Inspection on 18/11/08 for Rainbow Homes (London) Limited

This inspection was carried out on 18th November 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rainbow Homes (London) Limited 28/08/07

Rainbow Homes (London) Limited 08/01/07

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Rainbow Homes (London) Limited 23 Hoop Lane Golders Green London NW11 8JN     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: THOMAS McKERVEY     Date: 1 8 1 1 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: Rainbow Homes (London) Limited 23 Hoop Lane Golders Green London NW11 8JN 02084588288 02084588288 fsaweh@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rainbow Homes (London) Limited care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home This home is owned by Rainbow Homes London Ltd., which is a private company. The home opened in July 2006, following a major refurbishment of the property, which was previously owned by the local authority and accommodated homeless people. This is the companys only care home, but the proprietors intend to open other care homes in the future. The home is located in the Golders Green area of North London, near to a large shopping area, and is well serviced by public transport. The home is registered to provide care and personal support for six people between 18 and 65 years of age who have mental health problems that may be associated with drugs and/or alcohol. The service aims to promote and develop service users independence through community living. The semi-detached building has three storeys, with one bedroom on the ground floor, three on the first floor and two located on the third floor. There is no lift in the building, which restricts the ability to accommodate people with mobility problems in upstairs bedrooms. All the bedrooms have en-suite facilities. There is a large communal area for the residents which has recently been extended by the additoin of a conservatory, located on the ground floor. The communal area contains the kitchen Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home and a dining table, and also the lounge. A washer/drier is integrated with the kitchen units. In addition, there is a staff office and an area for storing medication on the ground floor and there is a small area for parking at the front of the building and a large garden and patio at the rear of the property. The fees for the service range from £1,015 to £1,260 per week, depending on the needs of the person. 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: 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 of this service took place on the 28th of August 2007. This announced inspection, was carried out as part of the Commissions inspection programme to check compliance with the key standards and the requirements made at the last inspection. This visit was announced because the inspector was accompanied by an expert by experience, and it was necessary to ensure that the manager would be present. An expert by experience is somone who is using care services or has experienced care in the past. This gives them an insight into how services should be provided from a users perspective. The expert by experience assisted the inspector by speaking to the staff and the people who live in the home, and assessing the environment. The expert by experiences comments are included where appropriate, in the body of this report. The inspection took place over a period of six and a half hours Care Homes for Adults (18-65 years) Page 6 of 30 with a break for lunch. The registered manager and two members of staff were present, all of whom offered every assistance with the process. At the start of the inspection, the inspector discussed the homes Annual Quality Assurance Assessment (AQAA), which the manager sent to us. This document is completed by the manager and describes what the home does well and what needs to improve. The AQAA also gives us numerical information about the residents and the staff. The inspection also consisted of a tour of the home, discussions with the manager and staff, and the six people currently living in the home. The process also entailed examining residents and staffs records, the homes policies and procedures, and other documents pertaining to the management of the home. A community mental health nurse who was visiting the home during the inspection, was also spoken to about their opinion of the service. 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 Care Homes for Adults (18-65 years) Page 8 of 30 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 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. People are not admitted to the home until a full assessment of their needs has been carried out. This ensures that the home is appropriate to meet the persons needs. Potential service users can be confident that they will have written service agreements that inform them about their rights and responsibilities as residents. Evidence: Rainbow House is a large two storey property which provides accommodation for up to six residents, staff office and stores. The property is situated on a busy residential road close to several local amenities, serviced by very good accessible public transport. A gazebo has been built in the baxk garden to provide a sheltered area for people who smoke which is forbidden indoors. At the time of this inspection, six people were living in the home, four women and two men. There were no vacancies. The homes Statement of Purpose and Service User Guide provide comprehensive information about the service. This states that in addition to having mental health problems, people with a history of drug or alcohol related problems are eligible to be Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: admitted. Four residents case files were examined in detail. These included full needs assessments by the Community Mental Health Team, as most people are referred from hospital. The manager also undertakes her own assessments to ensure that the home is appropriate to meet the persons needs. The AQAA states that one person is