Inspection on 14/10/08 for Prudential Care Home Limited

This inspection was carried out on 14th October 2008.

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

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

Other inspections for this house

Prudential Care Home Limited 20/11/07

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Prudential Care Home Limited 23 Ivatt Way London N17 6PF     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: Susan Shamash     Date: 1 7 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 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Prudential Care Home Limited 23 Ivatt Way London N17 6PF 02082452859 02082117406 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karl Graham Dicks Type of registration: Number of places registered: Prudential Care Home Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 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: Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home 23 Ivatt Way provides support for up to five adults with mental health needs including those subject to conditions of Section 37/41 of the 1983 Mental Health Act. The home is run by Prudential Care Home Ltd, a private provider that owns other residential services in the area. The property is a large two storey building with five bedrooms for residents with a separate toilet and bath/shower room on the first floor and a lounge, kitchen/diner, toilet and staff office/sleeping-in room on the ground floor. The stated aim of the home is `to provide the high quality residential support for adults with mental health needs who are not yet ready to live independently?. The home is Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 5 Brief description of the care home approximately 10 minutes walk from Turnpike Lane Underground Station, and is served by local buses. It is close to shops, pubs and other public amenities. Weekly fees are currently charged at 550GBP - 1400GBP depending on level of need. Current CSCI inspection reports can be obtained directly from the home and can also be viewed on www.csci.org.uk Care Homes for Adults (18-65 years) Page 5 of 32 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 last inspection on this service was completed on 20th November 2007. The current unannounced inspection took place over two days and lasted approximately seven hours. This was the homes second inspection undertaken by the Commission for Social Care Inspection since it opened last year. There were five people living at the home at the time of the visit, with no vacancies. The registered manager assisted throughout the inspection. I conducted a tour of the home and I had the opportunity to speak to four people living at the home. I also spoke to the two support workers on duty and observed routines within the home. Care Homes for Adults (18-65 years) Page 6 of 32 Five completed questionnaires were received from people living at the home and five were recieved from staff members. A variety of records, including care plans, staff files and health & safety documents, were examined. Information provided by the home in the Annual Quality Assurance Assessment, was also taken into account as part of the inspection process. What the care home does well: What has improved since the last inspection? Since the last inspection, the homes statement of purpose had been updated to include some further details to ensure that people are being provided with sufficient information about the service. The contracts between residents and the home had been updated to ensure that peoples rights are protected as far as possible. Medication cabinets were being kept locked at all times when not in use and the storage temperature of medicines was being monitored to ensure that the medication needs of people living at the home are met safely. The adult protection policies for the homes local authority and the placing authorities of all people living at the home had been obtained for the protection of people living at the home from abuse. Lockable storage facilities had been provided in each persons bedroom for the safe storage of their valuables. Staff files for all people included evidence of safe recruitment practices and adequate training to meet peoples needs safely. Monthly unannounced inspection visits were being made to the home on behalf of the provider organisation to ensure adequate quality monitoring for people living at the home. Care Homes for Adults (18-65 years) Page 8 of 32 The fire prevention authority had been consulted regarding the homes fire risk assessment, and a number of safety certificates had been obtained for the home for the safety of people living and working at the home. As recommended that the garden area at the rear of the home had been made more attractive and comfortable. Paper towel dispensers were fitted in each bathroom/toilet for hand drying, to improve hygiene for people living at the home. In addition new sofas had been provided in the homes conservatory. As recommended all policies for the home had been reviewed within the last year. 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 9 of 32 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 32 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. People moving into the home feel that they are provided with adequate information and their needs and wishes are assessed so that the home can be sure that it can meet their needs and preferences. Their rights are protected by appropriate contractual arrangements with the home. Evidence: I had the opportunity to speak with four people living at the home. They told me that they enjoyed living at the home and thought that all their needs were being met appropriately. Detailed assessments were available in each persons care file indicating that a comprehensive assessment is undertaken prior to any person being admitted to the home. People spoken to advised that they had been given sufficient information about the home prior to moving in, although one person felt that one interview had not been Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: enough. The statement of purpose indicates that the home will take all steps necessary to combat discrimination and take positive action to promote equal opportunities while appreciating the benefits of diversity. As required at the previous inspection, the homes statement of purpose needs to be updated to include the sizes of all rooms in the home and a copy of the current service users guide for the home should also be sent to the local CSCI area office. People living at the home advised that they had had opportunities to visit the home for short visits, overnight and weekend stays prior to moving in. This was confirmed by staff spoken to and recordings in each persons daily notes. Peoples files included statements of terms and conditions between the home and people