Inspection on 24/11/08 for St Raphael`s Integrity Care Home

This inspection was carried out on 24th November 2008.

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

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

Other inspections for this house

St Raphael`s Integrity Care Home 08/08/06

St Raphael`s Integrity Care Home 26/09/05

St Raphael`s Integrity Care Home 09/06/05

St Raphael`s Integrity Care Home 02/11/04

St Raphael`s Integrity Care Home 15/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Raphael`s Integrity Care Home 93-95 Stanhope Gardens Haringey London N4 1HZ     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: Margaret Flaws     Date: 2 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: St Raphael`s Integrity Care Home 93-95 Stanhope Gardens Haringey London N4 1HZ 02088006393 02088000429 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Phivos Joannides,Mrs Eftychia Joannides care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Limited to 7 adults of either gender with a learning disability (LD) and one female over the age of 65 years who has a learning disability (LD(E)). Date of last inspection Brief description of the care home St. Raphaels Integrity Care Home is a care home registered to provide personal care for a maximum of eight residents between the ages of 18 to 65 years who have learning disabilities. One specified resident may be over the age of 65 years. The home consists of two adjoining two storey terrace houses that have been converted to become a single home. There are eight single bedrooms located on both the ground floor and the first floor. None of the bedrooms have en-suite facilities although each bedroom has its own sink. The two kitchens, dining room and lounge are on the ground floor. The front of the building is primarily paved. The back garden is partly paved and accessible to residents. It is attractively arranged and contains a variety of fruit trees and flowers. The home is situated in a residential area of Haringey and close to a large selection of shops and multi-cultural facilities located along Green Lanes and in Wood Green. St. Anns Hospital is about half a mile away. The home currently charges from #550 per week depending on the assessed needs of the service user. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 7 Brief description of the care home The registered manager stated that information, including the contents of CSCI reports is shared with stakeholders and a copy of the latest CSCI report is kept available in the home. The stated aim of the home is to provide a high quality of care within a comfortable and homely environment and to enable residents to lead as independent a life as possible. 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 unnannounced key inspection took place over one day on 24 November 2008. We were assisted by an Expert by Experience Carol Merenghi and her assistant John Robinson. They focussed on gaining the views of the people living in the home. The Registered Persons Mrs. Eftychia and Mr. Phivos Joannides and the Service Manager Chris Joannides were present and worked with us throughout the inspection. The inspection consisted of meeting with and talking to people living in the home, with the Registered Persons and Service Manager and with staff. We also saw care and staff records and general home records. We also undertook tours of the building. The home supplied with us with a good quality Annual Quality Assurance Assessment (AQAA), which we used in the inspection. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: 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. New residents can be confident that their needs will be fully assessed before they move in so that they know the home can meet these needs. Evidence: At the time of the inspection, there were eight people living in the home. The Registered Manager said that they come from the London Boroughs of Haringey, Islington and Camden. We saw the files of two people who had moved into the home since the last inspection. The files had a good range of assessment information completed by the home and by the referring agencies. The evidence we saw on peoples files was in line with the homes admissions policy and procedure. One person had recently moved in from another care home and the Area Manager showed us evidence in her notes of how her wellbeing had improved since being at St Raphaels. We observed this resident throughout the inspection and noted the positive interactions between her and staff. There was also evidence on file that the local authorities had completed annual reviews Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: of peoples needs and of multi-disciplinary assessments for peoples changing needs. 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. People living in the home have good and well planned care to meet their needs and wishes, including their specialist needs, and they are actively involved in identifying and planning for their needs. They are supported to make their own decisions and choices and work towards degrees of independance. Risks to their wellbeing are assessed and managed to protect their interests. Evidence: On this inspection, we were supported by an Expert by Experience, who spent time talking to the six residents and asking them about how they felt about living in the home. The feedback she received from residents was very positive. Residents told her that they really liked the Registered Manager and referred to her as Mrs. Happy. They said that they were very much at home and happy; that staff Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: listened to them and acted on their suggestions. The residents gave examples of how their wishes had been considered: in replacing a pool table with a piano for music sessions; creating a lovely, communal, covered, all-year round space (between the two houses) where people can spend time together. We saw the care files and plans for four people. The care plans were up to date and regularly reviewed. The Area Manager said the care plan