Inspection on 15/12/08 for The Limes (Northampton)

This inspection was carried out on 15th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Limes (Northampton) 24/11/05

The Limes (Northampton) 04/08/05

The Limes (Northampton) 02/09/04

The Limes (Northampton) 13/04/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Limes (Northampton) 193 Weedon Road Northampton Northants NN5 5DA     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: Sally Snelson     Date: 1 5 1 2 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 31 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 31 Information about the care home Name of care home: Address: The Limes (Northampton) 193 Weedon Road Northampton Northants NN5 5DA 01604751948 01604751948 limescare@majproperties.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Philip Henry Keet,Mrs Maureen Elaine Keet care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: No person falling within the category mental disorder (MD) can be admitted where there are already 8 persons of category mental disorder (MD) in the home. ( Total number of service users in the home must not exceed 8. Two people whose primary need is mental disorder (MD) but who also have a physical disability (PD) may be accommodated. Date of last inspection Brief description of the care home The Limes is a care home providing personal care for a maximum of 8 people aged between 18 and 65 years who have mental health problems. Two people who also have a physical disability can be accommodated. Mr and Mrs Keet who run the Msaada goup of services own the home. The house, which is a large semi-detached property, is located in a suburb of Northampton within easy walking distance of a local shopping centre and approximately 2 miles for the town centre. Public transport is close by. The accommodation consists of 4 single and 2 double bedrooms. The two double rooms are currently occupied as singles and this will only change where there is a special request by two people to share. There are two large lounge areas and a kitchen/diner. There is Care Homes for Adults (18-65 years) Page 4 of 31 8 Over 65 0 Brief description of the care home a rear garden and off road parking at the front of the house. Fees range from £1,500 per week. Care Homes for Adults (18-65 years) Page 5 of 31 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: This inspection was carried out in accordance with the Commission for Social Care Inspections (CSCI) policy and methodologies, which requires review of the key standards for the provision of a care home for adults that takes account of residents views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment, (AQAA) which was requested earlier in the year, has also been used to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit. This inspection was a key inspection. Care Homes for Adults (18-65 years) Page 6 of 31 Joanne Samuels, the manager, was present. Feedback was given to her throughout the inspection, and at the end. During the inspection the care of two people who use the service was case tracked in detail. This involved reading their records and comparing what was documented to what was provided. In addition to sampling files, people who lived at the home and staff were spoken to, and their opinions sought. Any comments received from staff or residents about their views of the home, plus all the information gathered on the day was used to form a judgement about the service. The inspector would like to thank all those involved in the inspection for their input What the care home does well: What has improved since the last inspection? What they could do better: There were a number of recommendations and requirements made as a result of this inspection. These include: Accommodation must not be provided unless the needs of a resident have been assessed by a person suitably qualified to do so. The Statement of Purpose and the Service Users Guide should be kept up-to-date and should accurately reflect the service provided. It should be clear how decisions to impose any limitations on residents have been agreed. Care files would benefit from including more information about a persons current and past interests, in an attempt to support staff to find appropriate activities to provide stimulation inside and outside the home. Care must be taken that the all medications are correctly signed into the home, and accurate records of administration are kept. Priority should be given to the repairs needed. This relates to the need to replace a Care Homes for Adults (18-65 years) Page 8 of 31 window pane and provide a serviceable cooker. There must be sufficient staff on duty to provide adequate cover. There must be a detailed training and development plan with a dedicated budget and there should be a training matrix available. Staff must receive six supervision sessions per year. There must be a process to assess the quality of the service provided. There must be evidence that regularly fire checks are carried out. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was limited information to support how staff had assessed a prospective resident to ensure that the staff team could meet needs. Evidence: We asked for a copy of the Statement of Purpose and were provided with the document that was kept in the policy and procedure file. It included most of the information required by Schedule one of the National Minimum standards, but was not current and consequently not completely accurate. We were not provided with a service users guide and the people using the service that we spoke to were not aware of a guide, although we were aware from the last inspection report and the AQAA that a guide had been produced in the past. During the inspection we tracked the care of two people, one of whom had been admitted to the service since the last inspection. Neither had been fully assessed by a member of staff from the home before moving to the service, so it was difficult to see how the staff had made the decision that the needs of a prospective resident could be Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: met. The manager told us that because the move was made from another Msaada property, although not a registered care home, they had all the information and a preadmission assessment was not considered necessary. Moves were usually