Inspection on 27/04/08 for Northbrook Care Home

This inspection was carried out on 27th April 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northbrook Care Home 02/08/07

Northbrook Care Home 26/01/07

Northbrook Care Home 06/07/06

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Northbrook Care Home 63 Northbrook Road Ilford Essex IG1 3BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jackie Date     Date: 0 7 0 5 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. 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 31 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.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: Northbrook Care Home 63 Northbrook Road Ilford Essex IG1 3BP 02089119110 02089114900 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) : Northbrook Homes Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender : Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Northbrook Care Home opened in March 2006. It is a home for 4 adults with learning disabilities. The 2-storey house is in Ilford close to bus routes, the station, shops and leisure facilities. The home is not accessible to wheelchair users and the service will not be accepting people who are wheelchair dependent. There are four single bedrooms, each with ensuite toilet, shower, and wash hand basin. In addition there is also a communal bathroom. There is a small lounge upstairs and a dining room downstairs. At the time of the visit two women were living at the home and a third was about to move in. They do not attend formal day services but are supported by the staff team to do activities. The scale of charges is from 1177 pounds to 1400 pounds per week. The manager provided this information at the time of this inspection. Information about the service provided is contained in the service users guide. Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was on 15th May 2008. This inspection was unannounced and took place over two separate days. Two people were living at the home when the inspection started but another person moved in during the course of the inspection. The judgements in this report relate mainly to the care of the two people who had been living at the home for sometime. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that people using the service receive, and were also observed carrying out their duties. Due to the degree of their disabilities neither person living in the home was able to give any feedback but time was spent with them and observing their interactions with staff. All of the shared areas and three of the bedrooms were seen. Care Homes for Adults (18-65 years) Page 6 of 31 Staff, care and other records were checked. Verbal feedback was received from a relative, the care managers of both people living at the home and three staff members. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in April 2009. Information provided in this document also formed part of the overall inspection. We would like to thank the people living at Northbrook and the staff for their import to during the inspection. 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.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 31 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 10 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. Information is available to help people to decide if they want to move into this home. Assessments completed by the home and information and reports received from health and social care professionals means that staff have the necessary information available to enable them to determine whether or not the home can meet a person needs. Evidence: Standards 1, 2, 4 & 5 were tested. There is a statement of purpose and service user guide. The service user guide has been simplified and pictorial symbols have been added to make this more user friendly. The service user guide has been translated into Urdu and put on tape for one person. This is good practice and means that people have information that helps them to decide if they want to use the service. Since the last inspection one person has moved on to supported living. Another person Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: was moving into the home on the day of inspection. The file for this person contained the necessary pre admission and assessment information. There were also minutes of meetings that have been held to discuss and arrange the placement. The person had declined to visit the service before she moved in but other professionals supporting her had visited the home. Staff from Northbrook had also visited the place where she had been living. From discussions with the manager and the persons social worker it was evident that all of the necessary information had been gathered and that appropriate arrangements had been made for the person to move in. The files seen contained contracts/statements of terms and conditions and therefore people have information about the service that they are entitled to. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans and risk assessments contain sufficient information to enable staff to safely meet peoples needs. People are consulted about what happens in the home as far as they are able. Peoples information is safely stored to maintain confidentiality. Evidence: Standards 6, 7, 9 & 10 were tested. Each person has a care plan and these contain information about them and the support that they need. This included health care, personal care, communication, behaviour, sexuality and cultural and religious needs. A care manager previously said that her clients cultural needs were very well met. The plans seen were up-to-date and contained appropriate information. Daily recording are made about what each person has done and the support that they have been given. These recordings are Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: broken down into various areas including night care, personal hygiene, communication, socialisation and meals. Therefore information is available about each individual and this can be used as part of the review process and to identify ongoing and changing needs. Each person has a key worker and care plans are updated informally each month at a meeting between the person and their key worker. Neither of the people using this service are able to comment on their care or their care plans but notes from key worker meetings indicate that staff try to explain things to them and to get their opinions. This is often by asking simple questions and trying to get a response. For one person this is a smile if she is happy and the other person can sign yes. Records also show monthly residents meetings. Notes of meetings confirm that people have