Inspection on 15/09/09 for The Peacocks

This inspection was carried out on 15th September 2009.

CQC found this care home to be providing an Good 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 Peacocks 01/06/10

The Peacocks 01/10/07

The Peacocks 04/07/06

The Peacocks 01/09/05

The Peacocks 15/06/05

The Peacocks 03/11/04

The Peacocks 06/04/04

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 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Gail Richardson Date: 1 5 0 9 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. They reflect the things that people have said are important to them: 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 Care Homes for Adults (18-65 years) Page 2 of 39 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 39 Information about the care home Name of care home: Address: The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG 01209218271 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : mhinchliffe3@aol.com Ms Margaret Hinchliffe care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection 0 4 0 8 2 0 0 8 A bit about the care home The Peacocks is a mid terrace house with two floors. Care Homes for Adults (18-65 years) Page 4 of 39 The house is just outside the village of Four Lanes. The home is between Helston and Redruth. The Peacocks provides care for three people with learning disabilities. The registered persons live on the premises with their family. People have their own bedrooms There are bathrooms and toilets on both floors. Care Homes for Adults (18-65 years) Page 5 of 39 The home is not suitable for people who use wheelchairs or with mobility problems The home has a car suitable to take people out. The fees at the time of the inspection are £490.00 per week. Care Homes for Adults (18-65 years) Page 6 of 39 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 Care Homes for Adults (18-65 years) Page 7 of 39 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by one inspector who visited the home without telling anyone she was coming. Throughout this report the term we will be used as the report is written on behalf of the Care Quality Commission We were there from 10:00am until 2:00pm. There were 2 people currently residing at the home. Another person stays for 2 days every 2 weeks. We spoke with two people living there. Care Homes for Adults (18-65 years) Page 8 of 39 We talked to all the staff on duty and the manager. We sent out surveys but non have been received back to us yet. We looked at the care records of two people who lived in the home. We looked at other records that told us how the home is run. This included staff records and health and safety records Before the inspection an Annual Quality Assurance assessment (AQAA) was completed by the acting manager. This is a form the acting manager fills in and sends to the Care Quality Commission telling us how the Care Homes for Adults (18-65 years) Page 9 of 39 home is meeting the needs of the people that live there What the care home does well The home provides a family run service where people told us they were happy. The home is part of the local community. Care Homes for Adults (18-65 years) Page 10 of 39 The home has lots of pets. People living at the home go to day centers and activities locally. People are supported to keep in touch with family and friends. The home is a nice environment with enough space. Each person has their own room. Care Homes for Adults (18-65 years) Page 11 of 39 People are looked after and can see a doctor if needed. There are a small group of staff who know everybody very well. People go on frequent holiday breaks What has got better from the last inspection Care Homes for Adults (18-65 years) Page 12 of 39 Some staff training has taken place Some decoration to the home has taken place What the care home could do better People need care plans and risk assessments to be correct to make sure they are safe and their care is recorded. Care Homes for Adults (18-65 years) Page 13 of 39 People should have a contract with the home to say what service they will receive. Staff need more training in several areas to ensure people are safe. The windows and radiators need to be risk assessed and action taken to make sure people are safe. The home needs to look at the environment and make a risk assessment to promote safety for people using the service. Care Homes for Adults (18-65 years) Page 14 of 39 Portable appliances need to be checked to see that they are safe. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Gail Richardson CQC South West Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel: 03000 616161 Fax: 03000 616171 E-mail: southwest@cqc.org.uk 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. Care Homes for Adults (18-65 years) Page 15 of 39 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 16 of 39 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 17 of 39 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. An updated Statement of Purpose and Service User Guide is available to provide details for any prospective person using the service. A copy is stored in each persons care plan. The homes does not have a contract supplied by the home and uses the contract supplied by the Commissioning Authority. Therefore the terms and conditions of residency are not signed as agreed by the person using the service. Evidence: The home provides an updated Statement of Purpose and Service User Guide for all prospective people using the service. A copy of this document is available in each persons care plan. No new people have been admitted to the home since the last key inspection. One person has recommenced receiving respite care. The homes Annual Quality Assurance Audit (AQAA) told us that prospective people are invited to visit the