the result of a crisis and because the person had challenging behaviours. Care Homes for Adults (18-65 years) Page 12 of 31 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. There were care plans in place to indicate to staff the needs of a resident. However, because they had not always been updated, and because old records were also kept in the file it was not apparent if they were current. Evidence: We tracked the care, and read the records, of two people using the service. Both of the residents had plans of care that described their needs, planned a goal and suggested the required action. These plans were in sufficient detail to ensure that staff could provide consistent care, and they appeared to cover all areas of support and care provided. The plans we sampled had been signed by the key-worker and the person using the service. The plans had been reviewed regularly and new plans completed with the appropriate changes made. However, although the National Minimum Standards require care plans to be reviewed six monthly, staff were writing a review date of three months from the last review and then not achieving this. For example one of the plans of care we looked at had last been reviewed 13/08/08 and had a next Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: review date for three months from that date, meaning the review was already a month overdue. It was apparent that people using the service could make decisions for themselves and were supported by staff to make informed decisions and choices. For example, one resident we spoke to was allowed a cigarette every hour. He was able to tell us that this was to help him cut down and that it was with his agreement, but without supporting documentation it could appear this restriction infringed his human rights. On the whole risk assessments were well written, and there was documentation to support any incidents that had taken place as the result of risk taking behaviour. Residents meet regularly with staff and it was apparent from conversations with them that they were aware of how the home was run. Care Homes for Adults (18-65 years) Page 14 of 31 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. If they wanted and needed support, staff would support residents with a variety of activities. Evidence: Residents were supported to be as independent as they wished. The manager told us that it was not appropriate to make many plans for activities in advance as peoples mental states altered, and they would not necessarily want to pursue something they had chosen to do the week before. One member of staff spoke to us about her enjoyment in supporting a resident, or residents, outside of the home. Files would benefit from having more information about their past interests and hobbies to support staff to help them with meaningful past-times and activities. None of the residents worked or attended any educational establishments. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: Many of the current residents would go out alone, it was expected that they would tell staff where they were going. One resident regularly went to the local shops to buy bread and milk for the home. Residents could have visitors to the home between 10am and 10pm. The manager told us that friends could stay overnight but that this was not encouraged. People using the service could get up and go to bed as they liked. During the inspection we did not see one resident who was experiencing sleep pattern disturbances, and was confusing night with day, so was in bed throughout our visit. Residents confirmed that their mail was given to them unopened, and that they signed a post book, to confirm that they had received their post from a staff member. Staff had sourced a mosque for Muslim. He was offered appropriate meals if he wanted, but also given the freedom to eat what he liked. Residents had been provided with an out-side area in which to smoke. This protected the non-smokers from excessive fumes. Some residents chose to smoke in their bedrooms, but agreed to the ban in the communal rooms. Staff and residents had met together to plan a four week menu. The menu did not offer an option, but residents told us that they could have an alternative to the planned meal if they wished. During the inspection we witnessed one resident choosing to buy himself a roll from the local bakers, rather than having one made at the Limes. This he paid for himself, which we believed acceptable if it was his choice not to eat as acceptable meal at the home. Staff recorded in the daily log what a resident had eaten and drunk during the day. Care Homes for Adults (18-65 years) Page 16 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had built good links with community health staff and would support people using the service to make healthy choices. Medications procedures were not always correctly followed and could cause problems. Evidence: Few of the people living at The Limes needed assistance with care continually, but many needed prompting and intermittent support with care. The manager told us that at the time of the inspection none of the people using the service had nursing needs. In the past when people had nursing needs the community nurses had supported these. Community Psychiatric Nurses were frequent visitors to the home and staff had good relationships with them and the GPs and consultants involved in residents care. Staff recorded when visits to health professionals were due and also kept records of any visits made by health professionals to the home. The one resident who had physical disabilities had been assessed by an occupational therapist, so that the appropriate aids and equipment were provided. This person had the sole use of a double room on the ground floor, with easy access to a wet room and Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: toilet. The medications of the two people whose care was tracked was looked at in detail. Medication had not always been signed into the home, so it was not possible to reconcile the medication which was carried over from one month to another. For one resident we also counted signatures on the Medication Administration Record (MAR), and the number of tablets left in the box dispensed by the pharmacist and again this did not reconcile. We were aware that this was possibly due to the