Inspection on 10/06/09 for Park View Road Care Home

This inspection was carried out on 10th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Grayling

The Cornerstone

John Street Nursing Home

Pennine Camphill

Snydale Care Home

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 View Road Care Home 2A Park View Road Bradford W Yorkshire BD9 4PA     The quality rating for this care home is:   one star adequate 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: Caroline Long     Date: 1 2 0 6 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 30 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 30 Information about the care home Name of care home: Address: Park View Road Care Home 2A Park View Road Bradford W Yorkshire BD9 4PA 01274481030 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): glen.sutcliffe@yorkshirehousing.co.uk Brunel Support Works Name of registered manager (if applicable) Glen Brian Sutcliffe Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code LD, maximum number of places: 9 Date of last inspection Brief description of the care home Park View Road is a residential care home for nine people who have a learning disability and may also have additional health or other complex needs. It specialises in providing care and support for people with autism. Park View Road is managed by Support Works which is part of Yorkshire Housing. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 9 0 9 0 Brief description of the care home Park View Road is a single storey building. The home is split into two areas but overall it has nine single bedrooms, three having en-suite facilities and communal toilets and bathrooms. There is a large main kitchen which provides meals thoughout the day, a kitchenette area where people can prepare their own drinks, snack etc. There is a spacious lounge/dining area which has direct access to the garden, and two other small lounges where people can sit quietly. The home is in Heaton and is near to local shops, and bus routes. Care Homes for Adults (18-65 years) Page 5 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The costs of living at Park View Road is dependent upon peoples assessed care needs. This is what we used to write this report:We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment questionnaire. We visited the home twice, in the evening and during the day, spending altogether about seven hours at Park View Road. Whilst at the home we talked with the staff and the registered and deputy manager about their work and the training they have completed, and checked some of the records, policies and procedures the home has to keep. Care Homes for Adults (18-65 years) Page 6 of 30 We spent time observing the staff supporting and talking with people who live in the home and we telephoned to ask their views. We looked at peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 30 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. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move into Park View Road. Evidence: Park View Road has recently registered with the Commission, and there are now seven people living in the home. The registered manager explained there has been a flexible approach taken to how people move into Park View Road and the move is always taken at the persons own pace. For some people who need a very structured routine, the staff have been seconded to care for them in their previous homes. So the person can get to know the staff and in return the staff can become familiar with the persons routine. Others have been able to visit Park View and stay overnight to see if they like it. The registered manager explained one of the main parts they consider is whether people will be compatible. Staff explained significant time and effort is made to make sure moving in is personal and well managed. Staff were fully aware of peoples needs before they moved into Park View, and were confident they had the necessary skills Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: and equipment to care for the person properly. As part of this process the staff will also gather information from any other agencies involved. We looked at the records to see if the staff at Park View Road had carried out their own assessment of peoples needs, however we found these had either not been completed or were incomplete. To provide a consistent standard of care for good practise the staff should always carry out and keep a record of peoples assessments before they move in. Staff confirmed they had the necessary training, to enable them to look after people properly. Such as conflict resolution and managing challenging behaviour. We looked at two contracts and found these were in place and had been signed by the social services care managers on peoples behalf. Park View Road has an information guide for people to look at this is in a easier to read format, it has many pictures and the print is larger than normal. Care Homes for Adults (18-65 years) Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff help people to make decisions about their lives, however the support plans need more information to ensure continuity. Evidence: We were able to observe how staff were helping and encouraging people to make choices about their daily lives. They offered people various activities and asked if they wanted various drinks and food. Some people living at Park View Road have autism and have lived in a hospital settings for many years, this can mean they like to follow very strict routines and if they cannot follow them they may become distressed. To help us find out if the staff were providing support according to their needs and wishes we looked at peoples support plans We found the support plans and risk assessments were general and there were gaps and more detail was needed because of peoples strict routines. Examples of this were Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: for one person who was able to understand some verbal communication but could not respond verbally, it said speak slowly. This would not have been enough information to enable a new member of staff to communicate with this person and without good communication this persons needs would not have been met. For another person who could display challenging behaviour it state support them, this