home and test run the service to see if it suits them. They can stay for a few says before any decisions are made. The AQAA told us that they are given a Statement of Purpose at this time. Care Homes for Adults (18-65 years) Page 18 of 39 Evidence: The registered manager has completed an NVQ level 4 and is undertaking further relevant training. The registered provider is a retired Registered General Nurse. Both the provider and manager reside on the premise and provide the majority of the care provided. The registered manager is confident that collectively they can provide the skills and experience to deliver the service the home offers to provide. People living at the home told us that they feel well looked after and supported by the staff at the home. Each person has a contract from their commissioning authority. The home does not have specific terms and conditions of residency in the form of a contract. However the Statement of Purpose stored in each care plan is very detailed about the services to be provided. It is recommended that each person residing at the home has a signed contract with the provider to ensure clarity about the terms and conditions of residency. Care Homes for Adults (18-65 years) Page 19 of 39 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. Care plans are available for each person but need to be updated and regularly reviewed to ensure they are an accurate reflection of the care needed and provided. Appropriate risk taking is promoted, risk assessments need to be more regularly reviewed and updated. All records are stored securely; people using the service have access to their care records should they want to. Evidence: Each person using the service has a care plan, we looked at two of these plans of care. The care plans identify any specific risk, need or aspiration by that person and how those areas can be met. One care plan for a permanent person at the home contained some detail but needed to be updated to reflect changes which the registered manager described had taken place over the last twelve month period. These changes were being managed by the home and due to the small staff numbers all staff were aware of the developments and the resulting Care Homes for Adults (18-65 years) Page 20 of 39 Evidence: identified needs. However should a change of staff have to take place, because the records were not updated this may place people using the service and staff at risk. The person told us that they made decisions about everyday choices, when to get up and go to bed, what to wear, what to eat. They told us that they had help whenever they needed it. People told us that they felt part of the home and that they went shopping as part of household organisation and all went on holiday together. They chose where to go on holiday. Some people have a limited understanding of danger and need support to ensure their safety. Following the identification of an area of risk, this should be included as part of the care plan and appropriate action documented. However not all areas of risk have been assessed. It was seen that the home has a large dog. The environmental risk of this should be assessed and documented to ensure a safe environment for all. There was evidence of the persons involvement in the care plan but this had not been reviewed since 2006. Further development of risk assessment and goal setting may be helpful for the development of people using the service. Care plans also demonstrated that the services of specialists have been sought. There was evidence of input from relevant health professionals and changes in care where appropriate. The care plan for the person receiving respite care was limited in content. The areas of assessed need where documented but lacked sufficient detail to inform any staff of the detail of actions to be taken. Whilst it was evident from discussion with the registered manager and people using the service that the placement was going well, there was no clear audit trail of actions taken which would appear to have improved the placement. Whilst the care plan identified some risk areas there was no assessment of the risk and plan available to support the person and staff to promote choice and Independence. There was no evidence to support that either care plan had been reviewed The care records are stored securely but people were able to access their records when they wanted to. Care Homes for Adults (18-65 years) Page 21 of 39 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in age, peer and culturally appropriate activities, and people use the local community. Residents are treated with dignity and respect and their rights supported. A varied diet is promoted. Evidence: We spoke with two people living at the home. They told us about the day centers and work placements they attended. They both appear settled and enjoying these placements. Where previous placements had been unsuccessful the manager had been proactive in supporting the person. Neither person has any current college placement but this has been undertaken in the past. The home is a domestic setting with the registered provider and family living at the home. Therefore, people told us that they were involved in family life and were very happy at the home. The home has many pets which people using the service appear to Care Homes for Adults (18-65 years) Page 22 of 39 Evidence: enjoy. The home has a multi purpose vehicle which is used when people go out. People told us that they were supported to maintain contact with their families. An independent advocacy service is available if needed. They told us that they went to the local public house and were involved in community activities. People are supported to access any spiritual needs they may have. One person told us that they