medication being started on the previous MAR sheet but as it had not been carried forward we were not sure. On occasions omission codes had been used, but the back of the MAR had not been filled in to indicate the reason for the omission. There were some gaps on the MAR that had not been coded, so it was unclear if these medications had been refused, or given and not signed for, or forgotten. We were concerned that on the day of the inspection one resident had received their medication but had the chart had not been signed. When it was pointed out to the two staff responsible the administration of medication that morning they signed the chart and admitted their error. Care Homes for Adults (18-65 years) Page 18 of 31 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. The home had a complaints procedure that offered the people using the service a number of alternative agencies to raise any concerns with. Evidence: The home had a complaints procedure that was displayed in the entrance hall. However we were not sure that the format it was in would make it suitable for all those using the service. We were told that there had been no complaints made to, or about, the service since the last inspection. The manager had a file in which to record any complaints made and was aware of the procedure for responding to complaints. Some staff had had training in the recognition of, and their responsibility to report abuse. We were told in the AQAA that it was a priority to ensure that all staff had the appropriate training to recognise abuse. The preferred method for this training was via the Internet. Only one of the two people who we were tracking asked the home to support him by holding money on his behalf. There were receipts to support all transactions and the money reconciled correctly. There was evidence that staff supported residents to sort out their finances and to pay their bills. We would have liked to be sure that the person paying for a daily taxi to the pharmacy Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: to be given a dose of methadone should pay for the taxi as it would be assummed to be the responsibility of the home as it is part of his care, unless there were good reasons for him being charged. Care Homes for Adults (18-65 years) Page 20 of 31 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. The Limes offered the people using the service a homely accessible place in which to live comfortably. Evidence: The home was situated in a residential area and had the appearance of a large family home. It was registered for eight people, but as there were only six bedrooms (two were large enough to be double rooms) it would be unlikely that eight people would be living at the home at any time. The home may wish to consider reducing the registration to six to reduce their bed fees. The bedroom occupied by the person using mobility aids, was on the ground floor and was a large room so there was plenty of room for the necessary mobility equipment and for him to move around. Residents told us that they could personalise their bedrooms if they wanted but that they were provided with the furniture they needed. Residents had the choice of two lounges on the ground floor and a kitchen/diner. A ramp had been placed at the front of the house for access and the ground floor of the home was wheelchair accessible. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: On the day of the inspection two of the residents complained of being cold and the radiators were only luke-warm. The manager was made aware of this. A resident told us that this had been an on-going problem since the weather turned colder. There was toilet facilities on each floor and a large bathroom with a Jacuzzi bath on the first floor. On the ground floor there was a wet room and toilet facility suitable for disabled use. The kitchen/diner was a large room. At the time of the inspection the oven door was missing from the main oven. We were told a new one was on order and that either the small top oven was used, or staff cooked next door; This premises is owned by the same company. Residents were observed spending time within their bedrooms, using both communal lounges, the kitchen and walking around the house and the garden during the inspection. The manager told us in the AQAA that the proposed extension to the lounge had not taken place but was still on the agenda to be done. A window had been recently broken in a lounge; it was boarded up. The manager was aware of the need to keep written records of all decorating and repair jobs that were carried out and when these were done. Care Homes for Adults (18-65 years) Page 22 of 31 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training records were not robust enough to confirm that the staff team had the necessary training and experience to care and support the people using the service. Evidence: At the inspection it was difficult for the manager to provide clear details of what training staff had undertaken. She did not keep a training matrix and staff files were not kept up-to-date with training certificates. When a bundle of training certificates were found it was clear that staff were having training in infection control, managing challenging behaviours, drug and alcohol awareness, first aid etc, in addition to the mandatory training and NVQ courses. The manager told us that her priority was to enrol staff on NVQ training. All staff received safeguarding training via an e-learning package. We were unsure if this would dove-tail to the Local Authority procedures. We were concerned that without a training matrix it was not possible to see if the duty rota including staff with the necessary training and experience to care and support the people using the service at all times. The rota confirmed that there were two staff on duty during the day and that the manager was supernumerary and that at night there was a waking and sleeping member of staff on duty. We spoke to a new member of staff who had worked at the Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: home for a month and had not worked in care before, but would work day and night shifts. She confirmed that she had shadowed a member of staff initially and that she had completed an in-house induction course. She told us that she felt supported and that she could could request