Inspection on 11/08/09 for Rockville House

This inspection was carried out on 11th August 2009.

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

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

Other inspections for this house

Rockville House 13/02/09

Rockville House 11/01/08

Rockville House 11/10/06

Rockville House 06/02/06

Rockville House 29/09/05

Rockville House 08/02/05

Rockville House 17/08/04

Rockville House 03/02/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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: Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG The quality rating for this care home is: zero star poor 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: Stella Lindsay Date: 1 8 0 8 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 32 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 32 Information about the care home Name of care home: Address: Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG 01752 407520 01752 481624 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Independence South West Name of registered manager (if applicable) Ms Josephine Louise May Whetton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 physical disability Additional conditions: Age 18-65yrs One Service User named elsewhere, who is under 18 years of age can reside at the home Date of last inspection 1 8 0 2 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Rockville Respite Centre is owned and managed by the registered charity Independence South West. The respite facility is purpose built on one level, and is adjacent to a day centre that is owned and managed by the same organisation. The service is registered to provide respite accommodation to a maximum of three service users who have a physical disability and who may also have a learning disability. The centre is situated in a residential area in the town of Plymstock, and is close to shops and leisure amenities. The centre has the use of two minibuses. There is a standard fee of 110 pounds per night. Care Homes for Adults (18-65 years) Page 5 of 32 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: zero star poor 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 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on Tuesday 11th August and Wednesday 12th August, and met with the Registered Manager, one of the trustees, two staff on duty and the two service users who were staying at the time. We looked at care plans, staff files, some policies and procedures. We received surveys from staff and from people who use the service, along with their families. We looked at how medicines were organised. Care Homes for Adults (18-65 years) Page 7 of 32 We saw how residents money was looked after. What the care home does well Rockville has plenty of room and it is easy for people to move around. The staff are kind to the residents There is a lovely bath and a separate shower. Care Homes for Adults (18-65 years) Page 8 of 32 Rockville has a very good manager and some lovely staff. What has got better from the last inspection There have been many improvements. Care plans have been written anew, so the staff know what they should do for people. The medicines are organised properly. Care Homes for Adults (18-65 years) Page 9 of 32 There are more outings, sometimes in the evenings, but especially at weekends. What the care home could do better The people who are responsible for running the service must take actions to ensure that the service will be run properly in the future. More staff training is needed, so that they can understand peoples problems better, and help them do things for themselves. Care Homes for Adults (18-65 years) Page 10 of 32 Staff must follow the procedures that have been advised by health care workers, to keep service users safe. 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 Stella Lindsay Care Quality Commission Citygate Gallowgate Newcastle upon Tyne NE1 4PA Telephone: 03000 616161 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.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 11 of 32 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 12 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users needs are considered before they are admitted. The aims and objectives of the home have been set out in a statement. Terms and conditions have been written. Evidence: There is information about the service available for the public, including the homes Statement of Purpose and a Service Users Guide. The Manager was aware that these would benefit from updating, and she had plans with respect to making them more easy to understand. There had been no new people being assessed to use the service since the last inspection. The regular service users had been admitted and discharged at intervals as booked by their informal carers. The Manager told us that when she takes a booking, she ensures that there will be sufficient staff on duty to meet that persons needs. Some service users need 1;1 care, which had been provided for, as they were normally admitted with only one other client, otherwise additional staffing had been arranged. Most service users leave the respite unit during the day to attend the Day Centre. A service user who does not normally attend the day centre was expected the following week, and an enabler had been engaged to work during the day time hours with them. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: We did not see that peoples care plans were reviewed at each admission, but the service is in regular contact with most of its clients through the adjoining day care service. We found that the service was well received by the people using it, and much appreciated by their families. A typical quote from a survey returned to the CQC said, I dont know what I would do without Rockville, it is my lifeline. We saw a statement of terms on residents files, but they had not been signed by them or on their behalf. Care Homes for Adults (18-65 years) Page 14 of 32 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. Care planning had been much improved with more information about residents care needs made available to staff. Further progress was needed to support service users in working towards independence. Evidence: We examined two care plans in detail. We found they had been reviewed and rewritten recently. They included the daily routines preferred by the service users. One had not been updated in line with new advice from professional health care workers, but staff were aware of the new advice. There were records of assessments by health professionals, including continence advisors, physiotherapists, which matched practice as described by staff. The Manager was keen to develop person centred plans in consultation with service users, but these were not in place at the time of this visit. Relatives returning surveys said they were pleased with the care provided, for example, I trust the staff with my son, and My daughter is often ill...she is happy after her stays, which makes our lives easier, knowing she is in capable hands. At Rockville, residents would not expect to be supported in major life decisions, as they normally live at home with their family, and the service provides intermittent care away from home. However, there Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: should be opportunity for people to develop their independence. The Manager was planning to actively encourage independence for service users by developing their care plans and risk assessments in more depth. Staff had received training in the Mental Capacity Act, though it was not clear how this was being used, as yet, to clarify support that would help Rockvilles service users in making decisions. They may need support to obtain their own advocate if a major life change is anticipated, or wished for. We saw risk assessments on residents files with respect to moving and handling, bathing and showering. There was an explanation of why bed guards were used. We did not see risk assessments with respect to promoting independence and activities outside the home. Staff told us that communication was much improved, and they were now given updated information about service users needs, which was put into the care plans promptly. Care Homes for Adults (18-65 years) Page 16 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are given the opportunity to take part in a variety of activities. Good meals were served using fresh ingredients. Evidence: There had been a great increase in the opportunities for outings, during the evenings and particularly at weekends. A driver had been engaged, and frequent outings had been arranged, with one or two enabling staff accompanying one or two service users. This has made a lot of difference to us, said a member of staff, particularly at weekends. Relatives said, I cannot fault anything. My son goes out on trips, and has a choice of what to do. Staff were alert to events in the community. The driver had been booked for the evening following this inspection, to take a resident to a local firework competition. A file was kept of the activities, showing where people had been and how they enjoyed and benefited. Risks had been assessed with respect to traveling, and arrangements made to ensure safety. Escorts and drivers had been trained in clamping wheelchairs and belts to ensure safety of service users in the minibus. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Staff knew the service users particular interests, which included motorway bridges, opportunities to spend money, and people watching. Venues had included various seaside attractions, a local folk festival, markets and places of interest on Dartmoor. The residents had Communication Books, to let their families know what they had been doing during their stay. Staff prepared the evening meal, a sausage casserole, so that it was in the oven cooking when the service users arrived from the day service. The staff were able to tell us of the residents particular dietary needs. We saw strawberries and plenty of salad in the fridge, and cauliflower, carrot and swede were simmering on the hob. A service user told us, I have days out to go for lunch. I like cooking and doing dishes. Care Homes for Adults (18-65 years) Page 18 of 32 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 staying at Rockville receive personal and healthcare support delivered with respect for their dignity. The home has a good system that is well managed to deal safely with service uses medication. Evidence: All care plans and risk assessments had been reviewed since the previous inspection, to ensure that service users individual needs were documented. There were neat charts for recording food and drink consumed, and bathing. A good piece of work was being carried out with respect to improving the personal care routines of one of the service users, with advice and support from the Occupational Therapist and Continence Nurse. The Manager had plans for developing the care plans with more individual information, and to make progress with health action plans. The need for invasive procedures were being superseded, under professional guidance, and when injections had been needed a District Nurse had visited the home for this purpose and had also provided good information for staff with respect to diabetes care. The system for administering medication had been improved. A new medication cupboard had been provided. The records of medication received