had been supported by the management of the home to maintain a long term friendship. The registered provider has a holiday caravan which people using the service visit on average once a month and have their own rooms there. They told us how much they enjoyed this. They also plan to take a holiday to a place of their choice later in the year. People also told us that they could watch TV in their rooms or in the communal lounge, Freeview boxes are available with all TVs. There is a large screen TV and DVD player in the lounge and people were seen to move freely around the house and garden. People were not seen to have a documented activity plan. The registered manager and one of the people using the service have booked to go to a study day together on this subject to learn together how to create this plan and so that the person can be actively involved in its update. Each person has a key to their bedroom door and the registered manager has an emergency access key. The registered manager and people using the service were noted to all treat each other well .There was clearly a comfortable relationship between all living at the home with free speech, jokes and stories being told throughout the day. There is some flexibility around meals and mealtimes to fit in with activities. Breakfast consists of cereals and toast etc. which are chosen by people using the service . Lunch is a lighter meal with the main meal being in the evening, at weekends this is reversed. People can assist with shopping and meal preparation. The kitchen is accessible most of the time and people have the facility to make a hot drink when they want to. The kitchen is only locked when the floor has been cleaned and when cooking is taking place to ensure the safety of people who may not be fully aware of the risk of injury during cooking. Care Homes for Adults (18-65 years) Page 23 of 39 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. Each person receives personal support as they require and that has been agreed with them. This agreement needs to be updated. People told us that they have their physical and emotional needs met. No regular medication is administered at the home. Evidence: There is currently no personal care provided at the home but support is given as needed. One person does require some support with hair washing. This is documented within the persons care plan. One person has some issues regarding hygiene and the home have accessed professional advice. This detail needs to be documented in the persons care plan. The registered manager confirmed that the management of the situation is ongoing. People using the service access local GPs and specialist support as required. Health is monitored and recorded in the persons daily book. These books were not available to us at inspection as the registered manager advised they had been accidentally archived the previous day. We were advised that these books included medical visits, any homely medications administered and any current information. These books will need to be reviewed at the next inspection. Care Homes for Adults (18-65 years) Page 24 of 39 Evidence: The registered manager and registered provider have received medication training but this requires updating to reflect current best practice. The registered manager advised us that currently nobody is taking any medication. Should homely remedies be required these are recorded in the persons daily record book. Care Homes for Adults (18-65 years) Page 25 of 39 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 confirmed that they would raise any concerns and would be confident that they would be acted upon appropriately by the management of the home. Policies are in place to protect residents form abuse. Formal training in abuse awareness is needed to ensure that staff are aware of the correct process to follow if there is an allegation of abuse. Evidence: There is a basic complaints policy in the homes Statement of Purpose. Whilst no complaints policy was on display, the two people at the home told us that if they had any problems or concerns they would talk to the registered manager or registered provider. The contact details contained in the policy need to be updated to reflect the current contact details for CQC. This will enable people to contact us should they feel their complaint has not been correctly addressed. No complaints have been recorded at the home since the last inspection and CQC have not received any complaints about this service. The home is aware of the input of the Safeguarding Vulnerable Adults Team and has a large print copy of How to Spot Abuse. This contains the contact details of the local Safeguarding Team. There was no evidence in staff files that any training has been undertaken by any staff in Care Homes for Adults (18-65 years) Page 26 of 39 Evidence: abuse awareness. This is recommended to be undertaken as a priority. Individuals need assistance to manage their personal finances and appropriate records are kept of staff involvement. Financial records were maintained in the form of a spreadsheet for each person, receipts and all transactions are updated monthly. Care Homes for Adults (18-65 years) Page 27 of 39 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 Peacocks is a domestic setting which is a comfortable environment for people using the service Evidence: The Peacocks is a terrace property located close to the local village. Local amenities such as a shop, church and public house are within easy walking distance. There are steps to the front of the house and this would restrict anybody with any mobility difficulties. The home is not environmentally suited to people using a wheelchair within the home. The house is a domestic setting with the people using the service and the