Inspection on 14/10/08 for Redlands House

This inspection was carried out on 14th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Redlands House 246 Leigh Road Chandlers Ford Eastleigh Hampshire SO53 3AW     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: Sue Kinch     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 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 31 Information about the care home Name of care home: Address: Redlands House 246 Leigh Road Chandlers Ford Eastleigh Hampshire SO53 3AW 02380271222 02380273344 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Alison Mackereth Type of registration: Number of places registered: Truecare Group Ltd 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 to 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) Date of last inspection Brief description of the care home The home is situated back from the main road and is reached up a steep slope and car park to the front of the building which is surrounded by new fencing. The home is provided on two levels in a domestic property extended to the rear with a moderately sized back garden. All people living in the home are provided with single rooms and ensuite facilities on the ground and second floor. Shared facilities include bathrooms, kitchen, laundry a lounge, dining room and additional lounge and a small sensory room. There are local shops within close proximity and not far from the centres of Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 8 Brief description of the care home Eastleigh and Chandlers Ford. The home provides support for people with learning disabilities including people with behavioural support needs and aims to provide structured day time activities. Care Homes for Adults (18-65 years) Page 5 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 peterchart Poor Adequate Good Excellent How we did our inspection: For this unannounced inspection we reviewed information, held by CSCI, about the home and assessed the information provided in the Annual Quality Assurance Assessment (AQAA) provided by the manager. We also took account of the information from staff provided in nine surveys but had no completed surveys from people living in the home. We visited the home and met two of the people living there but information received was limited due to their communication needs. However, we were able to observe staff working with two people as one person was away and another was in their room most of the time and did not want to take part. We viewed a sample of records and policies and procedures. Fees for the home range from 1700 pounds to 2500 pounds per week. Care Homes for Adults (18-65 years) Page 6 of 31 Care Homes for Adults (18-65 years) Page 7 of 31 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 8 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 9 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. People living in the home have had their needs assessed prior to admission and have followed a transition plan to support them through their admission to the home. Evidence: The home has admitted four people since July 2008.There is a detailed a preadmission and admission process and the manager said that an admission is agreed following visits and meetings and assessment. A transition plan is agreed for each person. We looked at files for two people living in the home and found that there was written evidence of the homes pre-admission assessment, transition plan, care plans and risk assessments. Information had been obtained from previous placements and there had been reviews since people had arrived at the home . There was verbal and written evidence of reviews of some specific needs, which included involving external professionals,since people had arrived at the home. Initially the care management assessments that are obtained before admission were not available but this information was obtained for two people during our visit. Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: The manager has reflected on the admissions process so far and spoke of staff having spent time with people before they move in and making alterations to care provided as people move in to try and make things work for people . However, she would like to increase the time spent on this before future admissions and would like more in depth assessments. The home has a statement of purpose which has been made available and a service user guide with a symbol format . However, terms and conditions of residence have not yet been provided to people living in the home so that they or people close to them can know what their rights are or what payments are made. In addition information about charges or copies of agreements with social services were not in the home. Some of this information was made available later in the day of our visit. Care Homes for Adults (18-65 years) Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported with individualised personal plans based on their assessed needs and through consideration of their wishes,consultation with other professionals and people involved in their lives. But they would benefit from more risk assessments , where necessary including a wider range of people, to ensure that all restrictions and physical interventions are fully assessed and agreed. Evidence: We sampled personal files held for two people living in the home and found that the home is developing detailed care plans and risk assessments based on identified needs in the pre admission assessment and from ongoing review. Care plans cover many areas of care . Those we sampled included personal care,health,diet,medication,hygiene,risks, communication, choices, finances, and interests. Staff said that these reflect peoples needs, are regularly updated and they are informed of changes.We saw evidence that they sign records to show that they Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: have read updates. During our visit we observed people giving much one to one support in a positive manner with clear communication. Staff were able to explain actions that they took and why in relation to the needs and safety of individuals. There are a number of risks that have been identified to people living in the home and many individual risk assessments have been developed and we saw staff taking action in relation to them. Not all risks such as access to the laundry ,kitchen and external doors are assessed and all of them are locked. One person was supported in the kitchen during our visit and staff were holding an arm to prevent scalding however, details of when such action should take place were not detailed enough in the care plan. The front door was locked due to the specific needs of one of the people but this was not documented. As discussed with the manager during our visit, not all of restrictions have been assessed on paper or agreed with care managers or relevant others. In