format had been improved in the past two years to include more comprehensive information. The care plans covered a range of peoples physical, social, emotional and mental health needs. The home is registered for people with a primary need related to their learning disability but has resident some people who have mental health issues in addition to their learning disability. There was good evidence that the home assesses and meets these needs. The management team also described an example where they assessed that they could no longer meet the changed mental health needs of one resident and how they helped this person to move on to more suitable accomodation. There were good evidence of how peoples needs were planned for and met. In the example of one resident who had moved in from another home where her needs were not being met, staff said the her wellbeing had improved considerably, in several ways. At the home, she was becoming familiar with her Greek cultural background, speaking Greek to staff, eating Greek food, sleeping properly and developing self confidence as a result. She was also giving up smoking with the homes support. These improvements were doucmented in care plans and reviews. Residents involvement in the reviews was documented and signed off by them. We checked the daily notes for several staff. These gave reasonable information about each person but we noted that the language used in some notes was inappropriate. This was particularly notable when some staff referred to continence and challenging behaviour issues and gave an unprofessional and possibly judgemental message. We discussed this at length with the Registered Manager, who understood our concerns. A requirement is given that staff, for whom English is not their first language are provided with some additional training and that specialist training is provided in using the appropriate professional and respectful language in care notes. We observed good communication throughout the day between the residents and the staff. There is a good system in place for supporting people with their finances. The Registered Manager showed us samples of how three peoples money was kept safe. This is usuallly involves receipting in and out small amounts of petty cash for day to day expenditure. For those residents who manage their own finances, staff said that Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: they assist with budgeting advice. One person now has local authority guardianship and we saw the records of this process. Risk assessments were in place for a range of risks and these had been regularly reviewed in the files we saw. Examples of risks assessed included crossing the road, cooking, getting locked in the toilet, going missing, and daily living activities. There were also good risk assessments put place for one person where there were specific concerns about previous associates and in other instances where people could be vulnerable to exploitation. There were also generic risk assessments on file for the home and these had been regularly reviewed. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy a good range of activities that meet their needs and preferences, including their cultural needs. Contact with relatives and friends is supported in line with their wishes. Their rights and responsibilties are respected and promoted within their daily lives and they enjoy balanced and varied meals that meet their needs and preferences. Evidence: Over the inspection day, residents who were able to go out unaccompanied came and went according to their wishes. One person went to a local cafe, two others went out on visits to other parts of London and another person went on a family visit. Residents have freedom passes and use public transport. The home also has a minbus for outings. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The day of the inspection was a Greek Saints day and residents who wanted to were going to the Greek orthodox church to celebrate. The Registered Manager also told us that there was a celebratory meal that evening. A Greek Orthodox priest regularly visits the home and staff said that other residents attend a local Pentecostal church. Residents had made recent visits to the Science Museum and and a Halloween party. The residents had begun planning for Christmas and New Years Eve and for visits to other museums. We discussed activities with the Area Manager. He told us about a range of activities offered by the home. These included arts and crafts sessions, regular group visits to local restaurants, partipation in food shopping and drama therapy. He said that the home works to improve peoples independance by teaching them shopping and cooking skills and some residents do move on to supported living services, which they organisation also runs. Each resident has an activity plan. This includes peoples wishes and interests. In the plans we saw evidence that people regularly attended colleges,went to day centres, lunch clubs and cafes. Both the Registered Manager and residents told the Expert by Experience that there had been some problems with access to local colleges and day centres because there had been changes in these organisations. They said that the home had done its best to make up for these problems. The home is nicely decorated with a range of photos of residents at events, celebrations and on holiday. All residents go on holidays annually, which are well documented. In the past two years, all residents have been on holiday in Britain and four have been to Greece. They are always accompanied by staff. In the case of another resident who did not know his cultural background, he went to his family village and enjoyed new contact with people there. Most people we spoke to have family support and where people do not, the home has helped them to find advocates. Family visits are a regular part of the life of the home. There was good evidence that residents are supported to develop the friendships and relationships as they wish. Residents discussed their daily lives with the Expert by Experience. They