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Inspection on 19/03/09 for Oakdene Care Home (Residential Unit)

Also see our care home review for Oakdene Care Home (Residential Unit) for more information

This inspection was carried out on 19th March 2009.

CSCI found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oakdene Care Home (Residential Unit) 10 Woodborough Road St Anns Nottingham NG3 1AZ 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: Rose Moffatt Date: 1 9 0 3 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. 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 © (20092008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Oakdene Care Home (Residential Unit) 10 Woodborough Road St Anns Nottingham NG3 1AZ 01159580172 01159482700 linda.sadler@nottinghamcity.gov.uk 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) : Nottingham City Council care home 25 Number of places (if applicable): Under 65 Over 65 25 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is 25. 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 0 5 0 4 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Oakdene is situated close to Nottingham city centre, near to local shops, pubs and restaurants. Oakdene provides care and support, including short-term care, for up to 22 people with a learning disability. The home was originally purpose built for people with physical difficulties so there is good access throughout the building, with two passenger lifts as well as stairs. Acommodation and communal areas are on three floors. There is a large communal dining room situated in the adjacent day centre. The fees range from £245 to £345 per week. Information about the home, including CSCI inspection reports, is available from the 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: 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 the service experience adequate quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key inspection or annual service review. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; Care Homes for Adults (18-65 years) Page 7 of 31 relevant information from other organisations; and what other people have told us about the service. We carried out an annual service review (ASR) of the home in February 2008. The ASR looked at all the above information. The ASR showed us the home continued to provide good outcomes for people living there. We carried out an unannounced inspection visit that took place over 6 hours on 19th March 2009. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out surveys to people living in the home and to staff employed at the home but we did not receive any completed responses. There were 21 people accommodated in the home on the day of the inspection visit. People who live in the home and staff were spoken with during the visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 3 people were selected and the quality of the care they received was Care Homes for Adults (18-65 years) Page 8 of 31 assessed by speaking to them, observation, reading their records, and talking to staff. What the care home does well What has got better from the last inspection Windows had been fitted with restrictors to ensure the safety of people in the home. The short breaks service had been developed to provide flexible respite care for people in the community and their relatives/carers. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home could do better 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 Rose Moffatt 33 Greycoat Street London SW1P 2QF Care Homes for Adults (18-65 years) Page 10 of 31 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 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. There were detailed assessments of peoples needs and abilities so they, and / or their representatives, were confident the home could provide the care and support required. Evidence: Since the previous inspection in 2006, the home had developed a short breaks service to provide respite for the families/carers of people living in the community. We found that there were detailed assessments of the needs of these people. The assessments were provided to the home before the person was admitted. We looked at the records of 3 people who lived permanently in the home. The records included a good range of information about each persons needs, abilities and preferences. Staff told us that people were offered visits to the home prior to admission. One person told us I like living here. We saw from the care records that peoples changing needs were recognised and met at the home. The AQAA said the home provided a needs led service which is well used and appreciated. The home had improved by increasing staff numbers and improving the short breaks service. The home planned to improve by recruiting additional staff and Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: further developing the short breaks service. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were encouraged and supported to make decisions about their lives, including taking risks. There were gaps in the care records so that peoples needs were not always well documented. Evidence: The 3 care records we looked at all had an individual care plan written in a person centred style. There were good details of the persons needs, abilities and preferences, and of the action needed by staff. 2 of the care plans had been reviewed approximately every 3 months. The other had been reviewed twice in 2008 and once in 2009 - even though it indicated that reviews should be monthly. Changes in the persons needs noted at reviews were not always added to the original care plan. This meant that staff had to look through all the reviews to check for any changes to the care plan. Daily records were informative and gave details of the persons general condition, mood, behaviour, and any changes or causes for concern. For 2 of the care records seen, there were missing entries where the daily record had not been completed every day. The daily records did not always comply with current good practice in record keeping, such as always writing in black ink, and including the time the entry was Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: made. There was evidence of people being supported to make choices in their daily lives. For example, choice of whether to attend activities or not, choice of clothes to wear, choice of food at mealtimes. There were regular meetings for people in the home to express their views about life in the home and their ideas for activities, meals, days out and so on. There were some risk assessments in place in 2 of the care records seen, though not for all areas of risk identified on the care plans. For example, a person noted to be at risk of choking on food did not have a risk assessment to cover this. 1 person did not have any risk assessments even though there were identified areas of risk on their care plan. The AQAA said people were involved in meetings and discussion groups which direct the service provision. The home planned to improve by increasing staff numbers and building on existing improvements. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a range of appropriate activities and opportunities offered so that people had a lifestyle that met their needs and preferences. Evidence: The home was attached to a day centre that some people from the home attended. Other people in the home attended different day centres. Some people chose not to attend a day centre. There was evidence from observation, talking to people and staff, and from the records that people could follow their preferred daily routines. Staff told us that people who attended day centres often liked a lie-in at weekends as they did not have to get up so early. People told us they liked to go into the city centre with staff, and also to local pubs. The care records included details of relatives and other people important to people in the home. There were no visitors in the home on the day of the inspection visit. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: There was a dining area with adjacent small kitchen area on each of the three floors in the home. There was a main kitchen in the day centre that supplied all meals to the home. The small kitchens were used for preparing drinks and snacks. The dining areas were bright and clean. The dining tables on the top floor had plastic cloths and these appeared old and worn. The other dining areas used ordinary table cloths. People ate their main meal at tea-time and this was served in the dining area of the day centre. The menu for the week was displayed on the notice board in each of the kitchen/dining areas. The menu appeared varied and there were choices available at each meal time. People told us they enjoyed the meals and were always given a choice. We observed a lunch of sandwiches was served to 3 people who were in the home on the day of the inspection visit. The sandwiches were prepared by the main kitchen, rather than by the people in the home. The AQAA said the home provided support to enable people to meet their cultural and spiritual needs, and opportunities for people to pursue hobbies and leisure interests. The AQAA said they had listened to people in the home and provided phones and freeview boxes as requested. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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 received sensitive support with personal and healthcare to meet their needs and preferences. Evidence: The care plans we looked at had good details of the needs and preferences of people regarding personal care and daily routines. Staff we spoke with were knowledgeable about the needs and preferences of people in the home. The care records showed that peoples healthcare needs were identified, monitored and met. We observed that staff had a warm and friendly approach to people in the home. We observed that people were treated with respect by staff. Medication was administered by staff who had received appropriate training. None of the people in the home managed their own medication. There were good records of the receipt and disposal of medication. The medication administration records (MARs) had been correctly completed for oral medication. The MARs were not signed when prescribed topical creams had been administered. Handwritten instructions on MARs had not been signed by the person completing them or countersigned by another member of staff who had checked the instructions were correct. Medication was stored securely. There were no records of the temperature of the Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: fridge used to store medication. The medication reference book was several years out of date. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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. There were appropriate systems in place and satisfactory staff awareness so that people were protected and their complaints were effectively dealt with. Evidence: There was a satisfactory complaints policy and procedure in place. The records seen showed that appropriate action was taken to address issues raised. People in the home were also encouraged to raise any issues at their regular meetings. There were appropriate policies and procedures in place regarding safeguarding vulnerable adults. Staff had received training about safeguarding vulnerable adults, but for some staff this had not been updated for several years. Staff spoken with were aware of safeguarding issues and procedures. During the inspection visit we were informed of an incident of alleged abuse. The incident had been reported to the persons social worker and appropriate action taken to protect the person. The incident had not been notified to CSCI as required. There was a satisfactory system in place to deal with the personal money of people in the home. The money was kept securely and there were good records of all transactions made. The AQAA said the home listens to and acts on concerns raised by people in the home, and by their carers. Each person has their own keyworker to provide support with any concerns. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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 home was clean and fresh and suitably equipped to meet the needs of people living there. Bedrooms were individually decorated and personalised, but some of the communal areas appeared drab and tired, more institutional than homely. Evidence: The home was in a building shared with a day centre. There was a separate external entrance for the home and, internally, a door with a code lock between the two services. The main kitchen was in the day centre and supplied all meals to the day centre and the home. People from the home ate their main meal at teatime in the day centre dining area. The home was on three floors, each accommodating 7 or 8 people. There was a passenger lift and stairs for access to all floors. Each floor had a kitchen area used for making drinks and snacks, and a dining area. The floor coverings in the kitchen and dining area on the top floor appeared marked and stained. There were large notice boards in each kitchen with some information for people in the home and also information for staff. Along with other notices displayed for staff, this detracted from the homeliness of these areas. There was a small lounge on the ground floor that was comfortably furnished in a domestic style, although the decor, carpets and curtains appeared dated and worn. The lounge on the top floor was bright, pleasant, and comfortably furnished. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: The bedrooms were individually decorated and were personalised with photographs and possessions. People told us they liked their bedrooms. Equipment was provided to meet peoples needs, including ceiling track hoists and specialist beds. There were 4 bedrooms with en-suite facilities. A bedroom on the top floor had a heavily creased carpet that could be a trip hazard An adjacent bathroom had stained and marked floor covering that had lifted around the toilet. The bathrooms were well equipped to meet peoples needs, including assisted baths and easy access showers. The outside area was not fully accessible or welcoming for people in the home to use. Staff said they planned to help people plant sunflowers in pots outside to brighten up the area. The home did not have their own maintenance person and relied on help from the maintenance person at another home. Staff said this sometimes caused delays in repairs and other work being carried out. The home appeared clean throughout with no offensive odours on the day of the inspection visit. None of the staff at the home had received training about the control of infection. Staff spoken with were aware of basic infection control procedures and there were notices in toilets and kitchens reminding staff how to wash their hands effectively. The main laundry was suitably equipped. The care staff were responsible for doing all the laundry. The washing machines in the kitchen areas on each floor were used for personal clothes and bedclothes, including items contaminated by urine. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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. There was a satisfactory recruitment process and appropriate staffing levels so that people were protected and their needs were met. Evidence: We looked at the records of 3 members of staff. All the required information and documents were in place, except for photographs. New staff had an induction that met the Skills For Care standards. Staff records showed that all staff had an annual personal development review where training needs were discussed. Most staff had received training in manual handling and fire safety. Most staff had received training specific to the needs of people in the home, such as training about epilepsy and challenging behaviour. More than 50 of care staff had achieved a relevant National Vocational Qualification (NVQ) at level 2 or above. We observed that there appeared to be sufficient staff on duty to meet the needs of people in the home. Staff rotas showed that there were usually 6 or 7 care staff on duty in the mornings and afternoons. Staffing was flexible to ensure the needs of people admitted for short-term care could be met. Staff told us the staffing levels were usually sufficient. Care staff were supported by domestic and kitchen staff. Care staff were responsible for some domestic tasks - doing the laundry and helping in the kitchen. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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 home was generally well managed to ensure people received a service that met their needs. However, there were gaps in some areas where the health, safety and welfare of people in the home was not robustly promoted. Evidence: The manager had NVQ level 4 in care and management and was supported by two team leaders with NVQ level 3. Staff told us that the manager and senior staff were all approachable and supportive. The AQAA was completed by the manager and returned before the due date. The AQAA was not clear in places as information had been crossed out. The AQAA provided a reasonable picture of the current situation in the service, although there were limited details of how the service was planning to improve. There were some gaps in the data section of the AQAA. Quality assurance was highlighted in the previous inspection report as an area for development and although some improvements had been made, the quality assurance system was not fully developed. There were regular meetings for people in the home to express their views and ideas for improvements. There were monthly visits by the area manager where the views of people in the home and staff were noted and action Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES Evidence: was planned for improvements. We were told there were no regular surveys carried out to check if people in the home, and their representatives, were satisfied with the service provided. Also, that there was no annual quality assurance report about the home to show where the views of people had been taken into account. There was no evidence of the use of local advocacy services for people in the home. Information in the AQAA showed that the maintenance of systems and equipment was up to date. We looked at records of checks of fire safety systems and equipment and found these were up to date. We saw satisfactory records regarding accidents to people in the home and staff. As noted in the Environment section of this report, staff had not received training about the control of infection. We had received notifications from the home of significant events as required. However, as noted in the Concerns, Complaints and Protection section of this report, an incident of alleged abuse of a person in the home had not been notified to CSCI as required. Also, staff had not received regular training to keep them updated about safeguarding vulnerable adults issues and procedures. As noted in the Individual Needs and Choices section of this report, there were some gaps in care records and risk assessments. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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 20 13 There must be a record of the administration of all medication, including topical creams / ointments. 30/04/2009 This will help to protect people and ensure they receive their medication as prescribed. 2 23 37 Notification of events listed 30/04/2009 in Regulation 37 must be made to CSCI without delay. This will help to protect people in the home. 3 24 13 The carpet in the identified top floor bedroom must be repaired or replaced to minimise the trip hazard. This will help to ensure the safety of the person using Care Homes for Adults (18-65 years) Page 28 of 31 30/06/2009 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 the bedroom. 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 6 All records should be completed in line with current good practice in record keeping to ensure a robust system that protects people in the home. Specifically, records should be completed in black ink, the time of the entry should be recorded (as well as the date), there should be no spaces left at the end of the entry and no gaps left between entries. Any changes in the persons needs noted at reviews should be added to the original care plan to ensure staff have easy access to up to date information about the person. There should be assessments of any area of risk identified for each person with details of the action required to minimize the risk. Wherever possible, people in the home should be encouraged and supported to assist with preparing meals. This will help to promote individual choice and independence. To ensure a more robust system that protects people: Handwritten instructions on MARs should be signed by the person who has written them and countersigned by another member of staff who has checked the instructions are correct; there should be daily records of the minimum and maximum temperature of the fridge used to store medication; there should be an up to date reference book about medication. All staff should have annual training to ensure they are up to date with how to recognise and report abuse of vulnerable adults. 2 6 3 9 4 17 5 20 6 23 Care Homes for Adults (18-65 years) Page 29 of 31 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 7 24 The ground floor lounge should be redecorated and refurbished to provide a more pleasant and homely area. As far as possible, people who will be using the lounge should be involved in choosing decor and furnishings. To provide a more pleasant and better maintained environment for people in the home: the floor covering in the identified bathroom on the top floor should be replaced; the floor coverings in the kitchen and dining areas on the top floor should be replaced. The outside area should be made more accessible and welcoming so that people in the home can enjoy and benefit from having a pleasant outdoor space. There should be a full time maintenance person based permanently at the home so that repairs and other maintenance work are carried out promptly. This will help to ensure a better maintained environment for people in the home. All of the staff in the home should have training about infection control to ensure people are well protected. Advice from the local environmental health department should be sought and followed regarding the use of the washing machines in the kitchen areas. This will help to ensure people in the home are protected by a robust infection control system. As part of a robust recruitment process that protects people in the home, there should be a photograph of each member of staff. There should be a comprehensive quality assurance system in place that includes actively seeking feedback from people in the home, their families, friends and advocates. 8 24 9 24 10 24 11 12 30 30 13 34 14 39 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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