing. The manager advised that the home had applied for a grant from Essex County Council to refurbished the bathroom,and therefore only minor repairs had been undertaken. The service users bedroom with on suite shower facilities requires attention. The Manager advised that this is currently not in use. Prior to any service user making use of the facility the cracked tiles must be replaced, as they are dangerous and could cause a slip or trip. The shower hose is extremely dirty and unpleasant looking, and does not function properly. The toilet seat in the female toilet must be replaced, as it is cracked and could cause possible discomfort and infection. The bedroom located at the end of the corridor has been re decorated but the curtains Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: have yet to be replaced. In the same bedroom the T.V was hazardous but was removed immediately when pointed out as a concern. Despite the above, overall the home was seen to be comfortably furnished, clean and tidy. Service users spoken with said that they like their bedrooms and it was evident that service users had been encouraged to bring small items of furniture ornaments etc to personalize their individual rooms thus further promoting the homely environment. The garden was seen to be attractive and accessible to service users. Care Homes for Adults (18-65 years) Page 22 of 32 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. Service users needs are appropriately met by the levels of staff, who have been satisfactory recruited, and are enthusiastic about the work they do. Evidence: Four members of the care staff were spoken to during the inspection and all were enthusiastic about their work in the home, and one said, that there is an open and happy atmosphere here. The Service users are encouraged to be independent and supported by staff when necessary. This was confirmed in several surveys from relatives and professionals. One relative said staff are very good, and very kind. Another person said They know the residents well, and have an interest in each individual. One professional survey said The staff have a nice repore with the people, there is a nice atmosphere, sitting and talking with them. The level of staffing in the home is adequate, there are currently five Service Users living at the home. There is usually two staff on both the Morning and Afternoon shift. At night there is one waking night staff and one sleeping in person who can be called if necessary. There is an expectation that all care workers also undertake tasks in relation to cooking, laundry and cleaning. Whilst it is appreciated that some of these Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: tasks are supporting Service Users to maintain and develop new skills. Many Service Users require support to undertake even the simplest of tasks. Staff reported that much of the non-care work is completed when Service users are at college, or out and about, so currently was not a problem. New staff members said that they generally felt well supported by the manager, and senior staff based at the home, and that the manager very often worked on shift coaching, and supporting staff. However there was limited evidence of regular supervision or appraisals. One new member of staff said he had been supervised, and notes were available of one session. There was also no evidence of handovers, other then limited information on individual service User files. Team meetings are usually held jointly with Service Users, and three had been held in Eleven Months. The service employs a number of staff with limited experience working with varied, sometimes challenging people and it is important that the management team ensure staff are supervised on a regular basis. A range of training is offered to Staff working at the Meadows, but again staff training files had not been fully updated. Evidence was available to confirm completion of training in the form of certificates etc, but not in all cases. An example of this was the person administering medication without evidence that the basic training had been completed. The manager continues to support staff to complete N.V.Q training, and several new staff were waiting to be registered. The files of two new employees were inspected. They contained all the appropriate security and identity checks including Criminal Records Bureau checks and two up to date references. Care Homes for Adults (18-65 years) Page 24 of 32 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. The Owner/Manager of the home has a clear understanding of the principles, and focus of the service provided, but improvement of recording and updating of policies would ensure consistency and safety of service users. Evidence: The Owner/manager is experienced in the care of people with a Learning disability,and has completed the Registered Managers Award. Feedback from residents and staff about the registered manager was positive with comments received about them being approachable, supportive and always on hand for advice. The Manager stated that both himself and the assistant manager work as part of the care team providing guidance and direction to staff when necessary, to ensure that Service Users receive consistent, quality care. Due to possible staffing issues over the last twelve Months the care and support of people living in the home has remained a priority, but the completion of essential paperwork has suffered due to the time the manager has allocated to supporting both staff and service users. The Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: