Inspection on 13/01/09 for Selly Oak Road (310)

This inspection was carried out on 13th January 2009.

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

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

Other inspections for this house

Selly Oak Road (310) 24/01/07

Selly Oak Road (310) 13/02/06

Selly Oak Road (310) 17/10/05

Selly Oak Road (310) 24/03/05

Selly Oak Road (310) 28/09/04

Selly Oak Road (310) 17/01/04

Similar services:

Tanglewood

88 Church Lane

Harmony Care Home

Olivet Christadelphian Care Homes

Sayer House

Beacon Centre For The Blind

60 Olive Lane

Bryndale Avenue, 41 Flats 13, 14 & 18

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Selly Oak Road (310) Selly Oak Road (310) Selly Oak Birmingham West Midlands B30 1HL     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: Kerry Coulter     Date: 1 3 0 1 2 0 0 9 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Selly Oak Road (310) Selly Oak Road (310) Selly Oak Birmingham West Midlands B30 1HL 01214595199 01214513523 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Birmingham Focus on Blindness Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: Residents must be aged under 65 years That Barbara Wright successfully completes the Registered Managers Award or equivalent by August 2005. That the home can continue to accommodate one named service user over the age of 65 years. Date of last inspection Brief description of the care home 310 Selly Oak Road is a detached property situated in a residential area of Kings Norton in pleasant grounds and benefits from off-road parking. The rear garden is mostly laid to lawn with a patio area furnished with attractive garden furniture. The home provides care and accommodation to five adults with sensory disabilities. Disabled access to the ground floor of the home is good. There is no lift; therefore people with a physical disability cannot be accommodated on the first floor. There are ramps, handrails and adapted bathing facilities on the ground floor of the home. Each Care Homes for Adults (18-65 years) Page 4 of 30 5 Over 65 0 Brief description of the care home person has their own room, which has been decorated according to their individual tastes. The furnishings and decoration of the home are generally of a good standard. There is a lounge, a separate dining room, kitchen, laundry room, toilet and one bedroom on the ground floor. On the first floor there are four single bedrooms, staff sleep-in room/office, bathroom and separate toilet. The home is within walking distance of local shops, transport links to the city centre, leisure facilities and places of worship. Rubery, which has cinemas, shops and restaurants, is a fifteen-minute drive away. The CSCI inspection report was available in the Home and people confirmed that the outcome of inspections is shared with them. The current scale of charges for the home is six hundred and sixty eight pounds to one thousand one hundred pounds per week. 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: 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: This inspection was carried out over one day, the home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home and the Annual Quality Assurance Assessment (AQAA) completed by the manager. This provides information about the home and how Care Homes for Adults (18-65 years) Page 6 of 30 they think it meets the needs of the people living there. Two of the people living in the home were case tracked. This involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. A tour of the premises took place. A sample of care, staff and health and safety records were looked at. All the people living there were spoken to and asked their views on living in the home. The manager and staff on duty at the time were spoken with. What the care home does well: What has improved since the last inspection? What they could do better: Further development of care plans should be made so that they give good clear information about how peoples needs should be met by staff. Records should be maintained of when people receive input from the chiropodist to show that peoples nail care needs are being met. Staff recruitment records need improvement so that recruitment is more robust and Care Homes for Adults (18-65 years) Page 8 of 30 people are protected from having unsuitable staff working with them. Refresher training for staff in fire and manual handling needs to be arranged as soon as possible so that staff have the knowledge they need to keep people safe. Records of monitoring of the medication fridge temperatures should be maintained to show that the home is checking that medication is being stored at safe temperatures. Improve systems for quality assurance to include improving the frequency of visits to the home by the providers representative to make sure the home continues to be well run for the benefit of the people living there. 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 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 have all the information they need about the home so they can make a choice as to whether or not they want to live there. Evidence: The statement of purpose and service user guide was looked at and describes the services and facilities provided. The guide is available in a variety of formats that includes an audio tape version that is more suitable to the needs of the people at the home than the written format. The home has a stable resident group and there have been no new admissions to the home for more than ten years. Therefore it was not possible to assess standard 2 relating to assessment of people before they move into the home. The provider has an assessment procedure that if followed should ensure that peoples needs would be assessed prior to admission. Care Homes for Adults (18-65 years) Page 11 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. Staff have most of the information they need so they can support people in the way that the individual chooses so ensuring their safety and well being. Evidence: The records of two of the people living there were looked at. Whilst the plans covered areas of need such as activities, health, communication, personal hygiene, social contact and culture plans were not that detailed in content and had not recently been reviewed. Discussion with the manager and minutes from a recent staff meeting show that the home has obtained a new care plan