Inspection on 13/01/09 for St Annes Road East (85)

This inspection was carried out on 13th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Annes Road East (85) 04/09/09

St Annes Road East (85) 11/08/06

St Annes Road East (85) 01/12/05

St Annes Road East (85) 09/08/05

St Annes Road East (85) 16/12/04

St Annes Road East (85) 11/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF     The quality rating for this care home is:   one star adequate 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: Phil McConnell     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. 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. 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: St Annes Road East (85) 85 St Annes Road East St Annes Lancashire FY8 3NF 01253789074 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Steve.Turner@unitedresponse.org.uk United Response care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home 85 St Annes Road East is a small care home for adults with learning disabilities, registered for six people. The well-established national charitable organisation United Response is the registered provider. The home is a semi-detached three-storey house providing good access to local services and amenities. The organisation provides a vehicle to enable people living at the home to take part in leisure activities and access amenities. The staff team support individuals in all aspects of daily living according to their assessed needs and as identified via the care planning process. Individuals are supported and encouraged to develop their independence and take part in all aspects of community living. The service adopts an active support approach, providing people with practical day-to-day support, in order that individuals can take as much control of their lives as possible. Care Homes for Adults (18-65 years) Page 4 of 30 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: Various information was obtained in order to assess the key standards that are identified in the National Minimum Standards for Care Homes for Younger Adults, including: The Annual Quality Assurance Assessment (AQAA), which had been completed by the registered manager (Stephen Turner), an unannounced inspection visit to the home on the 13th of January 2009 and the annual service review (ASR), which had been completed in January 2008 by an inspector from the Commission for Social Care Inspection (CSCI). The registered manager was available during the unannounced inspection visit. All of the files were examined including, the staff files and the files of the people who use the service. Care Homes for Adults (18-65 years) Page 6 of 30 Throughout the day there was the opportunity to observe the support being provided by the staff, which was carried out in a professional, caring and appropriate manner. There was the opportunity to speak to some of the staff during the day. The discussions were beneficial and constructive. The organisations polices and procedures were examined and were found to be up to date and appropriate. The health and safety inspection certificates were examined and they also were found to be up to date, with satisfactory checks having been carried out, helping to give the assurance that peoples health and safety is monitored and managed. A full tour of the home was carried out. (See environment section). Following this inspection the registered manager was given some feedback. Some requirements and recommendations have been made by the CSCI, following the inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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. There are satisfactory pre admission procedures in place, helping to give the assurance that peoples needs will be met. Evidence: The statement of purpose and the service user guide gave clear and up to date information about the organisation and what people can expect to find, if they choose to go and live at St Annes Road. Although there have been no new admissions to to the home since the previous inspection visit, it is clear that there are sufficient systems and procedures in place. This helps to demonstrate that satisfactory assessments will be completed before a person goes to live at St Annes Road. In discussion with the registered manager it was apparent that an appropriate pre admission assessment would be carried out, giving the assurance that a persons care and support needs would be provided for. The AQAA says, we plan our services in an individualised person centered manner and work in partnership with all relevant others including, families professionals and friends etc. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The AQAA also says, we have used the Good to Great tools, which is a major part of the support planning initiative that has been rolled out across the United Response Organisation. It was apparent that the Good to Great tools are not being used at the home. This was discussed with the registered manager and an assurance was given that the Good to Great care assessment and planning documentaion would be implemented as soon as possible in the home. It was also mentioned that he AQAAs should contain individualised information for each of the care homes. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a lack of consistency, detail and up to date information in peoples care plans and their risk assessments. This fails to give assurance that peoples assessed needs are being satisfactorily provided for. Evidence: Peoples files were examined and it was apparent that there is a lack of consistency among them. However, all of the files did contain some information regarding individuals care needs. The AQAA states that the home is using the already mentioned Good to Great tools, which includes the Listen to Me booklet and Individual Support Plans,however only one or two people have completed plans in place and even these lacked up to date information. This information is needed to ensure that a person assessed needs will be satisfactorily met. Generally peoples files were quite untidy and disorganised. They need to be properly audited to ensure that they all contain up to date, appropriate and relevant Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: information. This will give some assurance that peoples needs and any changing needs are identified, monitored and addressed accordingly. It was clear that the staff are fully aware of individuals needs, but the problem is that they are not sufficiently recorded. It was also apparent that the staff team have managed to continue to provide a good level of support to people who use the service, without the correct management support being in place. During the inspection visit the staff were observed communicating, consulting and negotiating with people about daily lifestyle issues including, where a person would like to go for the afternoon, what to have for a meal and some people were actively getting involved in participating in chores within the home. This helped to show that people are enabled and empowered to be included as much as possible in daily events and in the different aspects of daily living. It was evident that the support staff are endeavoring to promote peoples independence. This was observed in the discussions that took place with the staff and the people who use the service. This was by way of encouragement, patiently listening and giving the individual the opportunity to make informed decisions or choices. However, peoples files did not contain sufficient, up to date or satisfactory risk assessments, that would clearly demonstrate that independence is being promoted. An assurance was given by the registered manager that a new team leader would be recruited and until then he would spend more time at the home. This should help with improved consistency and continuity of management, with increased support to the staff and also to the people using the service. 