addition physical interventions are included in the care plans identifying different interventions for people. The manager said that some of the care managers had seen risk assessment and care plans but there was not written evidence that risk assessments leading to these physical interventions had been agreed with relevant people. The manager agreed to address these issues. We had verbal and written information from the staff who say that they are given up to date information about the needs of people living at Redlands House.They say that the way information is passed between staff and the manager always or usually works well. One person said that they sometimes had difficulties when written or verbal information is misunderstood. Another said that people living in the home are given a lot of attention and another that it is a new service and a new staff team but that they were getting to know and understand the people that they support. Care Homes for Adults (18-65 years) Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of social and recreational activities offered to people living in the home is currently limited while the staff team is becoming established, confident and equipped to meet needs in the community and more creatively in the home. The home needs to ensure that rights and responsibilities are fully promoted by only placing restrictions on people when the evidence is fully documented after appropriate consultation. Peoples special dietary needs are taken into account when planning food at the home. Evidence: The home is currently recruiting and this will include an activities co-ordinator. There are activity plans and people are consulted about options available to them and staff Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: say that activities currently include going to the park , some shopping ,using the trampoline in the garden and football. Verbal and written feedback from staff included comments that day care for people could be improved. We also noted that activities include listening to music , using the sensory room and cooking. Records show that some of these activities happen but the lack of variety of activity reported by staff is reflected in daily activity records. Comments were received from staff that use of the community is limited. Comments from staff attributed this to insufficient staff with the right knowledge of people and experience to provide the right support, especially as one person needs two staff to go out. Another commented on the need for enough drivers to meet needs away from the home. In one persons record it suggested activities included trying swimming, horse riding and using trains but since being in the home few experiences had been out of the home. The manager agreed that recreational and social activities were in need of development and action was taking place to deal with this. She also gave examples of how ongoing assessments of needs are including meeting social and recreational needs and said that for one person the need for more personal space had been identified and a heated summer house was now being planned. People living in the home are able to make some decisions about their lives on a day to day basis and during our visit one person was not wanting to engage in activities due to not feeling well , another was noted to be supported by the staff in doing what want they wanted to do in the house and in the afternoon another person had chosen to have a sleep. There are some restrictions in the home and action needed in relation to these, to promote the rights and responsibilities of people living in the home, are documented in this report in the section on individual choice. Contact and involvement with families is encouraged and supported .Staff said that one person was away visiting relatives. Others we noted had been involved in the post admission review. Discussions with staff and observations of records show that behaviours and communication are assessed and supported in the home to enhance all relationships. We noted that support for regular contact with the family was documented in one of the care plans sampled about this issue. We were not able to discuss food with the people living in the home but some discussion was held with staff about the particular needs of one person. They were aware of that persons specific dietary requirement and showed us that there is a Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: cupboard in the kitchen which contains specific foods to provide for a wheat and gluten free diet. We noted that details were recorded in the care plan, records of food provided were held and staff were observed to support the person to eat regularly in line with the care plan. Care Homes for Adults (18-65 years) Page 16 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. People living in the home receive support with personal care and physical and emotional health based on their individual needs and with support from external professionals. Thorough systems for administration,storage and recording of medication would be enhanced by ensuring that individual guidance is in place for all as required medications. Evidence: The information gathered by the home prior to the admission of people includes details about their emotional and physical health, medication ,personal care routines and personal preferences. The transition plans included action plans to transfer to new health professionals and these were reviewed in post transition meetings. In the sample of personal records noted there was guidance for staff for supporting in these areas. The home also had records of reviews of some needs and records of consultation with health professionals. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: On the day of our visit a nutritionist was visiting the home and discussing the need of a person living in the home with a member of the staff and the discussion included the need to liaise with the general practitioner. In respect of the same person a staff member and the manager referred to training planned in the next week to assist in meeting that persons needs. This training was to be on sensory processing and intensive interaction. Conversations were held with staff about elements of health needs which they say are brought to their attention. We observed some of their actions and these indicated that they were following guidance such as support with dietary needs. A conversation was held with a member of staff who said that they had been assessed as competent to administer medication and that senior staff usually carry out the tasks. They also said that a system was in place to check that previous medication had been given when giving medication and for taking action if not. Staff were observed to prepare medication to give to someone living in the home and a witness was also used to check procedures. Medication was given