Inspection on 15/12/08 for Vinegar House

This inspection was carried out on 15th December 2008.

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

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

Other inspections for this house

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

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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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Vinegar House Vinegar House 17 Longford Street Derby DE22 1GJ     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: Claire Williams     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. that people have said are important to them: They reflect the things 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: Vinegar House 17 Longford Street Vinegar House Derby DE22 1GJ 01332299533 01332299533 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Heather Fox,Mr Ian Brown Name of registered manager (if applicable) Mrs Heather Fox Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 8. The registered person may provide the following category of service only: Care home Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Vinegar House is a 8 bedded Care home which provides personal care and support to younger people of both gender with a mental disorder. The home is located in a residential area, close to Derby City centre. It is accessible to local shops and public transport. Accommodation comprises of 8 single bedrooms all fitted with shower ensuite facilities. Lockable storage is available in all rooms. People have access to a homely dinning area and lounge on the ground floor. This is a non-smoking home and people are able to smoke outside the front door as this is a covered area or in the Care Homes for Adults (18-65 years) Page 4 of 31 care home 8 Over 65 0 8 Brief description of the care home courtyard which is at the rear of the building. People are provided with information about the service as they are provided with a servce user guide. Information about the location of inspection reports is included in this guide. Details of the inspection report can be found on the Commission for Social Care Inspections 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: The inspection visit was unannounced and took place over a period of 1 day. This is the first inspection of this service since their registration in August 2008. As part of the preparation for this visit we looked at all of the information we have received since their registration this includes: What the service has told us about things that have happened in the service, these are called Notifications and are a legal requirement. The annual quality assurance assessment (AQAA). This is a self- assessment that focuses on how well outcomes are being met for people using this service. We received Care Homes for Adults (18-65 years) Page 6 of 31 the AQAA within the required timescales. Surveys-These are sent to both staff and the people who live in this service in order to obtain their feedback. We received four staff and five surveys from people that live in the service after the draft report was completed. Their comments have been included in the final report. We were assisted on this visit by an expert. An expert by experience is a person who, because of their shared experience of using services, and / or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. During the site visit case tracking was included as part of the methodology. This involved the sampling of a total of three peoples files representing a cross section of the care needs of individuals that use this service. Discussions were held with those individuals by the expert, and observations were made of the interactions between the staff and people. Individuals care planning and associated care records were also examined and their private and communal facilities inspected. Discussions were also held with staff about the arrangements for peoples care and also for staffs recruitment, induction, deployment, training and supervision. We were told that the current fees for this service are 550 pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 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. Prospective people are provided with the information they need to know about the service, and comprehensive assessments take place prior to admission ensuring that the service can meet their needs. Evidence: In the self assessment the manager provided us with information about what they do well. They said; they provide a friendly, informal atmosphere, good food and realistic support which is offered in keeping with the persons recovery plan. As this is a new service all of the required information was available to people. Information seen clearly describes the aims and objectives and the services that the facility is able to provide. All people currently living here confirmed they had received information about the service before they moved in. Pre- admission assessments are conducted prior to anybody being offered a service, this information was seen on peoples files we sampled. All individuals who are referred Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: receive a visit and initial assessment which is carried out by their respective Care manager, CPN and by the manager of the service. This is to ensure the individual meets the criteria for this service and to ensure the placement is right for their needs and aspirations. People, their families and representatives are provided with the opportunity to visit the service, and this can be flexible depending upon the individuals needs. 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. Each person has a plan of support that they had been involved in making, which ensures their needs are met. People are supported to make decisions and are supported to take risks to enable them to stay independent. Evidence: In the self assessment the manager provided us with information about what they do well. They said they try not to reflect an institutionalised service. They help to support people in a friendly, and homely environment. They said their main focus is to promote social inclusion and to help support people in accordance with their recovery plan. Each person has a support plan in place and three were sampled during this visit. The support plans covered a variety of areas, which were applicable to the needs of the individual. There was evidence in the files to demonstrate that individuals are fully involved and consulted in planning their support which is agreed with them. All interventions are planned at peoples request or with