Inspection on 12/01/09 for Old Barn Close (4)

This inspection was carried out on 12th January 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.

Other inspections for this house

Old Barn Close (4) 18/01/08

Old Barn Close (4) 22/02/07

Old Barn Close (4) 17/07/06

Old Barn Close (4) 15/02/06

Old Barn Close (4) 27/09/05

Old Barn Close (4) 15/03/05

Old Barn Close (4) 13/07/04

Old Barn Close (4) 23/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Old Barn Close (4) Gawcott Bucks MK18 4JH     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: Chris Schwarz     Date: 1 2 0 1 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. the things that people have said are important to them: They reflect 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.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: Old Barn Close (4) Gawcott Bucks MK18 4JH 01280821006 01280821006 4oldbarn@nildram.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Hightown Praetorian & Churches Housing Association Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - 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 - LD Date of last inspection Brief description of the care home 4 Old Barn Close is situated in a quiet residential area in the village of Gawcott. The village is a short distance from the town of Buckingham, which has a variety of shops and other local amenities. Gawcott is served by infrequent local bus services with more extensive transport accessible in Buckingham. The home is a modern bungalow and provides care to service users with learning and communication difficulties. The home has an enclosed garden which provides service users with a safe external area in which they can walk unhindered and in safety. All service users are accommodated in single bedrooms. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 4 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 peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted by Chris Schwarz over the course of a day and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place on 18th January 2008. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and surveys were sent to a selection of people living at the home, staff and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the homes required Care Homes for Adults (18-65 years) Page 6 of 31 records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: Care plans do not take into account the full range of needs that people have such as those related to their disabilities, religious and cultural needs, which could mean that peoples overall needs are not fully recognised and met. A protocol on the use of as required lorazepam needs to be re-written and countersigned by the prescribing doctor, to make sure that the medicine is used appropriately and in line with the prescribers instructions. Ways of enabling people using the service to express concerns need to be explored, using a variety of different media appropriate to their communication needs. Clarification is to be sought with the environmental health officer to check that it is safe for the freezer to be located next to the washing machine in the utility room. A certificate verifying satisfactory gas safety needs to be obtained for the service, to ensure that gas appliances are in good working order. This is to protect staff and users Care Homes for Adults (18-65 years) Page 8 of 31 from risk of harm. A review of the quality of care needs to be undertaken to make sure that standards of care are sufficient to meet peoples needs. 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 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. Systems are in place to ensure that prospective users have opportunity to visit the service and have their needs assessed before they are offered a placement. Evidence: There had not been any new admissions at the service since the last inspection. An admissions policy was in place which outlined the process to be used when prospective users are being considered for a vacancy. This included attending relevant meetings where appropriate, setting up short visits to enable the person to meet staff and people using the service and to share a meal and staying overnight. Guidance to allocate a link worker and set a date for a three month review was included plus practical points such as registering with a doctor, informing the Department for Work and Pensions of the change of address, explaining and getting a licence agreement signed, setting up support plans and making sure the person knows how to contact their care manager, link worker and an advocate. The manager has worked in services for people with learning disabilities previously and Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: is used to assessing needs. She would be involved with any referral and would consult with line management where a placement is being considered. A care manager returned a survey and said that that the services assessment arrangements usually ensure that accurate information is gathered about people. A statement of purpose was in place which outlined the philosophy and aims of the service and contained useful information. The manager was aware that it needs to be updated to reflect management and other staff changes. Fees for the service are subject to assessment of care needs. Details may be obtained by contacting the provider. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Risk assessment, user involvement and management of peoples money are handled well at the service. Care plans do not take into account the full range of needs that people have such as those related to their disabilities, religious and cultural needs, which could mean that peoples overall needs are not fully recognised and met. Evidence: Care plans were in place for each person living at the service. Files contained a photograph of the person, a brief care needs summary which included information about how they communicate and likes and dislikes, an index to the file, weekly timetables of their routines, support plans and accompanying risk assessments. Support plans for one person covered eating, putting clothes away, clearing up after meals and personal care - bathing, cleaning teeth and cutting nails. Another persons support plans covered encouraging to eat slower, encouraging independent living skills and eating with a visual impairment. In feedback to the manager, it was advised that peoples care plans needed to take a more holistic approach to their needs and cover a Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: full range of physical and emotional aspects, promote social and community contact and take into account their needs arising from diversity such as disability, cultural and religious needs. They also need to be person centred and produced in formats that people using the service can make use of. A requirement is made to address this. Risk assessments had been produced for each person and covered areas such as accessing the community, using the kitchen, trips and falls, injury to others, using a harness in the vehicle, bathing, keeping money in bedrooms, eating inappropriate items, walking in the village, learning disabilities and autism, and accidents and incidents. These were in the process of being reviewed by the manager. It was noted that an advocate had countersigned risk assessments. Peoples money was kept in locked facilities in their rooms. Each person had a cash tin with individual financial transaction records which included samples of staff signatures. Each tin and set of records was looked at. Records were being well maintained with a signature alongside each entry. Receipts were in place to verify expenditure and records tallied with actual balances. House meetings have been held on a regular basis at the service with a record kept of items discussed. Staff were seen to involve service users as much as possible in daily life such as in answering the door, helping to set and clear tables and going out to buy food. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are available to people using the service to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. Food is well prepared and presented attractively to make sure that nutritional needs are met. Evidence: Each person at the service had a weekly timetable of their routines and activities. Records were being kept of any activities they had taken part in such as listening to music, meals out, walks, helping with household chores, visiting family, attending Winslow day service and taking part in cookery sessions run by Milton Keynes College at the service. Minutes of residents meetings reflected some successful holidays last year in the UK and the manager thought that the same place would be used this year. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Menus had been prepared and reflected a range of meals. People using the service were described as having good appetites and enjoyed fruit and vegetables with their meals. The kitchen had a good supply of foods, including plenty of fruit and vegetables. Lunch on the day of the inspection was poached eggs on toast with tomatoes and fresh pineapple with ice cream for pudding. In care plan files there was evidence of dietician involvement at the service to best meet peoples nutritional needs. No visitors came to the service during the inspection but the manager said that people using the service have good contact with their families and some of the relatives are particularly involved, such as tending to the garden and helping out with redecoration of bedrooms. Staff facilitate one person to stay with his family on a regular basis by providing the transport. 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. The health and personal care needs of people living at the service are well met, promoting health, well-being, taking into account their preferences and ensuring that they receive medication in a safe and consistent manner. Evidence: Records were being kept of medical appointments and interventions on care plan files. These showed that people using the service had been accessing health care support as and when required, including preventative treatment such as influenza vaccination. Records of peoples seizures were being maintained noting the date, time, where the person was, a description of the seizure, recovery and if any medication was needed. Weights had been noted on a monthly basis. Body maps had been used to note any marks or bruising. Medication was being well managed at the service. Each person had a metal medicines cabinet in their room. Medication was being stored safely and medication administration records were in good order with signatures alongside prescribed dose times. A protocol was in place for one person who is prescribed as required Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: lorazepam. This had been written by a previous senior member of staff and had not been countersigned by a doctor to verify the dosage and other instructions were appropriate. It is recommended that this is re-written and countersigned by the person prescribing the medicine. There was a medication policy in place at the service for staff to refer to, covering areas such as self medication (not appropriate for current users), ordering, disposal, administration, controlled drugs and homely remedies. Health care passports were in place. Two were looked at. One had been completed in full and provided a good account of the persons needs. The other had been partially completed and needs to be finished to be of use for an event such as a hospital admission. A care manager said in a survey that peoples health care was always properly monitored and attended to and considered that the staff team managed peoples medication appropriately. Good regard for privacy and dignity was also indicated. 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. Procedures and training are in place to make sure that people using the service are protected from the risk of harm and that complaints made on their behalf are responded to appropriately. Evidence: A complaints procedure was in place at the service. One complaint was indicated in the pre-inspection self-assessment. This was noted in the complaints log and related to a parking issue which a neighbour was unhappy about. It has since been resolved. Several compliments, especially from families, were also recorded. A simplified version of the complaints procedure, with use of colour and space to include key people, was seen although was not in use at the service. In discussion with the manager, it was recommended that the service look at ways of enabling people to communicate any concerns through use of different formats, such as pictorial, use of symbols or signing. The service had a safeguarding procedure in place which included the need for staff to notify the Social Services Department and the Commission for Social Care Inspection of any allegations or suspicions of abuse. The local authority inter agency guidance had been obtained for staff to refer to. In the pre-inspection self-assessment, no safeguarding issues or referrals were indicated for the past twelve months. The Commission is not aware of information to the contrary. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: An advocate was involved with the service. In the sample of staff training records examined, safeguarding had been undertaken in the past year. It is now part of the providers e-learning package and easily accessible to staff. A care manager said in a survey that any concerns had always been responded to appropriately. A member of staff who competed a survey said they knew what to do if anyone raised any concerns about care practices. 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. The premises are clean, well decorated and adequately maintained, promoting a positive environment for the people who live there and which is suitable for the range of disabilities that people have. Evidence: The building is a large, detached bungalow at the end of a quiet residential cul-de-sac in the village of Gawcott. It is opposite another of the providers services for people with learning disabilities. The bungalow is set in spacious grounds which overlook open land at the rear. There is parking for a few cars on a paved drive. Inside, there are four good sized bedrooms. Three were in use at the time of this visit, each had been personalised to the persons taste and made to look and feel homely. One person had a fish tank in his room. Bedrooms were close to communal bathroom/shower and toilet facilities. The lounge and dining room were spacious and the kitchen was domestic in scale. There was a utility room housing the boiler and laundry equipment. The office was compact with plans to remove the bed currently used for sleeping in purposes, which will liberate space for a proper desk and better storage of records. The building was clean throughout. Staff were observed vacuuming twice during the day to keep the place clean. A system of colour coded mops and buckets was in use to prevent cross infection. Systems for managing clinical waste safely were in place. The manager Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: advised that new lounge furniture was to be purchased in February this year and that redecoration of communal areas is to take place at some point to smarten the service. The only query raised during the inspection was whether the environmental health officer had any concerns that an upright freezer was next to a washing machine in the utility room. The report of the last environmental health visit could not be found. The manager is advised to seek clarification on this with the environmental health officer to make sure that there is no contamination risk. 