Inspection on 27/10/08 for The Old Dairy

This inspection was carried out on 27th October 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Dairy 14/11/06

The Old Dairy 14/02/06

The Old Dairy 22/07/05

The Old Dairy 25/02/05

The Old Dairy 22/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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 Old Dairy 11 High Street West Lavington Devizes Wiltshire SN10 4HQ     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: Malcolm Kippax     Date: 2 7 1 0 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 Old Dairy 11 High Street West Lavington Devizes Wiltshire SN10 4HQ 01672562755 01672569477 old_dairy@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Lisa Driscoll Type of registration: Number of places registered: Cornerstones (UK) Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Any placement for short-term care or for an emergency placement must be agreed with the Commission before the placement commences. For the purpose of this condition, short-term is defined as a placement that is expected to last not longer than 3 months. An emergency admission is defined as an admission whereby someone is likely to be placed at short notice without an up-to-date assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. Date of last inspection Brief description of the care home The Old Dairy is one of a number of care homes in Wiltshire that are run by Cornerstones UK Ltd. The Old Dairy is an old property in the village of West Lavington. Each person has their own bedroom. One bedroom is on the ground floor and the others are on the first floor. The communal rooms consist of a lounge and a dining room. The home has a domestic type kitchen. There is a garden and parking area at the front of the property. People who live at the home receive support from a home Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 5 Brief description of the care home manager, a deputy manager and a team of support workers. Information about the home is available in a Statement of Purpose. Copies of inspection reports are available from Cornerstones UK and are also available through the website www.csci.org.uk 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: 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 asked the home to complete an Annual Quality Assurance Assessment, known as the AQAA. This was their own assessment of how they were performing. It also gave us information about what has happened during the last year, and about their plans. We sent out surveys to the home, so that these could be given to the people who live there, to staff, and to other people who know the service. We had surveys back from four people who live at the home, from two staff members, and from two health care professionals. We looked at all the information that we have received about the home since the last key inspection. This helped us to decide what we should focus on during an Care Homes for Adults (18-65 years) Page 6 of 31 unannounced visit to the home, which took place on 27th October 2008. We met with four of the people who live at the home. We also met with the manager, and with the support workers who were working at the time. We looked at some records and went around the home. The fees at the time of this inspection ranged from 650 - 1373 pounds per week. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visits. What the care home does well: What has improved since the last inspection? Peoples service user guides have also been updated, to give better information about the things that they have to pay for out of their own money, because they are not covered by the fees. The guides have also been personalised, so that they are more meaningful to the people who live at the home. Parts of the home have been refurbished and received attention, so that the Care Homes for Adults (18-65 years) Page 8 of 31 environment has been improved and made more attractive for the people living there. The number of staff with a National Vocational Qualification has increased, which means that people at the home are receiving support from staff members who are better qualified in the work that they undertake. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2 was not looked at on this occasion. Nobody has moved into The Old Dairy since the last inspection. The standard was met when last inspected and Cornerstones UK has a policy and procedure in place for new admissions. Evidence: We assessed standard 2 when we inspected the home in November 2006. We reported at the time that one person had recently moved into the home. Their needs had been assessed and they had got to know The Old Dairy before moving in. This had helped ensure that the home could meet their needs and was suitable for them. Care Homes for Adults (18-65 years) Page 11 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. Peoples needs and goals are well reflected in their individual support plans, which helps to ensure that staff provide consistent support in the way that people prefer. People are assisted to make decisions and they receive support, which reduces the risk of being harmed. Evidence: We looked at the records for three people who live at the home. These included a Care and Assessment file for each person. The files were well organised, with sections for care assessments, care plans, and risk assessments. The care plans consisted of a range of forms, covering areas such as Safety Awareness, Social Skills, Communication, Medication and Daily Routines. They provided clear guidance for staff about peoples needs and preferences in these areas. One section of the care plans concerned peoples individual goals. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: Two peoples care plans and assessments had been rewritten and updated during 2008, so that they reflected their current needs. Another persons care plan was due to be reviewed. Miss Driscoll said that they were waiting to hear back from this persons care manager about whether they would be attending the review meeting. Letters had been sent in connection with this. Monthly evaluation forms were being completed, which provided a record of significant events and of the progress that people were making with their individual goals. In their surveys, staff told us that they are always given up to date information about the needs of the people that they supported. There were references within the care plans to show when risk assessments had been undertaken. This helped to ensure that staff were aware of the hazards relating to a particular activity or area of support. The risk assessments were recorded on forms that included sections about hazards and potential risks. The benefits of the person participating in a particular activity or task, for example being out in the community, were not being recorded, although this would have reflected a more person centred approach to the carrying out of the assessment. Sometimes a risk assessment had resulted in a restriction