Inspection on 17/12/08 for Redcourt

This inspection was carried out on 17th December 2008.

CSCI found this care home to be providing an Good 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

Redcourt 18/12/06

Redcourt 07/11/05

Redcourt 19/08/04

Redcourt 26/05/04

Redcourt 09/12/03

Redcourt 29/09/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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: Redcourt Hollincross Lane Glossop Derbyshire SK13 8JH 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: Brian Marks Date: 1 7 1 2 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 31 Information about the care home Name of care home: Address: Redcourt Hollincross Lane Glossop Derbyshire SK13 8JH (01457)852687 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St. Christopher`s Trust (Glossop) Limited Name of registered manager (if applicable) Joan Roebuck Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 36 0 care home 36 learning disability 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 is within the following category: Learning Disability Code LD The maximum number of service users who can be accommodated is: 36 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Redcourt Care Home can look after as many as 40 people but not that many live there at present. GLOSSOP X2 Redcourt is near Glossop town centre. The accommodation is made up of 2 units, for men and women. Each unit has bedrooms, a kitchen and everybody has their own space to enjoy. Care Homes for Adults (18-65 years) Page 5 of 31 Additionally there is a Day Centre within Redcourt that people go to during the week. The Trust supports people from the home to move on and to live more independently. The council pays for people to live at the home. Care Homes for Adults (18-65 years) Page 6 of 31 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 Care Homes for Adults (18-65 years) Page 7 of 31 How we did our inspection: X This is what the inspector did when they were at the care home We came to the home without telling the manager before we came and spent a day there. We had received a lot of information about the home from the manager, the staff and people living at the home before we came. The information we received before we came helped us plan what we would do when we arrived. At the home we spoke to the Manager and Director who told how things had changed since we last came. X5 We looked at a lot of papers and documents in the office that told about the home. We spoke to five staff who were working during the time we were at the home. We spoke to 3 people who live at the home about their rooms and they told how they like the new furniture and decoration. We walked around the home and saw how people were being looked after by staff and saw some having their lunch. This is the first inspection of this home since 18 December 2006 - two years ago. X3 Care Homes for Adults (18-65 years) Page 8 of 31 What the care home does well X9 The people in charge of Redcourt are making it better for everybody and they have helped nine more people move out to their own homes. The people in charge of Redcourt are always listening to the people who live there and have changed things in the ways that they want. People from outside, such as doctors, nurses and social workers, are regular visitors to the home and they have helped staff at the home to look after people properly and to be healthy. Staff at the home work well to give people a good life and they get regular training to help them do things even better. Staff look after people properly and treat them with respect. The manager at the home does a good job and people can go and see her at any time. Care Homes for Adults (18-65 years) Page 9 of 31 The home has been made nicer place to live in by improvements to bedrooms and redecoration of the areas that everybody uses. People living at the home have said what they want changed about the building. What has got better from the last inspection The people who run the home have done everything they were asked to do at the last inspection and the way they run it has been improved. The home is better place to live and this includes the improvements to building and the places where people live. Staff have had more training which has helped them do their jobs better and some have achieved a care qualification. Care Homes for Adults (18-65 years) Page 10 of 31 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Brian Marks CSCI Eastern Regional Office CPC1, Capital Business Park Fulborn Cambridge CB21 5XE Tel: 01223 771300 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. Care Homes for Adults (18-65 years) Page 11 of 31 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 12 of 31 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 13 of 31 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 support and care needs of individuals are properly assessed to ensure that the home continues to be right for them and that their aspirations are properly planned for. Evidence: In the AQAA we were told how small groups of residents who wish to move into supported living in the community have been identified, and how things at the home are being moved around to accommodate those groups into flats within Redcourt. We were also told how families and outside agencies have been involved in the assessment process and have assisted people living at the home to make the best choice of moving on or staying at Redcourt. The majority of people living at the home have done so for many years, some since childhood, and the care records that we looked at reflect this situation. Since modernisation of the home commenced with the introduction of the National Minimum Standards, all of the residents have been subject to revised assessments of their abilities and this has continued since the last inspection, as further opportunities for Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: moving on have been identified. In the past year nine more people have moved into two supported housing groups in the local town. Staff from the University of Derby have continued their programme of assessments of skills within the day centre at Redcourt and a number of professionals from the local Learning Disability Service have been involved with individual residents during the past year and have provided further aspects of assessment activity. Everybody is now the subject of an annual review with members of their families and professionals from the Adult Social Care Department, and the care records looked at indicated how these