said that they were very pleased with the spiritual support they received or none, as in if people dont have a belief then thats fine too). We saw the food on offer in the home. There was a menu on the noticeboard. Food choices and requests were discussed at the two monthly residents meetings and with residents on a daily basis. In the residents meeting minutes, there were recorded Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: discussions about individuals requests, for example, for rabbit stew and sausages and putting these on the menu. During the inspection, one resident requested a traditional Greek breakfast of haloumi cheese, which the staff prepared. People ate a healthy lunch. We saw staff bringing back the food shopping for the home and food kept in the home was good quality and plentiful for peoples needs. Staff showed the Expert by Experience that book for recording the food that people like and eat and she felt it showed good choices and healthy food. Care Homes for Adults (18-65 years) Page 17 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. Residents receive appropriate personal care support, in line with their wishes. Their physical and mental health needs are assessed and met, with specialist support as needed. They are also protected by the homes new medication policies and procedures. The home know what people would like if they die. Evidence: Most residents need some form of support with their personal care needs, but for most people this is mainly prompting. Some residents require a higher level of support. This is documented in their care plans. Residents physical and mental health needs were assessed as and when needed. Routine health care appointments were also planned for and appointments made. These appointments were documented in peoples files and in the diary.This meets a requirement from the last inspection. Residents are supported to attend hospital appointments if necessary. Residents also had six monthly medical reviews. For residents who have additional mental health needs, mental health support is in Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: place with appropriate professionals. The Registed Manager is also a registered nurse who can assess peoples changing health needs on a daily basis. The home has a completely new and simple medication policy and procedure that has been put in place since the last inspection which the Registered Manager explained. The local Pharmacist delivers the medication monthly using a blister pack system and this is entered clearly in the medication book and signed for by staff. This meets two requirements from the last inspection. There is also a good system for medication returned to the Pharmacy. Staff prepare the medication for the week and two staff complete an audit. We sampled the medication records (MAR sheets) and these were in good order, with no errors or omissions. Medication is stored in two places - in a day to medication cupboard and under the stairs for the medication received monthly. There is no seperate locked internal cupboard for controlled drugs under the stairs. A requirement is given that the medication storage arrangements be reviewed to ensure that these medications are safely kept. The Area Manager said that he is currently writing a self-medication policy and procedure. All staff have NVQ2 qualifications and have completed the modules on medication. Peoples wishes in relation to death and dying have been fully assessed and recorded. Care Homes for Adults (18-65 years) Page 19 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. Residents and others can express their views and concerns and know that these will be addressed appropriately by the home. They are also safeguarded from harm by the homes policies, procedures and staff understanding of how to put these into practice. Evidence: Residents are encouraged to express their concerns as and when they have them. We saw the complaints policy and procedure. The Registered Manager said that all residents have copies. This is also translated into Greek for those residents for whom this is their first language. We saw the complaints records and there were no signficant complaints recorded since the last inspection. Complaints have been addressed with actions and follow-up documented. The home has copies of the local authoritys safeguarding policy and procedure. There was one safeguarding referral made since the last inspection. It involved concerns about heating and provision of food. Safeguarding strategy meetings identified the concerns mainly related to one of the organisations supported living homes and were satisfied that residents were well safeguarded. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: All staff have been trained in safeguarding by attending a one day course. Three senior staff were also booked in advanced safeguarding training. They were aware of the issues involved and actions to be taken if there was a disclosure or allegation of abuse. Care Homes for Adults (18-65 years) Page 21 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. Residents live in a home that is well decorated, maintained and meets their needs. The home was clean and tidy throughout and residents said that they liked their physical surroundings. Evidence: The home consists of two adjoining two storey houses that have been converted into a single home. There are eight single bedrooms on the ground and first floors. These bedrooms are not ensuite but each has its own sink. The two kitchens, dining room and lounge are in the ground floor. There is a pleasant and accessible back garden which people said they liked and used regularly. We toured the building and saw the residents rooms. The home was in a good state of physical repair. The bedrooms were highly personalised by the residents. Residents told the Expert by Experience that they had chosen how their rooms were decorated, their furniture, etc. It was a cold day and the home was kept warm and comfortable. The Area Manager described improvements made to the home since the last inspection in 2006. Several