being imposed on what the person at the home could do. However the reasons for the restrictions were recorded in peoples care plans, and these were primarily to do with peoples safety. For example, one person was required to have support when outside the home and a restriction had been agreed about the amount of money they spent each week on a particular activity. A financial risk assessment had also been undertaken in connection with this. Individual review meetings were being held, when people could talk about new things that they wanted to do and make decisions about the future. At the time of our visit, one person who normally lives at The Old Dairy was having their needs assessed during a temporary placement away from the home. Miss Driscoll said that people who live at the home used to meet together, so that they talk about things that affected them. However the meetings had not been successful and some people had found them difficult. Miss Driscoll said that the formal meetings had now stopped, and that more attention was being given to seeking peoples views on an individual basis. We saw that peoples views were being recorded in a comment book. These showed that action was being taken in response to what people had said. People received support with managing their money. We saw examples of the records Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: that were maintained, such as after people had been shopping. Receipts were obtained and numbered, and then the records were signed by two staff members, so that peoples money was well accounted for. Peoples service user guides have been updated since the last inspection to give information about what things they would have to pay for out of their own money, because they were not covered by the fees. The guides had also been personalised, so that they were more meaningful to the people who live at the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to participate in a varied range of activities throughout the week. Peoples ideas for new activities have been responded to very positively. People receive support that helps them to maintain relationships and to be part of the local community. People enjoy their meals and are able to choose dishes that they particularly like. Evidence: When we arrived at the home, one person had left the home to attend a local resource centre. Two people were about to visit a sports centre, which Cornerstones UK had arranged as part of their own activities programme. Another person was getting ready to visit a friend in Swindon, accompanied by one of the staff members. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: We saw that each person had a written timetable, which showed what they did each day. People had different activities during the week, such as going to resource centres, a community farm, and attending the Cornerstones UK arranged events. Each person had at least one session a week at Trowbridge College. The sessions attended covered topics such as relaxation, music, drama, and good grooming. Information was recorded in the comments book and monthly evaluation forms about the one off events and social events that people had taken part in. People had been provided with experiences that were outside a solely learning disability setting. They had been on train journeys, gone camping, been to the theatre and visited local places of interest. One person had wanted to go on a plane and when this idea was put to other people they had all wanted to go. A flight and a day trip was then arranged from Bristol Airport. People were engaged in different activities when they returned from their day activities. Some people spent time in the lounge where the television was on. People showed us their rooms, which reflected their individual interests, such as flying, and collecting things. We read in peoples care plans about their likes and dislikes, and their preferred activities and routines. There was information related to peoples diverse needs and individual backgrounds. Details of peoples family contacts and important relationships were recorded in their individual files. Staff supported people to keep in contact with their family and friends. We read that one person at the home had recently been to a presentation at the farm they attended and they had received a certificate in recognition of their work. A photograph had been taken and staff helped the person to send this to a relative in Australia. Miss Driscoll said that sometimes people used email to communicate with their friends and relatives. Peoples individual care plans included a section on Eating, which provided information about individual needs and preferences. Each week, people talked about the meals that they would like to have. People took it in turns to choose the main meal. A menu was then written for the week ahead. We saw copies of the weekly menus, which showed the different meals that people had chosen. There was also a section on the menu to record when people had had something different to the planned meal. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met. Staff provide assistance, to ensure that people receive the support that they need from outside health professionals. People are protected by the homes procedures for dealing with medicines. Evidence: Peoples care and assessment files included details of the personal support that they needed from staff. There was also guidance for staff about peoples care routines at different times of day. We read in peoples records about the involvement of outside professionals, including the contact that people had with the Community Team for People with Learning Disabilities C.T.P.L.D.. A consultant psychiatrist was currently involved with one person. Each person had a separate file, which contained their health related records. We saw records of GP visits and appointments with dentists and other health care professionals. Staff members supported people with nail cutting and a record of this was kept. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Well Man check ups had been arranged and some people at the home have had flu jabs. Health action plans had not been completed; we thought that these would be useful in providing an overview of peoples health needs and how these are being met. We received surveys back from a GP and a Health Support Worker. They responded positively about the care, and the support with medication, that people received at the home. When asked what they felt the care service did well, one of these people commented Promotes Independence. The other person stated Personal Care, Individualised. One of the files we looked at included information about the support that the person received with managing their epilepsy. Their records included an epilepsy profile and intervention plan, and a separate emergency plan. The community nurse had been involved in producing this. Miss Driscoll said that the nurse had been written to about reviewing the plan. Other records were being kept in relation to the epilepsy. Information about peoples medication was included in their individual plans and personal records. Medication came to the home as part of a monitored dosage system and was stored in a metal cabinet. We looked at the current medication records, which were being appropriately completed. Nobody living at the home had been prescribed PRN (as required) medication. We were told that no controlled drugs were being prescribed. The current storage arrangements were not up to the standard that is required for controlled drugs. 