Inspection on 14/10/08 for Old Ford Road (69-71)

This inspection was carried out on 14th October 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Ford Road (69-71) 02/07/07

Old Ford Road (69-71) 27/04/06

Old Ford Road (69-71) 21/10/05

Old Ford Road (69-71) 19/05/05

Old Ford Road (69-71) 17/11/04

Old Ford Road (69-71) 21/06/04

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Old Ford Road (69-71) 69-71 Old Ford Road Bethnal Green London E2 9QD     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: Pursotamraj Hirekar     Date: 1 4 1 0 2 0 0 8 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 30 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 30 Information about the care home Name of care home: Address: Old Ford Road (69-71) 69-71 Old Ford Road Bethnal Green London E2 9QD 02089805631 F/P02089805631 Kerri.Read@mencap.org.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) : Royal Mencap Society care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 7 Old Ford Road is a residential care home registered for seven service users with learning disabilities. Currently there are no vacancies. The home is situated in the Bethnal Green area close to central London. It is comprised of two terraced houses interlinked through a shared conservatory, and with a shared garden. Parking in the area is restricted but there are good public transport links. The registered provider of the service is Mencap. Care Homes for Adults (18-65 years) Page 4 of 30 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 Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is the report of the unannounced key inspection carried out on the 14/10/08 over 5 hours 45 minutes by Pursotamraj Hirekar. The current acting manager coordinated the inspection. The method of inspection included study of care plans, risk assessments, staff recruitment records, relevant care delivery documents, observation of administration of medication to people who use the service, partial tour of the premises, discussion with staff, acting manager and conversation with people at the home. The pre-inspection survey of people who use this service, staff responses, health professionals, the annual quality assurance assessment (AQAA) - providers self assessment and in response to key inspection headline feedback session the Care Homes for Adults (18-65 years) Page 5 of 30 documentation received from the acting manager, post this inspection is included for analysis and preparation of this report as well. The quality rating for this services 2 stars. This means the people who use this service experience good quality outcomes. What the care home does well: What has improved since the last inspection? What they could do better: The home must carry out pre-admission assessment of potential people who may use the service, to demonstrate that the home could meet their assessed needs. The home should review and update the statement of purpose to include the current staff details. The home should complete the contracts / terms and conditions for each individual service user with all the relevant details. The home must notify the commission under regulation 37 of incidents and accidents that happen at the home. The home should consider to keep under continuous review of the night staff arrangements in consultation with the specialist nurse for epilepsy. The home should complete all the repair, refurbishment and redecoration work as scheduled. The home must evidence pre-employment checks for all the relief staff working at the home. The home must evidence that the relief staff receive regular supervision in the best interest of the people who use this service. Care Homes for Adults (18-65 years) Page 7 of 30 The home must evidence that all the relief staff working at the home have received all the mandatory trainings. 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 8 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We have looked at outcomes for the following standards - 1, 2, 3 The assessments carried out by the local social services are taken into account prior to the admission of service users. However, the home need to carry out pre admission assessment to demonstrate that it could meet the assessed needs. Evidence: The statement of purpose and the service user guide were comprehensive that contained information about the service provision and the details of service arrangements presented in a pictorial format as well. However, the statement of purpose needed review and update to include the current staff details, for example the service do not have a registered manager currently and is being managed by an acting manager. There has been a new admission in October 2007 to the home, since the last inspection. The home has not carried out a pre - admission assessment, to make an Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: informed judgment on the suitability of the potential service user, taking into account the needs of the service user and capacity of the staff working at the home to demonstrate that the home could meet the assessed needs. However, the service had accepted the assessments carried out by the Tower Hamlets Social Services and offered the admission. This was brought to the attention of the acting manager as part of the inspection headline feedback. The acting manager had confirmed with us in writing, that the home would carry out assessments for all the service users. Staff was observed communicating with people using the service in different forms of communication to suit their individual preferences and needs. The case files examined did not contain the contract/terms and conditions for individual service users. This was brought to the attention of the acting manager, who confirmed with us in writing, that the Tower Hamlets Social Services were engaged in a consultations with service providers around introduction of a new contract for service users in residential services. Information received from the current acting manager prior to this inspection stated that the home had clear procedures for prospective users considering the service around visits and overnight stay before they move in. Care Homes for Adults (18-65 years) Page 11 of 30 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. We have looked at outcomes for the following standards - 6, 7 & 9. The home had developed detailed risk assessments and support plans that were reviewed and updated regularly to reflect the changing needs of the people who use the service. Evidence: The care documents of 