Inspection on 22/10/08 for Orchard View

This inspection was carried out on 22nd October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Orchard View 24/10/06

Orchard View 07/03/06

Orchard View 05/10/05

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Insight - Eastchurch

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Orchard View 1 Parsonage Lane Rochester Kent ME2 4HP     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: Eamonn Kelly     Date: 2 2 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. 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home Name of care home: Address: Orchard View 1 Parsonage Lane Rochester Kent ME2 4HP 01634725363 01634725363 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr David Michael Clements Type of registration: Number of places registered: The Regard Partnership Ltd care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 9. 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 Orchard View supports people with learning and physical disabilities people. The premises are close to town facilities and public transport. The home provides 24 hour support and residents have single bedrooms and spacious living areas. The service specialises in supporting younger adults who, in time, may be able to live in less supported settings. The guide to the service (Statement of Purpose) states that members of staff have specialist knowledge in supporting people that present difficult Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 9 Brief description of the care home behaviours. Weekly fees and other charges may be obtained from the manager of the service. Care Homes for Adults (18-65 years) Page 5 of 29 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: The inspection took place on 22nd October 2008. It consisted of meeting with the manager, Mr David Clements, support workers on duty, three residents at the premises in the morning and early afternoon and five other residents as they returned from a series of activities. Care practices were discussed and all parts of the premises were visited. Some records were seen during the visit principally those addressing the personal and healthcare support of residents. The Commission received an annual quality assurance assessment (AQAA) from the manager. This provided good information about how residents are currently supported and how the service is being further developed. The previous report contained four requirements. These related to the need for better Care Homes for Adults (18-65 years) Page 6 of 29 arrangements for medicine storage and administration, improved staff development arrangements, safer storage of cleaning materials and better knowledge by members of staff of circumstances that could be interpreted as inappropriate restraint. This report indicates that the previous requirements have been addressed. It contains no requirements or recommendations. The AQAA (annual quality assurance assessment) outlines how the manager is developing the service and how specific plans for the future are being acted upon. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 29 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 29 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. Prospective supporters and residents can be confident that they will have their needs fully assessed before being offered a place at the home. Evidence: From examples discussed with the manager about how the support needs of existing residents were assessed prior to them taking up residence, the evidence is that thorough pre-admission assessments are conducted. This is supported by how the present procedure is working in relation to possible admission of a resident. Other care professionals including care managers, behavioural specialists and psychologists are also involved in the procedure. Written support plans are begun at this stage. From the examples seen, support staff have good information about individual support needs of residents. The manager is starting the process of re-writing the guide (Statement of Purpose) to the service. This includes updating the description of the support structure of the service with due emphasis, for example, on how to enable people to make decisions and express their Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: views with confidence. Risk assessments are completed to help ensure service users are safe in the home and grounds. There was evidence that new residents receive the levels of assistance, understanding and support that they need. The personal contract, available in formats useful to some residents, outlines the rights and responsibilities of both parties well. The AQAA outlines the managers intention to develop a residents welcome pack with the involvement of residents to give their own perspective on Orchard View. The pack will describe the opportunities within the premises and in the local community. This will involve new formats for the benefit of some residents and ways to obtain the views of all residents. A proposed induction pack for residents envisages information about, for example, what to do when the alarm sounds, explaining residents rights and responsibilities and using self advocacy within settings that give them confidence. Care Homes for Adults (18-65 years) Page 11 of 29 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. Each resident has a person centred plan that meets his/her needs. They are helped to make decisions about their lives and participate in the running of the service. Evidence: There was good evidence of residents being supported to take risks as part of an independent lifestyle. Examples were seen in three care plans as well as via discussion of profiles of the residents. Each resident has a person centred plan. These have been further developed following a recent adult protection review. The Commission has seen reports by care managers about the effectiveness of the care plans at the current state of evolvement. The reports indicate that the care plans are relevant to the support needs of residents. It is the managers intention to use this process to progress the care for new residents admitted. One such admission is currently under active consideration. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: There was evidence of direct involvement of residents in the preparation of care plans and in reviews. The plan includes the support the person needs within everyday life as well as their hopes and wishes for the future. The plans have been adapted to include pictures and symbols and Mr Clements is developing this further to help people understand their own plans and be able to articulate their views. Good examples were seen of how photos are used to build a persons life story. Members of staff said this contributes to their understanding of the full person. Work is progressing to help people understand and sign their plans to give them some ownership and control. Person centred plans are kept under review; residents provided examples of how they work with key workers and the evidence was that they regard this system as useful. During the inspection and meetings with staff and residents, there were many examples observed of how well residents are encouraged to make choices and decisions about their own lives. Various communication tools including pictures and symbols are used to help them communicate what they want and how they feel. The decisions they make are respected by the staff but great emphasis is placed on practice standards where risk assessments and other practice approaches are necessary for the safety and comfort of clients. Resident meetings take place regularly. Residents take a full part in these including preparing minutes and advocating on their own behalf. The previous inspection report outlined how these meetings are opportunities for residents to say how they feel about things in the home and to share any ideas, suggestions or concerns with agreed action points followed up at the next meeting. On this occasion, there was evidence that these procedures have been further developed and, for example, a resident showed how he provides briefings on health and safety requirements and checks that action points are followed up. The objective of the service of involving residents in all aspects of life at the premises is, as far as can be determined by the examples seen during the inspection, proving to be of great benefit to residents. There was evidence that, as part of helping residents achieve independence, procedures are in place to help them manager their money. Individuals are supported to take risks as part of an independent lifestyle. Risk assessments have been completed for activities that people wish to do and the measures necessary to reduce the risks are shown in some detail. These are updated as necessary and the examples seen were appropriate and relevant to each resident. Progressively good risk assessments have enabled individuals to go out independently and enjoy a range of activities. The AQAA refers to an anticipated secondment to the service of an experienced team Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: leader from the companys Supported Living Team to work with residents wishing to and able to move on to supported living in future as part of a long term transition plan. The AQAA also refers to increasing skills by staff in understanding residents needs through supporting each other and sharing key knowledge within the staff team. It refers to the benefits of resident-led Health and Safety meetings. Individual risk management plans have been developed and implemented with full involvement of residents in a user-friendly format. Picture formats with actual photos are enabling residents to take photos of their own possessions for their files if they so choose. The AQAA states that the management team will carry out medication assessments to enable residents who wish to and have the capacity to self-medicate to do so subject to regular review. Care Homes for Adults (18-65 years) Page 14 of 29 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. Residents have good opportunities for social, leisure and educational activities. They are supported to do the activities they want to, to get a job or undertake college courses if they wish. They are helped in building and maintaining relationships. Evidence: There was evidence, for example in the daily activity chart and description by residents of their activities, that each resident has a plan of activities available for them to do each week. Individuals are closely involved in drawing up their activity planner. Records show that people have busy and fulfilled lifestyles. A resident showed how he completes his personal diary each day or more often; others said they preferred a member of staff to keep this record. The types of activities that people do include courses at college, shopping and banking, attendance at social club, going to the pub, Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: trampolining, art lessons, exercise classes, cookery, using the home computer, drama and volunteer work. Visitors are welcomed to the home and people living in the home are supported to keep in contact with their family and friends. There is considerable emphasis on achieving what the resident wants rather than particularly what relatives want although there is a high level of skill practiced to avoid conflict between the two, At the time of the inspection five residents had gone out with two carers using public transport. Public transport is regularly used by residents on their own or when accompanied by staff. Residents and staff also have the use of a company vehicle. The manager said he is satisfied with the good level of financing he receives on a weekly basis from the company to cover activities and educational commitments. This makes it easier for staff to plan effectively to enable a wide range of opportunities for residents to be identified and engaged. There were many examples evidencing that the rights of residents are respected and they are supported to make their own decisions. They are also supported to understand their responsibilities within the home. People are encouraged to be involved in some household tasks to help them learn new skills and become more independent. Rotas are shown for these activities and some residents showed how they are carrying out the agreed tasks. Residents have access to the kitchen and some assist in cooking main meals and preparing drinks. A regular topic, according to minutes kept by residents, is meals, menus and purchase of food. They make suggestions for things they would like to add or remove and picture cards are available to help them with this. On a daily basis people can choose to have something different to what is on the menu. Snacks and drinks are available at anytime of the day or night. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive good personal and healthcare support. They are protected by revised medication handling procedures. Evidence: Each residents support plan states the levels of support they need with everyday tasks. They are able to do many things for themselves and the evidence was that they receive any support they need with personal care in a professional and discreet way. The evidence from three care plans seen and discussion of the profiles of residents was that residents have their health needs identified within their person-centred plan. Each is registered with a GP and darers help them to make appointments. Appointments are also arranged when needed with the optician, dentist and other health care specialists. Referrals are made through the GP or the local learning disability team for support from psychologists and behavioural specialists. The previous report required improvements to be made to medication handling arrangements for the safety of residents. There was evidence on this occasion that the Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: improvements have been carried out. Care managers have made checks of how the arrangements suit the needs of clients and the evidence was that the procedures are effective. On this occasion, MAR sheet records were up to date and an example was seen where a care manager requested that PRN recording be improved. Mr Clements had taken the necessary steps to meet this request; he is making arrangements to ensure that controlled medicines are securely stored in accordance with revised RPS guidelines and he is looking at the advantages for staff and residents if all staff could complete the 12-week distance learning course on safe administration of medicines. The current short course is of benefit but it has many limitations. Care Homes for Adults (18-65 years) Page 18 of 29 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. Residents are aware of how to make a complaint and know they will be taken seriously. They are protected from abuse. Evidence: A pictorial complaints procedure is available for residents and their supporters. One adult protection intervention by Medway Council is still underway and is subject to a Coroners inquiry. Medway Council is currently investigating issues brought to its attention by the deputy manager. Members of staff receive guidance on the relevance of POVA (protection of vulnerable adults) procedures and discussion with carers on duty indicated that they are aware of local authority procedures for investigating complaints, concerns and allegations. In the example referred to above, the issue was referred to Social Services immediately. There was also evidence during this inspection that residents discuss events and concerns during residents meetings. The strengths of these meetings were referred to earlier in this report. The company has introduced detailed quality assurance surveys to obtain the views of residents and others on a regular basis. This contributes to enabling residents to have confidence in expressing their views. Several did so on this occasion. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Some members of staff are not fully satisfied with the effectiveness and relevance of current training around issues of restraint. They discuss actual and potential issues as part of helping each other deal with practice issues. As part of this group self development, the staff group discuss the types of methods and practice standards most relevant to identifying signs that residents are becoming agitated and how to predict and defuse situations. As part of helping residents to achieve their personal objectives, there is a high level of professional intervention for the benefit, comfort and safety of residents. The AQAA provides a good analysis of how the service is progressing in this important area of service provision. It declares that all members of staff have read and understood the revised whistle-blowing policy. An easy-read Mental Capacity Act booklet is displayed on all notice boards. Key policies are discussed at Our meetings (the name given by residents to resident/staff meetings). The person-centred format of the complaints procedure is included in the resident induction and kept in individual care plans. Specific risk assessments are implemented with reference to resident vulnerability as appropriate including finances, sexual, emotional, physical abuse. Key policies are discussed at staff induction and care is taken to ensure that all members of staff understand the full implication. Residents give feedback during inspections by other senior managers of the service, results of these visits are displayed in a userfriendly format and any issues made known during the visit are immediately reported and acted upon. The AQAA suggests further development work in accessing suitable advocacy services for residents, further communication training and additional audio/visual materials to assist residents understand issues connected with the running of the service and achieving their personal aspirations. Care Homes for Adults (18-65 years) Page 20 of 29 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 suitable for the support needs of vulnerable people. Evidence: Each resident has his/her own bedroom. Each is decorated well and some residents said that they were discussing possible improvements with a member of staff. A resident showed how a bedroom was being redecorated for a new resident. Four bedrooms are on the ground floor and five are on the first. The premises were comfortable and maintained in a hygienic way. The lounge has plenty of seating, a computer, digital TV and a DVD player. The dining room was well maintained. There are sufficient bathroom facilities situated over two floors. The kitchen is fully accessible for everyone to use. The AQAA indicates that improvements to benefit residents have taken place over the past year. Examples