absence of documentation has been raised in many areas of the report. The Statement of Purpose and Service user guide is out of date by several years and there is now a vacancy in the home. The Care Plan format is good, but has not been regularly updated. This included health care information which is essential information to provide good quality care. Whilst it is acknowledged that the home is small, and that the staff team generally work well with the service Users, there is a number of new staff who must have access to up to date information to enable them to work consistently with people. Staff spoken with stated that supervision does take place, but evidence was not available to support this. Handovers and team meetings separate to Service Users is also not current regular practice, and both service user and Staff would benefit from a team that is able to meet more regularly and discuss current issues. The Service supports people in the management of personal allowances and savings. Three Service Users cash transaction records were inspected and all were inaccurate. Bank statements were also seen that did not confirm current expenditure. The owner/manager advised that a current up to date statement had been requested from the Bank and this would clarify current withdrawals. The manager agreed to forward a copy of this information to the C.S.C.I once received. The homes policies and procedures are all in the process of being updated. All safety certificates were in place. The fire log book had regularly been updated, and electrical appliances had been inspected for safety. Care Homes for Adults (18-65 years) Page 26 of 32 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 34 19 schedule 2 The registered 31/12/2006 provider/manager must ensure that criminal records checks are undertaken on all new staff employed in the home. Care Homes for Adults (18-65 years) Page 27 of 32 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 6 15 The Registered Manager must ensure that individual care plans reflect levels of dependency and support required by the service user to meet their needs within a person centred programme approach, which are reviewed and updated on a regular basis. To ensure the health and safety of Service Users. 31/03/2009 2 19 12 The Registered Manager must ensure individual care plans reflect health care needs and that potential health risks are assessed and appropriate actions in place to reduce them are recorded Consistency and Safe care of service users. 31/01/2009 3 20 13 The registered manager will make arrangements for the safe storage of medication 31/01/2009 Care Homes for Adults (18-65 years) Page 28 of 32 To ensure medication that is adminstered to service users is stored at the appropriate temperature as recommended by the manufacturers. 4 20 18 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service users ensure that persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform.This specifically refers to medication training and recording. Safety of service Users when receiving medication. 5 24 23 The toilet seat in the female toilet that is cracked and worn must be replaced to ensure cntrol of infection and possible harzard to the person who uses it. To ensure the facility is safe for use by service users. 6 24 23 The flooring in the main bathroom must be replaced, and the bath panel made safe to protect service users from possible harm. To minimize possible hazards to service users. 7 24 23 The cracked tiles, and shower hose must be 28/02/2009 30/01/2009 30/01/2009 31/01/2009 Care Homes for Adults (18-65 years) Page 29 of 32 replaced, and the area made safe for use in the ensuite shower room to limit a possible hazard. To ensure the facility is safe for service users to use without risk of possible harm. 8 35 18 The registered person must 30/01/2009 ensure the most recently appointed staff undertake a formal induction programme that is recorded. To ensure the service users are being cared for safely by staff who know the service and can adequately meet their needs. 9 36 18 The Registered Manager 30/01/2009 must ensure staff have regular recorded supervision meetings at least six times a year in addition to regular day to day contact. To ensure staff are able to fully meet the needs of the service users in their care. 10 41 17 The registered Manager must ensure that records relating to service users finances is kept uptodate, and regularly audited For the protection of service users. 11 41 17 Records required by 28/02/2009 regulation for the protection of service users inspected on this occasion included a sample of staff rotas, staff 30/01/2009 Care Homes for Adults (18-65 years) Page 30 of 32 supervision records, service user assessments, care plans, and daily care records (including weight monitoring, medication, and menus. Where relevant, records have been commented on under the relevant standard, but were generally not adequately maintained. For the safety and protection of service users. 12 42 13 All COSHH products must be 20/01/2009 stored in a locked cupboard, and be put away once used to ensure the protection of service users To ensure the protection of service users. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Service users would benefit from an uptodate statement of purpose and service users guide which clearly outlines the current service offered. Care Homes for Adults (18-65 years) Page 31 of 32 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. 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