into the home, and administered showed a full audit trail, so that the Manager could account for every tablet held. When Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: any medication had been given PRN, the reason and amount given were recorded in service users care plans. There is no supplying pharmacist, as service users brought their medication with them from home. This is checked in by Senior staff on their arrival, and on the day of their departure the medication stays in the secure storage while the person is in the Day Centre, until it is time for their journey home. Care Homes for Adults (18-65 years) Page 20 of 32 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We could not be confident that the home would be safe for service users, as the service providers, Manager and staff had not always followed the procedures that had been agreed to ensure their safety. The Board of Trustees had not always worked in harmony with the Manager to ensure that good practice is maintained. Evidence: The complaints procedure is included in the information given to new service users and their representatives. Seven out of nine people who completed surveys said they would know how to make a complaint. They all said they would know who to speak to if they were unhappy. Staff had received training from the Learning Disability Team on good practice with respect to the Protection of Vulnerable Adults. The Manager was negotiating with a training provider to deliver training in their duty as Alerters. The home had received a complaint from a relative, as a service user had suffered a fall due to the failure of staff to follow procedures. We found this to be upheld, as the staff who had been on duty at the time had known that the care plan required two staff for all transfers, and had not put this into practice. Though the Manager had not immediately acted upon the possible safeguarding issues, since receiving the complaint she subsequently took appropriate action. We were told that there had been other breaches of moving and handling guidelines, and Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: that the Manager had not been backed in her efforts to keep the staff working to guidelines, due to the influence of one of the Trustees who is often in the establishment, and to whom some staff turned. We had information from previous staff and managers as well as visiting professionals showing that this situation had been on-going, with effects on the safety of the service. Repeat training in Moving and handling had been arranged for the following month, and staff had been advised that any further breaches will result in disciplinary action. Care Homes for Adults (18-65 years) Page 22 of 32 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. Rockville House provides a clean, safe and comfortable environment for the service users. Evidence: The Respite unit at Rockville comprises a suite of rooms along the side of the main building which houses the day centre. Residents have access to all the facilities, which include a sensory room and physiotherapy room. The laundry is also upstairs in the day centre. There are gardens and patios to the front and rear of the building. They were being developed with wind chimes and other items of interest to people with sensory problems. There had been internal decoration, with the walls painted cream, so all was light and smart. Some fine paintings, done by service users in the day centre, had been hung on the walls. There are three bedrooms for service users. All have hi-lo beds with removable cot sides. One had an alarm that alerts staff if the occupant starts to have an epileptic fit. Lockable storage had been provided in bedrooms, and residents consulted as to whether they wished to be a keyholder. There were appropriate locks on bedroom and bathroom doors. There was a choice in bathing facilities, with a Parker bath with shower attachment, and an accessible shower. Liquid soap and paper towels had been provided, and there were sound surfaces in all bathrooms to maintain good hygiene. Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: The lounge had comfortable sofas, and a large screen television. Satellite channels are available. The kitchen had good cleanable surfaces. Service users could sit to the dining table or a worktop to help with food preparation. Care staff maintain cleanliness at weekends. During the week domestic services are provided under contract, with the cleaner coming to the residential unit while most service users are in the day centre. Care Homes for Adults (18-65 years) Page 24 of 32 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. Staff are employed in sufficient numbers to meet service users care needs, and had built good relationships with them. Further training is needed to enable them to develop their role in promoting the independence of the service users, with specific understanding of varying conditions. The recruitment process is sound, ensuring that service users will be protected from potential harm from employees. Evidence: Staff who met with us were committed to providing a good service. Service users completing surveys, some with help from relatives said, The staff are always polite and approachable, and nothing is too much trouble. The staff are always supportive, and the staff are very switched on and deal with each situation as it happens. The staff rota was written in the diary. This avoided any confusion for staff, but did not inform service users who would be supporting them. The Manager told us she planned to gather photos of staff to display, showing who is on duty, and who is due in later. There are at least two care staff on duty at all times, and a third is engaged if care needs