meetings have been used to summarise any new assessments that have been carried out. Another critical development that has occurred since the last inspection has been an increase in people living at the home who have been noticeably affected by the ageing process. At the same time as the more able people have moved on from the home, the remaining group have become more physically dependent and some have changed very rapidly indeed. Care records indicated how professionals from local specialised and generic healthcare services have been actively involved in reassessing the needs of those people most affected. At present no new service users are to be admitted to the home until changes to the service are implemented; this by the decision of the trustees. Care Homes for Adults (18-65 years) Page 15 of 31 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 . Residents care needs have been assessed, risk factors identified and care planned in ways that reflect their individual preferences and abilities. Evidence: In the AQAA we were told how steps have been taken within the home to respond to identified changes in the needs of people living there. These have included restructuring the home to accommodate adaptations and equipment and the provision of a dedicated staff team to meet the growing needs of people who have a mixed range of health problems. We were also told how staff will continue to identify and implement changes to meet changing needs. The care records of four residents were examined and they showed evidence of revision since the last inspection. Most of the key information is now contained in one reference file with daily records and interventions kept on another. All of the care plans examined had key areas completed as well as records of the involvement of outside professionals, incidents, accidents and other logged events. A range of risk assessments is in place and these have been substantially updated since the last Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: inspection to reflect specific behaviour issues and health needs. All of the records looked at contained an assessment and care plan prepared by a social worker from the local disability service and also records of meetings to discuss progress with each individuals plan. However, the standard of care planning documentation was varied and did not indicate regular attention to reviewing the details of staff activities nor sufficient auditing of the processes in place that are helping individuals plan for their futures. Since the last inspection representatives of the local advocacy service have continued to be available to the people identified for moving on, and this has assisted them to express their preferences and to make decisions about the changes. Within the home the manager and staff spoke about how they have encouraged residents to speak out for themselves, both as individuals and through the group at a formal meeting. Staff commented that it has become an increasing challenge to them to find new ways of assessing opinions of the people living at the home, as the latter are becoming more dependent and less vocal. The extension of the range of activities available to the residents and promotion of independence skills is accompanied by the recognition of risk and, as noted above, risk assessments are undertaken to assist in this process. Care Homes for Adults (18-65 years) Page 17 of 31 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 living at the home have continued to enjoy opportunities to develop life skills and wider social contacts; links with families and friends are promoted and supported. Evidence: In the AQAA we were told how families and friends are encouraged to maintain links, which in the past may have lapsed, and how residents are given the opportunity to choose from a wide range of leisure activities. We were also told how some of the more dependent residents now use wheelchair accessible taxis to gain access to community facilities, which for some includes involvement with local churches. Arrangements are also being changed in the main living unit so that the arrangements in the new flats include food preparation areas to enable greater participation in this activity. Discussion with staff and observation during the visit confirmed that the daily routines of the home continue to be flexible and residents were seen in the two living units Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: interacting in communal areas or spending time in their own rooms. Most people spend at least two days in the day centre, within the grounds of the home, and staff from the University of Derby have continued to provide skills-based activities there that help people become more independent. The care records looked at indicated that people had continued to enjoy activities within the home and also in the local and wider community with staff support. Visits to local shops, pubs, cinemas and restaurants are regular and there is an active hill walking group, which extended its activities this year to enjoy a holiday in the mountains of southern Spain. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a 4-week menu is being followed. The menu, which includes both traditional and more cosmopolitan items, indicates a choice at the main meals of the day and residents identify their preferences to kitchen staff during the morning. The cook described healthy eating as the principle they work to, and deliveries of fresh local produce are made through the week. Special diets are catered for which include both weight increase and reduction as well as softened diets, the latter indicating how the catering service is being responsive to the changing needs of people living at the home. Whereas the regular meeting with residents previously produced a lively discussion about food options, the cook described how staff are increasingly advocating on behalf of the less able group of people in residence. Lunch was observed in the womens unit and staff were seen to be attentive to the needs of those people requiring assistance. Care Homes for Adults (18-65 years) Page 19 of 31 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 personal and health needs of residents are dealt with in a satisfactory way, and people living at the home continue to receive good support from outside professionals, so that they have access to local services like everybody else. Evidence: In the AQAA we were told how the home has continued to work closely with healthcare professionals to make sure that general and