Inspection on 02/07/09 for Park Lodge Care Solutions

This inspection was carried out on 2nd July 2009.

CQC found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park Lodge Care Solutions 21/08/07

Park Lodge Care Solutions 16/10/06

Park Lodge Care Solutions 05/12/05

Park Lodge Care Solutions 18/07/05

Park Lodge Care Solutions 29/11/04

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Southfields

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Insight - Eastchurch

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Park Lodge Care Solutions 24 Goffs Park Road Southgate Crawley West Sussex RH11 8AY     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Annie Taggart     Date: 0 2 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Park Lodge Care Solutions 24 Goffs Park Road Southgate Crawley West Sussex RH11 8AY 01293548408 01293426831 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Park Lodge Solutions Ltd care home 10 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 10. 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 Allied Care Ltd has taken over the home, operating as Park Lodge Care Solutions and the home is registered to accommodate up to ten service users with a learning disability. The accomodation, which is a large two storey, detached Victorian house is situated in a residential area of Southgate, Crawley. There are ten bedrooms, with accommodation provided over two floors, this includes a good range of communal areas and a garden and the property is within reach of bus and train services The Registered Provider is Park Lodge Care Solutions Ltd and the Responsible Individual is Mr Aslam Dahya. There is no registered manager and the post is vacant. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 10 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: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: In order to prepare for this inspection an Annual Quality Assurance Assessment was sent to the manager for completion and surveys were sent to Service Users and the staff team. The AQAA was returned within the given timescales and it contained clear information about the service being offered in the home. Five Service Users and four staff surveys were returned, all made positive comments about the home but two staff surveys told us that the people completing them felt that higher staffing levels would have more positive outcomes for Service Users. In additions to the AQAA we also looked at the last inspection report and any other information we have received about the home since the last key visit. The unannounced visit was carried out at 10am on Thursday 2nd July and lasted for five and a half hours. During that time we were able to spend time with the people living in the home both in their private bedrooms and in communal areas, we spoke with the staff on duty and observed staff practice. We tracked the care plans and all Care Homes for Adults (18-65 years) Page 5 of 28 supporting documentation such as daily records and risk assessments for four people and we also looked at the homes system for the administration and recording of medication. We also looked at food records and menus, health and safety files, accident and incident reporting, maintenance and fire records and tracked the system for managing peoples monies. Four staff files were tracked and all contained the required documentation. Following the inspection visit feedback was given to the manager. Care Homes for Adults (18-65 years) Page 6 of 28 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 8 of 28 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. People have their needs and wishes assessed and recorded and contracts of terms and conditions of residency are in place. Information about the home needs to be updated to ensure that prospective Service Users and their families have current information about the home. Evidence: There is a Statement of Purpose and Service User Guide in place but we were told by the manager that this had not been recently updated to reflect the changes in management and staffing at the home. The manager told us that he is in the process of updating the documents. No new Service Users have been admitted since that last inspection visit and we discussed the procedures that would be carried out in order to admit new people to the home. We saw documentation to evidence that that there was an assessment process that is carried out by the manager of the home and the area manager for the organisation and prospective Service Users and their families can visit the home and spend time meeting with the current Service Users and seeing if the home can meet Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: their individual needs. At the last inspection visit contracts of terms and conditions of residency were in place. Care Homes for Adults (18-65 years) Page 10 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In order to ensure that the staff team have current and clear information about the needs and wishes of all of the people they are supporting, care plans must be reviewed, updated and kept under regular review and the standard of daily records needs to clearly reflect outcomes for people. Evidence: From tracking the care plans for four Service Users we saw that although there was a lot of information available about the needs and wishes of people it was dispersed over a number of files and was not easy to track or to monitor. When we asked the staff on duty for the care plans we were given three different files, all containing information regarding Service Users but none contained the current, updated basic care plans that guide the staff team to the needs of the people they are supporting. We saw that clear and detailed care plans had been in place for people at the last key inspection but for most people these had not recently been reviewed and updated and monthly reviews had not been recorded. There have been a large