been told and asked about things and their response is recorded in terms of smiles and nods. Therefore the staff do attempt to involve people as much as possible. There were up-to-date risk assessments covering the necessary areas. These were relative to each individual, the activities that they do and their own specific behaviours. People are supported by a small consistent staff team who know them well and are very aware of risks to themselves and the individuals using the service. Personal information and records are securely stored in a lockable cabinet in the office and staff are aware of issues of confidentiality. Care Homes for Adults (18-65 years) Page 14 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. People only have the opportunity for limited activities within the home and in the community and this needs to be developed to ensure that they have an interesting and stimulating lifestyle with opportunities to develop their skills. People are supported to keep in contact with their relatives and visitors are made welcome at the home. People are given meals that they like and that meet their needs and preferences. This includes their cultural preferences. Evidence: Standards 12, 13, 14, 15, 16 & 17 were tested. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Both people that have been living at Northbrook require a lot of staff support for all of their activities. One person is now going to Newham College twice per week and staff feel that she enjoys this. People spend time in the garden and go to the park or shops when the weather is nice. They also go out for lunch sometimes. The home has bought and made some sensory things and use these for short activities. Staff said that one person likes face painting and also a weekly massage. Psychology input for one person has developed guidelines that include structured activities. However the activity programme and daily notes do not reflect the sort of structure required. Feedback from the local authority responsible for this person was that some things are going very well but there are gaps and that once recommendations have been received from the necessary professionals the local authority will then pay to bridge the gap in needs until an appropriate tailor made service can be found. Another person moved out earlier this year into more independent accommodation. This was helped by the support and encouragement, to be more independent, that staff gave her during her time at Northbrook. There has been some improvement with regards to activities. However this is still an area that needs further development to ensure that people have an interesting a lifestyle as possible and opportunities to develop to their skills. Staff were observed to spend time with the people who use the service. For one person they spend a lot of time sitting and chatting to her and it was very obvious from her response that she is very happy in the company of the staff team and enjoys contact with them as she smiles when she sees or hears them. Only one of the people living in the home has regular contact with her family. They visit regularly and she also visits them. The person who has moved out since the last inspection also had regular contact with her family. Families are invited to any celebrations at the home. This has included birthdays, Eid and Christmas. People are supported to keep in contact with their family and relatives are welcomed at the home. Neither of the people who have been living at home are able to say what they want to eat but one person can be offered a choice and can sign yes or no. Menus are based on peoples likes, dislikes, health and cultural needs. One person is provided with halal meat to meet her cultural needs and the other has Caribbean lunches out occasionally. Care plans give information about nutritional needs and likes. For example one person does not like water but likes fruit juices. People receive meals that meet their needs. Care Homes for Adults (18-65 years) Page 16 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. People who use this service receive personal care that meets their needs and preferences and staff support them to get the healthcare that they need. People are given their prescribed medication safely. Evidence: Standards 18, 19 & 20 were tested. People using the service require a lot of support and are dependent on staff to meet their personal care needs. There has been a fairly stable staff team and staff know how each person needs and likes to be supported and this information is detailed in their care plans. One person used to require the help of two staff for her personal care but due to improvements since she is moved into the home this is no longer necessary. Each person has their own ensuite shower which gives added privacy. There is a communal bathroom if anybody prefers to have a bath. One person is supported to wear the traditional clothing of her culture. People are supported to receive the personal care that they need in a way that is appropriate for them. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: All the people using the service go to local doctor and specialist help is received from the community learning disabilities team. One person has had input from the psychologist. Staff support people to all of their medical appointments. Both files checked showed that, when appropriate, people are going to the optician, dentist and chiropodist. When one person moved into the home she was very weak, quite frail and unable to walk. She has put on weight, is enjoying her food and can even go upstairs now without staff assistance. This persons social worker said her client had been very well cared for and that she had done very well. Also due to an improved diet and exercise this person was no longer totally dependent on one of her previously prescribed medications. Therefore people are supported to receive the healthcare that thy need. None of the people living in the home can self medicate and therefore medication is administered by the staff team. A monitored dosage system is used and staff have received training from Boots. In addition the manager has also assessed the competency of staff to administer medication and evidence of this was seen in staff files. The medication is securely stored in an appropriate metal cabinet on the wall in the office. The MAR (Medication Administration Record) folder contains a list of the names and specimen signatures of staff that can administer medication. It also contains photographs of each person and a record of any allergies or health issues. This is good practice. Medication records are appropriately kept and were up to date. They accurately reflect the medication