their consent. The support plan is Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: updated to reflect any changes and progress in peoples well being. People receiving the service are encouraged to make decisions about their life with support from staff. They are involved in all aspects of life in the home, as they are encouraged to participate in the day to day running of the service. Regular meetings are facilitated, where people can express their suggestions and views about the service. The expert by experience spoke to all the individuals that were living in the service and some of the comments people made include; I like it here, there is a magnificent sense of togetherness and its like a big family here I always feels that my input matters in the home. I always has a choice of what I do and my achievements have been perfect We also received many comments in the surveys and some of these included: We have many choices and i actually enjoy being faced with a choice to make every day I make decisions everyday with the help from the staff, and i made the right decision to move here A range of risk assessments had been completed and were available in peoples personal files; these covered areas applicable to the individual. Information was also provided about relapse triggers to enable the staff to be aware when a person may need more support. On occasions there may be a need to limit individual choices in order to maintain safety but this is discussed with the person and their agreement is sought where possible, this was demonstrated by information seen in peoples files. 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. The service supports people to follow personal interests and activities and they are able to participate in the local community. This ensures their social needs are met by this service. Evidence: In the self assessment the manager provided us with information about what they do well. They said they offer a relaxed approach to activities that include drink, but engage in developing a moderate approach. They said they provide a relaxed and friendly environment for families and visitors, and offer focused intervention to help people to complete their social / work activities as outlined in their plan. There was evidence in peoples files to support that individuals are encouraged and supported to access the community. People told the expert by experience about how Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: they spend their week and what activities they undertake and some of these discussions included the following; I attend the Mind Day Centre on regular occasions, where I can play pool and socialise with other people and talk to the staff there. I will also be starting a computer course in February, which the staff here helped to enroll in. I visit my family on regular occasions and when my relatives visit the staff always make them feel welcome. I am looking forward to spending Christmas Eve until Boxing day with my family, which has been arranged by the manager of the home. I am very happy here the home is good. I always feels that I can choose what to do and have plenty of encouragement to go out into the community. I have just started a part time job which Heather the manager had encouraged me to apply for via the internet. I am also being encouraged to join a gym, which I am going to look into after Christmas. I am encouraged to visit my family. I really like it here and I am working toward independent living. I attend a tennis club 4 times a week, and go shopping and have been on holiday. I am also going to enroll on a computer course in February along with the others. I occasionally have friends and relatives to visit and staff always make them feel welcome. There is plenty of activities organised by the staff like going out for meals and days out. Information we received in the surveys also confirmed that people have lots of opportunities and comments made include: We have lots to do and do anything we want, all we have to do is discuss it with the staff We are encouraged to construct our time respectfully People told the expert by experience the routines in the service are flexible. We were told the only restrictions in place are that people are encouraged to rise by a certain time and to be back in the home at night for a certain time unless a later time has been agreed. People spoke about the food provided with the expert by experience and the following comments were made; The food is wonderful Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The food is fantastic, and I help to prepare it regularly. I have learned how to cook. I dont eat pork, but thats not a problem as the staff will always offer an alternative if you dont like whats on the menu. The menus are completed in consultation with people and individuals take it in turns to cook and undertake the food shopping if they wish to. The kitchen is domestic in design and all records were in place to meet the food and hygiene standards. Care Homes for Adults (18-65 years) Page 17 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. People receive personal support in the way they prefer, which ensures their health needs are met. Evidence: In the self assessment the manager provided us with information about what they do well. They said they maintain a focus on improving peoples hygiene whilst supporting social integration. They encourage people to assist with the cooking of healthy meals and eating a varied diet. They review peoples recovery plan to see if there has been a change in direction reflected by them. They encourage people to engage and to attend health care checks. Each person admitted to the service is individually assessed using a wide range of tools and a personal and recovery support plan is implemented in partnership with them. Personal care is negotiated with each person and the service is trying to respond to requests regarding peoples preferred gender of support worker by employing both male and female staff. Support plans seen during this visit recorded peoples preferred name of address. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: There is multi disciplinary approach to care and individuals using this service have access to a wide range of health care professionals as applicable to their needs. The service intends to develop a wide range of therapies including, one to one counseling, educational approaches, art and creative therapies, peer support and relaxation. Information seen in the three files sampled during this visit demonstrated that recovery and treatment plans had been implemented in consultation with people. Care notes sampled provided clear and comprehensive records of the care and support provided. A number of positive comments were received by the expert by experience from people about the care and support that they receive and comments included; the staff are highly capable and friendly, the staff are thoughtful and protective and they understand me, the home has a kind and friendly atmosphere and its all good. During this visit the medication practices were examined. People are encouraged to self administer their medication in order to maintain their independence. Detailed risk assessments are carried out at the time of admission, and lockable facilities are provided in their bedroom for safe storage. The medication administration records were examined and these were seen to be in order. Medication was appropriately stored and recorded. There was evidence to support that staff that administer medication had completed training in this area. An assessment of staff members competency had not yet been completed to ensure their practices are safe, but would be undertaken in the near future. At the time of our visit a signature sample sheet was not in place and the medical reference book was out of date. We were told these would be addressed in the week following our visit. Care Homes for Adults (18-65 years) Page 19 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 using the service are informed about the process of raising complaints and procedures in place ensure they are safeguarded from abuse. Evidence: The service has a complaints procedure in place, which is included in the service user guide. Information supplied in the AQAA states that staff are encouraged to respond to observations, suggestions and concerns at the earliest opportunity and people using the service are supported as required in making complaints. A suggestions book is also available in reception. Since the registration of this service there have not been any complaints received by them or by the Commission. All people spoken to by the expert by experience said they were aware of the complaints procedure and would know who to talk to if they had a concern. This was confirmed by the comments we received in the surveys and some of these included: There is always someone you can talk to and I feel listened to. I can speak to any member of staff day or night all the time. I can ask any questions I like to the staff anytime I want and need to. The service has local safeguarding vulnerable adults procedures in place. Staff receive safeguarding vulnerable adults Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: training as part of their induction and as part of the National Vocational Qualification (NVQ) training which all staff are encouraged to complete. This was confirmed by staff training records and from members of staff spoken with. Both the manager and deputy were clear about their responsibilities should they witness or be made aware of any incident where the safety of people is compromised. There have not been any safeguarding incidents since the service was registered. People are encouraged and supported to manage their own finances and for some people support plans are in place for this. Systems were in place for the safekeeping of peoples finances and these were checked and found to be satisfactory. Care Homes for Adults (18-65 years) Page 21 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 using the service are provided with a safe, comfortable and homely environment, which meets their needs. Evidence: In the self assessment the manager provided us with information about what they do well. They said they aimed to provide a small and user friendly environment, which did not reflect an institution style. All rooms are provided with en-suite facilities, which allows for maximum privacy. The atmosphere is relaxed and friendly. They said they check the environment and safety aspects every month and keep records to support this. As this is a new service it meets all of the environmental standards. It is a small home registered for 8 people, and the building is homely in design. Due to the time of our visit the environment was decorated with a variety of Christmas decorations. The expert by experience made the following comments about the building; On arrival at Vinegar care home I noticed that the building looked like a new build, and was very inviting. I was met at the front door by a service user who was polite and welcoming. The home itself was clean and homely with a pleasant smell inviting a Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: relaxed welcome as you walk though the front door from both people and staff. People made the following comments about the environment during the discussions we had; I am relaxed in these surroundings and i am very happy at the home, I like how the home looks. It is very homely - like a home from home. I like my bedroom it is my private space. Both staff and people also made positive comments about the builidng in the surveys we received and the following comments were made; It is always fresh and clean The home is exceptionally good, as each person has their own en-suite and the bedrooms are well furnished. People are encouraged to bring in any preferred possessions for their rooms, and all rooms have shower en-suite facilities. During this visit the home was cleaned to a good standard and was hygienic. Infection control procedures are available and cleaning schedules are in place. Care Homes for Adults (18-65 years) Page 23 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 are supported by appropriate numbers, trained and competent staff who are supervised. However shortfalls in the recruitment of staff could place people at risk. Evidence: In the self assessment the manager provided us with information about what they do well. They have a staff group who are developing their skills and interaction with people living in the service. They are encouraging all staff who are not qualified to work towards a NVQ level 3. They said they have a system in place for the supervision of all staff. The service is currently supporting five people, and therefore has recruited staff in accordance with this. There is a skill mix of staff which comprises of trained Mental Health workers, social workers and staff who are new to working with this client group. The current staffing levels are one staff member on each shift, but the manager works flexibly so therefore two staff members are usually on shift. The staffing levels are also dependent upon the support people require to access the community, and appointments, so therefore it is flexible and