format that they intend to implement so that the detail in plans is improved. This will help to ensure that staff have the information they need on how people prefer and need to be supported. We identified at the homes last key inspection that more information was needed in the care plans about peoples goals and wishes for the future. Care plans still need improvement in this area. However, whilst documentation regarding planning for and Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: meeting peoples goals needs to improve there was evidence that staff do help people to achieve their goals. For example recently one person has been supported by staff to achieve his lifetime ambition of driving a car. We spoke with people at the home about their care plans. One person told us we are involved in our care plans, staff explain it, if there is anything new we are told about it. The people living there said and it was observed that they could make choices about what they do during the day, how they spend their time and what they eat and drink. Sometimes formal meetings are held with all the people living there. The minutes of these showed that people talked about menus, how they want to celebrate their birthdays, activities, staffing, home maintenance and holidays. People are fully involved in how the home is run. Minutes of meetings show people are consulted, for example about who they would like to be their keyworker. The day after our visit to the home a meeting was arranged to discuss future plans for the home, relatives and advocates had been invited to the meeting. All of the people who live at the home were aware of the meeting and its purpose. At the end of our visit the manager made sure that people who live at the home were present for our feedback about how the home is performing so that they know what we think the home does well and what it needs to improve. Records included individual risk assessments that stated how staff are to support individuals to take risks in their day to day lives whilst ensuring that they can be as safe as possible. These had been reviewed regularly to make sure the information was up to date. Care Homes for Adults (18-65 years) Page 13 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. Arrangements ensure that people living there experience a meaningful lifestyle that ensures their self-esteem and well being. People are offered a healthy diet and enjoy their meals. Evidence: People participate in a wide variety of activities of their choice. All people at the home attend a day centre either on a full or part time basis. The day centre is specifically for people who have a sensory impairment. Records show that other activities include shopping, meals out, foot massages, going to the cinema and going to a local social club. Some people are actively involved in the church and attend weekly services. People have different hobbies and interest, which they are supported to maintain and develop. One person is a really keen football fan and enjoys watching football. People Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: chatted enthusiastically about holidays they have been on, this includes destinations such as Spain, Scarborough or Weston. People are actively involved in planning the holidays and decide where they go and who they go with. During our visit people told us a good home, good atmosphere, listen to TV and radio, just got a dvd player, we go out on Saturday nights to the rover club for a drink, we go out for meals on peoples birthdays and never get bored. Records sampled showed and people said they can keep in touch with their family and friends if they want to. This ensures that people can maintain relationships that are important to them. One person went out with staff during our visit, they told us they were going to buy a relative some chocolates. Another person told us they were going out with staff the next week to buy a new suit for a relatives wedding. Peoples relatives or advocates are included in what is happening at the home, as stated earlier in this report they had been invited to attend a meeting at the home the following day. Menus seen indicated that a range of nutritious and culturally appropriate food is provided. A record of what each person has eaten is kept so that staff can ensure that people receive a balanced food intake to maintain healthy living. Food stocks seen provided a good choice of food and fresh fruit and vegetables were available. Records and discussions with people show that people are involved in menu planning. People told us food is nice, we get to choose, they have a menu, food is alright and food is excellent, we get to go food shopping. Care Homes for Adults (18-65 years) Page 15 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. The health and personal care needs of the people living there are met so ensuring their well being. Evidence: The people living there were well dressed in appropriate styles to their age, gender, cultural background and the activities they were doing. Attention had been paid to individuals personal care indicating that people had the support they needed so ensuring they felt good about themselves. One person told us that they were supported by staff to go out and choose their own personal toiletries. People had a health action plan in place, this gives information about peoples health care needs and the support they need to stay healthy. One person has diabetes, records and discussion with them show they are supported to attend the diabetes clinic annually to make sure their diabetes is stable. Whilst not all staff at the home have received training about diabetes staff we spoke with had generally good knowledge of the support the person needed to manage and monitor their diabetes. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: One person has a history of epilepsy, although they have not had any seizures for a couple of years. Clear guidelines were in place so that staff know what to do if a seizure occurs. We spoke with two staff, both knew what to do to keep the person safe should they have a seizure. Peoples weight is regularly monitored, this means that the home is able to identify if people have gained or lost a significant amount of weight as this can be a sign of ill health. Records show that people attend regular checks with the dentist and optician but there were no records of any chiropody input for people. Chiropody input is particularly important for people who have diabetes as their nail care should be undertaken by someone who is properly trained to do this. The manager said that everyone at the home has regular chiropodist care but that this is not recorded. We were able to verify that this is the case by speaking with people at the home. Luckily the chiropodist was also visiting the home whilst we were there, they told us they are at the home on a monthly basis. Advice was given to the manager to record chiropody input in peoples records. We looked at the medication administration system. It is good that each person has their own medication stored in a locked cabinet in their bedroom. Some people at the home administer their own medication, risk assessments had been completed for this to make sure they were safe to do so. Staff also complete checks on a regular basis to make sure people have taken their medication as prescribed. Medication Administration Records (MAR) sampled had been signed, this indicates that medication had been given as prescribed so ensuring people get the medication they need to be well. Records showed that people have their medication regularly reviewed by their GP to ensure that it is still effective in meeting their health needs. Copies of prescriptions are retained by the home so that staff can check that the medication delivered by the pharmacist is what has been prescribed by the GP. One person has insulin stored in a fridge in their bedroom. On the day of our visit the thermometer on the fridge showed it was at a satisfactory temperature to store the medication. However the home does not keep any records to show that the temperature is being regularly monitored. Care Homes for Adults (18-65 years) Page 17 of 30 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. Arrangements ensure that the views of the people living there are listened to and acted on and they are protected from abuse so ensuring their well being. Evidence: The home has a complaints procedure that is on display, it is also available to people in an audio version so it is accessible to people with visual impairment. The manager confirmed that no complaints have been received in the last twelve months and we have not received any complaints about this home. People we spoke with were aware of the complaints procedure, they told us if any worries we just speak to staff and they always sort it out, everything is explained to us like the complaints procedure and would speak to the manager or deputy if have any complaints, but have not got any. Staff have a clear procedure to follow in the event of any safeguarding (abuse) issues and records show that staff have received training. We spoke with staff about safeguarding procedures and they had a good understanding of what they needed to do to keep people safe if abuse was suspected. The finance records of one of the people living there was looked at to ensure that their money was being looked after appropriately and was safe. Receipts were available for Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: all expenditures and money is checked by a senior manager as part of their monitoring visits to the home. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, well decorated and safe home that meets their individual needs. Evidence: The general standard of cleanliness throughout the home was good. The home is comfortable, domestic in layout and style and generally well maintained. There are lots of personal items around the home including photographs, pictures, plants and flowers making it a welcoming and comfortable environment for people who live there. One person who lives at the home told us that the home needs new seating in the lounge as they struggle to get up from it. We saw that the seating in the lounge was quite worn and did need replacing. Records showed that the provider did intend to replace the seating. However discussions with the manager indicate that the replacement seating was not going to be new and was being donated by someone who was having their own new furniture. It was not clear if the donation was going ahead due to the shop where they were getting their new furniture from recently going bankrupt. Some bedrooms have been redecorated and everyone has had a new bed in the last two years. Peoples bedrooms were very personalised in style according to their Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: gender, age, culture and personal interests. For example one persons room is decorated throughout with items from the football team they support. Some people have their own telephone line in their room so they can make and receive calls in private. People were all happy with their bedrooms. One person told us my room is wonderful, it is warm enough and I have my own keys to it. We saw that one persons bedroom carpet was quite stained, arrangements will need to be made to replace this if cleaning fails to remove the stains. There is one bedroom on the ground floor, which is accessible for a person with limited mobility there is also a shower room with a fully accessible shower. There is no passenger lift so the first floor is not accessible for a person with limited mobility. The bathroom and toilet on the first floor are small and domestic in style. There are handrails on the stairs to help people safely use the stairs. The provider is looking long term at the needs of the people at the home and recognises that the current design of the home will not be suitable for them if their mobility deteriorates. Consideration has been given to finding a new property or extending the current one. Discussions with people show they have been kept fully informed of possible plans for the home. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for staffing, their recruitment, support and development generally ensure that the needs of the people living there are met. Evidence: More than 50 of staff have a National Vocational Qualification (NVQ) at level 2 in care. The manager told us that four staff are now undertaking an NVQ at level 3. This exceeds the standard that at least 50 of staff have this qualification and means that people are supported by qualified staff. Interactions between people at the home and staff were friendly and relaxed. People spoke very positively about the staff team and manager. One person told us staff are very good and we know them well. Discussion with the manager indicate that the home has a stable staff group, some of whom have worked with people for twenty years. The manager said that they do not use agency staff but that staff are very flexible at covering extra shifts if needed. At our last key inspection of the home it was identified that a staffing review had taken place and it was planned to increase the number of staff on duty in the mornings. Staff rotas and discussions with people show that staffing levels have now been increased. Discussions with people at the home and staff indicate there are usually enough staff on duty to meet peoples needs. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: We looked at the recruitment files for three members of staff. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau (CRB) check had been completed to ensure that suitable people are employed. For one member of staff there were two references but neither was from the staffs last employer. Employer references are needed to ensure the recruitment procedure is robust. Although the staff had not worked for a number of years there was no explanation in the file as to why an employer reference was unavailable. The manager told us that recruitment is undertaken by the personnel department and she would follow this up with them. Staff spoken with told us they were happy with the training on offer, one commented can ask for any training we want, its very good. We saw that each member of staff has their own training records. These showed that staff had received training that included the prevention of abuse, food hygiene, first aid, medication and sight loss. Staff had received training in fire prevention and manual handling but were overdue refresher training. We spoke with the providers training manager on the telephone and they assured us that this training was currently being arranged. Staff meeting minutes showed that these usually happen regularly so that staff can keep updated with best practice and know about the changing needs of the people living there. Records show that staff do receive supervision and for some staff there was evidence that this was regular. However for two staff there was no record of supervision for several months. The manager said that she was sure that supervision had been done recently but she was unsure where the records for this had been filed. Staff should have at least six formal supervision sessions each year so that they are supported and know how to meet the needs of the people living there. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure that the home is safe and well run in the way that the people living there want. Evidence: The manager has many years experience working with the client group. She has completed NVQ level 4 and the Registered Manager award. People who live at the home told us manager is very good, always asking us if there is anything we want to improve, they tell us about everything, explain things, and Barbara is a good manager. It is clear from speaking to people at the home that they are continually being consulted about how the home can improve, this is also evident from residents meeting minutes. However most quality assurance in the home is on an informal basis and would benefit from being more formalised, for example the use of questionnaires for people at the home, their relatives and any involved care professionals could be introduced. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: At our last inspection we found that a representative of the provider did unannounced visits each month to talk to people about the home and to check and comment on the standards of care. At this inspection records and discussion with the manager indicated that these visits have not been happening every month. These need to be done to make sure the home continues to be well managed. A number of health and safety records were looked at. An external company had completed a full health and safety audit of the home in July 2008. Some minor areas for improvement had been recommended and the home has actioned these. Records sampled showed that equipment in the home is regularly serviced and well maintained so it is safe to use. Water temperature checks are completed weekly to prevent the risk of scalding to people. Fire records showed that staff test the fire equipment regularly to make sure it is working. People who live at the home have previously been included in fire training and there are regular fire drills so that staff and the people living there would know what to do if there was a fire so minimising the risks to their safety. 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 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 Care plans should contain more detail about the support people need, their goals and aspirations for the future and be reviewed more frequently. To help ensure people get the support they need in the way they prefer it. Records should be maintained of when people receive input from the chiropodist to show that peoples nail care needs are being met. Records of monitoring of the medication fridge temperatures should be maintained to show that the home is checking that medication is being stored at safe temperatures. Make arrangements to replace the lounge seating and stained carpet in one persons bedroom so that the home remains in good condition and is a nice place to live. Staff recruitment files need to be improved to provide evidence of why normal recruitment practices have not been followed, such as seeking a reference from previous employers. This will ensure recruitment practice is robust and people are protected from having unsuitable staff working with them. Refresher training for staff in fire and manual handling needs to be arranged as soon as possible so that staff have the knowledge they need to keep people safe. Page 28 of 30 2 19 3 20 4 24 5 34 6 35 Care Homes for Adults (18-65 years) 7 36 Records need to be available in the home to show that staff have regular supervision so that they are supported and know how to meet the needs of the people living there. Improve systems for quality assurance to include improving the frequency of visits to the home by the providers representative to make sure the home continues to be well run for the benefit of the people living there. 8 39 Care Homes for Adults (18-65 years) Page 29 of 30 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!