management of the home and their family all living together. People using the service have their own lounge, shower / toilet room and individual bedrooms. There is a shared kitchen, toilet and outside space. Access to the first floor is by stairs. The garden is at the front of the house and has seating areas and play areas for the providers family. All parts of the home are decorated to the tastes of the people living there. There are several pet,s including dogs, birds, fish and a tortoise. One bedroom has a built in fish tank. People using the service told us that they like the pets. The homes Statement of Purpose states clearly that this home is suitable for people who like pets. Each person has their own bedroom. personal items were seen to be in place. One person Care Homes for Adults (18-65 years) Page 28 of 39 Evidence: has a glass door to their bedroom. The registered manager said that this does not present a problem for the person living there as the glass is partially occluded and the persons dignity is maintained. Toilets and bathrooms were available on each floor. The ground floor bathroom has a Jacuzzi bath and the upper floor bathroom has a shower. There was hand wash available and the registered manager told us that each person uses their own hand towels. Currently staff do not provide personal care, should this be a development , it would be required that paper towels be made available for staff to use to prevent the risk of cross infection. One bedroom was noted to have an unrestricted window. This room is currently empty. The registered manager was advised at the time that this should be risk assessed and appropriate restrictions be put on the window. Unrestricted windows may pose a risk of falls to people using the service. This risk is heightened by the geographical layout of the home. The management of the homes accommodation is to the rear of the house and that particular room being at the front of the house. Some radiators were observed to not have heat restricting covers on them. The covers are needed is the surface temperature is high.These radiators must be risk assessed and the appropriate action taken as they may pose a risk of burns to people using the service. All areas appeared clean but there was a malodour which may be related to the animals at the home. Care Homes for Adults (18-65 years) Page 29 of 39 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 using the service benefit from a small and consistent staff team. Staff training is needed to be updated to reflect current good practice. Evidence: The home has a staff team which is stable. The registered provider and registered manager provide the majority of care. Should further assistance be needed a further two voluntary staff are available. The voluntary staff have been employed on this basis for many years. People using the service told us that they know all the staff and like them all. The registered manager has completed and NVQ level 4 in Management and Care and the registered provider is a retired Registered General Nurse. The registered manager is currently undertaking an e-learning program on the Deprivation of Liberty. Both the manager and provider have had training in the Mental Capacity Act. All staff have undertaken training in medication administration in 2003 and basic food hygiene in 2007. However these areas need to be updated to reflect current good practice. Management of the home have undertaken moving and handling training, but this training needs to be updated. Manual handling is not currently required at the home for the care needs of the people living there. However it would be good practice to undertake this training should the peoples care needs change. Care Homes for Adults (18-65 years) Page 30 of 39 Evidence: The registered manager must also ensure that all staff have received up to date first aid, infection control and fire safety training. Records of all training undertaken needs to be maintained in each persons staff file. The issue of staff training updates and lack of documentation to evidence that training had taken place was made at the previous Key inspection. This requirement would appear not to have been met on two previous occasions and evidence must be provided to CQC that this requirement has now been met by the timescale stated. People living at the service told us that staff are always available and approachable and that should they need anything they just have to ask for it. The registered manager told us that overnight they only need to call and they would be heard. This would need to be reviewed should the health of the people deteriorate. No new staff have been recruited to the home since the last key inspection. Due to the small staff compliment and the management structure of the home, supervision is ongoing as a dialogue between the manager and provider. The voluntary staff work infrequently and so are updated when appropriate. Care Homes for Adults (18-65 years) Page 31 of 39 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. The home is well organised and people using the service views are sought and play an important part in the development of daily life. The health, safety and welfare of residents is promoted. Evidence: The registered manager is Cheryl Dean. She has manager the home for a period of years and appears to be suitable experienced and skilled to meet the needs of people using the service. People living at the home spoke with confidence about the manager and we observed a friendly rapport and friendship. Views as to the quality of the service provided are sought from people using the service on an ongoing basis. The views of relatives and people who access the home have recently been sought but no responses received at this time. The last time