responsive to peoples needs. Each staff member has a training file, which contained evidence of their induction and Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: some certificates of the training and qualifications they have already achieved. This demonstrated that staff have the skills and knowledge to meet peoples needs. A training programme will be developed as new staff are recruited, and this will cover mandatory topics and training in relation to the needs of the people living in the service. We were told that one to one training sessions are already provided to the staff who are new to this client group, to support them and increase their knowledge about specific conditions and approaches. There are currently 5 staff members employed in this service, and 4 of these have achieved a National Vocational Qualification to level 3. Systems are in place to support staff thought the provision of regular supervision and team meetings and records in place supported this. Comments made in the surveys we received confirmed that staff feel supported in their role. People spoke positively about the staff team and the following comments were made: The staff here are really nice and supportive The staff can be trusted and are good. The staff are nice and friendly and help me when I need them to. Comments made in the surveys include; The staff treat me well and always have time for me All the staff are good and they give good advice Observations supported that the staff members had a good knowledge of peoples support needs and provided assistance in accordance with peoples preferences. We examined the recruitment files for 2 of the most recently appointed staff members. Each file contained majority of the recruitment information that is required by the current regulations in order to protect people that use this service. The shortfalls identified include; a full employment history was not requested on the application form, and therefore this was not provided. However gaps in employment were explored and explained. One file did not contain 2 references, as one could not be located in the filing draw. Staff have not been provided with the General Social Care Code of conduct (GSCC) but we were told copies of these would be obtained and distributed. 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. The service is run in the best interests of people using it. The environment is safe for people because health and safety practices are carried out. Evidence: In the self assessment the manager provided us with information about what they do well. They said they have a review system in place together with a risk plan for each person. The environmental health standards are met, and any concerns are recorded and discussed with management. The manager told us she is currently undertaking her NVQ level 4 in order to gain the management qualification. She also told us that all of the policies and procedures are accessible to the staff and people who use the service. The manager of this service is also the owner, and she is a retired approved Social worker, who has many years experience of working with this client group. The deputy manager is also a social worker who has also worked with this client group for many years. Both individuals therefore have a vast amount of experience and knowledge to provide guidance, advice and direction to the staff team. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: Staff spoken with said that they felt supported by the management team and this was supported by the comments made in the surveys. The manager was observed to have an open approach and aims to ensure she is accessible to people and the staff. The service has a structure of staff meetings in place which was confirmed by the records in place. We received many positive comments about the service in the surveys and some of these included; The service supports everyone well, and lets people have freedom lo live everyday and do what they would like to do. Everybody here can be trusted and we are friends, dignified and sophisticated. I am very comfortable and very happy where I am today. People are supported to share their views and provide feedback at the monthly meetings and the minutes from these meetings are recorded. Questionnaires are available in the reception areas and families and visitors are encouraged to complete these so their views can be obtained. We had a look at some of the completed forms and the feedback on one sheet said; An excellent service is being provided. All completed forms demostarted peoples satisfaction with the service. An advocate from MIND has visited the service and spoke with people about the service they provide and how to access it. People told us they do not require these services at this time, but are aware that the provision is there. We were told that surveys will be distributed to the people in order to gain their feedback about the service in the future when the service has been operational for a longer period of time. We received confirmation that a report would be completed following this to analyse and reflect what people said. The information provided in the self assessment demonstrated that the service has systems in place to ensure peoples health and safety. As we received confirmation during our visit that the recruitment practices would be improved and the application form would be amended, we have not included these shortfalls in this section as there was no evidence to support outcomes for people were being directly affected. 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 34 17 All of the required 01/02/2009 recruitment information must be obtained before staff commence employment in this service. This is to ensure people living in the service are safeguarded from harm and staff are vetted appropriately. 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 3 A letter should be sent to the individual to confirm that the service is able to meet their needs following the completion of a pre- admission assessment. An updated medical reference book should be obtained, and a signature sample sheet completed for auditing purposes. 2 20 Care Homes for Adults (18-65 years) Page 29 of 31 3 20 All handwritten medication instructions should be countersigned by two people. This is to ensure instructions are correct. Certificates should be held of staff files to confirm the training and qualifications they have achieved. Staff should be provided with a copy of the General Social Care council code of conduct. 4 5 32 34 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. 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