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. People have the opportunity to raise concerns and are listened to by staff. Staff members receive training and guidance, which helps to protect people at the home from harm. Evidence: A pictorial complaints procedure had been produced for the people who live at the home. We read in the care plans that the procedure had been gone through with people individually, so that they would know what to do if they had any concerns. The staff members who completed surveys confirmed that they knew what to do if somebody raised concerns with them about the home. It was reported in the AQAA that the home had not received any complaints during the last year. The home had a procedure for following up allegations of abuse. Guidance was available to staff about the arrangements being made in Wiltshire for safeguarding vulnerable adults, and about how any allegations will be investigated. The home has had experience of making safeguarding adults referrals and the Commission has been kept informed of the action being taken. Prevention of abuse and the safeguarding of vulnerable adults were included in the Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Cornerstones UK staff training programme. When we looked at the staff members individual records we saw that they had received this training. The home had a policy on physical intervention. We were told in the AQAA that there had not been any incidents involving restraint during the last 12 months. 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. People are benefiting from improvements that are being made to the accommodation and facilities. However there are areas that are in need of further attention. Evidence: The Old Dairy is a detached property in a prominent position within the village. It is very close to some village amenities and is located between a public house with a restaurant, and a convenience store. There was a garden and parking area at the front of the property. Various improvements have been made to the accommodation and facilities over recent years. These have continued since the last inspection with the refurbishment of the kitchen and the communal rooms. People said that they liked the lounge, which had been given a more modern appearance and had new chairs and sofas. The dining room has also been improved with a new floor covering. When we looked around the first floor we saw that the landing carpet was stained in places. We discussed this with Miss Driscoll, who agreed that it needed attention and that further cleaning would not achieve a satisfactory result. The bathroom at the end of the corridor was also in need of attention. The floor covering was in a poor condition Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: and the edges were not well sealed. The shower rail was damaged and some of the chrome fittings were rusting. Apart from that, the home generally looked clean and tidy, although the condition of some parts made it difficult to achieve a clean appearance. An in-house inspection of the premises was being carried out regularly and a checklist completed. When going around the home we found that one bedroom door needed adjustment so that it did not close with undue force. We brought this to Miss Driscolls attention. Miss Driscoll also confirmed that the window opening restrictors in the home would be checked, to ensure that these were working correctly. There was a laundry and utility area beyond the kitchen, which meant that food preparation and laundry could be kept separate and there was less risk of cross infection. The home had a policy for infection control. An environmental health officer had last visited the home in August 2008. We saw a copy of their report, which showed that some items were found to be in need of attention. These mainly concerned the safe storage of foodstuffs. Miss Driscoll said that these items had now been dealt with. A new kitchen log book has been introduced for the recording of daily checks. Fridge and freezer temperatures were being checked regularly, to ensure that these items were operating safely. An officer from the district council had also visited the home in November 2007 in connection with legislation about smoke free environments. It was found at the time that the home was complying with this legislation and had the appropriate signage in place. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home are supported by staff who are developing their skills, but have not yet received all the training that they are expected to in order to meet peoples individual needs. People are mostly protected by the homes recruitment procedure, although there are shortcomings in the process and in the records that are kept. Evidence: In addition to the manager and deputy manager, there was a team of five support workers. The management and staff team met together regularly. Formal staff meetings were being held, usually every two months, and we looked at the minutes from recent meetings. One support worker had achieved their National Vocational Qualification (NVQ) at level 2 since the last inspection. Another support worker had recently enrolled for the same qualification. Of the other support workers, one had achieved a NVQ at level 2, and two had achieved the qualification at level 3. The deputy manager had also achieved a NVQ at level 3. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: We had made a short visit to the home in June 2007 in connection with some incidents that had been reported to us. We wanted to see whether the staffing levels at the time were sufficient to meet peoples needs. After the visit we discussed this further with the home and with the Community Team for People with Learning Disabilities. A new on call system was arranged for use during the night. The purpose of this was so that the staff member present during the night could quickly receive support from a second person if the need arose. The on call system involved a small number of staff who lived locally. No new permanent staff members had been recruited since the last inspection. Miss Driscoll said that somebody from outside the staff team was available to help out with the night on call arrangement. This person was known to the home and staff team, but they had not worked as a support worker before. We looked at their recruitment record. References had been received and there was documentation relating to their Criminal Record Bureau (CRB) disclosure. Their name had been checked against the Protection of Vulnerable Adults POVA list. However, an application form had not been completed and Mrs Driscoll said that the usual recruitment process had not been followed with this person. Miss Driscoll said that this would now be completed with the person in question. There was a policy for staff training, and a plan that set out the training that staff were due to receive. New staff members underwent a period of induction. For staff who were new to working in a social care setting this was an accredited induction programme which included the common induction standards. The training plan looked very comprehensive and set out the training that staff would receive following their induction. Training was listed in the plan under the headings of Essential, Desirable, Specialist and Mandatory. We talked to Miss Driscoll about the implementation of the training plan, and we looked at examples of the staff members personal training records. Staff were receiving the mandatory training, as listed in the training plan. Staff were up to date with first aid training and refresher training in moving and handling had been arranged for the following month. It was reported in the training plan that staff would receive the Essential training within 12 months of employment, with annual refresher training. The Essential training included subjects such as risk assessment, challenging behaviour and equal opportunities. Staff were not attending this training consistently and arrangements had not been made for staff to attend the training in the future. In their survey, one staff member commented that they received mandatory training but they felt that there was very limited opportunity for further training. They thought that more training in various fields would be very beneficial. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: In addition to the staff members own training records, we thought that it would be useful for the home to have a training matrix, which would provide an overview of the training that staff had received and show when refresher training was due. Care Homes for Adults (18-65 years) Page 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well run home and from the improvements that are being made. Their health and safety is being protected. Evidence: Miss Driscoll has been the homes manager for several years and overseen a number of developments during that time. Miss Driscoll started the Registered Managers award over two years ago but said that completion of the award had been delayed because of difficulties with the external training provider. This meant that the award needed to be started again using another provider. Miss Driscoll said that she was now near to completing the award and would then be starting the National Vocational Qualification in care at level 4. In their surveys, the staff members responded positively about the support that they received from their manager. A representative from Cornerstones UK visited the home regularly and carried out an Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: audit of standards in the home as part of the organisations system of quality assurance monitoring. People at the home and their representatives were asked for their views in meetings and through the use of annual surveys. These contributed to an annual quality assurance report. The most recent report had been written in April 2008 and was due to be reviewed in October 2008. An action plan had been produced as part of the report. This focussed on the outcome of the audit of standards, rather than on the feedback that had been received from people. We were given information in the AQAA about the improvements that had been made during the last year. These included for example, the refurbishment of parts of the home, and reviewing some of the homes working procedures. Temperature regulators were fitted to the hot water taps, and radiators had covers fitted to reduce the risk of burning. An in house health and safety checklist had last been completed in October 2008. The AQAA included information about the arrangements in place for maintaining the homes fire precaution systems and other servicing which involved outside contractors. A fire drill had been held, and staff had received training in fire precautions during October 2008. Portable electrical appliances had been checked in May 2008. Risk assessments had been undertaken concerning the environment and peoples safety within the home. The homes fire risk assessment was reviewed in December 2007. Care Homes for Adults (18-65 years) Page 27 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 28 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 24 23 The bathroom must be refurbished. This is so that people can live in a home which is kept clean and well maintained. 31/01/2009 2 24 23 The carpet on the first floor landing must be renewed. This is so that people can live in a home which is kept clean and well maintained. 31/01/2009 3 34 19 All parts of the homes recruitment procedure must be completed and appropriate records kept. This is to ensure that a robust recruitment process is being operated, which protects people at the home from being supported by unsuitable staff. 27/11/2008 4 35 18 Arrangements must be made for staff to attend the Essential training that they are required to receive in 31/12/2008 Care Homes for Adults (18-65 years) Page 29 of 31 accordance with the homes training policy and plan. This is so that people at the home are supported by staff who have received the training that is necessary in order to meet peoples individual needs. 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 That, in addition to the hazards, the benefits of people participating in a particular activity or task are also recorded on the risk assessment forms. This is so that there is a more person centred approach to the risk assessment process, and that peoples rights are considered as part of this. That health action plans are completed with the people who live at the home. These will be useful in providing an overview of how peoples health needs are being met, and will be met in the future. It is strongly recommended that a medication cabinet is obtained which meets the appropriate standard for the safekeeping of controlled drugs. This is to ensure that the home will be able to comply with the current requirements, if controlled drugs are prescribed in the future. That an employment checklist form is used, which would provide a record of the recruitment process and the checks that have been undertaken. That the feedback that has been received as part of the homes quality assurance is reflected in the action plan. This is so that people at the home, and their representatives, can feel confident that their views are being taken into account and followed up. 2 19 3 20 4 35 5 39 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). 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