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. People are positively supported to participate in meaningful and appropriate activities in the local community. Evidence: There was evidence to show that people do access various meaningful and stimulating activities including, aerobic classes, meals out, sensory drama classes, and daily outings in the local community. During the inspection visit people were observed coming and going, with adequate support being provided. It was evident that people were familiar with the different activities they access and some of their comments were, I love going dancingand I like going to the pub, its great. It was mentioned by a member of staff, the staff at the pub are marvelous, they really are very good and always make us welcome and another person wrote, we make sure our clients get out into the community and try to fulfill their requests as to what and where they Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: want to go to the best of our abilities. This helps to demonstrate that community presence and participation is positively promoted. Daily shift reports are maintained and it was evident that relevant information is taken from the reports and placed into the monthly reports. This is then used for future planning. It was suggested to the registered manager that dates and names should be placed on all staff communications and daily reports. This would help ensure that there is a consistency with the recording of information and it would be clear who had written a particular entry and when. It was stated by the staff that people do have appropriate relationships with friends and contact with family members is maintained and encouraged, with one person writing, we have good relationships with our clients families, who all visit on a regular basis. The AQAA says, Learning logs and shift reports record evidence of activities taking place and contact with families. It was evident that good and trusting relationships existed between the staff team and the people using the service. It was also apparent that people were treated respectfully and with dignity. People are encouraged and empowered to maintain nutritious and wholesome diets. It was clear that when possible people are supported in meal preparation and cooking. It is apparent that the staff team actively promote healthy lifestyles for the people who use the service. 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. Peoples health and personal care needs are being appropriately provided for, demonstrating that peoples health care and wellbeing is promoted and monitored. Evidence: As already mentioned peoples files were generally disorganised however, it was evident that there was sufficient information in place to enable the care staff to provide personal care to the people they support, albeit some of the information was out of date. In observation and in discussion with the staff it was clear that they have a good understanding of peoples personal care needs. The AQAA stated that health action plans had been initiated for each individual, but only two of the four people had them in place. There was however, information available to show that people attend GP visits, medical appointments, Dentists and during the inspection visit a Chiropodist was attending to the people who live at the home. There was the opportunity to have a brief discussion with the Chiropodist and she said, I have been visiting for six years and I now feel part of the team. It was evident that people felt comfortable with this person and two people expressed how Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: they liked, having their feet done. One of the staff comments was, we try to make sure our clients get the best care that we can provide. The medication was safely and appropriately stored,with correct and up to date records in place, showing that they were being administered according to the organisations medication policy and procedures. Care Homes for Adults (18-65 years) Page 17 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. Correct policies and procedures are in place, helping to give the assurance that people are protected from harm or abuse. Evidence: The policy and procedures regarding concerns and complaints were examined and found to be satisfactory, giving appropriate , relevant and clear guidance. The complaints procedure is also available in picture format, helping people to have a better understanding. A copy is provided with the service users guide when a person joins the service. No complaints have been received since the last inspection visit. There was a policy in place to deal with a suspicion or allegation of abuse. In discussion with some of the staff there was a clear awareness of the process to follow in the event of an allegation or suspicion of abuse being made. It was evident that staff have received training in the safeguarding of adults. The AQAA says, all team members are required to familiarise themselves with the organisations Prevention of Harm and Whistle blowing policies and the No Secrets in Lancashire, which is a document provided by the government, giving guidance regarding protection and safeguarding issues. The staff have had criminal record bureau (CRB) checks, helping to show that only appropriate people are employed to care and support vulnerable people. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Care Homes for Adults (18-65 years) Page 19 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. There is a need to ensure that all areas of the home are clean, giving the assurance that people live and work in a comfortable, safe and hygienic environment. Evidence: A tour of the home was carried out and in many areas it was of a reasonable standard regarding decor, being comfortable ,safe and hygienic. A new modern and fully equipped kitchen had been installed since the last inspection visit, although some redecoration is in need of being completed. Once this is done, it will be a pleasant, modern and hygienic kitchen. The home has a fully equipped laundry that is situated at the rear of the building, it is easily accessible and it is sufficient to meet the needs of the people who live at St Annes Road. It was evident that the dining room, the sitting room and the hall stairs and landings have been decorated since the last inspection visit. These areas have benefited from this refurbishment, making them more pleasant and comfortable. However, it was observed that the staircase and landings were very dusty and the fire extinguishers in Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: many areas were quite dusty. This was raised with the registered manager and an assurance was given that the cleaning in all areas of the home would be looked at, ensuring that the home is clean and hygienic. Peoples bedrooms were observed to contain their own personal items, helping to demonstrate that individualism and independence are promoted. One of the bedrooms is in need of being redecorated, which would make it more pleasant and comfortable and bring it up to the same standard as the other bedrooms. The outside grounds were neat, tidy and they were observed to be safe and maintained to a good standard. Generally the environmental standards within the home have