special health needs are properly identified and met. Health staff have also been involved in training staff at the home and supporting them to give direct care where it is appropriate for them to do so. We were also told about the programme of support directed at a resident managing her own medication which is being carried out with the support of her doctor and the homes pharmacist. Since the last inspection there have been three deaths at the home and, from discussions with staff, it is apparent that whilst the more able individuals have moved into more independent community based accommodation, at the same time the remaining group has shown signs of increasing physical dependence. Signs of the onset of dementia for a number of individuals were commented upon at the last Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: inspection, and this has gathered pace with, for some, a very rapid deterioration being noted. A programme of staff training aimed at equipping them to support people with dementia has been commenced and those spoken to commented on how useful this had been in helping them work more successfully with the individuals concerned. The care records looked at confirmed the involvement of the local Learning Disability Team with individuals living at the home, and these include occupational therapist, speech therapist, physiotherapist and social worker. They receive good support from the primary care team and a local GP is a trustee of the home. As noted above, dependency levels amongst the homes residents vary and continue to change although, as noted at previous inspections it was clear that the mens group continues to be more independent. Levels of support required by individuals is identified in care plans and staff are attentive to individual needs rather that responding in a routine way for all. With the rapid onset of dementia for certain individuals there are now residents with substantial physical disabilities and staff have received proper training in safe manual handling and hoists are now in regular use, within the womens unit in particular. Apart from the one individual mentioned in the AQAA, everybody that has prescribed medication require staffs help with management and administration. Examination of the arrangements for the receipt, storage and administration of medicines indicated that these are generally satisfactory and that all entries in the written records had been made properly. Medication is stored securely and the home uses a weekly cassette system for the dispensing of most of the medicines in use. Care Homes for Adults (18-65 years) Page 21 of 31 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 . Residents are protected by having their rights to complain upheld and through staff understanding their responsibilities to report concerns. Evidence: In the AQAA we were told about the homes complaints procedure and how an independent advocacy service is available to support people if they have any issues with life at the home. We were also told that all staff receive training to make sure that people living at the home are properly safeguarded and how a care manager from the local Councils Adult Care Services has recently carried out a full audit of the finances of all residents. During the past year there has been one formal complaint from an ex member of staff which is documented in the records and was made to both the local Council and to the Commission. This was fully investigated with the help of the homes Director, and was agreed to be substantially unfounded. There have been no instances in the past year when the statutory procedures for Safeguarding Vulnerable Adults has been used and training records indicate that all new staff receive proper training in these procedures when they start work (induction) and regular refresher training is available for experienced staff. Care Homes for Adults (18-65 years) Page 22 of 31 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 living at the home have continued to benefit from an improving physical envoronment that is equipped to meet their needs. Evidence: In the AQAA we were told how there had been significant improvements made to the facilities provided at Redcourt in advance of the unit previously occupied by male residents becoming a mixed unit. We were told that a more personalised service will be promoted by breaking the home down into smaller living units, and that this will support the identification of further groups moving into supported living in the local community. Within what is currently the mens unit we saw the extensive improvements made to the bedrooms with two areas transformed into three-person flats, which will give people a feeling of greater independence. The bedrooms in these areas all have ensuite facilities as well as a small living room for the occupants to have personal and private space. The other bedrooms have all been completely refurbished and redecorated, and these have been done in ways that reflect the choice of the individual involved. This unit will be occupied by eleven men and nine women leaving a group of five women in the other unit, who will occupy a five-person flat and will be helped to prepare for a discharge from the home into supported living locally, sometime in 2009. We were also told that the communal areas in the mens unit will be completely Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: carpeted within 4 weeks of this inspection. Overall the changes to the environment of the home indicate a high level of financial investment and demonstrate the continued commitment of the Trustees to improving the quality of the lives of the people living there. We also saw that some of the improvements to bathrooms and bedrooms reflected the changing physical dependency of some of the people living there and were told by staff that this group would have accommodation on the ground floor. Care Homes for Adults (18-65 years) Page 24 of 31 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 home has established systems for recruiting, training and supporting its staff, so that the interests of people in their care are protected and their overall welfare is promoted. Evidence: In the AQAA we were told about the way that staff are recruited to the home and how improvements in the standards of their training have been made to ensure that they have the skills to fully support the people living there. We were also told that the levels of staffing have been maintained even though resident numbers have decreased and the manager described how