to people individually. Medication was noted to be locked away securely. A sample of medication records was viewed and this showed that medication had been given and signed for by staff. We requested to see as required guidance for a sample of the medication prescribed in this way. Not all of these could be found although the manager thought that they were in place. She agreed to address this and review it with the general practitioner. Care Homes for Adults (18-65 years) Page 18 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. Systems are in place to enable people to communicate their needs and make complaints if they wish. Policies and procedures are in place to aid the safeguarding of people living in the home. Evidence: The home has a complaints procedure including timescales in which they should be concluded. There is also a version of this using symbols for people living in the home to use although their ability to understand this varies due to their cognitive abilities. The manager said that the home had not yet received any complaints about the service. We noted during our visit that the staff were taking care to use the communication styles individually with people and were observing behaviours in order to decide on action to take. The manager said that the staff are trained in understanding the complaints procedure and in our survey all staff except one, who had not yet completed their induction, said that they knew what to do if a service user or advocate or friend was not happy with the service. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: We also received information from a sample of staff who were aware of the whistleblowing procedures and had been given a copy of the General Social Care Council Code of Conduct. They also said that of they had concerns about the service they would bring it to the managers attention and were aware that there were policies in the home in respect of this. The home has financial procedures to ensure that the finances of people living in the home are handled accurately . A small check was made of records against cash held and this was accurate. Staff are supporting people with a range of behaviours requiring varied interventions. Strategies for dealing with these are documented in personal files and staff spoken with were aware of the support needed.Others had agreed, in the surveys that they had the information needed to meet needs. Bearing in mind that the home has only recently opened the manager said she is focusing on training for staff including this skill area and was considering how staff were deployed in order to meet needs. Some specific training for dealing with challenging behaviour had been provided and more is planned. Also more experienced staff were being brought in from another home to aid meeting specific needs. Staff training is elaborated on further in the staffing section of this report. Care Homes for Adults (18-65 years) Page 20 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. Pleasant and hygienic surroundings are provided to people who have enough space to pursue their chosen activities. Evidence: The manager reported in the AQAA that regular checks of the environment take place. We noted during our visit that the home is in a good state of repair and decoration except that the curtains in the lounges had been pulled of the track. The manager said that these were being replaced with curtains with pop off fixtures so that they can be replaced more easily when pulled down. Furniture in the home is of a good standard. Discussion with the staff and the manager showed that the individual needs of the people living in the home are taken into account when considering the environment. One person has access to a second bedroom for times when free space is needed and a heated summer house is being purchased to meet that need when the home is full and there are no spare rooms. Adaptations have also been made for another person so that staff can provide support safely. People have their own bedrooms and those viewed included personal effects . The manager has described removal of an inner door to one room which we were unable to view and additional curtains have been ordered. Procedures are in place to ensure that dignity and privacy are maintained. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: There are two lounges to allow for the differing needs of people and a small sensory room has also been provided and is regularly used. At the time of registration some matters regarding the environment were raised for further attention and had they been addressed. These included providing a system for staff to get help in emergencies, and risk assessing the sloping corridor. The manager said that there are plans to deal with uneven ground in the garden which will be addressed when the summer house is installed. There had also been discussion about a padlock on the side gate. The manager said that this was not necessary for the people living in the home and would ensure that this was included in the risk assessments. There are restrictions to some areas of the home as reported on in the section on lifestyle and individual needs and choices. The manager agreed to take action to demonstrate full assessment. During our visit the home was clean and hygienic and toilets and bathrooms contained facilities for maintaining hygiene. The home has policies for the maintenance of infection control although it is recognised by the management that more staff needed to be trained in this area as only three have been trained. It was also noted that infection control was not included in the homes initial induction and this was recommended. A conversation however was held with a new member of staff who had an awareness of aspects of infection control. Care Homes for Adults (18-65 years) Page 22 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 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 staff who would benefit by having additional training to ensure that the specific needs of people are fully met. A well managed recruitment process is in place in the home to offer safeguards to people living in the home. Evidence: The manager is in the process of developing the staff team and said she is paying attention to deployment on a regular basis to spread the skills of the staff across the shifts with the most experienced leading shifts. The rota showed that there are four staff a shift and staff confirmed this and said that at night there were two awake a one asleep including male and female staff to meet needs. Agency staff are being used to cover the three, soon to be four ,vacancies. In addition the manager said that staff were being deployed from another care home within the company starting in the week of the inspection to enhance the numbers of experienced staff and to meet some specific needs. She also said that three posts had been offered. In