each person is receiving as required by the previous inspection. People are receiving their prescribed medication correctly and as safely as possible. Care Homes for Adults (18-65 years) Page 18 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. People living in Northbrook are safeguarded by the working practices and support of the staff team. Evidence: Standards 22 & 23 were tested. There is a complaints procedure and it is displayed in the home but neither of the two people living there would be able to make a complaint. However the relative of one person visits regularly and would be able to make complaint on her behalf. Both people living there were observed to respond positively to the staff and seemed quite happy and relaxed in their company. One person in particular smiles broadly whenever she sees or hears staff. Feedback from the one relative that visits regularly was that the staff are doing a good job and she did not have any issues. The social worker of the other person said that her client was very well cared for and had made a lot of progress since moving into the home. There had not been any recorded complaints since the last inspection. The local authoritys safeguarding procedure is available in the home and staff have read this. They have had POVA (Protection of Vulnerable Adults) training and are aware of their responsibilities in this area. Since the last inspection they have had restraint training to help them to deal appropriately, if needed, with the challenging Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: behaviour of one person. There are guidelines in place to deal with this and the psychologist developed these. They clearly state what staff need to do and how to deal with various situations. There had not been any recorded incidents where staff have needed to use the restraint techniques and staff confirmed that it had not been necessary. It would appear that distraction techniques have helped. Also as there have only been two people living at the home recently they have had one to one staffing and therefore have been receiving individual support and attention. Feedback from staff, relatives and social workers was that they did not have any concerns about the way that people were cared for or treated. None of people using this service are able to manage their own finances. At present the home does not deal directly with the finances of any of the people living there. One persons family manage hers and the Court of Protection deals with the other persons. Money is requested periodically from the Court of Protection and the cheque is sent to the home. Receipts are kept of the expenditure and these are returned to Court of Protection. The cash held for this person was checked and agreed with the records kept. There was also evidence that as part of the monthly monitoring visits the proprietor checks the cash held and initials to say that he has done this. Therefore safeguards are in place for peoples finances. The service operates an appropriate recruitment procedure and this also helps to safeguard people. Further information about staff recruitment can be found in the staffing section of this report. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean home that is suitable for their needs. Evidence: Standards 24, 25, 26, 27, 28, 29 & 30 were tested. The home is a 2-storey house in Ilford close to bus routes, the station, shops and leisure facilities. The home is not accessible to wheelchair users. However, there are two ground floor bedrooms. There are four single bedrooms, each with ensuite toilet, shower, and wash hand basin. In addition there is also a communal bathroom. There is a small lounge upstairs and a dining room downstairs. At the time of the last inspection, which was last year, most of the home had been redecorated and some new curtains and new furniture purchased. The kitchen was also refurbished. The people living at the home do not require any aids or adaptations although two of them require wheelchairs to go out in the community. An additional handrail has been fitted on the stairs to assist people to use them safely. There is a garden at the rear of the building and most of this is a grass lawn. There are items of garden furniture available for people to use. One person in particular loves to be in the garden when the weather is nice. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: Each person has a single bedroom and these are appropriately decorated and have some personal items. The bedroom for the person that was just moving in was painted pink, as staff had been informed that she liked this colour. In reality people do not use the upstairs lounge very much and this was confirmed by a care manager who said that she thought it was really only used for meetings and visitors. The lounge is still quite bare and does not have a homely feel. More homely touches are needed to make the house as comfortable as possible for the people living there. There has been a vacant room since the home opened and this is used by staff for sleeping in, when needed, and also for storage of personal belongings. At the time of the visit the home appeared to be clean and hygienic and received a satisfactory environmental health report in January 2008. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the recruitment practices of the service. Staff receive the necessary training and support to provide an appropriate service. Staff have the opportunity collectively and individually to discuss their own development and any problems or developments within the service. Evidence: Standards 32, 33, 34, 35 & 36 were tested. There is a small all female staff team in post and the intention is that the home will only provide a service for females. Most of the staff have been working at the home for some time and know the people living there very well. One person who is not able to speak responds very positively when she sees and hears staff and it is obvious that she is very comfortable and happy in their presence. Since the newest person moved into the home there have been two staff on duty at all times. Prior to this there was two staff on duty during the day and one at night. From observations at the time of the inspection and from discussions with staff it was evident that staffing levels have been sufficient to meet peoples needs and that they were reviewed and changed when Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: a new person moved into the home. With the exception of the newest member of staff, who is doing NVQ level 2, the other staff have already completed NVQ level 2 and have almost completed NVQ level 3. Staff spoke about the training that they have