or planned activities make this necessary. Some staff work regularly in the respite unit, while some work only one or two shifts per week, which does not provide for good consistency or familiarity with care routines. Staff are called enablers, and are being encouraged to see their role as promoting independence and helping people consider different options. Training in Person Centred Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Planning and in Risk assessment had not been provided recently - three staff had received this input in October 2007. One Enabler had attended training in Social Role Valorisation, and in Advocacy. Of the eleven care staff employed in the residential part of this service, eight had achieved at least NVQ level 2 in care. Two were working towards level 3, and one to level 4. This shows good achievement and progress. Most staff had received training in Food Hygiene, and one had attended an Eating and Drinking training day. The Manager had booked training in Health and safety for all staff in October 2009. Several staff had received training in Moving and Handling in September 2008, and the Manager had booked this training for all in September and October 2009, to ensure that all would be able to attend. We looked at the file of four staff who had been recruited recently. We found that all the checks needed to protect service users from potential harm had been carried out. The Manager was introducing a system of appraisals and supervision. Some staff had received individual sessions, but not yet all. Care Homes for Adults (18-65 years) Page 26 of 32 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 Manager was clear about her management role, and had introduced many improvements to the running of the service. Evidence: The Manager, Mrs Josephine Whetton, has registered with the Care Quality Commission. She is a qualified Learning Disability Nurse, with extensive experience in Community and residential nursing. Surveys returned to us by service users, some with help from relatives, were positive about her contribution. Typical quotes were, The last year has seen some changes in staff and management which we have found positive. They are a very motivated, kind, cheerful team, and I felt that since Jo Whetton has taken over Independence House is working better...Jo is a pro-active manager and has implemented changes for the better. Rockville is owned by Independence South West, a registered charity. At the time of this inspection, there was no Responsible Individual registered with the Care Quality Commission. Lines of accountability within the service were not clear, as one of the Trustees of Independence South West was still working in the home and taking decisions without consultation which should have been the responsibility of the Registered Manager Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: who was familiar with the Care Homes regulations and with current good practice. The Manager had completed the Annual Quality Assurance Assessment, and provided full information to the CQC about the improvements that she had introduced, as well as those that still needed to be addressed by the Trustees. The Manager had demonstrated good skills for managing people, and commitment to promoting person centred practices. We saw that systems for safe working practices were in place in the home. The fire precaution system was maintained in good order, with staff training provided twice a year. All surfaces were sound and easily cleanable, and accidents were recorded and reported. Some staff needed an update in their First Aid training, to ensure that a qualified first aider is available at all times. Care Homes for Adults (18-65 years) Page 28 of 32 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 1 43 12 Lines of accountability within 02/04/2009 the home and with external management must be clear so that decisions can be seen to be taken in line with recognised professional standards and in the best interests of service users. Care Homes for Adults (18-65 years) Page 29 of 32 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 1 23 13 Staff must follow the homes 25/09/2009 written policies and procedures in order to provide the service in a safe way. 2 42 13 Staffs training in first aid should be up-dated 27/11/2009 to ensure that there is always a first aider available in an emergency. 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 2 1 5 Information about the home should be produced in a form that is easier for prospective residents to understand. The homes statement of terms should be signed by the service user or their representative, to ensure that they Page 30 of 32 Care Homes for Adults (18-65 years) 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 understand what is included in the service. 3 6 Care plans should be further developed in line with the principles of person centred planning, in order to involve service users, along with family, friend or advocate. Further progress should be made in supporting individuals to make choices and develop their independence. Risk assessments should be further developed, so that staff can enable service users to take responsible risks, in line with their individual plan and the homes risk management strategies. A risk assessment should be in place to advise staff as to how and when it is safe to leave unattended a service user whose care plan requires 1;1 staff at all times. The service should ensure that all staff receive training that is targeted and focussed upon improving outcomes for service users. 4 5 7 9 6 35 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or 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. 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