Inspection on 14/01/09 for The Letchworth Mental Health Project

This inspection was carried out on 14th January 2009.

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

The Letchworth Mental Health... 06/02/07

The Letchworth Mental Health... 10/02/06

The Letchworth Mental Health... 01/10/05

The Letchworth Mental Health... 09/03/05

The Letchworth Mental Health... 19/05/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Letchworth Mental Health Project 8-10 Springshott Letchworth Hertfordshire SG6 2HJ     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: Jeffrey Orange     Date: 1 4 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 29 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 29 Information about the care home Name of care home: Address: The Letchworth Mental Health Project 8-10 Springshott Letchworth Hertfordshire SG6 2HJ 01462678122 F/P01462678122 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Post Vacant Type of registration: Number of places registered: Granta Housing Society Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Springshott is part of the Letchworth Mental Health Project and provides accommodation and care to five adults who have a history of mental health problems. The home consists of two terraced houses that have been converted into one house. The accommodation consists of a lounge, kitchen/diner, utility, one bedroom, a staff sleep-in room/office and a toilet on the ground floor, with 4 further bedrooms, two bathrooms and a toilet on the first floor. There is a large garden and patio area with table, chairs and sunshade. There is also an adapted garden shed that provides a sheltered area for those service users who smoke. The property is situated in a quite residential area of Letchworth and is within walking distance of local shopping and public transport facilities. The only parking provision is on road, subject to availability. The home has a Service Users Guide and Statement of Purpose which contain contact details for the Commission for Social Care Inspection (CSCI) and the most up to date inspection report is also available. Weekly fees are £278.98 (As at January 2009) and Care Homes for Adults (18-65 years) Page 4 of 29 5 Over 65 5 Brief description of the care home are for accommodation and care. Items such as newspapers, hairdressing and personal toiletries are paid for by people living in the service, chiropody, dentistry and opticians services are also paid for by service users unless they qualify for free treatment under the NHS. Care Homes for Adults (18-65 years) Page 5 of 29 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: We last inspected this service on the 6th February 2007 and we also carried out an Annual Service Review on the 25th January 2008. This inspection was carried out by one inspector, in the report, when it refers to we it recognises that the inspection was carried out on behalf of the Commission for Social Care Inspection (CSCI). 8-10 Springshott forms part of the Letchworth Mental Health Project and the registered manager for the home also has responsibility for the other, non-registered parts of that project. As everyone associated with the home refers to it as Springshott, that is what we will call the home in this report. This unannounced inspection began early in the morning which provided an opportunity for us to observe the routine of the home as people living there were getting up and Care Homes for Adults (18-65 years) Page 6 of 29 ready for the day ahead. We were able to speak to some of the people living in Springshott as well as to members of the staff team on duty. We received survey returns from people who live in the home, their relatives and carers as well as staff and those comments are all taken into account in drawing up this report. We also spoke to health and social care professionals who are familiar with Springshott. Whilst we were in the home we looked at some key records including those for medication as well as care plans for people living in the home. The manager was not present at the inspection however we did speak to them immediately following our visit. This report takes account of the information provided to us by the home in their Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment document that sets out how well care outcomes are being achieved for people who live in the home, it also includes some useful statistical information. 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 29 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 29 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 who are considering Springshott as a home for themselves or someone they are responsible for can be confident that before admission there will be a thorough assessment of their individual needs and an individually tailored process of introduction to the home that should ensure that only those people whose needs can be fully met are admitted. Evidence: We were told in the homes AQAA that since the introduction of a bed management team in Hertfordshire to initially screen referrals to this service to make sure they are appropriate, the number of inappropriate referrals has decreased significantly. Although the service currently has one void, which clearly has financial implications for them, when we spoke to staff and saw details of the assessment process and how it works in practice, we were satisfied that it would not be compromised by any financial considerations. This means that an unsuitable placement would not be accepted just to fill a vacancy which could adversely affect the well-being of the people already living in Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: the home. When we spoke to staff they told us that only after a thorough and detailed process of assessment including several visits by the person concerned to the home to meet the people already living there, would an admission on a trial basis be considered. When we looked at the pre-admission assessment process undertaken in respect of a person who recently moved into the home we found that it was thorough and comprehensive and took place over an extended period, which gave everyone involved time to make sure that this was the most appropriate place for the person to live. When we spoke to the person concerned and observed their care and relationship with other people living in the home we found that their care needs were being well met and that they appeared to have fitted in well with the people already living in the home. We examined the written material available to people considering moving