rooms have been repainted, carpet replaced, new guttering put on the roof and a new garden shed has been purchased. The home uses a range of local Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: and accessible tradespeople for maintenance. New fridges and freezer have been purchased. Furniture appeared comfortable and appropriate. The commmunal spaces were comfortable and residents we saw throughout the day spent time there together and doing activities like reading, watching television (there is satellite tv and Greek television in the home) and listening to music. The Registered Manager said the home plans to get internet access for the residents. There are photos of the residents enjoying life nicely presented throughout the buildings. We met a new kitten and its mother, whom the residents said they enjoyed as part of the family. The home was clean and hygenic. Staff and residents told us that the Registered Manager has a high standard of cleanliness, which she expects staff to maintain. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes staffing arrangements, recruitment procedure, staff training and support. Evidence: On the day of the inspection, two staff were on duty on each shift, plus the Registered Manager. The Registered Provider was also working on duty. The Area Manager said that there had minimal staff change since the last inspection. The home has several bank staff who provide as and when support to group of homes and some occasional agency staff who know the home well are used. There were sufficent staff on duty to meet the needs of the residents. We saw the duty rota for the week. It included the full names of staff on duty. This meets a requirement from the last inspection, to ensure that staff first and surnames were noted on the rota. The home has a satisfactory staff recruitment process. We checked four staff files, including the file of one new staff member. All staff had had pre-employment checks, including full Criminal Records Bureau checks, two written references obtained and photographic identification supplied. We talked to the Area Manager and the Registered Manager about the range of Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: training provided. The home has a very good and well planned training programme in place and provides CSCI with regular updates of training completed. We sampled the training records of four staff. Staff had recently and regularly received a good range of mandatory training, for example, in first aid, infection control, health and safety, medication, safeguarding adults, working with challenging behaviour, food hygiene and equality and diversity. Staff are completing an in-house programme of training on medication, with an on-site supervisor from a local college. However, the home has had some problems getting training certicates from one education provider. Most staff have achieved a NVQ qualifications. Staff had also received good two monthly supervision. This was clearly documented and staff said that they found it useful for improving their practice. There are regular staff meetings which are minuted and include addressing resident and staff issues in a transparent way. Staff we spoke to said they liked working in the home and they also said the same to the Expert by Experience. Care Homes for Adults (18-65 years) Page 25 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. Residents live in a well managed home that is focussed on their interests. They are consulted on a day to day basis and their health and safety needs are safeguarded. Evidence: The Registered Manager is a registered nurse and holds a Registered Managers Award. She demonstrated a sound understanding of the residents needs and of how to manage the home well. The staff we spoke to indicated that they felt supported and encouraged to do their jobs well. There was good evidence that the home consults regularly with the people who live there and with their families. We saw the minutes of regular residents meetings and the annual satisfaction survey. The sampled surveys that we saw had been completed by the residents and was openly expressed. The Area Manager said the results of these surveys are collated and analysed, so that outstanding issues can be actioned. We checked the health and safety records and certificates. These were in good order Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: and confirmed the information provided in the homes Annual Quality Assurance Assessment provided to CSCI. Fridge and freezer temperatures were taken daily and recorded to keep food safe. Fire policy and procedures are followed. Regular fire safety checks had been carried out and fire drills, including an after dark drill, had been completed every three months and recorded. Fire equipment was professionally checked on a regular basis, meeting a requirement from the previous inspection. The fire safety risk assessment had been reviewed with a fire safety officer in 2008 and the front door closure system has also been checked and risks assessed, meeting another previous requirement. There are thorough health and safety risk assessments in place for the building and for issues in the home (for example, building security, the risk of residents going missing, infection control). These risk assessments have been regularly reviewed and updated. Care Homes for Adults (18-65 years) Page 27 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 28 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 must 27/02/2009 ensure that all staff for whom English is not their first language are provided with additional training and that specialist training is provided in using the appropriate professional and respectful language in care notes. The care notes must be written respectfully and professionally 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 21 It is recommended review the medication storage arrangements be reviewed to ensure that these medications are safely kept. 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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