Inspection on 08/07/09 for Rocklee

This inspection was carried out on 8th July 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rocklee 18/11/08

Rocklee 10/07/08

Rocklee 06/11/07

Rocklee 09/05/06

Rocklee 09/10/05

Rocklee 18/04/05

Rocklee 08/10/04

Rocklee 12/05/04

Rocklee 13/02/04

Rocklee 19/09/03

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Rocklee 341 & 343 Stone Road Stafford Staffordshire ST16 1LB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Capron     Date: 0 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Rocklee 341 & 343 Stone Road Stafford Staffordshire ST16 1LB 01785603407 F/P baugha1@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Jacqueline Downes care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 11. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder MD 11 Date of last inspection Brief description of the care home Rocklee is a residential care service that provides a service for adults who on admission have mental health needs. The service is located on the outskirts of Stafford town centre, having easy access to a wide range of local transport and amenities. The property consists of two semi-detached houses, the interior structure of which has been altered to allow access throughout. The exterior of the property has been maintained as two semi-detached houses in keeping with the local community. Rocklee provides accommodation for eleven people and has seven single and two shared bedrooms. En suite facilities are not provided. However, bathrooms and toilet facilities are conveniently situated throughout the home and are in close proximity to bedrooms Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 11 Brief description of the care home and communal areas. Two lounge areas that are comfortably furnished and equipped are provided for communal use. The kitchen consists of two areas with one containing the cooking and dining area and another currently awaiting refurbishment but intended to used as a second kitchen for people to cook their own meals. There is also a compact laundry area at the side of the property for communal use. The property stands in its own grounds with a lawned area and shrubs to the front, a private hardlandscaped area to the rear, together with car parking facilities. The service has a current Statement of Purpose and Service User Guide so that people know what to expect from the service. The fees charged are based on each persons needs. People considering using the service and stakeholders should contact the service directly to obtain current information regarding the scale of fees. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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: This inspection took place over a seven hour period. The service did not know we were visiting. Prior to the visit we had information from the Annual Quality Assurance Assessment that the service sent us. This is a document that the service completes that tells us about the service they provide, improvements they have made and how they intend to improve the service in the future. We also looked at information that the service sends us about incidents that have occurred. These are a legal requirement. We also looked at information we have about any complaints or safeguarding incidents that have occurred. We received surveys from seven people that live at the service, one relative and one social care professional. At the service we looked at how the service is meeting peoples health and personal care needs and whether peoples privacy and dignity is respected. We also looked at whether people can live the life they want and whether choice is promoted. We looked at how the service is protecting people and whether there are systems in place to listen to the views of people. As part of this inspection we looked around the service including a sample of bedrooms. During Care Homes for Adults (18-65 years) Page 6 of 30 the inspection we spoke to people that live at the service, staff and the manager. A random inspection took place during November 2008. At that inspection the service has met the requirements we had made at the last key inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The service must make sure that appropriate information relating to medication particularly creams and medication that is self administered are kept. This will make sure that staff know how to use and monitor that people are receiving the correct medication. The service has still not completed its refurbishment following the subsidence that occurred prior to our last key inspection. The service has given us a further date for completion of September 2009. The service needs to improve its record keeping. Currently care plans are basic and do Care Homes for Adults (18-65 years) Page 8 of 30 not provide sufficient information to be used as working documents by staff. This could affect the care provided to people. Whilst the service has a risk management system in place and currently the staff provide people with appropriate support information is not always adequately recorded. This could lead to staff who do not know people providing inappropriate support. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that use the service are provided with information about what the service will offer. People can be assured that an assessment of their needs will be completed to make sure that the service can meet their needs. Evidence: The services Annual Quality Assurance Assessment states that before anyone moves to Rocklee a full assessment is completed in order that the service can be confident that they can provide them with the support they need. It also states that they are invited to visit over a period time. The service has updated the information about the service to reflect the nature of the service and to identify the age range that the service admits. This information covers all the necessary areas to provide people with the information they need to decide of the service can meet their needs. The surveys we received from people that live there tell us that people feel had enough information to decide if the home could meet their needs. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Examination of a sample of records shows that an assessment of peoples needs is completed. This service gains information from health and social care agencies as well as completing its own assessment. The services own assessment covers such areas as physical and mental health, dietary needs, social care issues, spiritual and cultural needs as well as peoples likes and dislikes. We saw that the service provides people with contracts that outline their rights and responsibilities. The responses to our surveys tells us that everyone has a contract telling them about the services terms and conditions. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people are receiving the care they need care plans and risk management documents need to be fully developed in order that people can be confident that all staff know how to provide them with the support they need. People that live at the service are encouraged to make decisions about how they want to live their life and are involved in aspects of running the service. Evidence: The services AQAA states that peoples needs are set out in a care plan that is evaluated with the person concerned. We examined a sample of care plans and feel that these need to be further developed. Information needs to be developed to identify specific needs and to describe how these needs are to be met. For example information about peoples social care needs including the support people need to develop independent living skills is limited. Whilst the permanent staff are fully aware of each peoples needs the plans are not good enough to be used as working documents for staff that do not know the people, for example new staff and agency staff. There is evidence that the care people receive is evaluated and that multi Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: agency discussions take place over peoples care and progress. For example care coordinator meetings take place to monitor peoples health and welfare. The service has a risk management system in place and staff we spoke to are aware of the individual risks to people and how these are to be managed. However there are some gaps in the records. For example the manager said that there is a risk assessment in place due to the risks one person poses to themselves through smoking. This could not be located in the files. The manager acknowledges that the record keeping is not good enough and feels that due to competing issues she has not kept on top of this aspect of the service over recent months. She did show us evidence about how the service intends to improve the record keeping and said that they are going to implement computerised records in the near future. The service is promoting peoples choices. People we spoke to said that they decide when to get up and go to bed. We saw that people can spent time in their bedrooms and can eat in their bedrooms or in the lounge if they choose. There are choices for meals and people that live at the service meet regularly to plan the menus. The service has resident meetings run by the people themselves to discuss for example where they want to go on holiday and the activities they want to do. We also saw evidence of the use of advocates to support people to make decisions about their lives. Our inspection confirms that people are involved in aspects of running the service. We saw people making drinks and helping lay and clear the table. Several people tell us they clean their own bedroom and do their own laundry. Some people help with preparing meals. One bathroom has recently been decorated and the people living at the service chose the wallpaper. The services AQAA states that people are also involved in recruiting new staff. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service are encouraged to live the life they want and to develop their social and independent living skills. People enjoy a varied diet that is based on their choice and healthy living principles. Evidence: The services AQAA states that it supports people to take part in activities and has supported people to develop their education. The service states that it wants to do more work with people to develop their social and independent living skills. Discussions with several people that live at the service confirms that the service consults people about the activities they want to do and that people make choices about how they live their life. Two people attend college and have completed courses in I.T., numeracy and independent living skills. Another person we spoke said that they intend to go to college next term. Other people attend sessions at the local MIND Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: centre and the Quest centre. These groups support people with rehabilitation and social skills. Several other people attend a local social group that provides activities during the week for example playing bingo and going on day trips. An activity staff member works at the service and supports people to develop their social skills and take part in social activities both in the service and in the community. On the day of our visit two people went to Drayton Manor, several people went into Stafford shopping and one person went to the local shops. People that want to go to church are encouraged to do so. We saw that throughout the day many of the people that live there go out into Stafford, shopping or visiting friends and relatives. People are consulted about where they want to go on holiday. Recent trips include to Wales and a holiday to Skegness is due to take place in the near future. The responses to our surveys confirms that the service supports people to take part in activities. Comments from our surveys include enjoy the holidays and going out on trips. The service provides a flexible routine. People can choose when to get up and go to bed. Meals are not provided at set times and breakfast is provided when each person gets up. We saw that people can spend time where they want. Some people choose to spend time in their bedrooms and others in the communal rooms. If people wish to spend time alone this is respected but staff do monitor their welfare during the day. Another person said that they spend a lot of time out of the service, coming and going when they want. The service is placing a greater emphasis on trying to support people to develop their social and independent living skills. The service is working with some people to do their own cleaning, doing their laundry and ironing and preparing their meals. The service is creating a second kitchen to support people to make their own meals. One person in their survey did comment they help us to do things to make us a little bit more independent. A relative also made similar comments. The service supports people to maintain and develop relationships. Records show that people are encouraged to keep in touch with their family. One person visits their family most days. People tells us that they like the food and that they are always given a choice. The service also involves people in choosing the menus. The service tells us that the meals are based on choice and healthy eating. An examination of the menus confirms that a choice is provided. The service involves people in food shopping and in preparing meals. People with special dietary needs are catered for. One person is supported to have a low fat diet and another to have a diet that controls their diabetes. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service are supported to have their health and personal care needs met in a way that respects their privacy and dignity. People are having their medication needs met but some aspects of record keeping should be improved. Evidence: The AQAA states that the service identifies peoples health care needs and support them to have them met. Talking to people confirms that people are having their personal care and health care needs met. People tells us that they see the doctor when they are ill, have eye checks and see the chiropodist to have their nails cut. People can go to the dentist but two people we spoke to said they choose not to go. We did advise the service to maintain all health records including when people refuse treatment. Records confirm that people have health and medication reviews. One person said that since they have been at the service their health has improved considerably and puts this down to the TLC provided by the staff. This person states that the service has supported them to receive health care treatment for the last 12 months. Records confirms that the service works closely with mental health professionals and that Community Psychiatric Nurses visit regularly to provide people with treatment and support. Records also confirm that people are supported to see a Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: psychiatrist when needed. A social care professional in their survey said the service meets the needs of those service users who have severe and enduring mental illness, they are excellent in maximising peoples potential and maintaining a high quality of life. They liaise well with professionals and value the input and support offered. People that live at the service and responded to our surveys say they get the medical support they need and one commented the service always provides care and support needed. The service provides little direct personal care but encourages and supports people to maintain their own personal care. Staff we spoke could describe how they promote peoples privacy and dignity. They tell us that everyone now has a lockable bedroom and that toilets and bathrooms have locks. A social care professional tells us that the service always respects peoples privacy and dignity. The service administers peoples medication except in some cases creams which people keep themselves. Medication is kept securely and the service has a system of recording and auditing medication. Medication records are kept and we saw one minor error which the service is to address. We did inform the service of the need to record appropriately medication e.g. creams that people administer themselves or that staff administer when supporting them with their personal care. We also advised them to ensure that where medication is prescribed on an as required basis guidelines are in place so that all staff are aware of the circumstances when it should be administered. Staff are trained in administering medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service can be confident that their concerns will be listened to and acted upon. People can be assured that the service has procedures in place to keep them safe and that staff are alert to incidents of possible abuse. Evidence: The services AQAA states that it makes the complaints procedure known to the people that live there. They say that they view complaints as a way of improving the service. We saw that the complaints procedure is displayed in the service and is included in the information given to people that live there. People we spoke to say they know how to make a complaint. This was confirmed by the responses to our surveys. All said they they knew how to raise concerns and that staff listened to them and acted on what they said. The service keeps a record of complaints. One complaint has been made since we visited last. Records show that they service responded to this. We. the commission, have not recevied any complaints. The AQAA states the service makes sure people know their legal rights including under the mental capacity act. We spoke to staff about safeguarding issues and all tell us that they have received training in this area. Staff could describe signs of abuse and were clear over their responsibility to refer any concerns to the manager. Staff are not so clear of the need to refer issues to the local authority as the co-ordinating authority and we would recommend that the service provide staff with information about the locally agreed referral process. The service makes sure that the recruitment Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: procedures are protecting people through making all the pre employment checks. The service supports people that self harm. We talked to staff and they are aware of the plans in place to manage this behaviour. We saw evidence in files that these issues are discussed with the person and other professionals and any restrictions on people are agreed through multi agency discussions. The service does not manage peoples money with people looking after their own money. The service provides people with a secure place where they can keep money and any valuables. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service enjoy safe and comfortable private and communal accommodation although this will be of a higher standard once the refurbishment is finally completed. Evidence: The services AQAA states that they provide a safe and well maintained environment that is clean and hygienic. The service has been in process of refurbishing a significant part of the accommodation as a result of subsidence. This has been ongoing for a considerable time. The service tells us that this is now liable to be completed by September 2009. Once completed the service will have a second kitchen for the use of people to cook their own meals, a wet room to replace one bathroom, a conservatory and a number of bedrooms will have new windows. However the current accommodation is adequate to meet peoples needs. There is a nice kitchen/ diner, two lounges one of which is used for meetings and individual work with people such as chess and craft work. We looked at a sample of bedroom accommodation. These provide suitable private accommodation. Bedrooms are personalised to reflect the personality and style of the occupant. People tell us they like their bedroom. Where people are sharing a room this has been agreed. We asked the service to talk to one person who said they would ideally like a room of their own. There are sufficient toilets and bathrooms at the service. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: People that answered our survey said they find the service clean and fresh. We saw that this is a good standard of hygiene throughout. Most staff have received training in infection control. The service has suitable laundry machines and a number of people do their own laundry. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the service has sufficient staff to provide them with the support they need. The service provides staff with training to be able to support people effectively. The services recruitment procedures ensures checks are made on prospective staff in order to protect the people that live there. Evidence: The services AQAA states it provides staff with training to meet the needs of the people that live there. It also states that it ensures that it completes the required preemployment checks. We looked at three staff files and these confirm that the service obtains two written references and obtains a Criminal Record Bureau and Protection of Vulnerable Adult checks. The service did tell us that staff have access to health checks but the service is not routinely checking as part of their recruitment that people are fit enough to undertake the work. There is no evidence to show that the identity of prospective staff is routinely checked. The AQAA tells us that people living at the service are involved in the recruitment of staff. The staff provides two care staff on duty throughout the day and one waking care staff at night. In addition there is an activity staff member that works for 31 hours a week. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The service is currently short of permanent staff and has needed to use agency staff to cover for vacancies, sickness, training and holidays. The service acknowledges the need for a consistent staff group as this will ensure that all people are fully aware of each persons needs. The manager tells us that she is in the process of recruiting two staff. People that live at the service tell us that they like the staff. Comments from people include staff are good, we are looked after well and nice people and staff. Responses to our surveys tell us that staff are available and that staff listen to them and act on what they say. Discussions with staff and checking records confirms that staff receive training to do their job. New staff receive induction training and all staff receive ongoing training. This includes training in health related conditions including dementia care, mental health and Parkinson disease, training in legislation including the mental capacity act and training related to Health and Safety practices. The service has achieved Investors in People status. Talking to a sample of staff tells us that they are aware of each persons needs and are aware of how to support them. We also observed that there is a relaxed and friendly relationship between staff and the people that live there. A survey from a social care professional says that they feel that the staff usually have the right skill and experience. tp provide people with the care they need. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is being run in the interests of people that live there but there continue to be areas including the administration and refurbishment of the property that would provide people with a better standard of living. Evidence: The AQAA tells us that the manager/ owner is qualified and undertakes training to update her skills. She is clearly committed to the people that live there and to take the service forward. She is keen to further develop the staff and has a range of training organised for the staff. Recording at the service is not good. Care plans are not well recorded and do not cover all areas of need and are confusing. Some elements of risk assessments are not present in the files. These documents are not good enough to be used as working documents and would not provide adequate information for staff that do not know the people living at the service to provide a suitable service. The service has been undergoing refurbishment for several years . The service made a Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: commitment to us at our last inspection that this would be completed by October 2008 but on this visit it is not yet complete. The service provided us with an AQAA when we asked it. Although it provides us with information about the service it is not well put together and is in parts confusing. The AQAA did not tell us about the number of complaints received. There is a system in place to review and monitor the service that includes the views of people that live there, staff and health and social care professionals. The system also includes a range of audits of the service but an examination of the records shows that these are not always completed and the paperwork is somewhat disorganised. The manager is aware of the shortcomings in relation to the administration of the service and has plans in place to improve this aspect of the service. The service has Health and Safety procedures in place. Staff receive relevant training in for example fire safety, moving and handling and infection control. An examination of the fire records confirms that regular fire evacuations take place and that fire equipment is regularly checked. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Appropriate information 17/08/2009 relating to medication must be kept, for example in risk assessments and care plans, to ensure that staff know how to use and monitor all medication including self adminstered medication. This will ensure that medication is administered safely, correctly and as intended by the prescriber to meet peoples health needs. 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 Comprehensive person centred plans need to be completed as a working document for staff to show them how peoples needs are to be met. If a risk is identified a plan should be in place that shows how the person is to be supported 2 9 Care Homes for Adults (18-65 years) Page 28 of 30 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 3 24 To ensure that the refurbishment of the premises is completed. This will provide people with a more comfortable place to live and reduce the dispruption to people living there. The service should maintain records that staff are fit to undertake the work and also of proof of staffs identity. The service should ensure that the system for monitoring and reviewing the service is properly maintained. The service must keep proper records for the efficient and effective running of the service. 4 5 6 34 39 41 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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