living at the home and these included the room to be occupied and specify the care home at which the person lives, to ensure that peoples rights are protected as far as possible. Care Homes for Adults (18-65 years) Page 12 of 32 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. The home assesses and responds to the needs of residents whilst helping them to make decisions for themselves. People living at the home are supported to take appropriately calculated risks in order to develop their independence skills as far as possible. Evidence: I looked at the care plans of three people living at the home, in detail, which identified their primary needs and how these were being met. I also spoke to four residents about the support that they receive, and two staff members told me how they assisted residents to achieve the aims set out in their care plans. Care files contained up to date care plans and risk assessments, reflecting a personcentred approach to supporting residents. These were based on detailed assessments undertaken by the home and obtained as part of the admission information for each Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: person, and were signed by the relevant resident. The minutes of recent Care Programme Approach and psychiatric reviews were also available. Care staff interviewed were aware of the need to provide guidance and support to residents where necessary, whilst letting them decide for themselves as much as possible how they lead their lives. The residents said they could decide when they wanted to have their meals and what they had to eat, and generally chose how to spend their days. Risk assessments indicated that staff support residents to take risks as part of a more independent lifestyle, and this was confirmed by staff and residents spoken to. Observation of interactions in the home indicated that staff had formed supportive relationships with residents, enabling them to make choices about how they spent their time. No residents were self medicating at the time of the inspection, nor were risk assessments in place to determine whether residents might be able to do so. Likewise no residents had keys to the front door of the home, although they had keys for their own rooms, and a requirement is made accordingly. Following the inspection, the manager advised that a new lock would be fitted on the front door, so that residents could have front door keys if they so wished. Care Homes for Adults (18-65 years) Page 14 of 32 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. The home is good at enabling people to get out and about and lead lives of their choices. Residents enjoy a better quality of life because they have good links with the local community and close contact with friends and family. People are supported to make choices for themselves about how they spend their time. They are encouraged to help prepare meals at the home and consulted about the menus so that their preferences are taken into account, and a varied and nutritious diet is provided to them. Evidence: Residents spoken to advised that they were satisfied with activities available to them. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Regular activities attended by people living at the home include attending a local gym, college courses including English, Maths, Computers, and the Humanities, attending day centres, drop ins and a place of worship. One resident is aiming to undertake a plastering course at college and another to find work in bricklaying. All go out independently and make use of local shops and amenities. Other activities enjoyed by residents include playing football, trips to the cinema, reading daily newspapers and going clubbing. I had the opportunity to meet the operations manager briefly during the inspection, and she advised that she is also involved in taking residents on trips out within the local area and further afield. Residents confirmed that they had been on trips to Brighton, Southend on Sea, as well as participating in a barbeque, clothes shopping trips with staff support and attending social clubs. A holiday trip was also being discussed. However I noted that although a large number of suggestions for leisure activities were made during residents meetings, there was no evidence that some of these activities had been researched seriously or made available. Within the home they are supported to be involved in cooking their own meals and undertake housework in order to develop their independence skills. This was confirmed by staff members and service users spoken to. One resident is due to move on to a more independent setting shortly, and the home is commended for the support provided to this person. Staff were aware of peoples cultural needs, including dietary preferences and religious observance. Foods on the homes menu took account of the cultural diversity of people living at the home, including Halal meat for residents requiring this. One person confirmed that they are supported to attend their place of worship, and were supported whilst fasting for the month of Ramadan, as appropriate. People said they could have visitors when they wanted and spoke positively about how staff members respect their rights and give them responsibility. All are supported to have contact with family members where possible, and see them regularly. Residents have their own keys to the home and their rooms and staff have no access to personal/private space unless permission is received. Restrictions are kept to a minimum and where they are in place they are stated in the homes brochure or the contract. I observed that residents and staff related well to each other in a relaxed way. The home was well stocked with food including fresh fruit and vegetables. One person told me that there was nice food, and another that the food is delicious. People that I spoke to advised that they were consulted on menu choices and evidence within one persons care plan indicated that they were receiving support and advice around Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: managing their diabetes. Care Homes for Adults (18-65 years) Page 17 of 32 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. The staff team is good at providing physical and emotional support to residents in a way that they are comfortable with. There is an improvement in the support provided to residents to attend regular healthcare appointments. Residents are protected by the medication arrangements in place in the home. Evidence: Staff were observed to interact appropriately with residents and in a way that recognised their individual needs and preferences. They told me that their needs were being met and that staff were easy to talk to. One person told me that there was always someone to talk to if they were feeling depressed. Although there had been an improvement in the recording of support for residents to attend regular healthcare appointments, particular GP and consultant appointments, it was not possible to verify when some residents had seen dentists and opticians. Where residents refuse to attend such appointments, this must be clearly recorded, alongside support and advice given to safeguard their health and welfare. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: No residents were self-medicating at the time of the inspection, although the manager advised that some residents may be able to work towards this in the future. A detailed medication administration policy was in place for the home. The records relating to the administration of medication to residents were up to date and accurate. Medicines were stored within a separate small cabinet for each person. At the time of the inspection the keys for each cabinet were stored appropriately when not in use, as required at the previous inspection. The storage temperature of medicines stored at room temperature were also being monitored as appropriate to ensure that it does not exceed 25 degrees Celsius. However although few PRN (as and when) medicines were prescribed for people living at the home, they would be better safeguarded by clear written guidelines for their administration. Care Homes for Adults (18-65 years) Page 19 of 32 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. The home has a satisfactory complaints system so that people can be confident that their complaints and concerns will be listened to and acted on. Adult protection procedures are in place to protect people from abusive practices, alongside local authority policy and procedures. Evidence: The home has policies and procedures in place in relation to reporting and investigating complaints with each resident given a copy of the complaints policy as part of the service users guide. Four complaints had been made since the home opened, and these were recorded in an appropriate format outlining actions and timescales taken to address them. Residents said they felt able to make complaints and raise issues if they needed to. There had been no incidents in relation to adult protection in the home. Staff had had training in this area and the staff members on duty were aware of how to respond to incidents or allegations. The home has a detailed adult protection policy, including a copy of the adult protection policies and procedures for the host local authority (Haringey) and other placing authorities of people living at the home, as required at the previous inspection. Care Homes for Adults (18-65 years) Page 20 of 32 Care Homes for Adults (18-65 years) Page 21 of 32 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 homely, clean and comfortable environment, appropriately furbished to meet their needs. Evidence: Inspection of the premises showed that it was comfortably furnished and well decorated, providing a homely environment for residents. Residents commented that it was a nice environment to live in. The home was clean, and staff advised that they supported residents to keep their home clean and tidy. New sofas had been provided in the conservatory and residents were pleased with them, and a new CD player was also provided in this area. Bedrooms had been personalised, and each bedroom had a sink, radiator, bed, wardrobe, chest of drawers, table and chairs, bedside lamp, television, telephone and refrigerator provided by the home, exceeding the provision specified by the national minimum standards. As required at the previous inspection, lockable storage facilities had been provided in each room, to which residents had been provided with the keys. The garden area was maintained appropriately, with new bench seating provided, and Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: some plants. Residents told me that they had used this area in the summer, and continued to use it for smoking. The kitchen was well equipped, and staff and residents advised that all equipment was functioning well. The washing machine is currently located in the kitchen area, which is not a problem given the needs of the existing people living at the home. The manager is aware that it may need to be relocated should peoples needs change in this area, in line with better infection control procedures within the home. On the first day of the inspection, cloth towels were still provided in the communal bathrooms/toilets for hand drying by people living at the home. However by the second day of the visit, this issue had been addressed with the provision of stocked paper towel dispensers, to prevent the possible spread of infection within the home. Care Homes for Adults (18-65 years) Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from an experienced team of staff who support them appropriately. They are protected by the homes recruitment and training procedures, and regular supervision to ensure that they work in line with best practice. Evidence: I had the opportunity to speak to two staff members and the registered manager. Most staff at the home have worked at another home belonging to the registered provider and are therefore experienced at meeting the needs of people with mental health problems. Positive feedback was received from all residents spoken to, indicating that they felt well supported by staff at the home. One person told me that staff were so flexible, that when they needed to be escorted at all times, they had even accompanied them when they had chosen to go jogging in the rain, without complaint. It was not possible to inspect staff files on the first day of the inspection, as these were at the providers office, however these were all provided on the second day of the visit, and the manager advised that they would remain at the home from then on. I inspected five staff files, and they contained sufficient information to evidence that staff members had the appropriate checks made to protect residents from having Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: unsuitable staff working in the home. These checks included two written references, identity documents and enhanced CRB disclosures. Discussion with the manager indicated that he was aware of the appropriate procedures to follow when recruiting staff. However it is recommended that the verification of references be recorded to evidence that references are check appropriately prior to staff commencing work at the home. Records and certificates maintained in staff files indicated that the staff members had undertaken a thorough induction including basic counselling skills and mental health awareness. Other training courses undertaken included control and restraint, dual diagnosis, breakaway techniques, health and safety, food hygiene, first aid, fire safety and adult protection. Three staff had already completed NVQ level 2/3 qualifications in care, and others were in the