did not tell staff about the persons triggers or how to help calm them. We explained this to the registered and deputy manager and they explained how they have learnt the support plans need to be very detailed so staff will always be fully aware of peoples daily routines. They explained how they are in contact with the Autistic Society who are advising them about the best way to develop these plans. We also talked with the staff they told us they had regular hand overs and did read the support plans. The staff told us they had worked with people before they moved to Park View Road and had learnt about their routines at peoples previous homes. Staff were able to tell us about peoples routines and how they were working with people to promote their independence by introducing into their life various choices so they had to make decisions. Such as providing them with two choices of clothing in a morning or deciding where in the building they want to go to. They were also fully aware of the risks to people and how to manage them and they told us about how they were promoting peoples independence whilst managing the risks. Such as the carrying out various activities and encouraging people to extend their daily routines. Park View Road has regular tenant meetings where people can make their views known. Care Homes for Adults (18-65 years) Page 14 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. People are helped and supported by the staff to make choices about their lifestyle and develop their life skills, this results in them leading a full and active life. Evidence: Park View Road felt like a home, there was a calm atmosphere where people moved about freely. We saw plenty of good interactions with staff that were warm and supportive to people. Although the records needed further information we observed and the staff told us about how the service supports people to identify what they want to do and how they want to do it and then supports them to achieve this. Some of the people living at Park View Road have previously lived in hospitals or other institutions, where the opportunity to take part in activities in the community has been Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: limited. The staff told us how they are slowly introducing people to new experiences and activities and finding out what people liked or did not like. They explained how this had to be at the persons own pace and could not be rushed. An example they gave was for some people the only community activity they are familiar and comfortable with is a bus ride, so they provided this each evening. However they were now starting to encourage people to use the bus as transport and making sure when they had a bus ride they were encouraged to get off the bus at various places of interest. The staff were able to tell us about how people had become more familiar with going out, they now went to the pub for a meal, they had been to the lake district and the staff were planning holidays for people. People were encouraged to carry out activities in the home and staff told us how they will take into consideration peoples moods and adapt the activity to what helps them remain calm. We saw staff working one to one with people in the garden and enabling people to sing and take part in a musical activities. We did not see any relatives when we visited but in the annual quality assurance assessment, they have told us that relatives will be made welcome at Park View Road and the staff will help people to visit friends and family if they wish. Staff told us at present they are preparing the food and are aware of peoples likes and dislikes, and any special diets. The menu is in pictorial format and people are asked each evening about what they prefer to eat the next day. People also have access to a small kitchen where we saw they were helped to make drinks throughout the day. Care Homes for Adults (18-65 years) Page 16 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are receiving the health and personal care they need however this could be compromised by inadequate record keeping. Evidence: We were able to observe how people were treated with respect and dignity and how they had good relationships with the staff. When we looked at two peoples care records we were able to identify gaps in the support records which did not have enough detail to enable people to receive the care they needed. Examples of this were for one person the health plan was not completed, for another who liked to follow a strict routine full details were not in the support plan. Also where a person may become distressed the action to follow was to calm them down, but it did not say how to do this. However when we talked to the staff we found they were fully aware of peoples needs and how to support them with both their personal and health care. We also found the managers were not reviewing the serious incident report to enable Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: them to plan and support people properly. Where people are not able to communicate their need verbally it is necessary to review incident forms so they can respond to peoples needs, as they can give an indication of whether people are distressed or have a particular time of the day when they need more support. The staff also explained how they try to make sure that Park View Road always has permanent staff working, this is so people have continuity of care and are also not upset by new faces. We discussed this with the registered manager who explained they are reviewing the content of the support plans and would commence reviewing the accident and serious incident forms to identify any patterns. Staff were able to tell us about the specific training they had and how the induction had helped them to care for people with specialist needs. Examples they gave were learning disability awareness award, managing challenging behaviour and autism. From peoples records we were able to see people had been supported to visit health professionals as necessary. The medication looked at was kept in a locked cabinet and when administered, recorded on a medicine administration record sheet. To reduce the risk of people receiving the wrong medication the home uses the normad system where medication is dispensed by the pharmacist into a box, with compartments for each time they have to be taken. The registered manager explained the boxes are renewed weekly, when they will carry out an audit to make sure everything is in order. However some medications cannot be stored this way and for these the home has to monitor the amount that come into the home and how many they administer. When we checked it to see if the number given to the person tallied with the number which was left, we found they did not tally. This tells us that either people are not receiving their medication or the amount of medication staff are saying they are receiving is incorrect. To be sure people are receiving the medication exactly as prescribed, the medication records must accurately show the quantities of medicines received, administered and in stock. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make their concerns known, but more needs to be done to make sure they are fully safeguarded from harm. Evidence: We were able to see how people were able to talk to the registered manager and staff to make their views known. Staff also explained how they were able to recognise by peoples behaviour if they had concerns. The registered manager explained how he was intending to meet with people individually to provide them with the opportunity to raise any concerns. Park View Road follows Yorkshire Housing complaints policy, the home has had one complaint to the home which has been resolved by the manager. The complaints are held together and recorded in a book. We explained to the registered manager how this would no longer meet data protection guidelines, and protect peoples confidentiality. The registered manager agreed to review how complaints and concerns are recorded. Park View Road has regular meetings in the home where people can make their views known, people are also encouraged to use the local advocacy service. We looked at the serious incident forms and where there was a safeguarding issue staff were not consistently referring them to us or Bradford Adult Protection. Also the Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: forms did not contain details of how the person was restrained. The registered manager was also not reviewing these regularly so they could identify any patterns which would influence or change the care people received. People at Park View Road often make their views known through their behaviour therefore it is essential these forms are reviewed to identify any patterns or incompatibility so peoples needs can be fully met. Staff told us they have received training in adult protection and safeguarding as part of their induction issues either during induction or as part of their national vocational qualifications and three staff spoken with were aware of whom to alert if an incident occurred. However when we looked at the serious incident forms we saw the registered manager was not following Local Authority procedures for reporting safeguarding issues. Peoples records contained assessments about whether people could manage their own finances. A team leader was seen during the day giving people money and records looked at showed receipts are kept and two staff witness the withdrawal of peoples money. They also explained how the finances are audited both by a District manager and Yorkshire Housing regularly. 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. People live in a clean and comfortable environment. Evidence: Park View Road is split into two areas, overall it accommodates nine people. There is a spacious lounge/dining area which has direct access to the garden, and two other small lounges where people can sit quietly. There is a large main kitchen which provides meals though out the day, and a kitchenette area where people can prepare their own drinks, snack etc. There are nine single bedrooms, three having en suite facilities and communal toilets and bathrooms. We saw the home is equipped to meet peoples needs, we also saw an example of where the environment had been adapted to meet a persons specific needs. One person showed us their room, they explained they had chosen the decoration and layout of the room, it contained many personal possessions which reflected their interests. The staff carry out the cleaning of the communal areas at Park View Road and help support people to clean their bedrooms. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: We found the home to be pleasant, comfortable and clean. To make sure people consistently live in a safe environment, the annual quality assurance assessment questionnaire states regular house audits are done which highlight any work or improvements that may need doing. Also a maintenance file is kept to highlight any needed work in order of importance. To help prevent the spread of infections and to make the home a clean and comfortable place to live. Anti-Bac soap dispensers are installed at wash-points and staff are instructed to adhere to the infection control policies and procedures. In the annual quality assurance assessment the home has also told us they have a nominated a member of staff to assess and act upon infection control issues. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support people who use the service. Evidence: Six people live at Park View Road, the staff told us there were enough of them to make sure everyones needs were fully met. We were able to observe this through the availability of staff during our two visits, the amount of interactions people were having with staff, and the activities they were able to carry out. The team leaders told us to provide continunity of care and because the people in the home reacted far better to people they knew well, they would not use agency staff. The staff told us there were normally one team leader and four support workers in a morning and afternoon and two support workers at night and one support worker who sleeps in and is available if necessary. Although peoples needs are currently being generally met, we would recommend the number of staff is reviewed when anyone new moves into Park View Road. Staff are clear about their role, they knew what is expected from them and show a good understanding of the actions they needed to take to meet peoples needs in the Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: way they prefer and need. They were able to tell us about peoples specific needs and how they had managed to help them. Such as enabling a person who had not been on a community visit before to go. We looked at three staff records to make sure the home were employing suitable people for the job. We found staff were recruited properly and staff were not starting work before all the necessary checks had been carried out. Staff told us about their induction programme they explained how to help them to get to know people needs and to make sure there was a smooth transistion when people moved in to Park View Road, they had worked in peoples previous homes. Staff told us they had also completed learning disability awareness training and managing challenging behaviour training. This training helps to make sure that new staff members are given the right information to be able to do their jobs well and safely. Staff told us they have received the training they need to carry out their work well. One commented it is far better than where I was previously employed and training is really good. Examples of the specialist training they told us about were autism and self harm. They also hoped to have makaton training in the future. Staff told us they had received regular supervision from their managers and do feel supported by the management team. We were also able to see evidence of in their personal records. Staff confirmed they have regular meetings and the registered manager explained these are used as a opportunity to recap policies and to make sure staff are kept up to date and able to carry out their roles properly. At present the home is working towards ensuring over half of the staff have their National Vocational Qualification level two or above in care, this qualification helps to make sure staff are properly trained to carry out the work. 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. Park View Road is generally run in peoples best interests, however further systems need to be developed to ensure the quality of the service is consistently maintained. Evidence: The registered manager has had previous experience as a manager at other homes and has his registered managers award, he told us he is intending to carry out further specialist training to enable him to provide people with better care. He is supported in his role by the Deputy Manager and three team leaders. Staff told us they felt well supported by the management team. The registered manager completed the annual quality assurance assessment questionaire which contained, clear, relevant information which was supported by a range of evidence. The AQAA told us about changes they have made and where they still need to make improvements and it showed clearly how they are going to do this . The data section of the AQAA was fully completed. Park View Road has only been opened for six months and people are generally Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: receiving adequate or good outcomes. However we found there was gaps in the management and recording of records which could jeopardise this. An example of this is we found specific behaviours are not being analysed and reviewed regularly, and any finding used to enhance peoples support plans. Due to the number of people the home wants to accommodate and the complex needs and behaviours the reviewing and analysing of this information is crucial to enable the home to maintain the standard of care provided to people. The manager explained the quality assurance systems at present consist of the regular visits by one of the district managers regular house meetings. The manager also explained he was planning to meet regularly with people on a individual basis to find out their views. Some of the people living at Park View Road would be unable to make their views known easily and may not have regular visitors. Therefore to improve and maintain standards of care it is important the views of other agencies and advocates are regularly sought, collated and reviewed. We did not look at the maintenance and service records when we visit because it has only recently register with us and they are checked when this occurs. However the annual quality assurance assessment questionnaire states the maintenance and service records are in order and there is a nominated person for health and safety monitoring and maintenance. We did see the fire safety procedures on the walls were in pictorial format so people could understand them. 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 19 13 All the serious incident forms must be regularly reviewed and analysed. This is to help staff recognise any patterns and identify any changes to peoples needs. 14/07/2009 2 23 13 All safeguarding issues must 10/07/2009 be reported to the Commission and Bradford Adult Protection Unit. This helps to protect peoples rights and keep them safe. 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 Staff should always keep a written record of the assessments they carry out before a person moves into the home. To ensure people always receive the care they need the Page 28 of 30 2 6 Care Homes for Adults (18-65 years) 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 support plans and the risk assessments need to include more information about peoples individual needs. 3 4 19 20 Peoples health care needs should be fully assessed to be sure their needs are always met. In order to keep an accurate record of the medicines that are supplied in their original packaging, a brought forward system should be put in place for all medication. This would show the quantity of any medicines that are carried forward from one four-week MAR chart to the next, in addition to any new supply of the medicine and the nurse should receive medication administration training. To maintain confidentiality and to follow data protection guidelines concern and complaint records about individuals need to be recorded separately. To improve and maintain standards of care it is important the views of other agencies and advocates are regularly sought, collated and reviewed. To ensure the quality of the service the records should always be up to date. 5 22 6 39 7 41 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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