being supported to move on to more independent living in the near future. Regular CPA reviews are carried out by the Community Mental Health Team to ensure that the home continues to meet residents needs appropriately. The residents we spoke to, said that they enjoyed living at the home and that the staff were very competent to meet their needs and expectations. Residents were complimentary about the support they received and said that the staff listen to them. The residents were also very satisfied with their rooms, four of which the inspector and expert by experience visited with the residents permission. All the people in the home are funded by the local authority, and they have written service agreements, which the residents have signed. These contracts include details about the fees that are paid on their behalf. It is stated in the AQAA that service users gender, race and religious needs are discussed with them at preadmission and forms part of their care plan. There are three Jewish residents, and the home has links with the local synagogue who provide delegates to the home on Jewish religious festivals. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents can be confident that they are involved in the planning of their care, which affects their lifestyle. They are supported to choose and make decisions and there are appropriate risk assessments in place to ensure that they can pursue their preferred activities in safety. Evidence: The current residents are single people, who have a range of mental health problems, some having concurrent difficulties such as drug addiction, eating disorders and learning disabilities. One resident has additional mobility problems and has a downstairs bedroom. Four care plans were examined in detail. The residents needs were assessed to include mental and physical health, social and religious needs, medication and financial needs. Risk assessments were documented and included risk of self-harm, taking illicit substances and challenging behaviour. The plans provide the staff with clear guidance about how to support people in their Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: preferred manner, and how to look for emotional triggers that might lead to challenging behaviour. The residents sign their care plans, which indicates that they are involved in, and agree to, what is written about them. Each resident is allocated a key worker who has special responsibility for developing a close supportive relationship with them and for reviewing their care plan each month. Sanctions can be imposed when residents breach the house rules; for example, by taking illicit substances. This usually results in restricting their social leave in the community. Meetings are held each month between the staff and residents. We noted that the minutes showed that these meetings are chaired by residents in turn. This is good practice and gives people a sense of empowerment. The minutes confirmed that residents are able to put forward their views about the service and how the home is run. 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. Residents are able to discuss all aspects of living in the home at their regular meetings with their key worker and at house meetings. The routines are very flexible and people who live in the home are encouraged to make choices in major areas of their life. The residents can be confident that staff treat them with respect and support them to maintain contact with friends and relatives. Residents are supported to choose and shop for their own meals. Evidence: The residents can generally come and go as they please as long as they inform the staff of their whereabouts and the expected time of return. This is usually by 10 oclock unless agreed beforehand. In discussions with us, the residents confirmed that they choose their own meals, when they get up and when they go to bed. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Residents are responsible for cleaning their rooms and doing their personal laundry. These daily tasks are part of the rehabilitation programme and are intended to prepare people for more independent living in the community. Regular meetings are held with the residents to discuss all aspects of life in the home and they are encouraged to fully participate in these discussions. This includes chairing the meetings, the minutes of which we saw. The expert by experience noted that residents have their own televisions and music centres in their rooms. There is a large television and some board games in the lounge and conservatory. At the rear of the building, there is a large garden and patio available for barbecues etc in good weather. A sheltered area has been provided outside for residents to smoke, as this is not allowed inside. A record is kept of each residents activities. This includes visits to Brent Cross and other shopping areas. The residents have registered with the local Mind day centre, but the manager told us that this is of limited value and is not very popular with the residents. However, some residents have recently registered with the local college on various courses, including art, mathematics and literacy. It is intended to purchase a computer in the near future, with internet access for residents to use. In discussion with the expert by experience, residents said with reference to respect and dignity, that their experience of living at this home has been the most rewarding in comparison with other homes they had been in. This was further confirmed by our observations of how the staff and residents interacted with each other. The home has a policy about sexuality and there is a book to record all visitors to the home. There were records of residents visiting their families and staying overnight and weekends. The menus showed a good variety of meals and the residents said they enjoyed the food and were able to choose what to eat. The expert by experience noted that there was very good information for residents displayed in the kitchen about good nutrition and healthy eating. Hot and cold drinks are available at all