process of undertaking or upgrading these qualifications. As detailed in the Annual Quality Assurance Assessment the manager advised that a series of staff seminars had been provided this year including the history of Mental Health, Basic Counselling skills, Diagnoses of Mental Health/ Learning Difficulty and Forensic Mental Health. Supervision records indicated that staff receive regular one-to-one sessions as appropriate, and this was confirmed by staff spoken to and those answering questionnaires. However some staff indicated that there had been some issues between staff members within the team, particularly regarding shift patterns, and one staff member recommended that team building exercises might be beneficial. It is recommended that this be considered. Care Homes for Adults (18-65 years) Page 25 of 32 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. The home is generally well run so that people living there benefit from having their individual needs and preferences responded to. Residents contribute to the way in which the home is run, and although quality control measures are in place, there is room for some improvement in quality control procedures to ensure that high standards of support are maintained at all times. People living at the home benefit from a high standard of health and safety procedures and record keeping. Evidence: The registered manager for the home had been working in social care since 1984, and is a Registered Mental Health Nurse, and Learning Disability Nurse. He has a diploma in counselling and National Vocational Qualification level 4 in management and level 5 in Operational Management. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: The manager advised that regular staff meetings are held at the home during which people can put forward their ideas and suggestions on how the home is run. Meeting minutes indicated that they were used for consultation about the way the home is run, as appropriate. The manager advised that resident meetings were also held regularly and minutes indicated that these had recently addressed activities, food provision, and general shared living issues. It was noted that some of the suggestions raised at resident meetings regarding activities had not yet been addressed. Whilst it is accepted that not all suggestions may be practicable, it is recommended that each resident meeting should include feedback regarding suggestions and requests made at the previous meeting, so that residents feel that their views are being taken into account. The manager advised that monthly quality assurance visits were being undertaken by a representative of the provider organisation, and there were reports of these visits available in the office, to evidence this. Staff and residents confirmed that the provider visits the home regularly and makes time to speak to them. The manager advised that the Annual Quality Assurance Assessment completed for the home, was being used as a tool for quality assurance within the home. However he is aware that the views of all stakeholders involved with the home must be sought at least annually, including healthcare professionals, relatives, residents and staff. Clear policies were in place for supporting residents with their finances, and the manager explained the current procedures, and showed me current records as appropriate. A detailed selection of policies and procedures were available for the home. As recommended at the previous inspection, they were now dated, and reviewed within the last year. Health and safety records were looked at, including accident reports and daily refrigerator and freezer temperatures, which were current and complete. Inspection of safety certificates for the home showed that current gas and electrical installation certificates were in place and as required at the previous inspection, a current portable appliances testing certificate, emergency lighting certificate, and fire extinguishers servicing certificate were available. Environment risk assessments had also been reviewed within the last year. As required at the previous inspection, the fire risk assessment for the home had been sent to the local fire prevention authority for consultation and had been reviewed within the last six months. Regular fire drills were being arranged, as appropriate, however I noted that the testing of the fire alarm call points had recently been Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: changed to monthly instead of weekly. The manager advised that this followed advice given by the fire safety contractors, however it is required that this should be undertaken weekly to ensure the safety of staff and residents as far as possible. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 persons must 19/12/2008 ensure that appropriate risk assessments are put in place regarding individuals selfmedicating, keeping keys to the front door of the home and other relevant areas to ensure that they are encouraged to learn independence skills as far as possible. . 2 19 12 The registered persons must 28/11/2008 ensure that people at the home are supported to attend routine healthcare appointments such as dentists and opticians, to ensure that their healthcare needs are met appropriately. . 3 42 23 The registered persons must 21/11/2008 ensure that the fire alarms are tested at the home at least weely, including each separate call point in Care Homes for Adults (18-65 years) Page 30 of 32 rotation, to ensure the safety of staff and residents within the home. . 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 14 It is recommended that people living at the home be supported to undertake more varieties of leisure activities as suggested in their residents meetings. It is recommended that clear written guidelines (following consultation with their GP) be available for residents prescribed as and when medicines, to ensure that these are administered safely. It is recommended that a computer with internet access be made available for people living at the home, to learn and practice their computer skills. It is recommended that the management consider team building strategies for the staff team to ensure that they work well together in supporting people living at the home. It is recommended that how and when references are verified should be recorded on each reference for new staff members, for the protection of people living at the home from harm as far as possible. It is recommended that a more formal quality assurance procedure be put in place for the home including feedback from all stakeholders and follow up of suggestions and concerns raised at each residents and staff meeting, so that people feel that their views are being taken into account regarding the home. 2 20 3 24 4 32 5 34 6 39 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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