Inspection on 21/04/09 for New Redvers

This inspection was carried out on 21st April 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

New Redvers 26/11/08

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA 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: Stella Lindsay Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 31 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: New Redvers Bronshill Road Torquay Devon TQ1 3HA 01803409174 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : newredvers@yahoo.co.uk Diamond Care (2000) Limited care home 19 Number of places (if applicable): Under 65 Over 65 19 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) The maximum number of service users who can be accommodated is 19. Date of last inspection 2 7 1 1 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home The last inspection took place on 26th and 27th November 2008. New Redvers is a large Victorian house in a residential area close to shopping and leisure facilities including a swimming pool. The home provides care and support for up to 19 people with learning disabilities some of whom may have physical disabilities. All bedrooms except one are single, and most have en-suite facilities. There is a lounge and a separate dining room. There is an area by the kitchen where residents may make hot drinks and snacks. Some residents attend day centres or work placements. There is a level patio area, a good sized garden and a car parking area. The home has a vehicle for transporting residents. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection took place from 21st to 23rd April 2009. Seven residents and five staff completed and returned surveys. The Service Provider sent us their annual quality assurance assessment (AQAA) when we asked for it. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. During our visit we spoke to eight people who use the service and three regular visitors, the Manager, Company Secretary, and four other staff members. We saw other residents in the lounge and dining room. We looked at staff recruitment records, training records and policies. All this information helps us to develop a picture of what it is like to live at New Redvers. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well There is a lively social life in New Redvers, with residents taking an interest in each other. Most residents have their own room, and there is a big garden. Care Homes for Adults (18-65 years) Page 8 of 31 What has got better from the last inspection Residents have been given choices, and encouraged to think of what they wanted. Residents told us that they enjoyed doing their own shopping. Some told us of new activities that they were trying out. New staff had been recruited. The Manager is excellent, said a staff member, staff morale is brilliant now. Everyone’s care plan had been written again, so that staff knew what support people need, and what they like to do. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home could do better New Redvers needs more staff, so that people who need support can go out more. The residents need another living room, to give them more space. There should be a room for private conversations. All residents money must be sorted out, so it is properly organised. Care Homes for Adults (18-65 years) Page 10 of 31 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stella Lindsay If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 31 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 12 of 31 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 may be confident that their needs will be assessed before they are offered accomodation at New Redvers, and that they will be given information to help them come to a good decision. Evidence: There had been no new admissions since the last inspection, and there were currently no vacancies. Residents completing surveys said they could not remember moving in it was too long ago. One said their mother helped make this decision, another that their sister and social worker had helped them. In the AQAA, the Manager said that their normal practice was to visit the possible client, then invite them to come and look at the home and meet the others that live here. They may stay for a meal, and if they come for a second visit they may stay overnight. The Manager supplied us with a copy of the homes Statement of Purpose which included information about the running of the home, and had been updated to include information about the changes in management since the last inspection. She had added pictures and symbols to aid understanding and also said that she intends to review all the information about the home over the next year. Care Homes for Adults (18-65 years) Page 13 of 31 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 . Care plans were being compiled in a detailed and positive way, but were not yet complete. Risks had not all been assessed or dealt with, though good work was in progress. Evidence: Each residents care plan had been rewritten, in order to provide clear instructions to staff that were accurate, and gave detailed information about the residents care needs. All former records showing the use of restraints and a punishing approach had been removed to an archive. We looked in detail at a sample of five, and found they had been up-dated fortnightly. Clear daily routines were included. They were well written showing what the person could do for themself, which was not obvious, particularly to new staff. For instance, I am able to dress myself if you leave my clothes out after breakfast. Important instructions to staff were highlighted in red, to ensure they were brought to their attention. Some care plans were still in construction, with assessments by health and social care workers on-going. Visiting professionals told us that they were not yet happy with the homes care plan, one saying they needed to see better recording of their clients triggers which may lead to disturbed Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: behaviour. Key workers had been appointed, and staff had been given time for 1;1 discussions with the residents. In one file, we saw that good work had gone on through February as the keyworker had spent time with a resident who had particular communication difficulties, and had recorded how they were responding and showing appreciation. Unfortunately this activity stopped when this particular worker left New Redvers, and a new keyworker had not yet been appointed. The Manager said she had a particular worker in preparation for this role. In surveys staff said they found the introduction of the keyworker role was good for improving their own input and involvement with the development of the service to residents. A photo diary had been produced with and on behalf of one of these residents, which showed them engaged