Inspection on 07/07/08 for REACH Bierton Road

This inspection was carried out on 7th July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

REACH Bierton Road 13/07/07

REACH Bierton Road 20/12/06

REACH Bierton Road 23/05/06

REACH Bierton Road 02/12/05

REACH Bierton Road 07/07/05

REACH Bierton Road 05/01/05

REACH Bierton Road 15/07/04

REACH Bierton Road 20/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: REACH Bierton Road Aylesbury Bucks HP20 1EJ     The quality rating for this care home is:   one star adequate 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: Mike Murphy     Date: 0 7 0 7 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 28 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 28 Information about the care home Name of care home: Address: REACH Bierton Road Aylesbury Bucks HP20 1EJ 01296 429586 01296 429586 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: REACH Limited Miss Amanda Follette care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD 8 Over 65 0 Date of last inspection Brief description of the care home 20-22 Bierton Road, Aylesbury, is a care home providing residential care to eight adults with learning disabilities. The home is a conversion of two mid-terraced house. The Rehabilitation Education and Community Homes Limited (REACH), an organisation specialising in residential care for adults with learning disabilities, manage the service. The home is located about half a mile from Aylesbury town centre, convenient for the facilities of the town, the specialist facilities of Manor House Hospital, which is across the road and public transport. All of the homes bedrooms are single. None have enCare Homes for Adults (18-65 years) Page 4 of 28 suite facilities. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out over the course of one day in July 2008. It was a key inspection which focused on the key standards in Care Homes for Adults (18-65). The inspection included a visit to the service, conversation with six of eight residents, conversations with the registered manager and staff, examination of records (including care plans), a tour of the home and grounds, consideration of information provided by the registered manager in the form of an AQAA (Annual Quality Assurance Assesment), consideration of the content of one CSCI survey form returned by a person living in the home, and observation of practice. Fees at the time of this inspection were between £680 and £1300 per week. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people considering using the service are assessed by experienced managers to ensure that the service is able to meet the persons needs. People offered a place may visit the home prior to accepting to decide whether they wish to live there. Evidence: There have been no admissions to the home since the last inspection. REACH has good systems in place for assessing the needs of prospective users of its services. Referrals are made to the organisations head office in Gerrards Cross. A senior and experienced manager considers the referral. If it is appropriate then the manager gathers further information and makes arrangements to visit the person at their current place of residence. The manager conducts an assessment of the persons needs. The process includes liaison with relevant health and social care professionals. Care Homes for Adults (18-65 years) Page 9 of 28 The information acquired is then considered by REACH and an appropriate vacancy in on of its homes identified. Compatibility with current residents is considered. The organisations policy and practice aim to ensure that its homes, including Bierton Road, can meet the needs of a diverse community. Arrangements are made for the prospective resident to visit the home. This is followed, where appropriate, by extended visits. If all goes well then a trial admission of three months or so is arranged. A review is conducted with all parties at the end of this time. A permanent place is offered if all agree that this is appropriate to the persons needs. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 plan of care for people living there which they are encouraged to be involved in writing up. The home is making good progress in making the plan accessible to people. Plans are periodically reviewed to ensure that they are kept uo to date. However, maintaining continuity in key workers for individuals is problematic because of pressures on staffing. Evidence: There is a service user plan in place for each person living in the home. Plans are in Person Centred Plan (PCP) format. Staff encourage and support people living in the home to be involved in their support plans. Around the time of this inspection, continuity in key working was problematic on occasions of this inspection due to pressure on staffing. Care Homes for Adults (18-65 years) Page 11 of 28 Plans include a photograph of the person, essential details, details of health care appointments and correspondence, matters that are important to the person, notes on important people in the persons life, communication, a weekly diary, a list of likes and dislikes, what a special day (or evening or weekend) would be like, action plans, and in some files a copy of the service user guide and notes on the Mental Capacity Act 2005 in Widget form. Where the person is able, daily notes are written in their diary by the person themselves. A good practice. In other cases staff write up an account of the persons day. Night notes are written by staff. Plans include evidence of reviews with social services and correspondence with NHS and other agencies. Plans include text, picture and Widget forms of communication. The home has made progress in rationalising its care plans and in developing a PCP format. In particular PCPs now include more pictures. - including documents prepared for review meetings. The benefits of including documents in Widget form is debatable if residents and staff do not routinely use this form of communication in everday encounters. Training for staff on Widget was not included in any of the training documents seen on this inspection. People living in the home are supported by staff in making decisions as required. The degree of support required varies according to the persons ability and the particular circumstances which apply at any given time. Risk assessments are in place for a wide range of activities, both in the home and while in the community. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service lead a varied lifestyle according to their individual needs, abilities and interests. This aims to ensure that people experience a range of social and leisure activities and are supported in maintaining involvement with the local community. Evidence: The age of people living in the home range from mid forties to late sixties and the range and nature of activities varies according to individual interests. Since the last inspection the registered manager reports that there has been a decrease in the number of courses offered by local colleges. The manager said that the home is Care Homes for Adults (18-65 years) Page 13 of 28 making efforts to compensate for this by increasing the number of activities organised by staff and people living there. The home is in a convenient location for the amenities of Aylesbury town centre. Residents and staff use local shops and supermarkets. A coffee shop in the shopping centre is popular and some residents regularly go to a pub in another area of Aylesbury where karaoke sessions are held. Residents may also go to a Tuesday club, meals out, car boot sales, the local cinema, and bowling. In 2008 some residents had been on holiday in Bognor Regis, others to Bournemouth or Weston-super-Mare. Three residents were due to go to Disneyland in Paris before the end of the year. Residents are supported in maintaining contact with families although such contact varies. The present resident group have lived together for some time now and have established a regular daily routine. Residents are free to be alone or be with others as they wish. All of those seen during the course of the inspection (six of eight resident) appeared comfortable and happy living in the home. Throughout the inspection visit there was a gentle flow of activity around the home with residents and staff interacting well together. Meals are planned with residents. Breakfast usually consists of fruit juice, cereals, toast and hot drinks. Lunch is a lighter meal such as Spaghetti on Toast followed by Fruit, Hot Dogs and Onion Relish followed by Fruit, or Fish Cakes and Salad followed by Fruit. Supper is the main meal of the day. Choices from menus around the time of this inspection included: Liver and Bacon with Mashed potatoes and Cabbage followed by Yoghurt; Steak and Kidney Pie with Chips, Sweetcorn and Peas followed by Ice Cream; and, Ham and Cheese Bake with Potato Salad and Coleslaw followed by Yoghurt. A roast meat based dish is served on Sundays. Some residents go to Quest, a Richmond Fellowship supported employment service in Aylesbury or to a local education centre to work on textiles and IT. Care Homes for Adults (18-65 years) Page 14 of 28 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. People using this service can be assured that they will receive support in meeting their healthcare needs including liaison with local community health services where required. Arrangements for the control and administration of medicines are satisfactory and aim to ensure that people receive medicines as prescribed. Evidence: Staff provide support to residents as needed. Personal care is provided in bedrooms or bathrooms. Residents routines are respected and, subject to risk and level of support required, each resident is free to pursue his or her own interests. All residents are registered with a GP in Aylesbury or Stoke Mandeville. The majority are under the care of the Community Learning Disability Team (CLDT). Dentists and Care Homes for Adults (18-65 years) Page 15 of 28 podiatrists are accessed through a local health centre. Residents use opticians in the town centre. A resident with diabetes was being visited daily by a district nurse. The home encourages and supports residents in health screening. Seven of eight people living in the house at the time of this inspection were on medication. One was on insulin which is administered daily by the district nurse. A policy governs the administration of medicines. This was last reviewed in November 2006. Staff training is based on a CD ROM programme supplemented by an in-house programme of supervision by the manager. Staff are not allowed to administer medicines until approved by the manager. This process would benefit from a clearer definition of the levels of performance required and achieved. Arrangements for the storage of medicines are satisfactory. These consist of a portable box and a lockable cabinet which is fixed to the wall in a locked cupboard, and a small refrigerator for medicines in the staff room on the first floor. It was noted that specimen bottles were stored in the lockable cabinet. This should be reserved for medicines only. Examination of medicines administration record (MAR charts) raised no significant matters. The home has very good protocols for the administration of when necessary (also known as PRN) medicines. References on medicines for staff include a BMA textbook and the most recent guidance from the Royal Pharmaceutical Society of Great Britain also published in 2007. The home is advised to download a copy of the most recent CSCI guidance on medicines administration which is available through the CSCI Professional website. Medicines are prescribed by the persons GP and are dispensed by a local pharmacy. One person who was on a depot injection went to the GP surgery when it was due. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that complaints by people living in the home are appropriately managed and responded to. The interests of people living in the home are protected by the homes arrangements for safeguarding adults which include links with a local advocacy organisation. Evidence: The home has a complaints policy and procedure. It was last reviewed by managers in March 2008. The complaints procedure is also available in Widget form and through a series of photographs of managers. Widget is not routinely used in communications between staff and residents. The photographs were displayed under the heading complaints but the document did not include any text. However, the complaints procedure would be understood by some residents and it clearly outlines a process which a complainant or someone acting on their behalf could follow. The home has received one complaint since the last inspection and CSCI has not received any complaints about this service. The home has a copy of the REACH policy on the protection of vulnerable adults (now, Care Homes for Adults (18-65 years) Page 17 of 28 safeguarding adults). It has a copy of the current issue of the Buckinghamshire joint agency procedure on safeguarding adults. The subject of safegarding adults is included in the induction of new staff. The policy was last reviewed in November 2006. The organisation maintains good liaison with statutory services, including CSCI, with regard to reporting events which may compromise the safety or welfare of residents in its services. There have been no safeguarding adults investigations in this home since the last inspection. A policy on whistle blowing is in place. This was last reviewed in February 2004. The home has ongoing contact with Aylesbury Vale Advocates, although due to restrictions on the resources of the advocacy organisation, advocates now visit the home less often than in the past. The staff training programme includes training in dealing with challenging situations. Arrangements are in place for safe keeping of residents money. These are governed by a policy which was last reviewed in April 2008. The home manages some money for all residents. A safe is in place for secure storage of cash and valuables. Records are maintained of all transactions and receipts are retained. The Regulation 26 visits to the home by managers include a check on the arrangements and on some balances. The manager said that spot checks may also be carried out by a member of the finance staff. The cash balances of two residents were checked during the course of the inspection visit and found to correspond with records. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, comfortable and well maintained environment for residents. The home is well located for the amenities of Aylesbury town centre and local NHS and other services. It is therefore, a convenient situation for residents to access a range of recreational activities and support services. Evidence: The home is located a half mile or so from Aylesbury town centre. It is opposite Manor House Hospital (for Learning Disability services) and a short distance from the Tindal Centre (for Mental Health services). The home consists of two terraced houses converted to form one home. All areas of the home were tidy, in good order and clean on the day of the inspection visit. The entrance halls leads to a set of stairs to the first floor The ground floor comprises one bedroom, lounge, two dining areas, kitchen, office, laundry room, medicines cupboard, a small seating area towards the back of the Care Homes for Adults (18-65 years) Page 19 of 28 house, and WC. The laundry room is very small but sufficient for current use. There are two sets of stairs, one leads from the main entrance hall to the first floor, the second from a ground floor hallway to the first floor. The first floor is comprised of seven more bedrooms, staff sleep-in room, bathrooms and WCs. It is an older style property and bedrooms vary in size. The garden, to the rear of the home, is sufficient in size for current use. It includes areas of lawn, flower beds and a pathway. There is a storage area to the rear of the garden. The communal areas are bright and well furnished. Bedrooms are decorated and furnished in line with the residents wishes. The living room has a TV and music centre. There is also a music centre in one of the dining rooms. Since the last inspection some bedrooms and communal areas have been redecorated. New furniture has been purchashed for some residents. The dining room was being repainted on the day of the inspection. Overall the house provides a pleasant, clean and comfortable environment for residents. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by sufficient numbers of trained staff. However, ongoing pressures on staffing since the last inspection may lead to problems in maintaining continuity in key working. Evidence: All staff have job descriptions and the manager said that new staff are provided with a copy of the General Social Care Council (GSCC) codes of practice during their induction. The current staffing provides for two care staff in the morning, two in the afternoon and evening, and one waking plus one sleep-in at night. These figures usually exclude the Registered Manager. Pressure on staffing was evident at the time of this inspection. Staff turnover is relatively high. Of a staff establishment of 9.5 the home appointed five staff since the last inspection. Three staff were on maternity leave and one was on extended leave. The home had vacancies for two care team leaders. Interviews were scheduled to take Care Homes for Adults (18-65 years) Page 21 of 28 place a few days after the inspection visit. Vacancies were being covered by agency staff. The manager said that it was an agency with whom the organisation had good experience and which supplies good staff. Staff induction, training and