Inspection on 09/10/08 for Primrose Road (38)

This inspection was carried out on 9th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Primrose Road (38) 15/08/06

Primrose Road (38) 13/09/05

Primrose Road (38) 12/05/05

Primrose Road (38) 13/01/05

Primrose Road (38) 09/08/04

Primrose Road (38) 16/02/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Primrose Road (38) 38 Primrose Road Leyton London E10 5EE     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: Robert Cole     Date: 0 9 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 30 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 30 Information about the care home Name of care home: Address: Primrose Road (38) 38 Primrose Road Leyton London E10 5EE 02085586647 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Outward care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The home is situated in a residential area of Leyton in the London Borough of Waltham Forest, and is close to shops, transport links and other local amenities. The home is purpose built, and accommodates six service users with learning disabilities. The home is on two floors, and has a lift to allow access to all service users. The home is privately run and part of Outward. 6 Over 65 6 Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on the 9/10/08 and was unannounced. The inspector had the opportunity of talking with service users, staff from the home and the homes manager was present throughout the course of the inspection. The inspection also included observations of staff interaction with service users. The inspection included a tour of the premises, and an examination of records and other documents. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI, and surveys were issued to service users, all six of these were completed and returned to the CSCI prior to the inspection. All of this has helped to form judgments made within this report, and contributed to the overall inspection process. Care Homes for Adults (18-65 years) Page 5 of 30 During the course of this inspection, the CSCI inspector was accompanied by an Expert by Experience, with a view to gaining a greater understanding of the experiences of the people who live at the home. Where extracts from the Expert by Experiences report are included, this has been clearly highlighted. 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 7 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 8 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. It is the inspectors judgement that prospective service users are provided with sufficient information about the home to be able to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. Evidence: The home has a Stamen of Purpose in place, which has been reviewed since the previous inspection, and is now in line with National Minimum Standards, including accurate information around the homes admissions procedures. The Statement says the aim of the service is To provide long term housing with 24-hour staff support, empowering service users to participate in the decision making of the home and control in their own lives, encouraging service users to develop and maintain as much independence as they are able. The Statement also includes details of the management and staff team, along with the arrangements in place for consulting with service users. Care Homes for Adults (18-65 years) Page 9 of 30 Evidence: The home has produced a Service User Guide, this is in written and pictorial form, thus helping to make it more accessible to service users, and meeting their needs around equality and diversity issues. All service users have been given their own copy of the Guide. The Guide includes details of the homes physical environment, and of the complaints procedure. Service users have been provided with a contract/written statement of terms and conditions, which includes details of fees payable, along with the services and facilities provided. These have been signed by the service user and a representative of the home. The home has an admissions procedure in place, this makes clear that prospective service users will be given the opportunity of visiting the home before making a discussion as to move in or not. There has been one new admission to the home since the previous inspection. The inspector was pleased to note that a detailed transition plan had been implemented, that included several visits to the home, including overnight stays. The service user was able to confirm that they had indeed visited the home before moving in. A detailed pre admission assessment had also been undertaken by the homes manager. This was of a good standard and covered needs on personal care, mobility, accessing the community and equality and diversity needs such as culture and relationships. Care Homes for Adults (18-65 years) Page 10 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that service users have control over their day to day lives, and that they are given the opportunity of been involved in the running of the home. Evidence: Individual care plans are in place for all service users, which are subject to regular review. Care plans are of a good standard, clear and comprehensive. Service users are involved in drawing up care plans, and where able, they sign them to indicate their involvement and agreement with them. Care plans are produced on a standard proforma, which includes sections for the aim/goal, and provides information on how the home is meeting these goals. Plans are in place on personal care, social and leisure activities and cultural needs, and other areas as appropriate. The manager informed the inspector that all service users were supposed to have an annual review meeting in conjunction with their placing authority. However, despite Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: evidence that the home had made reasonable efforts to arrange these meetings, the relevant Local Authorities have not always attended these meetings. The home have nonetheless ensured that regular review meetings do indeed take place. Individual risk assessments are in place for all service users, which are subject to regular review. Staff are expected to sign risk assessments to indicate that they have read and understood them. Service users have a risk assessment in place around mobility, and a generic assessment covering any other areas of risk, for instance around accessing the community, maintaining a healthy lifestyle and going on holidays. However, two of the current service users have bed-rails fitted to their bed. The manager informed the inspector that for at least one of these, they were satisfied that these rails were necessary, but had doubts as to whether they were needed for the other service user. In both cases, there was no evidence of a risk assessment having been undertaken, to demonstrate the need for the rails, and to reduce the risk posed by them. In order to ensure that service users are safeguarded from risk, and that they are not subject to unnecessary restraints, it is required that comprehensive risk assessments are carried out for any service user who has bed-rails fitted to their bed. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. One service user commented that I do everything for myself. While another service user wrote in their survey from the CSCI that I choose what to do everyday, and I also choose my daily activities. During the course of the inspection it was noted that service users were able to get up at a time of their choosing, and were consulted by staff over meals for the day and activities. Service users are involved in the day to day running of the home. It was observed during the inspection that service users are involved in household tasks, for example peeling potatoes for lunch and clearing away the dishes after breakfast. The home has introduced picture books on menus, activities and holidays, which help service users who have limited verbal communication to make choices, thus helping to meet needs around equality and diversity issues. Service users have regular meetings with their keyworkers to discuss any issues of interest to them, and the home has arranged for two service users to have support from independent advocates. Regular service user meetings are held, the agenda has been produced in written and pictorial form to help make it more accessible. Minutes of meetings evidenced discussions around maintenance issues, holidays and activities. Service users have been involved in choosing holiday destinations, One service user said Ive been to Blackpool, I chose it, it was lovely. The manager informed the inspector that one service user has requested that their bedroom is painted pink, and that the home is hoping to arrange this in the near future. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: The manager informed the inspector that there are currently some staffing vacancies at the home, and that service users from the home will be given the opportunity of been involved in the recruitment process. The inspector was pleased to note that service users are to be provided with training around this, service users have also had access to assertiveness training. The expert by experience wrote in their report The ladies said they were happy living in the home, and would not change anything. They said they have choices of what to do during the evening but chose to be at home watching TV. Some of the ladies were looking forward to going out for music that afternoon, which they said they enjoyed. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgment of the inspector that service users are supported to live valued and fulfilling lives. Service users have regular access to the community, and food in the home was of a good standard. Evidence: No service users are currently involved in any formal educational or employment opportunities, although one service user attends a healthy eating course. Three service users regularly attend an over 50s club for adults with learning disability, where they are involved in various activities such as knitting and bingo. They also have lunch there, and it provides the opportunity of developing and maintaining friendships and relationships. One service user attended this club on the day of inspection, they informed the inspector that they very much enjoyed it. It was noted that they were able to attend without the support of staff from the home, thus helping to promote Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: their independence. Outward, the organization that runs the home, also provides various activities, including gardening, an art group, a disco and a music group, and three service users attended this music group on the day of inspection. Service users have routine access to community facilities, such as banks, shops, markets, and service uses access public transport including buses and cabs. Two service users regularly attend a Catholic church, thus helping to meet needs around equality and diversity issues. There was evidence that service users have access to a variety of community based social and leisure activities, including visits to restaurants, a city farm, theater and the cinema. The Newham Picture House cinema in Stratford puts on shows aimed at meeting the needs of adults with learning disabilities, and service users access this. One service user has a birthday coming up in the near future, they informed the inspector that they are going to a restaurant to celebrate, with some of their housemates, and that this was their choice. The home arranges occasional day trips, for instance two service users recently visited the London Aquarium. All service users are offered a weeks holiday away from the home as part of their basic contract price. Service users are able to help choose and plan their holiday. Service users have recently been to Blackpool, while there are plans for a service user to visit France later this year. In house service users have access to a variety of activities, including television, DVDs and music. The home arranges occasional parties and BBQs, and professional entertainers are sometimes booked, recently a singer was booked to sing at a party. Visitors are welcome to the home at any reasonable time, and service users are able to see visitors in private if they so wish. Service users are also able to visit relatives in their homes, and to maintain contact by telephone. Service users are given their own mail to open. Records are maintained of menus, these indicate that service users are offered a varied, balanced and nutritious diet. On the day of inspection service users were offered a cooked breakfast, and were seen to be given a choice over what they had for meals. Staff support with eating was provided in a sensitive manner, and mealtimes were seen to be relaxed and unhurried. Service users are involved in food preparation, including buying food. The kitchen was clean and tidy, and food was stored appropriately. The report by the expert by experience states One lady said she would like to be involved in cooking if the staff would support her. I sat at lunch to eat with the service Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: users. The food was good. The expert by experience made a suggestion about the home I would like to suggest the home has a sensory room where residents can go to relax. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It s the inspectors judgment that the home is generally meeting the health and personal care needs of service users. Service users are supported to manage their own personal care as much as possible, and have access to health care professionals as appropriate. Evidence: Care plans indicate that service users are supported to manage their own personal care as much as possible, which helps to promote both dignity and independence. Service users are able to choose their own clothes to wear, and all were appropriately dressed on the day of inspection. All service users are registered with a GP, optician and dentist. Records are maintained of medical appointments, including details of any follow up action necessary. Records indicate that service users have access to health care professionals as appropriate, such as district nurses and chiropodists, and four service users are currently working with a physiotherapist. The home works with the district nurse service who provide advice around the management of continence, and used continence products are Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: disposed of appropriately. As part of the care plan, each service user has an individual health action plan, which sets out how the home is able to meet the health needs of service users, for instance around diet and healthy eating, foot care, dental care etc. All service users have an annual review of their medication in conjunction with their GP. The home has a comprehensive medication policy in place, and all staff undertake training before they are able to administer medications. Medications are stored in a locked cabinet, or in a designated and locked medication fridge. However, the home does not check and record the temperature of this fridge, and in order to ensure that medications are stored appropriately, it is required that the temperature is checked and recorded daily. No service users are on any controlled drugs, and no service users currently self medicate. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. The homes management team caries out regular medication checks. Medication Administration Record (MAR) charts are maintained, those examined by the inspector were accurate and up to date. Where service users have been prescribed psychotropic medication on an as required basis, guidelines have been put in place on when this should be administered. One service user has been prescribed LORAZEPAM tablets on an as required basis. MAR charts indicated that it was given on the 28th and 29th of August and on the 9th of September 2008. This medication is to be given when the service user exhibits challenging behavior. However, the reason for its administration on these three dates was not recorded, and indeed, the daily logs for this service user did not make any record of any challenging behaviors on these days, or of any reason why this medication was given. To help ensure that service users are only given medication as appropriate, it is required that whenever service users are administered psychotropic medications on an as required basis, the reason for this is clearly recorded. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgment of the inspector that the home has taken reasonable steps to help ensure that service users are safeguarded from the risk of abuse. Appropriate policies and procedures are in place, and staff have undertaken training in adult protection. Evidence: The home has a complaints procedure in place. All service users are provided with their own copy, and a copy was on display within the home. Surveys completed by service users indicated a good understanding of whom they can complain to if they so wish. The complaints procedure includes timescales for responding to any complaints. The home has a complaints log book, this indicated that complaints are appropriately recorded and investigated. In addition to this, the home has a Listening book in which service users can raise issues of concern to them. For instance, service users recently used this book to note that they would like sausages and shepherds pie more often, and menu records indicated that this has subsequently been arranged. The home has a copy of the Local Authorities adult protection procedure, and also its own policy on adult protection. All staff have undertaken training on safeguarding adults, and staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to safeguarding. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The inspector was pleased to note that since the last inspection the organization that runs the home no longer keeps service users individual monies in its own bank account. Service users now have their own individual bank accounts, which they can access. The home holds money on behalf of service users in a locked safe, and records and receipts are maintained of financial transactions involving service user monies. The inspector checked the records for three service users, and these were found to be satisfactory. The expert by experience wrote in their report Service users are aware of the complaints policy and said they would talk to the staff or the manager if they were not happy. 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. It is the judgment of the inspector that the home is suitable to meet its stated purpose with regard to the physical environment. Service users are provided with adequate communal and private space, and the home was generally well maintained. Evidence: The home is situated in a residential area of Leyton in the London Borough of Waltham Forest, and is close to shops, transport networks and other local amenities. The home is purpose built over two floors, and has a service lift, thus making all areas of the home accessible to all service users, helping to meet their needs around equality and diversity issues. All service users have their own bedrooms, one of which is ensuite, while the others all have hand basins fitted. Bedrooms meet National Minimum Standards on size requirements. Rooms were clean, tidy and decorated to service users personal tastes, for example with family photographs and televisions. Carpets, curtains and bedding were well maintained and domestic in character. Bedrooms contained adequate furniture, including table, chair, wardrobe and chest of draws. The home has one bathroom/toilet, one shower room/toilet and one toilet on its own. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: These have been adapted to make them accessible to service users with physical disabilities. Bathrooms were clean and tidy, and free from offensive odour. All had working locks fitted, which included an emergency override device. The communal area of the home consists of a kitchen/dining room, a sitting room, and a smaller quiet room, along with a garden. Service users were observed to move freely around communal areas. The inspector was pleased to note that the discarded furniture found in the garden at the last inspection has now been removed. The home was well maintained both internally and externally. Furniture and fittings were well maintained, and domestic in character, presenting a homely feel to the house. The home has taken steps to help prevent the spread of infection, laundry facilities are appropriate in scale to the home, and hand washing facilities are situated around the home. Staff are provided with protective clothing to wear such as gloves and aprons, and COSHH products are stored securely. The expert by experience said in their report The garden is a good size with part of it laid to patio, which is accessible by wheelchair. Service users enjoy sitting out when the weather is good and also have barbecues and parties in the summer. 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. It is the judgment of the inspector that the home is staffed in sufficient numbers to meet the needs of service users, and that staff have a good understanding of their roles and responsibilities. Evidence: The home provides 24-hour support, including waking night staff and an emergency on-call procedure. There was a staffing rota on display, this accurately reflected the staffing situation on the day of inspection. Photographs of which staff would be working forthcoming shifts were prominently displayed in the home for the use of service users. In addition to care and management staff, the home also employs a designated cleaner who works 18 hours a week. Through observation and discussion there was evidence that staff have built up good relations with service users, and that they have a good understanding of the individual needs of service users. Service users spoken to expressed satisfaction with the staff, one commented that The staff are alright, I like it here. Throughout the course of the inspection staff were observed to interact with service users in a friendly and respectful manner, and there were examples of positive staff interaction, for instance with supporting service users at mealtimes. All staff have been provided with a copy of Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: their job description, and the home holds regular staff meetings. The AQAA provided by the home indicates that all new staff undertake a thorough induction process, which includes health and safety and service user issues. All but one of the care staff employed at the home have successfully achieved a relevant care qualification. Records are maintained of staff training, these indicate that staff have recently undertaken training in food hygiene, first aid, person centered planning and adult protection. The AQAA indicates that the home has all relevant employment related policies and procedures in place, including on equal opportunities and recruitment and selection. Employment records are held centrally by the organization that runs the home, this is with the agreement of the CSCI. The home does however hold a proforma for each member of the staff team which details what employment checks have been carried out. Those checked by the inspector indicated that checks have been carried out as appropriate, including CRBs, employment references and proof of ID. 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. It is the inspectors judgment that this is a well run home. The manager is suitably experienced, and appropriate systems are in place around quality assurance and health and safety management. Evidence: The home has a new manager in place since the previous inspection. They have fourteen years experience of working in social care, including eight years in a managerial capacity. They have a diploma in social care management. The manager informed the inspector that they intend to apply for registration with the CSCI in the near future. The home also employs a deputy manager, and there are plans to recruit a senior support worker to the home. The manager presents as having built up good relations with service users, and staff were observed to interact with the manager in a relaxed manner. Record keeping in the home was of a good standard, and confidential records are stored securely. Staff and service users have access to their records as appropriate. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The AQAA supplied by the home indicates that the home has all necessary policies and procedures in place as required by the National Minimum Standard. Those examined by the inspector, including admissions and medication were of a satisfactory standard. Care plan reviews, the listening book and staff and service user meetings all contribute to the quality assurance process within the home. Copies of previous inspection reports are available to view in the home, and there was evidence that regular Regulation 26 visits are now taking place, thus meeting a requirement set at the previous inspection. Fire extinguishers were situated around the home, these were last serviced in July 2008. Fire exits were clearly signed and free from obstruction. Fire alarms are tested weekly, and were last serviced on the 22/08/08. The home holds regular fire drills. Hot water and fridge/freezer temperatures are regularly checked (with the exception of the medication fridge, as previously mentioned). The home has in date safety certificates for PAT testing, electrical installation and gas safety. The home has in date employers liability insurance cover in place. 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 9 13 The registered person must ensure that risk assessments are in place for the use of bed rails for any service user that has bed rails fitted to their bed. To ensure the health safety and welfare of service users, and to ensure that they are not subject to any unnecessary restraint. 30/11/2008 2 20 13 The registered person must ensure that whenever psychotropic medications are administered on an as required basis, the reason for this administration is clearly recorded. To ensure that medications are administered as appropriate. 31/10/2008 3 20 13 The registered person must 31/10/2008 ensure that the temperature is checked and recorded at least once a day for any Care Homes for Adults (18-65 years) Page 28 of 30 fridges used to store medications. To ensure that medications are stored safely and appropriately. 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 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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 30 of 30 - 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!