had and this included POVA (Protection of Vulnerable Adults), restraint, equality and diversity, health and safety, first aid and medication. Staff confirmed that they have regular supervision and that staff meetings are held. They also said that they get good support and help from the manager and that there is good teamwork. A selection of staff files was examined at the time of the previous inspection and found to contain the necessary information and checks. On this occasion the files of the two new members of staff were checked. The files contained application forms, interview questions and answers, proof of I.D, residence permission and entry clearance, a completed induction book, training certificates and POVA First checks. There was also evidence that CRB (Criminal records Bureau) checks had been applied for. The manager said that the two staff had been working under supervision with permanent staff and that they do not work together or take people out on their own while they are waiting for the CRB check. Therefore an appropriate recruitment process is in place and this helps to safeguard people using the service. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Northbrook benefit from a service that is appropriately managed and has improved over the past year. They live in a safe home. Evidence: Standards 37, 38, 39 & 42 were tested. The manager has a lot of experience working with people with learning disabilities and managing residential services. She has successfully completed the RMA (Registered Managers Award) and NVQ 4 in care. At the time of the last inspection she had submitted her application to be registered. However the papers were misplaced and she had to resubmit everything. She has spoken to the registration section about this and is waiting for an interview date. All three staff spoken to said that they get good help, support and advice from the manager. It was evident that they do discuss the people they work with and the staff were well informed about the new resident. Feedback from a relative was that the Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: manager and the staff do a good job. The care manager of the person moving in said that from discussions with the manager she felt that she was aware of the issues, what to do about them and could give reasons why she was doing things. She also felt that her client would progress well there. The manager used to receive professional supervision from an experienced person contracted by the provider. Unfortunately this person has not been able to provide this support for some time and therefore the manager has not had professional supervision, support or guidance. This must be in place to enable the manager to discuss her own development and any problems and developments within the service. Also to give her professional feedback. The manager did say that this should be starting again soon. However the requirement has been made to ensure future ongoing compliance with this. Earlier this year the manager was absent from the service. In her absence a senior carer took responsibility for the service. However the responsible individual did not inform us of this at the time. The manager contacted us just before she returned to work. During the latter part of absence she was in contact with the home and was at the home on the day that the new person moved in to support the staff team even though she was not due to return to work until the next week. The manager and the staff team obviously work well together and are committed to the people that they provide a service to. The registered provider should have contacted the Commission to make us aware of the managers absence, as the manager was not able to do this at the time. If the registered manager is or proposes to be absent from the service for a continuous period of 28 days or more the registered provider must notify the Commission of this and of the arrangements that have been made for the management of the service in the managers absence. This is to comply with legal requirements and so that we are aware of the situation at the home and can monitor this accordingly. The proprietor now carries out the monthly monitoring visits and records from these were available at the home. These cover the necessary areas and the proprietor had signed financial records to confirm that he had checked these. Therefore the proprietor does monitor the quality of the service provided, as does the manager. The manager has sent out quality assurance surveys but there was a limited response. However she has received positive verbal feedback from the care manager of the person that moved out. All of the necessary health & safety checks are carried out regularly but the staff team. For example fire call points and hot water temperatures are tested weekly. Appropriate servicing is carried out on the fire system and equipment. There was a current Landlords Gas Safety certificate and a suitably qualified person had checked the electrical intake. The annual check for portable appliances was overdue but this was Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: arranged straightaway and has now been completed. A safe environment is provided. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 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 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 13 16 People must be supported to 31/12/2009 participate in more activities both in the home and in the community. This requirement also relates to standards 12 & 14. This is so that they have an interesting and stimulating lifestyle with opportunities to develop their skills. 2 37 38 If the registered manager is 31/08/2009 or proposes to be absent from the service for a continuous period of 28 days or more the registered provider must notify the Commission of this and of the arrangements that have been made for the management of the service in the managers absence. This is to comply with legal requirements and so that we are aware of the situation at Care Homes for Adults (18-65 years) Page 29 of 31 the home and can monitor this accordingly. 3 38 18 Arrangements must be in place for the manager to receive professional supervision, support and guidance. This will enable the manager to discuss her own development and any problems and developments within the service. Also to give her professional feedback. 31/08/2009 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 24 It is recommended that more homely touches be made to the house to make it more welcoming, comfortable, and homely for the people living there. 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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