the level of staffing has been improved by employing an extra person on each shift. This is aimed at making the planned changes at the home to go as smoothly as possible. There were six support workers and a team leader on duty at the home during the inspection and extra staff were also involved with an outing for some of the residents. Staff told us that this level was usual and allowed for them to work with individuals as well as small groups. They also told us that any gaps in the rota were nearly always met by colleagues covering for each other and by the use of the homes relief staff. They also told us about the new arrangements whereby the groups of staff who currently work in parallel over the three shifts will be joining up to form three teams with an enlarged group working in the combined mens and womens unit. They Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: reported that this should occur without problems as they are already used to working together. Examination of the recruitment files of the last two people to be employed at the home indicated that a standardised procedure is in place and that all the proper references and checks are sought. However one of them had not had a check by the Criminal Records Bureau (CRB) completed and we were were told that he would always work under the supervision of a more experienced colleague until it had been received. As he was working during the inspection, the individual concerned was able to confirm this arrangement; observation of his activities would suggest however that this is not a foolproof arrangement. In the absence of the training officer - a post that has been created since the last inspection - we were able to look at the computer held training records and were able to confirm that all of the key health and safety requirements have been covered by all staff. Records also indicated the commitment to getting staff through the National Vocational Qualification (NVQ) with the required 50 target at level 2 having been achieved. The staff spoken to also described attendance on a course aimed to help them care better for people with dementia and how they felt they now had a better understanding of this condition. One also described her recent attendance on a course provided by the Council about safeguarding vulnerable people, which will become standard for all staff. The most recently appointed staff member described the induction programme he had completed at the beginning of his employment and confirmed that this included a specialist element of foundation training for people working in learning disability services. Some of the computer-based records were difficult to access and may not have been complete; we relied on verbal evidence provided by the manager. Similarly the records for staff supervision were not complete and the manager confirmed that the system is in place, but meetings had not been occurring regularly enough because of the pressure of her responsibilities during the past year with the absence of the two assistant managers, who left the home at the beginning of 2008. Care Homes for Adults (18-65 years) Page 26 of 31 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 a well-managed and safe place in which to live and work and, because it is operated to modern well though out principles, the people who live there are able to enjoy lifestyles that reflect their individuality. Evidence: In the AQAA we were told how people living at the home are consulted when any new developments are planned and how there has been a steady move away from providing support on a residential basis to assisting people to move into community supported living. The latter are supported by an advocacy service, social workers and other relevant professionals from the local learning disability service. We were also told how the senior staff at the home have changed with the number of Team Leaders increased to three, all of whom have been supported to achieve level 3 of the NVQ. The homes commitment to the health, safety and welfare of people living there was restated. The home has continued to benefit from an experienced registered manager who has completed the Registered Managers Award since the last inspection. She is supported Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: by an active Director of the home and a Board of Trustees who continue to support the programme of change. The two assistant managers left the home early in 2008 but they have not been replaced as it is felt that the continued reduction in the numbers of people living there does not warrant that structure. Instead the role of the team leader has been enhanced and the manager described the increased levels of their responsibilities and duties. She has recently benefited from increased administrative support. The home has continued with the range of quality assurance activities described in the last inspection report, including a questionnaire that was completed by individuals with key staff support. The regular resident meetings have continued but the manager and staff described how this has become a difficult and less convincing way of getting peoples views, as the group remaining at the home has become increasingly dependent and less skilled in expressing their aspirations by verbal means. Families have continued to be involved with people at the home and the manager described how this had produced both positive and negative results. The manager told us about standards of health and safety activity and regular servicing of equipment at the home, and observations made around the building and a sample of fire safety and servicing records indicate that the home was hazard free at the time of the inspection. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 1 6 The care activities of staff should be regularly reviewed, and revised where changes of circumstances have occurred, so that care plans contain sufficient detail to enable them to care properly for the people living at the home. Care Homes for Adults (18-65 years) Page 29 of 31 2 35 Complete and up to date records of staff training achievements should be maintained so that the homes managers are able to monitor them at any time. All staff should receive formal 1-to-1 supervision from their line manager, at intervals of every three months; one of which must be observed practice. This will ensure the opportunity for regular consultation about and monitoring of their work. 3 36 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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