into the home and found that it was very full and detailed, was written in clear language and should provide anyone considering a potential move into the service with the information they need, including the way that their care would be financed, so that they could make a well-informed judgement. When people who live in the home sent us survey returns 100 of them indicated that they felt that they received enough information about Springshott before they moved in so that they could decide if it was the right place for them. Care Homes for Adults (18-65 years) Page 11 of 29 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 who live in Springshott can be assured that are supported by a high standard of person centred care planning that reflects their individual needs and how they are being met. They are enabled to fully participate in decisions about their care and are also supported to lead as independent a lifestyle as is possible within an effective risk assessment framework. Evidence: When we looked at care plans we found that they included evidence that they are regularly reviewed and that any changes in need are identified, with appropriate action taken to ensure that those needs are met. There was evidence that people living in the home are involved in reviews of their care plans and that they are consulted before decisions are taken that would affect them. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: When we looked at some of the care plans we found that there were not always specific detailed risk assessments in place with risks instead covered in general risk assessments. This was discussed with the manager and it was agreed that where appropriate, in order to facilitate the safe provision of care and assessment of potential risks, where there is a significant risk identified, it will be covered by a specific risk assessment. The homes AQAA told us that weekly resident meetings are held and we saw some minutes of these. One person living in the home is the tenants representative and they told us I am treated very well and always am listened to very carefully. The manager told us in the AQAA that people living in the home contribute to the annual quality assurance report. When we looked at the monthly monitoring reports carried out on the service we saw that they usually include details of the people living in the home who have been spoken to and involved in discussions about the service and how it provides care for them. All of the above means that people who live in Springshott are involved in decisions about their lives including their care and support and that their views are listened to and taken seriously. It was evident from records seen, from talking to people living in the home who were about to go out on their own to attend day centre or who were seen to be making their own appointments, that building independence, within an appropriate risk assessment framework is fundamental to the way this service operates. Since we last visited the home in February 2007 one person has moved into a more independent sheltered housing setting and another person who we spoke to during this visit was enthusiastic about their upcoming move to a similar, more independent setting.I am really looking forward to it was their comment. When we asked people living in Springshott; Do you make decisions about what you do each day?one said always, one said usually and two sometimes. All agreed that they could do what they liked during the day, evening and at the weekend. Care Homes for Adults (18-65 years) Page 13 of 29 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. People living in the home can be assured that they will be encouraged and enabled to maintain and wherever possible increase their independent living skills and to make use of community facilities in order to enable them to follow and develop their personal interests and relationships. Evidence: We saw evidence of menus in place and found that these reflected the likes and dislikes of people living in the home as well as their nutritional and dietary needs. We were told that there is a house rota in place for chores and care plans and introductory documentation about living in the home include commitments to this by both the home and people living there. The staff team supervise the overall standard of the homes cleanliness, however giving the people living there some responsibility Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: does mean that at times the standard of cleanliness reflects the fact that someone has not yet done their designated task. This shows however that there is a real responsibility given to people who live in the home to help keep it tidy and is preferable to having everything done for them as it better prepares them for living more independently. When we spoke to one person who hopes soon to move to more independent living they told us that they did all their own shopping and cooking. When we asked the relatives, carers and advocates of people living in Springshott about their relationship with the home they told us that it was very positive and supportive of their role. One person told us that their relative Comes to me at the weekends and I visit midweek as well Another comment was that I am kept wellinformed and one person noted about the lifestyle of people living in the home It is a good mix of private and personal life that provides a safe and steady life for them. When we looked at care plans we found that they contained evidence of the active involvement of families and friends with people who live in the home, in line with their wishes. All of the interactions that we saw during this inspection visit between care staff and people living in the home were appropriate and demonstrated a proper degree of mutual respect. It was clear when we were able to talk to people living in the home about some of the places they had been and the activities they had taken part in within the community, for example aqaa aerobics and weight clubs that they have been able to access the community under guidance within a risk assessment framework. We were also given details of a number of trips undertaken collectively, including to zoos, theatre trips, meals out, bird sanctuaries and Campden Market. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Springshott can be confident that they will receive care in the way they prefer and that they will be able to access the specialist health and social care support they need in order to maintain their health and well-being. People living in Springshott can be assured that their health and safety will be safeguarded provided the homes policies and procedures for the administration of medication are followed at all times, however this must be monitored more effectively to ensure that it is always the case. Evidence: When we looked at the care plans for people living in Springshott, we found that they were individual and person centred and included information as to how their care was to be provided in line with their personal choice and preference. We saw evidence that care plans are regularly reviewed. This should ensure that any changes in need are readily identified and appropriate adjustments to the care made to ensure that peoples needs continue to be met appropriately. When we received comments in surveys from people living in the home, we were told that care staff always listen to what they say and treat them well. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: When we looked at care plans and spoke to staff and people living in the home, there was evidence for the involvement of a range of health and social care services with them. One person living in the home was observed to be making their own appointment to see their doctor the next day.I self-medicate we were told by one person living in the home and this was confirmed in their care plan and supported by an appropriate risk assessment. The home told us in their AQAA about the steps they took after the unexpected death of a person living in the home last year to support the relatives of the person concerned, people living in the home and members of the staff team.This support included signposting to financial and emotional support, counselling for all concerned and encouraging people to talk about what had happened and how they felt about it. People living in the home were also given the opportunity and support they needed to attend the funeral if they chose to do so. When we looked at the medication administration records we found that although the basic standard of medication practice was adequate and whilst there had been some improvement from the last key inspection, for example in the way that medication is now stored and the temperature recorded to make sure it is safe and appropriate, nonetheless there had been a number of occasions over the Christmas period when medication had not been recorded as being given. This had previously been identified as a problem in the homes own monthly monitoring visits and immediately after the inspection copies of a memorandum to all staff was sent to the CSCI, setting out a new and more robust local policy for the monitoring and recording of medication administration. This means that people living in the home should be able to rely on the home to administer and record medication for them accurately. Care Homes for Adults (18-65 years) Page 17 of 29 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. Whilst the potential for abuse can never in practice be entirely removed, people living in Springshott can be assured that they are well protected by staff training and by the way that policies and procedures intended to protect them are reinforced and put into action. This provides confidence that any instances of abuse that may be seen or suspected would be identified promptly and dealt with appropriately. Evidence: All of those people that we contacted during this inspection process have indicated that either they or those that they are responsible for feel safe and well protected in the home and that they are aware of how they could raise and concerns or make a complaint if they needed to. When we looked at the complaints policy we found that it was easy to understand, was readily accessible and available in appropriate formats which should ensure that everyone can make sense of it and know what to do if they need to complain. We were told in the AQAA that The project prides itself on having an honest and frank relationship with residents, family and other health care professionals and this was confirmed when we observed interactions and spoke to or surveyed people who live in the home and those who are responsible for them. When we looked at the regular quality assurance reports on the service carried out by Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: people from outside of the staff team, we saw that they included reports on any problems and included specific opportunities to speak to people living in the home. We saw that advocacy services are available and are publicised in the home for people living there who may prefer to speak to someone outside of the home or their own family.The home told us in the AQAA that they were looking to use advocacy services more often and they were able to give an example of when the advocacy service had been used successfully recently. When we spoke to care workers they each had received training in the safeguarding of vulnerable adults and seemed to have a good understanding of what abuse is, what whistle blowing is and what to do if they saw or suspected abuse was taking place. When we looked at recruitment files for care staff we found that they contained evidence of rigorous checks that have been made to make sure that unsuitable people are not employed to care for people living in the home. When we looked at financial records kept by the home in respect of money held on behalf of people living there we found that they were accurate and that a system of checks and audits is in place to ensure that the financial wellbeing of people living in the home are safeguarded and that records are kept accurately. Care Homes for Adults (18-65 years) Page 19 of 29 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. Springshott provides a safe, comfortable and homely environment for those people who live and work there. Evidence: Everyone who lives in the home told us in their surveys that the home was always fresh and clean. When we walked round during our visit we saw that the home was reasonably clean and tidy given that it is the home of the people who live there and that they take some individual responsibility for cleaning and tidying communal areas as well as their own rooms. We saw two people who live in the home doing what they refer to as their chores. When we walked round the home we were able to confirm that there had been action taken to address any concerns raised in our last inspection with a new kitchen floor being laid. The homes AQAA told us that people living in the home are consulted about decoration and equipment, for example they had asked for and got a new dishwasher provided and had a significant contribution to make in furnishing and decor for communal areas and for their own rooms. The homes AQAA also informed us of the routine checks and environmental audits Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: that are done regularly to ensure the safety and well-being of people who live in the home.It is important that the overall appearance of the home, including the garden and exterior is maintained well, as this enhances the experience of those people for whom Springshott is their home. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Springshott can be confident that they will receive care from a well-trained and supported staff team with the skills and experience required to meet their needs. They can also be confident that they are protected by the way that staff are recruited to care for them. Evidence: We were given a copy of the local and training plan drawn up for the scheme by the manager and when we talked to staff they were able to give details of a comprehensive range of training already undertaken, including at NVQ level 2. Training records seen indicate that staff are supported with training, for example in issues around self-harm to enable them to provide a high standard of appropriate care for people living in the home. Staff told us that they were well supported by the manager, that they had regular supervision and that they worked well as a team and Fellow staff and administration are very supportive and caring, always there to help. When they completed their surveys they all agreed that they were given relevant Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: training that helps them understand and meet the needs of people living in the home and which keeps them up to date with new ways of working. When we talked to care staff on duty we found that several of the staff team have been with the project for a number of years, and this undoubtedly benefits the efficient and effective running of the service, which in turn benefits people who live there. One relative told us; I find Springshott staff obliging, helpful and cant sing their praises enough, please pass on my much held thanks to them all When we have seen recruitment files we have found that there is a robust and thorough system of staff recruitment in place to protect the best interests of people who live in the home. Care Homes for Adults (18-65 years) Page 23 of 29 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. Springshott is a well manged home and people who live there can be confident that their views, needs and best interest are kept at the heart of its operation. Evidence: The manager is not currently registered with the CSCI, in conversations with her and from information in the homes AQAA and local plan, this should be done within the next three months in order to confirm the fitness of the manager to manage a registered care service. From what we have seen, what we have been told and from the records that have been drawn up by the manager, for example the AQAA which was very well completed and an impressive Local and Training Plan for 2008/2009 it appears that the home is very well managed. When we looked at records, spoke to people who live in the home we found that people living in the home contribute to an annual quality assurance report, there is an Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: annual resident survey carried out by Granta, there is a quarterly newsletter, people living in the home have a weekly meeting and there is a residents representative at Springshott who attends meetings and sits on staff interview panels. That person told us; I am always listened to very carefully. One practical example we were told about was when the people living in the home asked for a dish washer, one was provided and we saw it being used during our visit. When we looked at risk assessments we found they were up to date and care plans provided good evidence of the priority given to the health, safety and well-being of people who live in Springshott. When we spoke to health and social care professionals about people who live in the home, they were very positive about the standard of both care and communication that they saw in Springshott for those people living in the home for whom they were responsible. We found when we spoke to care staff and saw relevant documentation and also when we spoke to the manager after the inspection that she is not full-time at the home and has only part of the working week allocated to her for the management and administration of Springshott. Staff confirmed to us that the manager often pops in outside of her set times and that she can readily be contacted by phone or can usually reach the home within a quarter of an hour if she is at one of the other services she is responsible for. The care outcomes we have seen suggest that this arrangement is currently working well. However, it works as well as it does in part because of the long-term staff in place, who as well as being very experienced and competent, are able to manage the home in the managers absence. In the event that there are a significant number of staff changes, particularly amongst very experienced staff, the management arrangements would have to be reviewed to ensure that they could continue to deliver the current high standard of care for people living in the home. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered manager 30/01/2009 must ensure that a regular and robust system of monitoring and audit of the records for the administration of medication is in place. This is to ensure that the homes policies and procedures are being followed at all times and to ensure that any errors are identified and rectified at the earliest possible opportunity with appropriate staff training put in place to address any consistent failures. 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 9 Where significant risks to the health, safety or well-being of people living in the home are identified, they should be the subject of a specific risk assessment in addition to any Page 27 of 29 Care Homes for Adults (18-65 years) general risk assessment in which they may be included. This is to ensure that significant risks can be recorded and reviewed effectively. 2 24 Consideration should be given to replacing the throws over the front lounge chairs which would further enhance the appearance of that communal area. Care Homes for Adults (18-65 years) Page 28 of 29 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. 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