help from the other staff, or the staff working at the home next door. We were concerned that as this home is not registered with us we do not regulate the care staff there. The duty rota suggested that staff worked long hours. We noted that one member of staff had been roted to work 51.5 hours and then offered to cover a waking night shift of an additional 10 hours. The manager was aware of the staffing problem and told us she insisted staff had at least one day off. She felt that one extra staff member would ease the situation. The home did not use agency staff as they were able to cover shifts from the existing staff team, or from other staff that worked for the Msaada group. We looked at the files for two members of staff. We would have liked to sample more files but staff who had been most recently employed did not have files in the home. We were told that this was because the head office kept duplicate files and the human resource manager had recently changed and was in the process of auditing the files. We would expect a file for each member of staff file to be available at inspection.The recruitment files that we sampled included all the required information. All contained fully completed application forms, appropriate references. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. Staff were receiving supervision but would not have the required six sessions in a year. The manager had devolved supervising some staff to a senior. The manager was not supervised. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager must audit what staff are doing and ensure that any shortfalls are identified and dealt with. The manager needs to do this to protect her registration. Evidence: The registered manager was very experienced and had worked at the home for a number of years. She held a HND certificate and NVQ level 3 in management, but not level 4. The manager was aware of her responsibilities for the home and kept her training updated. At the time of the inspection the manager had no systems in place to externally audit the quality of the service provided. An internal quality assurance manager visited the home monthly and provided a report of the visit. The manager confirmed that this was useful and resulted in some changes. We were provided with a policy and procedure file that provided the evidence that staff had read the policies. We noted that the policies had last been signed as being Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: reviewed 07/07 and that the last entry confirming staff had read them was 29.05.08. This suggested that the new staff that were now working without supervision had not read the policies, although a new member of staff we spoke to was aware of the policy folder. Throughout the report reference has been made to the importance of record keeping and ensuring that records were kept to provide the evidence that a task has been completed. Throughout the inspection we quoted to the manager If it isnt documented it has has not happened. Staff should remember that all records are legal documents and should use full names; this includes the duty rota. We asked to see the fire log and were given a file that included a policy that clearly outlined what health and safety checks needed to be done and the frequency of the checks. The manager was not able to provide the evidence that fire checks had been carried out weekly, athough it was stated that they were. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 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 2 14 Regulation 14 (1)(a) 01/01/2009 Accommodation must not be provided unless the needs of a resident have been assessed by a person suitably qualified. This provides the evidence that the service understands the needs of the prospective resident, and has a staff team that ensures these needs will be met. 2 20 17 Care must be taken that the all medications are correctly signed into the home, and accurate records of administration are kept. This refers to Regulation 17 (1)(a) This is to prevent any mistakes being made in the administration of medication procedures. 01/01/2009 Care Homes for Adults (18-65 years) Page 28 of 31 3 33 18 This refers to regulation 18(1)(a)There must be sufficient staff on duty to provide adequate cover. To ensure that the home is covered by staff who are familiar with their needs. 01/01/2009 4 34 19 Staff records of training and recruitment must be kept together and avialable for inspection. This is to ensure that the staff working have the correct checks to be employed to care for vulnerable people. 01/02/2009 5 35 18 This refers to Regulation 18(1)(c) There must be a detailed training and development plan with a dedicated budget. This ensures all staff receive th necessary training to provide the care needed. 01/02/2009 6 39 24 This refers to Regulation 24 01/04/2009 (1)(a)(b) There must be a process to assess the quality of the service provided. This ensures that the home is providing a suitable quality of care. 7 42 24 This refers to regulation 01/01/2009 23(4) There must be evidence that regularly fire checks are carried out. Care Homes for Adults (18-65 years) Page 29 of 31 This is to ensure people are kept safe and any problems are identified early. 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 1 The Statement of Purpose and the Service Users Guide should be kept up-to-date and should accurately reflect the service provided. It should be clear how decisions to impose any limitations on residents have been agreed. Care files would benefit from including more information about a persons current and past interests in an attempt to support staff to find appropriate activities to provide stimulation inside and outside the home. Priority should be given to the repairs needed. This relates to the need to replace a window pane and provide a serviceable cooker. There should be a training matrix available. Staff must receive six supervision sessions per year. All policies and procedures must be reviewed regularly and read by staff. Records must be accurate and care must be taken that they are dated and signed correctly using full names. 2 3 7 12 4 24 5 6 7 8 32 36 40 41 Care Homes for Adults (18-65 years) Page 30 of 31 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 31 of 31 - 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!