in activities, and helped them with expressing choices. This was good work. Other residents might also benefit from individualised methods of communication. Staff told us that they were pleased that over the past six months managers have started to give the residents freedom of choice, develop person centred planning, and empower clients to have control of their own life. Residents returning surveys said that they always (4) or sometimes (3) made decisions about what they do each day. Each care plan included a risk assessment entitled Keeping me safe. We saw that risks assessed included issues of direct importance to each resident, including the use of bedguards, ensuring that substances that might be drunk are locked away, and were followed by an action plan for dealing with the issue in a safe and acceptable way. These were not yet comprehensive. Each file included a general risk assessment, but action plans had not yet been drawn up for all the issues that had been highlighted a potentially or actually dangerous, including crossing roads and making hot drinks. They were not always followed through, for example, one resident was known to drink any liquids that were available. However, bottles of shampoo and other liquids were seen in communal bathrooms including the accessible shower. Staff told us that important information about the use of oxygen while out on trips had previously been hidden at the back of a residents care plan, but under the new Manager it had been brought to the fore and implemented, to ensure the residents safety. Care Homes for Adults (18-65 years) Page 15 of 31 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 . Residents were seen to be enjoying social activities in company with each other. New ideas for college and daytime activitieswere being tried out, but opportunities for outings were still limited for people who needed support. Nutritious food was served, but the experience of mealtimes could be enhanced, and consumption of fresh fruit and vegetables could be better promoted. Evidence: Three residents are assessed as able to go out independently. Others had regular activities and day opportunities. New opportunities were being tried out. Two residents had been to a cookery course at a local college on the evening prior to this inspection. Another resident was being assessed for a reading and writing course. Attendance at a gardening centre was being looked into for one resident, with support from their care manager. A white board was on display, showing a selection of possible activities for the week. We saw that decisions could be made on each day, for instance, at the time of this inspection the weather was good, and a group of residents were working in the Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: garden with a Support Worker, instead of the craft work that was programmed. Daily records of residents social activities were kept. These showed that for one resident, most days only recorded that they walked up and down the corridor with their football. When we arrived for this unannounced inspection, they had gone to the shops in the care of a Support Worker, with two other residents. Later in the inspection, they were seen enjoying sunshine and company in the garden. The Manager said they make sure this person gets out at least onece a week, but our observation suggests that this is insufficient, and discussion with the care manager should include these support needs. The Manager said in the AQAA that their plans for the year ahead include the promotion of activities outside the house. A staff member in a survey said that one of the things the home could do better is to provide more information to the residents about local activities around Torbay. Staff told us they were relieved that the former group activities were no longer obligatory for residents, but bingo and the video-based quiz were only played at the request of residents. Residents were excited with anticipation of the holiday they were about to go on. Some were booked to fly to a Mediterranean island, while others were going to two different holiday camps in southern England. They had been consulted about where they were going and who they would be on holiday with. The Company funds the cost of the first seven days of annual holiday away from New Redvers, for each resident. Breakfast is served from 8am onwards. Residents are woken early only if they have appointments to keep. The Manager had been questionning established practices, and finding what suited the residents. This had resulted in the relaxation of certain routines in the house, of times for getting up, bathing and mealtimes. We found that certain residents were more responsive and alert than at our previous visit, which we considered was a direct result of this personal consideration. The meals that we saw or shared during our visit were well accepted by the residents, who said they enjoy their meals. We found that they were not strong on the inclusion of fresh fruit and vegetables. Though we saw a modest amount of cauliflower, garlic, fruit and salad in the food store, we did not see this being served. Lunch was cheese on toast or a cheese sandwich, with orange squash. We consider that greater variety should be offered, with fresh salad or fruit prepared and made available for residents to choose. The Manager told us that the old tablecloths are to be removed, as the tables will be given new surfaces as part of the dining room refurbishment. More attractive ways of serving the food might be considered, with the choice of a salad garnish, real fruit juice, and attractive crockery instad of plastic mugs might be considered. There is a set menu for the main meal at 5pm. The Manager said that a vegetarian alternative or a salad is available, and we heard her discussing choices with residents. Residents who are not interested in eating vegetables may benefit if these are combined with their favourite dishes. Nutrition should be included in care plan discussions with the residents and their representatives. A staff member told us that residents are still getting used to having choices, as this did not happen under the previous manager. Staff prepare meals, with help from residents in laying tables and clearing up, as recorded in their care plans. Care Homes for Adults (18-65 years) Page 17 of 31 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 . Residents can be confident that their personal and health care needs will be met. Medication was administered with care. Evidence: Health and social work professionals and been visiting the home since the previous inspection, to assess and update all care plans. This work was still in progress. We saw good details in care plans about the way that residents liked their personal care to be given. The Manager had reorganised the timing of personal care