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. The service provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. Evidence: Information provided in the pre-inspection self-assessment showed that two staff had left in the past year, eight of eleven staff had achieved National Vocational Qualification level 2 or above with a further three working towards it. The staff team was a mix of male and female staff and a new manager was in place. Some temporary staff had been used at the time the assessment was completed - this was a mix of bank and agency workers. On the day of the inspection the service was well staffed with a new member of staff additionally working supernumerary. Staff were observed to involve people using the service in the routines of the home, such as in answering the door, and were gentle in their interactions with them. Staff did not go into bedrooms without first checking with users that it was alright to do so. They were polite, cheerful and friendly to both users and the inspector. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: In a survey, a care manager said that staff always have the right skills and experience to support peoples social and health care needs and that the service responded to different needs such as those arising from equality and diversity. The person added the service users in this home are quite challenging. Staff manage to work with their needs in an appropriate way to give choices and support as well as taking on concerns around risks to service users, staff and any others. The person also commented I have been impressed at times at what has been achieved in this home, for the residents and by them. A member of staff who completed a survey said that they are always given up to date information about peoples needs. They felt their induction had covered everything they needed to know and that training provided them with the skills and knowledge needed for the job. They said there are regular opportunities to meet with management for support and that the ways of communicating information worked well at the service. They said there were sometimes enough staff to meet needs, adding that all of the people at the service need two to one support to go out. They said they considered they usually had the right support, experience and knowledge to meet different needs. The induction process for new staff involves a comprehensive programme of familiarisation and learning. All new workers, including the manager, have two weeks where they are supernumerary. Mandatory training is covered during the first six months in post. Short listing for current vacancies took place on the day of the inspection. The manager said that the short listed applicants were experienced people. People using the service would be invited to sit in at the interviews to meet them. Recruitment records of two staff who have started at the service in the past year were looked at. Each contained evidence of thorough recruitment processes. Agency profiles were in place for a range of people who have worked at the service recently. One could not be located and the manager was advised to contact the agency to request a replacement, to make sure that it is in place in case the person is used again. A sample of staff training records was looked at. Training was largely up to date with use of e-learning to refresh peoples skills. The manager was also advised to make full use of free training run by Buckinghamshire County Council specifically for care providers. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Care Homes for Adults (18-65 years) Page 25 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. There is new management of the service. Monitoring systems to assess quality of care could be improved to make sure that peoples needs are consistently being met and that adequate measures are in place to safeguard well being. Evidence: The service had a new manager who started work at the beginning of December 2008. She has worked with people with learning disabilities previously and has already achieved National Vocational Qualification level 4 and the Registered Managers Award. She will be applying to the Commission to become registered. She was seen to be approachable to staff and people using the service. She described support from the staff team and the organisation as good and had been able to work supernumerary for the first two weeks in post, in line with the organisations induction process. Monitoring by the provider has taken place with reports available of findings. The most recent report was for September 2008 and the manager was advised to chase reports of any visits after this time to make sure they are available at the service. The last Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: quality assurance report was dated 2006. A requirement is made for another quality review to take place this calendar year. Health and safety policies and procedures were available to staff to refer to. Legionella testing had taken place last summer. Hot water temperatures and fridge and freezer temperatures were being monitored. Rudimentary evidence of portable electrical appliance testing was emailed to the service from the providers headquarters - the full report should be obtained and kept at the service for reference. There was evidence of satisfactory electrical hard wiring. The most recent gas safety certificate showed that the boiler was disconnected after a leak was detected in July last year. Maintenance records completed by staff indicated that the company had returned the following day to replace the faulty part and remedy matters but there was no safety certificate to verify this. A requirement is made to address this. Risk assessments were in place for each person in their care plan, as described under individual needs and choices. Assessments included accidents and incidents which informed staff to report these occurrences to the manager or a senior manager as well as the persons care manager. This is a good practice to adopt. There was a well stocked first aid box in the utility room. Accidents and incidents were being recorded and showed that action was taken where necessary to prevent recurrence. 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 6 15 Care plans are to be person 31/03/2009 centred, produced in formats that users can understand and take into account peoples wide-ranging needs, including those related to diversity. This is to make sure that their full ranges of needs are known and can be met by the staff team. 2 39 24 A review of the quality of care is to be undertaken. This is to make sure that standards of care are sufficient to meet peoples needs. 31/12/2009 3 42 13 A certificate verifying satisfactory gas safety is to be obtained for the service, to ensure that gas appliances are in good working order. This is to protect staff and users from risk of harm. 31/03/2009 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 1 20 The protocol on the use of as required lorazepam is to be re-written and countersigned by the prescribing doctor, to make sure that the medicine is used appropriately and in line with the prescribers instructions. Ways of enabling people using the service to express concerns are to be explored, using a variety of different media appropriate to their communication needs. Clarification is to be sought with the environmental health officer to check that it is safe for the freezer to be located next to the washing machine in the utility room. 2 22 3 30 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!