number of new guidelines and risk assessments put in place by the new manager but we saw that Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: these did not always relate to the needs identified in the original care plans. We spoke to the manager about how the information regarding Service Users identified care needs was confusing and he told us that he was in the process of carrying out new assessments with people and then completing more person centred care plans that were easy for the staff team to follow. We saw samples of two that had been completed. Daily records are written for each person and these identify how the person has spent their day and what observations were made by the staff team but the records did not give clear and concise information, for example records often said appears to be happy today without identifying how this was evidenced. From looking at daily records we saw that people are being supported with decision making and with participation in the running of their home. Care Homes for Adults (18-65 years) Page 12 of 28 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. People have access to a variety of day care activities and outings, they are offered a choice of fresh, home cooked meals and are involved in the running of their home. Evidence: From looking at records, talking to Service Users and observation on the day of the visit, we saw that people have access to a variety of day care opportunities and outings. Some people attend day centres or college and there is a large, dining room/activities room in the home where people can be involved in craft work, art work and other sessions. People are involved in their local community and go out for coffee and meals and we were told that most people go to their family homes for the week ends. People told us that they went on annual holidays and were pleased that a new mini bus had been delivered to be used for outings. People are involved in looking after their own home and one person told us that he was going to help to wash the minibus, another person was going bowling and others were swimming and shopping. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: We saw that for one person it had been identified that the day care options they were attending no longer met their needs and we were told that in- house activities had been put in place instead. However there was no clear plan in place to show how this person was being stimulated and engaged on a daily basis and the manager told us that he would ensure that this was done. We saw that people are offered a choice of fresh, home cooked meals and that they are involved in menu planning a cooking. Food records are completed on a daily basis and we saw that people are supported with healthy eating plans where this has been identified as a health care need. During the visit people told us that they enjoyed helping to shop for the house and help with cooking and we saw people go to the fridge and help themselves to drinks and snacks. The staff on duty treated people with dignity and respect by offering them choices and explaining what was happening next and we saw that Makaton sign language was being successfully used with some people to aid communication. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and health care 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although peoples basic health care needs are being met, there are risks to Service Users by restraint guidelines being in place that have not been agreed or the staff trained to carry them out and by errors in medication management. Evidence: There are Health Action Plans in place for each person living in the home but there was no evidence to show that these had all recently been reviewed and updated. For one person there was current information available and this had been updated in response to actions required by referrals to health care professionals. From looking at records we saw that people have access to a local doctor and dentists but we could not find evidence of people having chiropody services. We spoke about this to the manager and senior carer who told us that as most people go to their family homes for week ends, foot care is usually carried out at this time but this was not recorded in care plans. We were told that for one person who did have problems with their feet, treatment was being given by their doctor. From looking at care plans, incident forms and Regulation 37 Notifications we saw that there are regular incidents of challenging behaviors from some of the people living in Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: the home. For one person, risk assessments show that the behaviors can pose a risk to themselves and to other people and recently referrals have been made to Speech and Language services and the Positive Behaviour Team. We asked why referral had not been made sooner as records show that these behaviours have been recorded over a long period of time and the manager told us, the behaviours have got worse recently but I agree we should have sought professional advice earlier. From looking at risk assessments and behaviour management plans for this person we saw that the staff team had attended challenging behaviour awareness training and that guidelines had been put in place by the manager of the home guiding the staff team to restrain the person to stop them hurting themselves and others. From speaking to the manager we found that although the guidelines had been written with the ethos that they were in the persons best interests, there had been no professional , multidisciplinary agreement to the restraint plan, the staff team had not received training in restraint or break away procedures and the manager did not have the relevant training or qualifications to write restraint guidelines. We also saw from the guidelines that the onus had been put on the staff team to decide when and how restraint should be used and records also