including bathing, to ensure that residents wishes were respected. The Manager was overseeing the system for administration of medication, and developing it to meet regulations and ensure that the system supports residents good health. She had consulted with the pharmacist about the timing of giving residents their medication, in order that it should be as effective as possible. One resident was interested in learning to look after their own medication. A good assessment was seen on their care plan, showing what they were able to do, and what they still needed support with. The Manager was in the process of discussing with a Day Centre a safe way of accounting for medication that a resident had to take with them for consumption during the day. The pharmacy had supplied medication packaged specifically for the Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: holidays, to make this as safe as possible. Some staff were still in need of training, which had been booked for the month following this inspection. We saw a supervision record, showing taht a staff members competence to administer medication had been assessed. The list of staff who are assessed as competent to administer drugs was in need of updating to ensure accuracy. Care Homes for Adults (18-65 years) Page 19 of 31 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 . Management have worked with health and social work staff to ensure protection of residents from harm. Evidence: One visiting social worker said they had found the Manager to be welcoming to the reassessments that were still on-going. Another said they found that staff were keen to implement improvements, but did not always have the support of management with regards to resources. All seven residents who completed surveys said they knew who to speak to if they were unhappy, and that they would speak to staff. One said that the Manager and Assistant Manager help me out a lot. Staff told us they had received training in the Protection of Vulnerable Adults during 2009, and were awaiting receipt of their certificates. They said that they would tell the Manager if they saw or suspected any abuse. They would no longer be afraid to step up and say if something is wrong. Some issues were discussed with the Company Secretary regarding residents money. This is recorded in the Management section of this report. They had also received training in the Mental Capacity Act, and the provisions of the Deprivation of Liberty safeguards. Care Homes for Adults (18-65 years) Page 20 of 31 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 . The house is bright and comfortable. There is not enough communal space for the current large number of residents, and there is no suitable room for use as a care office on the ground floor, providing a suitable place for confidential discussions and consultations. Evidence: New Redvers is a detached house, in convenient walking distance of Babbacombe and Torquay town centre. A handyman is employed to maintain standards of decoration and utility. There was a dining room which is large enough to seat all residents if they wish to eat together. We were told that it was to be redecorated the following week while residents were away on holiday. There was also a comfortable lounge with a large screen television. However, this does not provide sufficient communal space for the number of residents currently living at New Redvers. It would meet the National Minimum Standards for 15 residents. There is a lean-to which is used by residents who smoke. It is just outside the kitchen, and very convenient for them, but questionable as to whether this is a good position with regards to odours. There is a large and pleasant room on the top floor which is available for staff meetings and private discussions of all sorts. This is accessed by a steep staircase. There is no care office on the ground floor. The partitioned area where medication is Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: stored is used as a care office, but this is inappropriate as voices can be heard, resulting in a lack of privacy and confidentiality. A room should be made available on the ground floor for this purpose. During this inspection a lobby by the front door was used both as a social area and for private meetings between residents and health care professionals, which is not suitable as it is also a corridor to some residents bedrooms. Visiting professionals also expressed the view that residents at New Revers do not have enough space. Seventeen residents had their own room, while two have shared a room for many years. All have an en suite toilet, and some had their own shower. In one bedroom, a sensor had been fitted to alert staff when the occupant gets up and walks across the room, so that they may give assistance to prevent falls. This had been done to keep the person safe without any restraint. One visiting professional said that the mirror in their clients bedroom had been too high for them to see, and one of the care staff had moved it. All should be checked for usefulness. There is a large and pleasant garden. Staff had begun to enable and encourage residents to use and enjoy it. There is a good quality accessible shower on the ground floor. Some residents have their own en suite toilet. The outside toilet by the kitchen door was in a poor state. The first floor bathroom had a shower attachment, and was well used. The enamel in the bath was worn, which poses a potential hazard to health. No paper towels or liquid soap were available, but residents toiletries were left out, including six bottles of shampoo, shaving gel and deodorant, and skin cream belonging to a resident who is unable to climb the stairs to this bathroom. There was a separate communal toilet, which was in need of a suitable lock that could be accessed by staff in an emergency. The Manager left instructions for the handyman to fit this. The laundry was in a good state, with sound walls and flooring, a Belfast sink for hand washing, paper towels and liquid soap, and shelves for clean clothes which had been cleared. Care Homes for Adults (18-65 years) Page 22 of 31 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 . Staffing levels had improved, but staffing for individual attention needs to be available and recorded, to ensure that people get the support they need. The service recognises the importance of training, and is providing the necessary training for all staff. Evidence: When we arrived at the start of this inspection, there were three Support workers on duty as well as the Manager and domestic. We were given a staff rota, which showed that four or five Support workers are scheduled to be on duty during the days. At night there is one carer awake and one asleep. We understand that some residents have 1;1 time allocated to them in their contracts with the local authority, but we did not see evidence of this being planned or provided. The Manager said that one of these residents frequently needed 1;1 attention when going for medical appointments. Staff in surveys said that there are usually enough staff to meet residents individual requirements, but that, sometimes there are people off, so we dont have enough people. All seven residents who completed surveys said that the staff always treat them well. When the service is under contract to provide 1;1 time, this should be clearly recorded, eg on the staff rota. This is so that staff are enabled to provide the care and attention that each resident needs. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Several staff had been recruited since the last inspection. We examined the files of recently recruited staff, and found that the correct procedure had been followed, and checks had been carried out, to assure the protection of residents from potential harm. They had been given the opportunity to meet with residents during the recruitment process, and their ability to engage in a positive way had been recorded. Induction training had been provided, and staff told us they had been allowed time to read the homes policies and procedures. Staff were very pleased with the training that had been provided in 2009, including Health and Safety, Food Hygiene, the Protection of Vulnerable Adults, and epilepsy training. The home is getting up to date with all essential training. They will then be able to move on to provision of training focused on delivering improved outcomes for residents, such as advancing skills in communication, person centred care, specific problems of residents, equal opportunities and challenging barriers to help the residents move towards independence. Care Homes for Adults (18-65 years) Page 24 of 31 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 Manager has dealt effectively with the reorganisation that was found to be necessary at the previous inspection. Poor practice within the home has been challenged and stopped. Further development is necessary for New Redvers to achieve the person centred service that it aspires to provide. Evidence: Since the last inspection, a new Manager had been appointed, though not yet registered with the Care Quality Commission. The Manager of a sister home has taken the role of Responsible Individual(RI) for the company, Diamond Care. The service is under pressure because of reorganisations needed following investigations of abusive practice during 2008. The Company Secretary is playing a full part in management and quality assurance while reviews of residents care are continuing, and while the RI concentrates on her new management role. The Company Secretary had carried out the monthly monitoring visits with additional care, as it had been found previously that staff and residents had been unprepared to confide problems occurring within the home. We were given records of recent visits, showing that staff and residents were taking opportunities to share views. She undertook to provide the CQC with a copy of the services quality audit later in the year. Residents meetings had been held, and Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: staff told us they would now be confident about putting ideas forward. Work was in progress with respect to residents finances, as some practices that are not acceptable had been normal practice at New Redvers. We had found that money had been removed from each residents personal allowance to pay for Christmas presents for themselves. No money may be removed without the express agreement of any resident, unless their representative has made this arrangement, with records kept. Some residents had bank accounts that they were unable to access. The Company Secretary was seeking suitable arrangements to solve this problem. The contract issued to residents by the Company had included a statement that any Disability Living Allowance (DLA) paid to the resident above the lower level would be kept by the home to fund additional 1;1 support. Any such support needs must be arranged through the contract with the local authority, and any transport charges made to the resident must be seen to be reasonable. The DLA must go to the resident in its entirety. The fire precaution system and extinguishers had been professionally serviced. Fire drills had been held. Professional fire safety training was advised. Care Homes for Adults (18-65 years) Page 26 of 31 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 27 of 31 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 9 13 Every activity highlighted as 18/07/2009 potentially dangerous should be fully risk assessed and have an action plan to follow. This is so that residents may be helped to take responsible risks, and engage in their preferred activities, while maintaining acceptable standards of safety. 2 13 16 Care planning should include 18/08/2009 sufficient social activities for all, with provision of staff to enable a good level of activity outside the home for residents who need support. This is in order to offer a good quality of life to residents who need support to engage in local social and community activities. 3 33 18 When 1;1 staffing has been 18/06/2009 Page 28 of 31 Care Homes for Adults (18-65 years) agreed with the local authority, this must be clearly provided, eg shown on the staff rota, with records kept. This is to ensure that residents are given the attention they need. 4 37 20 The Company must ensure 18/06/2009 that residents bank accounts are in their own name; that residents receive all their benefits; that any decisions taken on their behalf are discussed with their representative and recorded; and any 1;1 support is arranged and funded through the local authority. This is to ensure that the residents money is managed in their best interest. 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 Information about the home should be developed to be clear about how the service puts its aims into practice, with symbols and photographs to promote fuller understanding. The work of considering and arranging day opportunities for residents should continue, in consultation with the residents, and their representatives. More fresh fruit and vegetables should be included in meals and drinks, in order to improve nutrition in an acceptable way to residents. Provision of meals should be considered to enhance residents experience, and improve the variety of their 2 12 3 17 4 17 Care Homes for Adults (18-65 years) Page 29 of 31 nutritional intake. 5 35 Staff training should continue, and progress to include training focused on improving the quality of life of residents. The Manager should register with the Care Quality Commission. 6 37 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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