3 people using the service were seen which included risk assessments, health action plan and support plan. The information was holistic and from the view of the people using the service in relation to their choice of lifestyle, needs and aspirations. The plans had been written in sufficient detail including information that reflect equality and diversity needs for example a person said i like going to church Am a bell ringer to ensure that anyone working at the home could provide the necessary care. The information was written to help staff to provide the right level of support in relation to promoting independence and skills for daily living Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: such as personal care, domestic tasks and accessing the community. The risk assessments and support plans were seen and signed by the staff working at the home. The daily routines presented for individual service user reflected in the daily activities of the people using the service. There were some old documentations from the year 2005 and 2006 on there individual service user file along with the current care documents. It would be appropriate to keep only the current care documentation on the individual service user file to avoid any potential confusion whilst providing care. The old documentation could be filed separately or archived as appropriate. The acting manager confirmed with us, post this inspection that this has been actioned. The support plans were reviewed and regularly updated, as and when the need arouse and the changes are reflected in the support plan. For example a specialized alarmed mattress cover has been provided, that will inform staff if xxx moves excessively at night possibly indicating a seizure or if he were to leave his bed for a period of five minutes or more, than an alarm will sound. For an other person in response to diabetes type 2, a diet plan and managing diabetes and appointments were prepared. The staff working were aware of the changes to the support plans of the people using the service. The people using the service can access social and community activities locally, which include their daily routines; going to their place of work or day centre. Observations made indicated that the relationship between people using the services and the staff was relaxed, friendly and polite, showing respect to each other when they are talking or expressing a view. The staff on duty said people make their own decisions or are supported through conversation to make their own decision. For example, member of staff provided support to people whilst laying the dinning table and making arrangements for the dinner. Information received from the current acting manager prior to this inspection stated that the home regularly engage with service users and staff team to make continuous improvement. Care Homes for Adults (18-65 years) Page 13 of 30 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. We have looked at outcomes for the following standards - 12, 13, 15, 16 and 17. People who use the service experience and appeared to be enjoying a lifestyle that suits them, being part of the community and having meals of their choice. Evidence: Information about individual daily, social and community activities are detailed in the assessment and included in peoples support plan. Staff said people are supported to continue participating in daily social and community activities. The people using the services, confirmed during the discussion that they continued to participate in daily activities ranging from the day services, going out socially with family and friends. People can choose how to spend the evening and weekends, ranging from seeing friends and family and watching television. Activities and daily routines reflected in the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: records were consistent with the interests recorded in the individual support plans and have also matched with todays activity plan. The people who use the service indicated that they felt in control of their life at home and were not restricted in what they did. There was evidence that the home supported people to maintain family links and friendships inside and outside the home, in accordance with their wishes. People who use the service were spoken with, confirmed this view. Staff demonstrated a good understanding of the people they work with, recognizing if the person is anxious or unhappy, and how to approach them. People who use the service spoken to have said that they have the freedom to make choice of the meals and mealtime. Staff said they always encourage the people to choose their meals. It was noted that the people were neatly dressed and that they were treated as individuals. Throughout the inspection staff were seen talking to people and treating them with dignity; the people using the service had a good rapport with staff and the relationship between staff and the people appeared to be that of encouragement and supportive. Information received from the current acting manager prior to this inspection stated that the home regularly reviews and update support plans with relevant information about peoples life choices. Care Homes for Adults (18-65 years) Page 15 of 30 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. We have looked at outcomes for the following standards - 18, 19 and 20. The personal and health care needs of people, who use the service are met, promoting their independence and quality of life. Evidence: The personal and health care needs of the people who use the service are detailed in their individuals health care plans and support plans as well, which were clearly presented, staff has guidance in relation to the level of support required, if any. Risk assessments are detailed and to include information about personal care, personal hygiene, medication and day care activities. Staff appeared to have good working relationship with the people who use the service. This was supported through the observations made during the interactions, the people said; they are happy living at the home. Records viewed suggested that people received personal support in the way they preferred and were encouraged to maximize their independence. The people were able to identify the staff with their name, and said they were happy with the support they receive from them. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: The people who use the service said they were not restricted to continue living their lifestyle of their choosing. The home had made arrangements for the people to maintain contact with family and friends. The people who live at the home their privacy and dignity is respected. Support plans and health action plans detailed emergency contacts and health care professionals involvement in their care. For example one person was advised to start dialysis before the end of the December 2008 and the staff await for the hospital appointment, also specialized mattress cover has been purchased that will inform staff if xxx moves excessively at night possibly indicating a seizure or if he were to leave his bed for a period of five minutes or more than an alarm will sound. The social services team manager from the Tower Hamlets had agreed with the home manager to change from waking nights to sleep in staff, the current acting manager confirmed with us written post this inspection. However, it would be important to keep under continuous review, the night staff arrangements as mentioned in the previous inspection report to consult the specialist nurse for epilepsy who works with epileptic resident must approve the arrangement. The records showed people had regular appointments with health care professionals. Trained staff administer medication, staff training records, and staff spoken to have confirmed this. There has been 2 medication errors committed by the staff since the previous inspection, the management has taken appropriate measures and took the member of staff off of medication duties until the time that the staff member completed a medication training course. However, we have not received a notification of this incident at the home. The staff on duty demonstrated a good understanding of the administration of medication, and the importance of having medication on time. People spoken to have said they receive medication on time. A staff member administering medication to a person was observed and found that the staff member had administered appropriately and the person appeared relaxed during medication. As reported in the previous inspection report that the medicine received into the home are recorded on MAR sheet but should also be recorded separately in Medicine in and out book. When the pharmacist accepts returned medicine he should check it and sign the book. This procedures have been put in practice by the home and found satisfactory. Information received from the current acting manager prior to this inspection stated that the home had detailed personal and health care support plans for all the people who use the service and their health care professional appointments records are maintained as appropriate. Care Homes for Adults (18-65 years) Page 17 of 30 Care Homes for Adults (18-65 years) Page 18 of 30 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. We have looked at outcomes for the following standards - 22 and 23. People who use the service their interests are protected by complaints procedures and practices. Evidence: The complaints policy and procedure was available at the home. The people using the services indicated`that they were aware whom to complaint or express concerns about the provision of care provided to them. A person said, if Am not happy, I just speak to the staff member or the manager. The home had concluded actions about the complaints recieved. This was further supported from the documentation that was made available during the inspection and the details recorded thereof. The home had arranged for staff training on safeguarding, the staff on duty, demonstrated an adequate awareness of their role, responsibility, and procedures they are required to follow in relation to any allegation or suspicion of abuse. Staff were confident to whistle-blow poor or bad practice and confirmed that the acting manager is available should any concerns arise. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The people who use the service can choose to manage their own money, if they are able to do so. Records of money transaction were maintained. The staff member on duty described the process for recording and handling of money for people, which appeared adequate. On a sample, money transaction records and the balances for 4 people were checked and found in order. Information received from the current acting manager prior to this inspection stated that the home had clear complaints policy and procedures, the complaints received were resolved in time and service users are encouraged to voice any worries, which they may have. Care Homes for Adults (18-65 years) Page 20 of 30 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. We have looked at outcomes for the following standards - 24, 25 and 30. People who use the service live in warm, clean and homely environment. However, further development work that was in progress, needed to be completed as scheduled. Evidence: The home was maintained clean and tidy without any offensive odors. The home has had a regular premises maintenance programme in place. As`part of premises maintenance programme, repair and redecoration work has been carried out in the individual and communal areas of the building, during the inspection electrical work was being undertaken. Flooring, refitting of bathrooms and painting of front of the home, work was scheduled to be carried out. Individual bedrooms were personalized to suit the choice and taste of the people who use the service. The bedrooms are furnished with personal objects as well. The people appeared to be at ease in the home with the staff on duty, choosing to sit in the lounge or going to their bedroom. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The hot water temperature checks for bath, shower and wash basins were regularly carried out. Information received from the current acting manager prior to this inspection stated that the home is decorated on an ongoing basis and the service users were engaged in decision making process with regard to their choices about redecoration and refurbishment. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at outcomes for the following standards - 32, 34, 35 and 36. The people who use the service are protected by staff recruitment procedures, training and supervision. However, further development was needed to evidence relief staff pre-employment checks, training and supervision is carried out as well. Evidence: The interaction of staff with the people using the service was good; there was good rapport, both verbal and non-verbal communication was used. The staff appeared to be aware of the needs of the people and their daily routines and how best to communicate with them. On a random sample, 7 staff recruitment records were seen and found that, staff appointed upon receipt of application, interview, satisfactory references, POVA and Criminal Records Bureau (CRB) check. However, for the staff whose CRB was over 3 years old, the home did not have a policy for CRB renewals. The home could revisit the CRB policy on Renewals and introduce as a best practice initiative. The current acting managers recruitment records were not made available on this Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: inspection and we were told that, all her records are at their area office. However, post this inspection, the acting manager has confirmed with us in writing that her CRB check, references, application form, proof of identity and training certificates are now available at home. Staff training records showed that staffs have received training in safeguarding, fire safety, medication, manual handling, first aid, food hygiene and NVQ level 2 and 3. This was supported by staff spoken to , which identified varied training, which they had undertaken. The home had maintained adequate staff deployment ratio based upon the needs of the people who use the service. Staff on duty confirmed they received regular supervision. The home was in use of regular relief staff. On this inspection there was no evidence provided with regard to their pre-employment statutory checks, training and supervision. This was brought to the attention of the current acting manager during the inspection headline feedback session. The acting manager has confirmed with us in writing post this inspection, that relief staff are not non contracted workers on Mencaps Relief Bank. Mencap puts all of their relief staff through CRB checks and induction training covering all mandatory training such as medication, manual handling, first aid, before they are allowed to work in homes. Homes are sent monthly updated relief staff lists which has their Disclosure numbers on. Information received from the current acting manager prior to this inspection stated that the home had ensured appropriate staff deployment to meet the needs of the people who use the service and staff are given relevant training and supervision. Care Homes for Adults (18-65 years) Page 24 of 30 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. We looked at outcomes for the following standards - 37, 39 and 42. The current acting manager and the staff work as team, and have good working relationship with the people who use the service and with those external professionals who provide services to meet the needs of the people living at the home. Evidence: The home do not have a registered manager. Currently, the home is managed by an acting manager since March 2008. Discussion with the staff on duty and the people who live at the home, the acting manager appeared to have developed good working relations with the people who use the service and key external professionals as well. The various care documents seen on this inspection confirmed that the staff have clear roles and responsibilities in relation to the management of the home. staff team meetings are held to discuss any concerns, areas of improvements and staff development as well, that are in the best interest of the people who use the service. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: As part of the quality assurance system and procedure the home had a monthly quality monitoring mechanism in place and continuous improvement plan produced, to ensure that the people living at the home their quality of life goals both short term and long term, were reviewed and appropriate efforts were made to achieve them. The current acting manager and staff from the home provide supported living service to 2 service users with learning disability at Seward Stone Road which is outside the registration of this home. The premises, health and safety checks and risk assessments were carried out on the 21/04/08 and due for review in April 2009. These checks help in identifying any concerns to the premises and to action them on time, please refer environment outcome group of this report for more information. The people using the service spoken to have confirmed that, they are encouraged to express themselves about running of the home, what improvements are made in relation to their accommodation, decor and they can speak with the staff at any time. Information received from the current acting manager prior to this inspection stated that the home had regular staff supervisions and staff team meetings. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 2 14 The home must carry out 28/11/2008 pre-admission assessment of potential people who may use the service to demonstrate that their home could meet the assessed needs. Pre-admission assessment was not carried out by the home to determine that it could meet the assessed needs. 2 20 37 The home must notify the 28/11/2008 commission under regulation 37 of incidents and accidents that happen at the home. The home has not notified the commission under regulation 37 regarding the medication error. 3 34 19 The home must evidence pre-employment checks for all the releif staff working at the home. 31/12/2008 Care Homes for Adults (18-65 years) Page 28 of 30 The preemployment checks for the relief staff working at the home were not made available on this inspection. 4 35 18 The home must evidence that all the relief staff working at the home have received all the mandatory trainings. On this inspection evidence regarding relief staff mandatory training was not made available. 5 36 12 The home must evidence that the relief staff receive regular supervision in the best interest of the people who use this service. There was no evidence with regard to the relief staff received regular supervision. 31/12/2008 28/11/2008 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 2 1 5 The home should review and update the statement of purpose to include the current staff details. The home should complete the contracts / terms and conditions for each individual service user with all the relevant details. The home should consider to keep under continuous review of the night staff arrangements in consultation with the specialist nurse for epilepsy. The home should complete all the repair, refurbishment and redecoration work as scheduled. 3 19 4 24 Care Homes for Adults (18-65 years) Page 29 of 30 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. 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