are: resident involvement in the Health & Safety of the service, kitchen refurbishment, progress in refurbishing a shower room and improving the garden including involving residents in the cultivation of plants and vegetables. Plans Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: are continuing to achieve better support for maintenance issues, further redecoration of bedrooms and remaining bathrooms and new tables, chairs and flooring. Care Homes for Adults (18-65 years) Page 22 of 29 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. Residents are supported by an effective team. Evidence: Earlier in this report reference is made to how the staff team is developing and how, for example, members of staff are helping each other to develop knowledge and skills to enable residents to be assisted in increasingly professional ways. A relevant example is how the staff team is looking at ways of predicting residents behaviour so that timely interventions can be made. Carers receive good support from the company to develop their skills and knowledge. Prospective carers are introduced to residents whose views are taken into account as part of the interview process. A resident said that he is involved in these meetings with new staff. Two written references are obtained one of which must be from the applicants last employer and a full work history without any gaps must be given. All staff are aware of the need to inform the manager of any new convictions or police cautions. All new carers are required to shadow prior to working independently to enable a consistent approach. All new employees are subject to a 6-month probationary period. Members of staff are supervised every 4-6 weeks to enable them to discuss issues, concerns and successes. Observation supervisions are carried out to Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: enable staff to gain constructive feedback on their work practice. Members of staff receive a job description and Social Care Council code of practice, a statement of terms and conditions, a copy of current grievance and disciplinary procedures, whistle blowing policy and complaints policy. The manager said that he is confident that staff induction meets the standard recommended by Skills for Care (the relevant training organisation for the care sector). Mr Clements outlined how most recruitment matters are now conducted centrally by the company and he is confident that all necessary checks including CRB and POVA are carried out. Managers of services continue to have an important involvement in and impact on the recruitment, retention and training of staff. Most staff members have achieved an NVQ qualification. All receive support to achieve mandatory training as evidenced from a training matrix maintained by the manager. As referred to elsewhere in this report, whilst carers have attended a session on medicine handling residents staff would be better served by training such as the distance-learning course in the safe handling of medications. Likewise, whilst carers attend short sessions in what is regarded as mandatory training the evidence from certificates was that, as in the case of infection control, they do not receive the level of personal development that would be appropriate to meeting the support needs of residents. The manager is confident that new support workers will soon take up appointments. Mr Clements is satisfied that the company allows him to have sufficient staff on duty as he believes are able to meet the changing needs of clients. At the time of the inspection, staffing arrangements were stretched because of largely one-off conditions affecting the staff team. Agency carers are not generally used but some shifts were covered at this time due to the current pressures on the staff team. The previous inspection report suggested that formal staff supervision was not consistent but Mr Clements said that with assistance from the deputy manager appropriate formal supervision is now carried out and that he believes members of staff benefit from being able to discuss practice issues and career development. Care Homes for Adults (18-65 years) Page 24 of 29 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. Residents have the benefit of living in an environment that is well conducted. Evidence: The manager, Mr David Clements, has the qualifications and experience to conduct a residential home and to meet the objectives of the company in addressing the needs of residents. During the inspection, he provided access to copies of reports by visiting managers of the company that contributed to his direct management of the service. Mr Clements demonstrated that he keeps up to date with the companys changing policies and updates members of staff as necessary with relevant aspects of these changes. He keeps up to date also with current and changing legislation and standards affecting the care sector. Members of staff and some residents referred to the quality assurance measures undertaken by the company and there was evidence that these are reflected upon in developing the service. Service users health and welfare are protected and there was good evidence that residents are involved in some of the procedures. A resident was Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: able to describe the steps to be followed by residents and staff in the event of fire. There was evidence that residents finances are protected by the procedures followed by staff. The AQAA contained undertakings that the relevant safety checks on the premises are carried out and that all necessary maintenance certificates are up to date. Service contracts are in place for electrical systems including PAT testing, gas appliances, waste disposal, fire alarm/ extinguishers/detection systems, water safety monitoring and maintenance. Good risk assessments have been completed for the environment and in relation to each individuals required level of support. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 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 Care Homes for Adults (18-65 years) Page 28 of 29 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 © (2008) 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 29 of 29 - 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!