the views were sought was 2006. The registered manager is recommended to ensure that this practice is done annually to promote good practice. Care Homes for Adults (18-65 years) Page 32 of 39 Evidence: Policies and procedures were seen to reflect areas of abuse awareness, safety and complaints management. Records appeared to be stored in an office area which was in the process of being moved. This meant that some records had been archived and were not available. (See Standard 18). The home is also required to display the Certificate of Registration, insurance and complaints procedure at the home. This is recommended to be addressed. The homes AQAA stated that they did not have any portable appliances however this was discussed and clarified and the portable appliances are to be tested within a short timescale. The certificate of compliance is required to be forwarded to CQC within the given timescale. The fire system is checked weekly and the home has emergency lighting in the stair case area. The home has several areas which may pose a risk to people using the service and an environmental risk assessment was required at the last key inspection. This was not evident at inspection is is required to be forwarded to CQC within the given timescale. Care Homes for Adults (18-65 years) Page 33 of 39 Are there any outstanding requirements from the last inspection? Yes  No  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 1 35 18. 19 The registered person shall 01/02/2008 ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. This must include suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. (For example such training must include training as required by regulation such as fire training.) Accurate records of training must be kept including a certificate of completion of training courses attended. (Timescale of 01/12/2006 not met 2nd Notification) 2 42 13, 23 The registered person shall 01/11/2007 ensure that? (a) All parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety; Unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. (c) The Page 34 of 39 Care Homes for Adults (18-65 years) 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 premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally; (d) Equipment provided at the care home for use by residents or persons who work at the care home is maintained in good working order; (For example there must be: Evidence that a satisfactory health and safety risk assessment system is in place. Evidence of risk assessments must be forwarded to the commission within the timescale set. Gas appliances should be tested at least annually. Evidence of this must be forwarded to the commission within the timescale set. Care Homes for Adults (18-65 years) Page PAGE of NUMPAGES 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 Description 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 Description Timescale for action 1 5 5 The registered manager is 30/10/2009 required to ensure that each person has a standard contract for the provision of services and facilities by the registered provider. This is needed to ensure that people using the service are clear about the service they are paying for. 2 6 15 The registered manager is 30/10/2009 required to ensure that all care plans are reviewed and updated regularly to accurately reflect changes in the persons needs. Care plans should be detailed and include all areas of identified need. This required to ensure that the person has a clear record of care needs and how to Care Homes for Adults (18-65 years) Page 36 of 39 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 Description Timescale for action meet those needs. 3 9 12 The registered manager 30/10/2009 must ensure that all risks identified have a clear assessment of that risk and a plan of care to minimise and support the risk. This will ensure that the person is safe and the management of care supports independance. 4 26 12 The registered manager must ensure that any unrestricted upper floor windows are risk assessed and the appropriate restrictions put in place. 30/10/2009 This is needed to ensure the safety of people using the service. 5 35 18 The registered manager 30/10/2009 must ensure that training is provided in all mandatory areas and is updated to reflect current good practice. This will ensure that the health and safety of people using the service is maintained. 6 42 13 The registered manager 30/10/2009 must ensure that all portable appliances are tested as Care Homes for Adults (18-65 years) Page 37 of 39 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 Description Timescale for action safe. This is required to ensure that all portable equipment used at the home is tested regularly to ensure its safety. 7 42 13 The registered manager must undertake an environmental risk assessment of all areas of the home. 30/10/2009 This is needed to ensure that all areas of the home have as little risk as possible to peoples safety. 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 23 The registered manager is recommended to ensure that all staff receive training in abuse awareness. This is recommend for the protection of people using the service. Uncovered radiators are recommended to be risk assessed and appropriate action taken to ensure that the surface temperature does not pose a risk of burns to people using the service. The registered manager is recommended to make accessible by display the homes Certificate of Registration with CQC, the homes current insurance certificate and complaints procedure. This will enable people to access the information if needed. 2 25 3 40 Care Homes for Adults (18-65 years) Page 38 of 39 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 39 of 39 - 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!