Inspection on 22/10/09 for Melrose House

This inspection was carried out on 22nd October 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Melrose House 24/04/09

Melrose House 28/11/07

Melrose House 20/09/06

Melrose House 22/11/05

Melrose House 26/07/05

Melrose House 24/11/04

Melrose House 01/07/04

Melrose House 10/03/04

Similar services:

22 Sandown Road

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Dilston College Of Further Education

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Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Melrose House 25 Beverley Terrace Cullercoats Whitley Bay Tyne & Wear NE30 4NT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anne Brown     Date: 3 0 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 32 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Melrose House 25 Beverley Terrace Cullercoats Whitley Bay Tyne & Wear NE30 4NT 01912513259 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: scnemelrose@tiscali.co.uk Mr Stephen Hunter,Mrs Linda Hunter care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Melrose House is a small home for nine people who have a learning disability. The home provides care for male and female residents. Situated on the sea front, it provides a central location for access to local facilities. All of the bedrooms are single occupancy with bathrooms/toilets located around the building. There is a spacious and comfortable communal lounge and dining area. There were nine residents at the time of inspection. The service user guide and last inspection report were available at the entrance. The fees range from £392 to £432 per week. 7 Over 65 2 Care Homes for Adults (18-65 years) Page 4 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 1 star, this means that the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. An unannounced visit was made on the 22nd October 2009. Further visits were made on 28th and 30th October 2009 to speak to the staff. Before the visit we looked at:Care Homes for Adults (18-65 years) Page 5 of 32 Information we have received since the last last key inspection on 28th November 2007 and the random inspection on 24th April 2009; How the home has dealt with any complaints and concerns since our last visits; Any changes to how the home is run; The providers view of how well they care for people; The view of people who use the service, their relatives, staff and other professionals who visit the service. During the visit we:Talked with people who live in the home, staff, the operations manager and two visitors; Looked at information about people who use the service and how well their needs are met; Looked at other records which must be kept; Checked that staff had the knowledge, skills and training to meet the needs of the people they care for; Looked around the building/parts of the building to make sure it was clean, safe and comfortable; Checked what improvements had been made since the last visit. We told the operations manager what we found. Care Homes for Adults (18-65 years) Page 6 of 32 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 7 of 32 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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. Assessments are carried out prior to people moving into the home to help ensure that their needs can be met. Evidence: Copies of the care managers assessment are requested prior to people coming to live in the home. These are available on the case files. Where applicable information is sought from carers, relatives and relevant health care professionals. This information is used to produce the care plans which helps ensure peoples needs can be met. However there was no evidence to show the home had involved the prospective resident in this process. No one has moved into the home recently so the admission process could not be fully reviewed at this inspection. Care Homes for Adults (18-65 years) Page 10 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 information in the care plans is limited and does give sufficient information to staff about people goals and wishes. Evidence: The proprietor has recently reviewed the care plans and instructed the staff to discuss these with the people living in the home. This had not been done due to low staffing levels. The documents do not request the signature of the person living in the home. The temporary manager stated the organisation intended to develop more person centred plans. The current ones do not show how people are supported to make decisions about how they would like to live their lives. They do not explore and record peoples wishes and goals or discuss how to learn new skills. There were no guidelines in place for staff to deal with challenging behaviour or how to prevent certain situations occurring. The spiritual needs on one plan states the person is a regular practitioner and wishes Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: to continue. There was no religion recorded. There is a system in place for each person in the home to be allocated a key member of staff to work closely with them. However the member of staff on duty said she was the key worker for four people but due to low staffing levels she had been unable to spend one to one time with them. The staff try hard to give people choice in all aspects of their lives and encourage them to make decisions. The surveys returned by the people living in the home stated they made decisions about what they wished to do each day. However two people said they could not do what they wanted during the day or at weekends because there were no staff to take them out. People in the home take calculated risks if it is felt these will enhance their lifestyles. However risk assessments are not in place, e.g. going out alone, using taxis etc. Advocates have recently been appointed for three people living in the home to help ensure their best interests are protected. One person said I didnt know about the Advocacy Service. I wish I had known sooner. Care Homes for Adults (18-65 years) Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The opportunities for people to learn new skills or take part in activites are limited which restricts peoples ability to follow their preferred lifestyle. Evidence: The routines in the home are relaxed and people were spending their time in the communal areas and in their bedrooms. Some people living in the home attend day centres and various courses. One person has a job one day per week. The ages of the people living in the home range from 48 years to 92 years and may have different tastes about how they would like to spend their time. Six people living in the home require assistance to access activities outside the home. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: Two of these people go out with another resident who is able to go out alone. The others can only go out when there is sufficient staff on duty. One lady never goes out, apart from a weekly trip to the hairdresser by taxi. Two people would like to be supported to attend church. A visitor stated that the person she visits would not get out at all if she did not escort her. The staffing rotas showed that there is one member of staff on duty each day from 5 pm until 9 am. One a number of occasions there has been one member of staff on duty from 9 am until 9am the following day. This means that people who live in the home are unable to access local facilities and have to remain at home. At present six people require assistance to go out. One person commented Like to go for walks more but no one to accompany. One person living in the home likes to cook. Due to the staffing levels they are able to cook once a week and the staff felt this opportunity should be more frequent. The minutes of the monthly residents meetings from March 2009 to August 2009 stated that people would like to have more trips out. No one has had a holiday this year. The minutes dated August 2009 stated that there is no member of staff to take people to a local disco held every 12 weeks. The minutes from the staff meeting dated July 2009 stated the staff felt more staff should be on duty to provide activities inside and outside of the home. Seven surveys were returned by the people living in the home. Comments included:More activities in and out of the house. Another holiday. Trips. Id like someone to take me swmming and to bingo. Would like to go on holiday or on trips. Not enough staff. No one to take me out. Like being in room at night time. Id like to go out more, bored staying in. Visitors are made welcome in the home and can see their relatives in private. The menus in the home have recently been discussed. A menu is produced but this Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: can change on a daily basis according to peoples choice. Alternatives that are served are recorded. Fresh vegetables are served each day and the staff try to encourage healthy living. Two members of staff who sometimes work alone and are responsible for preparing food, do not have a food hygiene certificate. Everyone spoken to said they enjoyed the food as it was always good. People living in the home are not involved in shopping for food as the supplies are delivered. This means people do not have an opportunity to retain or learn new skills. Care Homes for Adults (18-65 years) Page 15 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. Peoples health and personal care needs are generally met but care planning is not sufficiently detailed to ensure this happens in a consistent way. Evidence: The revised care plans have not yet been discussed with the people living in the home to help ensure that personal support is being offered according to their individual preferences. The people living in the home have access to a variety of health care professionals. The daily records and letters from professionals confirmed this. However health appointment cards are not kept in the case files so it is difficult to confirm if all appointments had been attended. There was little evidence of risk assessments being carried out, e.g. mobility, vulnerability when going out alone, skin integrity. The temporary manager was meeting with a previous carer to try and gain some medical history about one person living in the home so this could be passed on to the Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: GP. She was also arranging for special shoes and slippers to be provided to another person. The staff on duty felt two people who were incontinent should receive a daily bath but there is not always enough staff on duty to assist them. One person had recently attended hospital on their own because there was insufficient staff on duty to provide an escort. One person suffers from erratic diabetes. The staff on duty had been given no specific training in this area but said she would seek medical assistance if there were any concerns. The pharmacist inspector visited the home to carry out a random inspection of the medication system. His report stated that the system was adequate but made two requirements and seven recommendations. See separate report. Care Homes for Adults (18-65 years) Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People may be at risk if the appropriate systems are not fully maintained when dealing with complaints, safeguarding issues and finances. Evidence: There is a written procedure for dealing with complaints. A procedure using pictures and symbols to make it easier for some people to understand is being developed. There is a complaints book in place to record any comments received. There were no entries in the book. However two visitors said they had made complaints to the manager and the proprietor. The surveys returned by the people living in the home stated four people knew how to complain and three stated they did not. One person said when they complained it took a long time to fix things. There is a safeguarding policy in place. Two members of staff have completed training on safeguarding vulnerable adults and two others are booked to undergo this training. However there were two incidents that had occurred in the home which had not been reported to the Commission and there was no evidence that an investigation had taken place. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: The temporary manager said staff are to receive training on the Mental Capacity Act and Deprivation of Liberty in the near future. Some people living in the home are unable to manage their own finances so their personal allowances are dealt with by the staff. These are delivered each week and recorded. The money is given to people when required but they do not sign to say they have received this. The money is kept in separate trays for each person with receipts for purchases which are made. Some receipts were numbered and others were not. This means there is no robust system for dealing with finances. Also the trays were muddled with hospital appointments, concert tickets and other personal belongings. Care Homes for Adults (18-65 years) Page 19 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. Some parts of the premises provide people with a pleasant place to live but other parts are showing signs of wear and tear. Evidence: Most areas of the home were comfortable and well maintained. A bath chair has recently been provided to meet the needs of some of the people who live there. Each person has their own bedroom. The rooms are personalised and reflect the hobbies and interests of each person. There was a very unpleasant smell in one bedroom. The temporary manager said the proprietors were looking at an alternative floor covering to overcome the problem. The pictures in this room were stored on the floor as they had been taken down to redecorate. The temporary manager said they were waiting for the handyman to come and hang them on the wall. A knob was missing from the wardrobe door. The cupboard in the roof is accessed from this bedroom. The door was unlocked and the cupboard was full of various items, e.g. games, bags etc. In the residents meeting minutes dated 31/8/09 it was recorded that one person in the home had requested to have her possessions returned Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: to her as they were stored in this cupboard. The carpet edging between a bedroom and landing on the middle floor was frayed which could pose a trip hazard. The upstairs carpets were splashed with paint following redecoration. The residents call system in one bedroom was broken. The temporary manager said this had been reported. The temporary manager said a new oven had been ordered as the door on the existing oven was not closing properly. The temporary manager said the staff are soon to complete training on infection control. The laundry is located in the back yard. The soap compartment and the information panel on the washing machine was broken. The laundry room is accessed by some of the people in the home. The room is used to store garden trowels, wall tiles, paint, ladders, curtain rails etc. Step ladders were also stored in the back yard. This does not protect the safety of the people living in the home. A knob was missing from the drawers in the downstairs bedroom. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some people living in the home may not be able to take part in appropriate activities of their choice if there are insufficient staff to assist them. Evidence: The home employ a temporary manager (40 hrs per week), 1 carer (40 hrs per week), 1 carer (18 hrs per week), one carer (24 hours per week) and one carer (16 hours per week). One person living in the home walks with a zimmer frame and needs assistance when using the stairs. There are two stairs between the lounge and the dining room. It was observed that on two occasions this person was trying to access these stairs alone as the member of staff on duty was busy with other tasks. Also the medications and records are located in the basement which means the staff on duty cannot be available to observe at all times. The staff files for two people who had recently been employed showed that the Criminal Records Bureau checks and two written references had been received before they were employed in the home. This helps to protect people from harm. These staff members were currently undergoing induction and mandatory training. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: The staffing rotas showed that they were working alone in the home prior to completing this training. The home have identified training that is required for the staff and are currently in contact with a training agency to book the courses. These include diabetes, medication awareness, infection control, care planning, challenging behaviour, dementia, nutrition, equality and diversity etc. One member of staff has achieved a National Vocational Qualification (NVQ), Level 2 and the Operations Manager said all staff would be enrolled to undergo this training. No formal supervision sessions took place for several months but these have now been updated and the notes recorded. Good relationships were observed between the staff on duty and the people living in the home. Five of the surveys received from the people living in the home said the staff always treat them well and listened and acted on what they said. The two other surveys said depends who it is. Care Homes for Adults (18-65 years) Page 23 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. People living in the home may be at risk if appropriate systems and assessments are not in place to ensure their safety and well being. Evidence: The home is currently being managed by a temporary manager. A new manager has been selected and the proprietor is awaiting a Criminal Records Bureau check before she is employed in the home. Regular meetings are held with the people in the home and the minutes are recorded. There was no evidence that their opinions and requests are acted upon. Regulation 26 requires a company representative to visit the home on a monthly basis and to produce a report on the quality of the service provided to the people who live there. Visits had been carried out on 24/8/09 and 7/10/09. The reports were brief and gave no detail about the quality of the service or the views of the people who live in the home. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: A quality assurance system is currently being introduced by the operations manager but this is in its early stages so could not be assessed. The temporary manager stated that surveys had been sent to relatives in May 2009 but the results of these could not be located. The fire log book showed that regular tests to the fire alarm had been carried out but tests to the emergency lights and fire extinguishers were out of date. North Tyneside Fire Authority visited the home after the inspection and will be making requirements directly to the home. A thermometer was not provided to test food, fridge and freezer temperatures which does not protect peoples health and safety. The seal on the fridge door was broken which does not protect peoples health and safety. It was recorded that one person had said they did not always feel safe going out alone and needed another person with them. There was no risk assessment in place. A lone working risk assessment could not be located in the home. The manager from another home owned by the proprietor said a policy was in place but it needed to be expanded and a risk assessment carried out. Care Homes for Adults (18-65 years) Page 25 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R 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 26 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 9 12 Risk assessments must be put in place to address all aspects of peoples lives. This will help ensure people stay healthy, safe and risks are eliminated as far as possible. 31/12/2009 2 23 16 A robust system for dealing with peoples money and valuables must be introduced. This will help ensure people living in the home are protected from financial abuse. 11/12/2009 3 23 37 Events which affect the well being or safety of any persons living in the home must be reported to the commission to decide who will investigate. 04/12/2009 Care Homes for Adults (18-65 years) Page 27 of 32 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 This will help ensure people living in the home are protected from abuse, neglect or self-harm. 4 24 16 The front panel on the washing machine must be replaced. This will provide people with adequate laundry facilities. 5 24 13 The frayed carpet edging on the middle floor must be made safe. This will help ensure this does not cause a trip hazard and help protect peoples safety. 6 24 13 Various items which are 11/12/2009 hazardous to people living in the home must be removed from the laundry and backyard. This will help ensure people are provided with a safe place to live. 7 25 16 All repairs to bedroom 18/12/2009 furniture must be carried out as identified in this report. This will provide people with suitable facilities to meet their needs. 8 33 18 There must be sufficient staff on duty to meet the 11/12/2009 04/12/2009 11/12/2009 Care Homes for Adults (18-65 years) Page 28 of 32 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 health and personal care needs of the people living in the home and ensure their safety throughout a 24 hour period. This will help ensure peoples needs can be met at all times. 9 35 18 All staff working in the home 31/12/2009 must receive appropriate training for the work they carry out. This must include mandatory health and safety training and specialist training to meet individual needs. People in the home need to be supported by a competent staff team to help ensure their safety and well being is promoted. 10 42 13 A thermometer must be 04/12/2009 provided to check food temperatures and fridge and freezer temperatures. This will help meet the food safety standards in the home. 11 42 13 The seal on the fridge door must be replaced. 11/12/2009 Care Homes for Adults (18-65 years) Page 29 of 32 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 This will help ensure food is stored at the correct temperature to protect peoples wellbeing. 12 42 13 Requirements made by the Fire Authority must be carried out. This will help to protect the safety of the people living in the home and the staff. 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 11/12/2009 1 6 The care plans should be expanded to ensure they are person centred and give information about individual goals and wishes. The people living in the home should be consulted and involved in the review of their care plan. All the people living in the home should be given the opportunity for personal development. The staffing levels in the home should allow all the people living in the home to participate in appropriate activities both inside and outside the home. A system should be introduced to show that all healthcare appointments are followed up. Each person living in the home should be aware of the procedure to follow to make a formal complaint. All complaints received by the home should be recorded along with the outcome of the investigation. Arrangements should be made to re-hang pictures in peoples bedrooms to provide them with bedrooms which are personalised with their own possessions. The upstairs corridor and stair carpets should be cleaned to Page 30 of 32 2 3 11 12 4 5 19 22 6 25 7 25 Care Homes for Adults (18-65 years) 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 provide people with a pleasant place to live. 8 25 The cupboard in the roof area of the top floor bedroom should be emptied and peoples possessions returned to them. The management should continue to develop a quality assurance system to help ensure standards are met. The monthly report by senior management to check on the quality of the service provided should include the views of the people living in the home. The minutes of the residents meetings should include an action section to help ensure suggestions and opinions are followed through. The management should ensure the lone working policy is available to staff and carry out an assessment for all staff working alone. 9 10 39 39 11 39 12 42 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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