development is managed from REACHs head office in Gerrards Cross. A wide range of courses are offered but due to staffing pressures the home is not always able to release staff to attend. Three documents on training were examined during the course of this inspection. A Training Report for the period January to December 2007. This listed the Training opportunities offered to REACH homes monthly. During that period a total of 102 opportunities were offered. A spreadsheet for 2007 listed training by subject and staff name. The dates were entered in black, blue and red ink - a different colour for each year. Two emails dated 2 June 2008 listed training carried out in April and May 2008. It is noted that no staff from Aylesbury attended training during that period. These records were subsequently discussed over the telephone with the registered manager. The manager said that the records for April and May 2008 meant that no staff were due to attend training on those months. That staff would have taken up the 102 opportunities offered during the course of 2007 and that the entries on the spreadsheet were for training attended. The manager added that while staff turnover was a concern, it did not affect the training provided to staff. It is noted that according to the spreadsheet one member of staff has not attended fire training since May 2001 or an update on POVA since September 2004. The home is supported in the recruitment of new staff by personnel staff based at the organisations head office in Gerrards Cross. Three personnel files of staff appointed since the last inspection were examind. Files were maintained in good order. All contained a photograph of the member of staff. Overseas applicants are required to complete an application form in their own country and again when they arrive in the UK - although for reasons unknown a few weeks can elapse between the person taking up post in the home and completing the application form in the UK. A POVA First clearance had been obtained prior to taking up post and an enhanced CRB certificate two or three weeks afterwards. The status of references varied - some open (i.e. to whom it may concern) and in one case a verbal reference. Files included a health declaration. The registered manager said that she aims to ensure that all staff receive supervision monthly. However, on occasions, due to staffing pressures, this can extend to two monthly. The home is meeting the national minimum standard of six times a year for its staff. The organisation has a policy that all staff are to have an appraisal annually. Care Homes for Adults (18-65 years) Page 22 of 28 Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from continuity of management which maintains a consistent quality of service and aims to ensure that individual needs are met. Arrangements for ensuring the health and safety of people living, working or visiting the home are satisfactory. Evidence: The registered manager is experienced in managing a residential service for people with a learning disability and has been employed by REACH for over nine years, managing this home since 2002. The manager has not yet undertaken training at NVQ 4 or the Registered Managers Award (RMA). According to the report of the last inspection carried out in July 2007 the manager was due to start RMA training in September 2007. There has been no further progress on this over the past year. Since Care Homes for Adults (18-65 years) Page 24 of 28 that inspection the manager has undertaken training in the Mental Capacity Act 2005 run by Buckinghamshire County Council and on bereavement and end of life care. A major quality assurance activity for the home is the REACH annual stakeholder survey. This was last carried out in May 2007 and the manager said that the 2008 survey is scheduled for July 2008. A report of a 2007 internal audit was seen during the course of the inspection visit. This led to an action plan which the manager was working through. The actions covered staffing, activities, PCPs, the environment, and staff appraisals. Informal feedback is obtained from families but contacts can vary considerably. The care services manager generally carries our Regulation 26 visits monthly. The reports of the April, May and June 2008 visits were seen and were found to be comprehensive and thorough. The organisation has engaged Peninsula Business consultants to advise on health and safety matters. The registered manager expects to have a health and safety audit before the end of 2008. Risk assessments covering a range of activities are in place. According to information provided by the registered manager in the AQAA the home fixed electrical systems were last checked in 2004 and are next due in 2009. Portable applian testing (PAT testing) was carried out in February 2008. Fire safety equipment was checked in April 2008. Gas appliances were checked in April 2008. A fire risk assesment was last carried out in May 2007. This should be reviewed for 2008. A fire drill was carried out in March 2008. Fire alarm points are checked weekly. Staff training in fire safety was carried out in October 2007. However, given pressures on staffing the registered manager should consider whether more frequent staff training in fire safety is required. Procedures are in place for reporting and recording any accidents to people using the service or to staff Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 15 22 It is recommended that the home develop the complaints procedure in a format, in addition to Widgets, which is understandable to people living in the home. It is recommended that the training records for this home make it clear what training has been attended by staff as well as the training opportunities offered. 16 35 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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. 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