times. The expert by experience found that; On observation of their interactions, there is mutual respect between staff and residents as well as amongst residents. During our one to one discussion, even the newest resident rated the quality of accommodation and relationships with the community and with their individual key worker quite highly. This positive relationship appeared to further increase over time and was particularly significant in the staff feedback on the improvement of another individuals personal development. For example, during our discussion with two staff, it was highlighted that when the resident first moved to the home, they would not go out even when accompanied. Over time with support from staff and after a period of accompanied outings, the resident has grown in confidence and is now able to travel on their own to the day centre three times per week. Care Homes for Adults (18-65 years) Page 16 of 30 Care Homes for Adults (18-65 years) Page 17 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. The people who live in the home are able to provide their own personal support and they describe the staff as respectful, caring and attentive to their needs. Residents healthcare needs are met through appointments with the full range of healthcare professionals and generaly, medication is safely administered. Evidence: At the time of the inspection, five residents were reported to be in good health, but one person is having ongoing investigations as an out-patient at the hospital. The expert by experience noted that a recently admitted resident who has a history of drug abuse, did not have specific specialist support in place for this problem. However, the manager stated that this was due to be discussed with the community mental health team in the near future to ensure that a programme is put in place. All residents are registered with a G.P, and there is a book for recording appointments with other healthcare agencies, for example; dentists. During the inspection, a community psychiatric nurse visited a resident to administer a medication by injection. The nurse stated that the community mental health teams view is that the care provided by this home is very good and they value the support the staff give to the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: residents. There was a record that the flu vaccination was offered to everybody this winter. All the people who live in the home are quite independent and are able to provide for their own personal care needs. They describe the staff as very respectful and supportive. None of the residents were self-medicating at the time of the inspection. However, it is recommended that in accordance with the homes stated aim of rehabilitation, a programme of self medication should be put in place for residents who are due to move on to more independent living soon. This would ensure that they become accustomed to care for their own medication safely when they leave the home. The medication records were checked. We noted that an over the counter medication of Solpedeine had been purchased by a resident for their own use. At their request, this medication was being looked after by the home. The label had been removed from the container and put on the MAR sheet, but there were no instructions about the time of administration. We were informed that this was only to be given when necessary at the residents request. This is not acceptable practice and advice must be obtained from the individuals GP to minimise any danger of this medication having an adverse effect on other prescribed medicines. We also found some confusion about two other PRN medications. These appeared to be regualrly administered twice a day, but it was not clear exactly how often and at what times they were to be given. Again, a requirement is made for this to be referred to the G.P for clarification. We examined the administration of medicines records, and found them to be otherwise satisfactory, with no gaps in signatures. The medication was stored securely. The residents have signed a consent form for the administration of medicines and staff have attended medication training. Care Homes for Adults (18-65 years) Page 19 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. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Policies and procedures regarding Safeguarding Adults are available to staff and give them clear guidance about what action should be taken if abuse is suspected. Evidence: We looked at the complaints log. This showed that the last complaint was lodged in 2006. The manager showed us several letters from residents and relatives that expressed thanks for the care they were receiving and were very complimentary about the manager and staff. In discussion with the expert by experience and the inspector, it was evident that the people who live in the home were aware of the homes complaints procedure, but at present, they had no concerns. Staff who were spoken to were very knowledgable about whistle blowing and reporting procedures if they were suspicious of any issues of abuse in the home. Their records showed that they had attended training in safeguarding people from abuse. 