the staff survey they said there are usually or always enough staff to meet needs Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: although one said that sometimes having agency staff makes meeting needs more difficult, this was put down to not having a full staff team yet. They also said in relation to meeting diverse needs that they usually or always had enough experience or knowledge to meet differing needs although some said they were still undergoing induction. As referred to in the lifestyle section of the report from conversations with the manager and the staff the home does not yet have enough experienced staff on duty to be able to meet the range of needs in the community or offer a range of regular activity to people. The manager is in the process of recruitment and a new member of staff began work on the day before our visit and was additional to the shift while on induction. We sampled the records held in the home in respect of recruitment and found that there is evidence of pre employment checks being completed.In all eight staff surveys they said that they had Criminal Record Bureau checks and references taken up before starting work. The manager said that one of her priorities was to provide training to develop the skills of the staff group. In the AQAA she said that staff are being given specific training to meet individual need and we found evidence of this from talking with staff. This included some training on working with behaviours and specific interventions. Further training was planned and including some to be provided in the following week on sensory processing and intensive interactions. The manager has a record of training completed by staff so far and and of training needed. These showed that the management and senior staff are the most trained and that although the house induction covers an introduction to several areas, several staff were in need of more detailed training in first aid, food hygiene, fire,and health and safety. The manager said that the new staff needing this would receive training in these areas on the more detailed induction courses planned from the time of the inspection until December. She said other training in management of behaviour was also planned. She also plans for staff to do National Vocational Qualifications. Two staff have level two or above and two other have started the course. In all eight surveys all staff said that there induction was covered very well. All staff said they have had training relevant to their role that helps them meet needs and keeps them up to date. During the afternoon of our visit the deputy chaired an in-house staff meeting which staff say are becoming more regular. Written and verbal feedback from staff was that they have regular support from the management. One person spoke of opportunities in Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: regular supervision to discuss how to work with each person. There are also regular daily hand-overs between shifts. One staff member commented that there is good team work in the home in an environment where people feel able to talk about their work. Care Homes for Adults (18-65 years) Page 25 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 people living in the home benefit from a manager with good leadership skills who is establishing an effective management system to promote the quaility of care provided to people and their safety. Evidence: Staff spoke positively about support from the manager who has relevant previous experience and is registered for this home. At the time of her registration it was raised that a check was needed by the company to ensure that her qualifications were commensurate with the Registered Managers Award. At this inspection she confirmed that this had been checked out agreed. The company has a system of quality assurance monitoring for the service to use. As the service is new the manager said that the home would be using questionnaires to check the views of the service within the next six months but peoples needs and wishes are taken into account on a day to day basis. She completes a range of planned and unplanned checks of the service and action needed is highlighted And acted on. A Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: record of this was observed showing that this is regularly occurring. The manager said that a full business plan has yet to be developed for the home but that there are some short term goals including establishing a full staff team and training them to carry out the work. Also to recruit an activities co ordinator and have a meaningful structure of activities in place for people. The AQAA was not comprehensive for this inspection and will need to be more detailed in future. In the AQAA the manager said that there are regular checks and servicing in the home and on our visit we noticed that there are charts for recording checks such as of water temperatures. A discussion was held with the manager and a large file of household risk assessments were seen to be in place. We have referred to risk assessments in the sections on lifestyle and individual needs and choices and noted that whilst safeguards are in place to prevent people from harm, more work is needed on risk assessments to demonstrate that any restrictions in the home are minimised whilst promoting the safety of people. Discussion and observation of records regarding staff training indicated that less experienced staff have had some familiarisation of health and safety in their initial induction but more detailed training is needed in a number of areas such as first aid ,fire matters, health and safety food safety and infection control. As referred to in the section on staff in the the manager has planned this and we recommended that checks are made to ensure that the deployment of staff for each shifts include those trained in first aid. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Risk assessments leading to restrictions or physical interventions must be agreed with care managers and other relevant professionals. This is to ensure that professionals involved are consulted and strategies agreed 12/12/2008 2 9 13 Any restriction placed on people living in the home must be preceded by a risk assessment agreed with relevant professionals .This includes access to the laundry,kitchen, entrances to the home and any are planned to be locked. Plans for access to those not restricted should also be in place. People living in the home must have free access to areas and not have restrictions placed on them 12/12/2008 Care Homes for Adults (18-65 years) Page 29 of 31 unless this is an agreed strategy to offer protection from harm to them or others. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 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. 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. 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