showed that restraint had been carried out by the manager on one occasion. We spoke to the manager about the seriousness of having these guidelines in place without multi-disciplinary agreement and training and said that he would remove them from the persons file and told us that training had now been arranged. We saw that for some people referrals had been made to mental health care professionals and people were supported to attend appointments and daily records identify any concerns regarding changed in peoples health. One of the staff team on duty told us, some times it can be quite difficult working with some people, the manager has been very good at putting in guidelines and explaining to the staff team the need for consistency in our practice. There are policies and procedures in place for the administration and recording of medication and we saw that the staff team had attended the relevant training. When looking at Medication Recording Sheets (MAR) we saw that some medications had been transposed in handwriting by the staff team and had not been signed or dated. There are no nurses on the staff team with the qualifications to transpose information onto MAR sheets. Recently in response to a Safeguarding alert regarding medication errors, we saw that the home had updated their guidelines for administration recording. From tracking records we saw that the home had not followed their own guidelines to double sign for medications, there were gaps in signing in the MAR sheets and where one persons medication had not been given there was no Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: explanation for this recorded. Care Homes for Adults (18-65 years) Page 17 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their complaints and concerns recorded and acted upon and the staff team demonstrate that they have an awareness of Safeguarding procedures. There are potential risk to Service Users regarding procedures not being followed and by restraint being used in the home. Evidence: The home has a complaints procedure, a copy of which is included in the Statement of Purpose and we saw that there was an accessible version for Service Users in words and symbols posted in the home. From looking at records we saw that there is a complaints log in place and that complaints are listened and responded to and outcomes are recorded. Service Users also have a chance to talk about things that are of concern to them at regular house meetings. We saw that no formal complaints have been recorded since the last inspection visit. From looking at staff records we saw that the staff team have attended training in protection people from risk of abuse and harm and the staff on duty during the visit told us that they would report any suspected abuse straight away. In the AQQA we are told that nine safeguarding referrals leading to five investigations have been carried out by the West Sussex safeguarding team and they are now closed. As detailed in other parts of this report, there are potential risks to Service Users by policies and procedures not being followed and by the use of restraint. Care Homes for Adults (18-65 years) Page 18 of 28 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. Park Lodge provides an attractive, homely and well maintained environment for the people who live there. Evidence: The home is purpose built and provides an attractive and homely environment for the people who live there. there is a large, bright lounge area, a dining/activities room and a conservatory and people have the use of a large, well maintained garden. People told us that they were happy living in the home and said that they were involved in helping with cleaning and keeping their home tidy. Maintenance issues are addressed, we saw that regular checks are undertaken, hot water temperatures are recorded and during the visit there was a maintenance person working with Service Users in the home. Peoples private bedrooms have been personalised with their own belongings and show evidence of hobbies and interests that people follow. There is some pictorial signing to aid communication and orientation for people and we saw that people had keys to their bedrooms and moved freely around the home. Two carpets were identified as needing cleaning or replacing and the manager said that he would address this. Records showed that regular fire checks are undertaken and that the staff team have Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: updated fire training. Infection control issues are identified and addressed by the use of protective clothing for staff and cleaning schedules and the home was clean and hygienic throughout. Care Homes for Adults (18-65 years) Page 20 of 28 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 people living in the home are supported by a committed staff team. Robust recruitment procedures are followed and there is a comprehensive staff training programme in place. Evidence: In the AQAA we are told that there are sufficient staff on duty to safely support the eight people currently living in the home and staffing rotas showed that there are either two or three people on each shift with one person awake at night. Service users described the staff team as kind and very nice and observation during the day showed that there was a good rapport between them. The staff on duty were patient and supportive in their dealings with Service Users, offering them choices and giving them time to make decisions. We tracked the records for four members of staff and found that a robust recruitment procedure had been followed. There was evidence of an interview process, two references had been gained and each person had a current Criminal Bureau Check (CRB) on file. For one new member of staff we saw that an in-house induction had been carried out but they had not yet started the formal Learning Disability Qualification induction. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: Training records showed that the staff team had undertaken mandatory training such as first aid and infection control and other courses such as Autism awareness, Epilepsy management, challenging behaviour and sexuality awareness had been attended. In the AQAA we are told that there is a stable staff team and of twelve support workers, eight have NVQ at level 2 or above. From looking at incident and accident records we saw that the staff team are sometimes injured in their dealings with Service Users and as recorded in other parts of this report a Requirement has been made for the staff team to receive further training in dealing with challenges and safe break-away techniques. The staff on duty told us that they felt well supported and comments included, I have worked here for five years and things are now much better, we get fantastic staff support, there have been more guidelines put in place for how we support Service Users and under the new Providers we have so much more training. From looking at records we saw that regular staff meetings are held and also staff supervisions sessions are recorded but these were not up to date for all of the staff team. Care Homes for Adults (18-65 years) Page 22 of 28 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager of the home has not yet been registered and there are potential risk to Service Users in the lack of clear policies, procedures and recording being in place. Evidence: The manager of the home told us that he has worked in the home for a year and has fifteen years experience working with people with a learning disability managing both residential and supported living services. The manager has not yet completed NVQ Level 4 or the Registered Managers Award and tells us that he has started the process to be registered with the Commission. All of the staff on duty were very complimentary about the manager and comments included, there have been lots of differences under the new manager, people used to have very regimented lives and often went out in large groups but now they are offered alternatives and have choices and the manager is very supportive, he listens to what you have to say and puts new things into action, we have lots of support and his door is always open. A full quality assurance process has not yet been carried out for 2009 and we saw that surveys had been sent to families and other people involved with the home. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: Regulation 26, Registered Providers visits are carried out and we saw that a full report is written following the visits. Incidents and accidents are recorded with risk assessments completed as a result and Regulation 37 notifications are being sent to the Commission as required. We tracked the system for recording and managing Service Users monies and saw that this was in some disarray. An example of this was that a large amount of money had been drawn out of one service users account but this had not yet been recorded on their files. We asked why such a lot of money had been drawn out and were told that there had been some difficulties with the persons account being frozen so the home had been lending the person money until it was sorted out. We saw that there were some receipts in place to evidence this but there was no running total completed, the records on the computer and paper files did not match and there was no way to track the evidence. We checked on two other files and found that one was correct, the other had too much money in an did not match the records. We asked the manager why such large amounts of money were being held in the home for people and were told that families managed monies and people did not have their own accounts in banks or post offices. We asked the manager if the home was insured to hold such large amounts of cash for people but he said he did not know, the manager also said that he would like it on record that he felt that there had been an uphill struggle to come to terms with all of the new processes put into place in the home and that as he did not have administration assistance he was finding it difficult to keep records up to date. Environmental and fire risk assessments are in place and health and safety risks are identified and addressed. Although the evidence shows that the new manager has made positive changes to the outcomes for Service Users in the home, there are potential risks to people by care plans not being current and clear, by there not being agreed guidelines and staff training in restraint procedures, by errors in medication management and records for the management of Service Users monies. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 and risk assessments must contain current information about the assessed needs and wishes of service users. This is to ensure that the staff team have the information they need to safely support service users. 30/08/2009 2 19 13 Restraint must not be used 30/07/2009 in the home unless it is following a multi-disciplinary agreement and staff have the correct training and guidance from the relevant professionals. This is to ensure that Service Users are protected by the homes working practices at all times. 3 20 13 The system for recording and administering medication must be reviewed and updated. 30/07/2009 Care Homes for Adults (18-65 years) Page 26 of 28 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 This is to ensure that Service Users receive the correct medication at the correct time and are not put at risk 4 42 16 There must be robust recording procedures in the home and records must be kept up to date including those for the management of service users monies. This is to ensure that there is a monitoring system in place that is easy to track and Service Users are not put at risk. 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 15/08/2009 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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