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. The residents can be confident that their home is comfortable and well maintained and there is good communal space for relaxation and socialising with fellow residents. They can personalise their rooms by choosing the furniture and decor. The home is well lit, clean and tidy and smells fresh. Evidence: The expert by experience visited residents bedrooms with their permission. The rooms were well decorated and had comfortable furniture and the rooms had several items of personal possessions. people told us they were very happy with the overall accommodation. Since the last inspection, a new conservatory has been built which provides much needed additonal space for residents to socialise with each other. One resident has moderate mobility problems and has a wheelchair for when they go on outings, otherwise, they have no difficulty accessing all downstairs areas of the home. The garden was well mantained, but the shed could do with a coat of paint to improve its appearance. Overall, the property appeared generally well maintained internally and externally at the time of the inspection. There is a contract in place for regular window cleaning and the home was clean and tidy and free of offensive odours. Care Homes for Adults (18-65 years) Page 21 of 30 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. The residents can be confident that there is always a sufficient number staff on duty to meet their needs. They can also be assured that their wellbeing is safeguarded by thorough staff recruitment procedures, staff supervision and appropriate training. Evidence: We looked at the staff rota, which correctly identified the staff present during the inspection. There are normally two staff on duty during the day and there is a waking night staff. The manager generally works office hours.Residents stated that staff are always available to talk to and they felt safe. From observation and discussions with residents and staff, they appeared to have a good relationship with each other. At the time of the inspection, there were no staff vacancies. In her AQAA, the manager states that there is very low turnover of staff. She also states that she is very keen to recruit a more ethnicly diverse staff group to reflect that of the residents. The records of three new staff were examined in detail. They showed that they all had undergone a written induction when they started at the home. Other training included the administration of medicines, health and safety, first aid and food hygiene. Staff also attended courses including mental health, breakaway techniques, and diabetes. Staff files showed that all staff had undergone an appropriate recruitment procedure, including application forms, interviews and health screening. They had also been screened by the Criminal Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Records Bureau before starting work at the home. All staff have achieved the minimum standard of NVQ level 2 and some have attained higher level NVQs. The registered manager is also an assessor for NVQ. The staff we spoke to, told us that they had regular one-to-one supervision from the manager. They said they valued this as an opportuntiy to discuss their job and performance and to identify training needs. 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. Residents can be confident that the registered manager is highly competent to run the home. Clear leadership is provided to the staff about the standard of care residents should expect. Residents are consulted about how they wish the home to be run and there are appropriate health and safety procedures in place for their protection. Evidence: The registered manager has extensive experience of managing services for people with mental health problems. She holds the Registered Manager Award qualification and NVQ level 4. The expert by experience states; I was very impressed that the manager and her team seemed to be conscientious and proactive in managing the services effectively, to the benefit of the residents wellbeing. However, I felt that in some ways, perhaps more can be done to encourage a sense of personal independence by training some residents to be more self-responsible. A survey of the residents views about the service was carried out this year. The audit confirmed a high level of satisfaction with the service. People who live in the home are also consulted about how Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: the home is run through monthly meetings with the manager and staff. The minutes of these meetings showed that residents views were recorded and actied on appropriately. Staff meetings are also held monthly and are minuted. The proprietor conducts monthly monitoring visits at the home. The reports of these visits were available for inspection. It is recommended that the initials of staff and residents who are interviewed at these visits are recorded, to ensure that all staff and residents have had an opportunity to raise any issues. The home keeps some residents money for safekeeping for purchasing personal items during the week. We selected two residents cash tins at random and found that the sums accurately balanced with the records of withdrawal. All records and important documents pertaining to residents, staff and the management of the home are well structured, accessible, and easy to follow. The manager stated that she is provided with sufficient budget to run the home effectively and that she was about to receive a finance/business plan for the new year. A fire risk assessment of the property was available for inspection. Fire alarms are tested weekly and drills are carried out. Certificates of safety were seen for gas, fire and electrical installations and portable electrical appliances are tested annualy. 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 20 13 Medication labels must not be removed from containers and stuck on MAR sheets The time of administration may not be clear which could lead to mistakes being made affecting the residents health and safety. 20/12/2008 2 20 13 the manager must clarify with the G.P, when the two PRN medications are to be admisnitered and enter these on the MAR sheets. To ensure that residents are not having medication at incorrect times. 20/12/2008 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 20 The provider should consult with the comunity mental health team regarding residents who may be deemed safe to administer their own medication. The outcome of these discussions should be recorded in the care plan. Page 28 of 30 Care Homes for Adults (18-65 years) 2 3 20 39 The manager should consult the G.P with regard to the compatibility of Solpadine with other prescribed medication. The initials of staff and residents who are interviewed during the proprietors visits, should be recorded to ensure that all staff and residents have had an opportunity to raise any issues. 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!