improved, although there are still some areas that need attention. Care Homes for Adults (18-65 years) Page 21 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. There is a need to appoint a team manager and provide the required specific training. This would give assurance that staff are receiving regular supervisions and people are supported by well trained and skilled staff . Evidence: The staff files were examined and they were found to contain some information, regarding the skills, experience and training that people have received. The files were quite disorganised and are in need of being audited and brought up to date. As previously mentioned the home has been without a team leader for a considerable time. It is apparent that this has contributed to the unsatisfactory organisation and maintaining of files and documents. The registered manager gave an assurance that a new team leader would be recruited as soon as possible and he would base himself at St Annes Road until another person is recruited. Although there has not been daily leadership in place, it was evident that the staff have continued to provide a good level of support and care to the people who use the service. Some of the comments from staff were, The management could do better,we lack supervisions and team meetings to discuss any issues I havent had a supervision for almost seven months and the team manager took up another post Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: with another company. No replacement was found and this has caused a lot of concern for the staff, two people have been off sick during this time. The AQAA says, United Responses recruitment process ensures that the correct clearance checks are made including CRB and the POVA list checked, that two satisfactory references are obtained and all other requirements are met prior to a new recruit commencing in post. The staff files contained evidence that the correct recruitment procedures had been carried out, helping to ensure that vulnerable people are protected. One hundred percent of staff have achieved the National Vocational Qualification (NVQ) in care. Although other relevant training is provided by the organisation, some concern has been raised by staff members including, we desperately need training courses which would help us better understand Autism and especially with the aging process of Downs Syndrome we could do with more training on communication, the training we were having wasnt completed because the trainer left and we need more in depth training, that covers Downs Syndrome and Dementia. A discussion took place with the manager, regarding the training that staff have highlighted and he said he would raise the issue with senior management. Care Homes for Adults (18-65 years) Page 23 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. There is a lack of effective management at the home, which has caused some shortfalls in the running of the home. Evidence: The registered manager is also responsible for three other care homes in the Lytham area, with each of these homes having a team leader in place to maintain the day to day running of the home. However, there is no team leader at St Annes Road. The previous team leader left in December 2008 and for a considerable length of time the person had only been working part time. This has caused some concern with the day to day management within the home. Some of the staff comments received regarding management were, The team manager reduced her hours. This was done without proper communication with staff and no replacement was found. This caused a lot of concern for the staff, as two staff members have been off sick The team manager could have done better at her role, we had no supervisions or team meetings to discuss any issues we had and due to our team manager taking up a second job we rarely see her, because she has dramatically reduced her hours. It is over seven Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: months since I last had a supervision. Although there has been a lack of consistent day to day management, the staff team have coped very well and it was evident that a good level of care and support has been maintained. As already mentioned the information contained in the Annual Quality Assurance Assessment (AQAA) is not totally applicable to the service being provided at St Annes Road East. This was also evident in the lack of recorded information , with regard to quality assurance monitoring.This quality monitoring task would have been regularly carried out by the team leader. All of these issues and concerns were discussed with the registered manager and an assurance was given that they will be addressed. Since the inspection visit we have received information that the registered manager is based at the home and the issues raised are being dealt with. The health and safety policies and procedures were examined and they were found to be up to date, with all of the necessary health and safety inspection certificates being available for inspection including, gas certificate, electricity, and portable appliance testing (PAT). There were records to show that fire safety checks, smoke alarms, emergency lighting and the checking of water temperatures are regularly carried out . This helps to demonstrate that the health and safety of the people who live and work at the home is positively promoted. Care Homes for Adults (18-65 years) Page 25 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 26 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 6 15 The registered person shall keep peoples care plans up to date and under review. There is a need to ensure that the care planning process is satisfactorily maintained, with sufficient information for the staff to be able to provide the persons assessed needs. 31/03/2009 2 30 23 The registered person shall ensure that all parts of the care home are kept clean and reasonably decorated. This will help ensure that people are living and working in an environment that is safe, clean and hygienic. 31/03/2009 3 33 18 The registered person shall 31/03/2009 ensure that at all times suitably qualified, competent and experienced persons are working at the care home. Care Homes for Adults (18-65 years) Page 27 of 30 There needs to be a team leader, who has the responsibility of the day to day running of the home. 4 35 18 The registered person shall ensure that the persons employed at the home receive training appropriate to the work they are to perform. Staff need to have the necessary training, in order to be able to support people to the best of their ability. 5 36 18 The registered person shall 31/03/2009 ensure that persons working at the care home are appropriately supervised. This would demonstrate that the staff are valued and their opinions are taken seriously. 6 37 18 The registered manager 31/03/2009 shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home. there is a need to have a team leader in day to day running of the home. 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The AQAA needs to reflect the actual service being provided at St Annes Rd. Page 28 of 30 Care Homes for Adults (18-65 years) It is apparent that the AQAA has been completed exactly the same for the other United Response homes in Lytham. 2 3 38 39 A team leader is needed to ensure that a consistent management approach is maintained. A consistent approach to quality assurance monitoring is needed.This will give some assurance that people have the opportunity to say how they feel, about the service being provided. 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!