Inspection on 11/11/08 for Warwick Road, 2

This inspection was carried out on 11th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Warwick Road, 2 23/02/07

Warwick Road, 2 01/11/05

Warwick Road, 2 12/07/05

Warwick Road, 2 19/01/05

Warwick Road, 2 05/10/04

Warwick Road, 2 18/03/04

Similar services:

22 Sandown Road

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Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Warwick Road, 2 2 Warwick Road Wallsend Tyne And Wear NE28 6RT two star good service The quality rating for this care home is: 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: Elizabeth Gaffney Date: 2 6 1 1 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. 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 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Warwick Road, 2 2 Warwick Road Wallsend Tyne And Wear NE28 6RT 01912343933 F/P01912343933 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northern Life Care Limited T/A U.B.U. Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies): care home 4 Number of places (if applicable): Under 65 Over 65 4 0 Learning disability Additional conditions: The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 4 men or women Date of last inspection 3 1 0 7 2 0 0 6 A bit about the care home The home cares for 4 younger adults with learning and physical disabilities. The home is a semi-detached bungalow with its own gardens. The home is in Wallsend which is in North Tyneside. There is a good bus route near the home. There are shops close-by. Each person has their bedroom with their own things in. There are bathrooms which people with physical disabilities will find easier to use. 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 How we did our inspection: This is what the inspector did when they were at the care home The Inspector talked to four staff to check that they know how to care for people living at the home. We watched staff to see how they care for people. The inspector looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We looked at some of the records that are kept by staff. We checked the building to make sure that it is a safe place to live. What the care home does well This is a sample of some of the things that the home does well: Staff keep good records about the care they provide. A lot of staff have obtained a qualification that will help them to provide more individual care. People are supported to keep in contact with their relatives, and they can see visitors whenever they want. People receive the health care they need to stay healthy. People receive their medication and staff keep good records. People receive support to visit shops and go out for meals. Staff help people to make simple choices and decisions. What has got better from the last inspection The home has a new manager who is beginning happier made. to make improvements. are being Professionals visiting the home are now that improvements People are now being cared for mainly by staff that are only employed to work at their home. What the care home could do better People’s care records should be available in an easy read format. The manager must make sure that all staff working at the home receive the support, guidance and supervision they need to do their job well. The manager and provider need to devise a development plan to improve the service during 2009. Staff should receive the medication training they need to administer medication safely. The manager should check to make sure that staff are good at administering medication. The manager must complete the training needed to run a home like No 2 Warwick Road. 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 Elizabeth Gaffney St Nicholas Buildings St Nicholas Street Newcastle NE1 1NB 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 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 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 . There are suitable arrangements for making sure that peoples needs are assessed before they move into the home. This will help ensure that staff are able to meet peoples needs on admission. Evidence: There have been no new admissions into the home since the last inspection. However, people previously admitted into Number 2 Warwick Road received a multi-disciplinary needs assessment carried out by experienced staff. Copies of the assessments carried out by other professionals were obtained and placed on peoples care records for staff to refer to. As part of the admissions process, people were supported to choose the decor, furnishings and fittings in their individual bedrooms. The provider has policies and procedures that set out how people can be referred to, and assessed for, a place at the home. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have good support plans that clearly set out how their assessed needs are to be met. This will help make sure that peoples individual needs and preferences are catered for. Staff will also be clear about how they should care for people. Evidence: Support specifications have been devised for each person setting out what support they require and in what areas. Support specifications cover such areas as help needed with medication, managing personal finances, continence, and morning and evening routines. They are detailed, easy to understand, written in plain English and are reviewed on a regular basis. However, none are in a format that can be more easily understood by people living at the home. People are unable to sign their support specifications to confirm their agreement with the contents. Staff who have worked at the home for a number of years rely on their experience, skills and knowledge to help them understand peoples needs and wishes. However, since the last inspection, the local authority contracts team have expressed concerns about inexperienced staff working together to cover shifts on the homes rota. The Commission is concerned that this may have led to people not always having had access to staff that know how to communicate with them and who understand their needs. Following the appointment of the new manager, less experienced staff are now always rostered on duty to work alongside more experienced staff. Staff spoke knowledgeably about peoples communication needs and their own communication skills. Care Management have arranged advocacy support for one person to ensure that their needs and wishes are taken into account when day-to-day decisions are made. In the surveys returned by staff, all said that they had been given up to date Evidence: information about the needs of the people they support. Observations of care provided by staff show that they try to involve people in making simple life choices and decisions. A range of risk assessments have been completed for each individual covering such areas as showering and access to the kitchen. The completed risk assessments provide staff with guidance on how to promote independence whilst also keeping people safe. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The arrangements for providing people with access to a range of activities both within, and outside of the home, have improved. This is helping people to access a more fulfilling lifestyle that is age appropriate and which helps them to achieve more community presence. Evidence: The local council contracts team have expressed concerns about there being limited opportunities for people to access activities. Discussions held with the new manager indicate that previous staff turnover levels, combined with the deteriorating health of some people using the service, have made accessing community facilities more difficult. The contracts team also expressed concern that an agreement to provide one service user with one to one support from a specific member of staff was, at times, not being complied with due to staff turnover and sickness levels. However, since the appointment of the new manager, more opportunities are now being created for people to access their local community and make use of every day community facilities. During the inspection, people were supported to go out for lunch and visit the local shops. A weekly activity planner has been devised for each person. A copy is kept in each person’s bedroom. This sets out how the service will provide day-to-day stimulation and access to the community. Also, each person has either had a holiday away from the home, or participated in various day trips, during the previous twelve months. Evidence: An Expert by Experience who attended the inspection said: ’Residents have a weekly activity planner on their bedroom wall. This has pictures on so they could see what they were doing for the week. The manager told me that they are going to use more pictures for activities as another way of communicating. One of the residents was out at a walking club that he goes to every week. Residents also go to an activity club called Blue Door. A member of staff told me that one resident goes to a cookery class once a week, and on a Friday night one residents mother runs a disco that some of the residents go to. I asked the manager what activities there are in the house, and she said that massage, foot spas, aromatherapy and gardening sessions are held. The residents also have their own televisions and radios in their rooms. There are also games like skittles. The residents also often go out for lunch, which they did when I was there. I think that there is a good choice of activities, but I think there should be more indoor games and activities for the residents.’ 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 . The arrangements to meet peoples personal and healthcare support needs are satisfactory and promote their good health and well-being. Evidence: People are registered with a local GP practice, optician and dentist. They have regular access to dental, optical, chiropody, and where required, more specialised health care services. For example, the new manager has arranged physiotherapy input for one person to help improve their physical health and mobility. A new wheelchair has been ordered for this person to enable them to access community facilities. A referral has also been made to the occupational health service to obtain any extra aids and adaptations that might be needed. Mrs Mowbray has introduced a monthly falls review to establish whether any further measures can be put in place to keep the person safe. A medication review has also been carried out. Support plans have been devised for each person to promote their health and well being. These cover such areas as support required when having a seizure, attending medical appointments and receiving emergency medication. One person living at the home receives their nutrition and fluid artificially. Before staff carried out this task for the first time, the manger arranged for them to receive specialist training. Mrs Mowbray also arranged further training from a specialist nurse who confirmed staff’ competence to provide artificial feeding support. A supportive care plan and risk assessment have been put in place. The inspector observed staff carrying out this task which they did in a professional and competent manner. People using the service are unable to comment on whether their health care needs are well met. A care manager who returned a survey said: I believe that people who Evidence: live at 2 Warwick Road are taken to see their GPs for medication reviews and or receive visits when unwell. When admitted to hospital I know that support staff do visit people as in-patients.’ Support plans setting out how staff should meet peoples personal care needs have been devised. For example, in one persons care records, there is guidance describing the support they need with bathing, oral hygiene and continence care. There are records covering the ordering, receipt, administration and disposal of medication. All medicines are kept safely locked away. The cabinet was clean and tidy. Staff administered medication in a safe and professional manner. None of the people living at the home administer their own medication. Although the provider ensures that its staff receive in-house medication training, this is not accredited training. Also, staff files do not contain evidence that staffs competency to administer medication is assessed on a regular basis. 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 can feel confident that their complaints or concerns will be listened to, taken seriously and acted upon. Satisfactory arrangements are in place to keep people safe from harm or abuse. Evidence: The provider has devised a complaints policy and procedure that all staff are expected to follow. People have a support plan that sets out how staff will support them to make a complaint. All staff that returned surveys said that they had been told what to do if they received a complaint. The Commission received an anonymous complaint in May 2008. The complainant said that service users were being neglected and receiving inconsistent care. They also expressed concern over the high level of staff turnover. Although the anonymous complaint was not substantiated, the inspector said that some of the concerns raised might well have been valid in the months leading up to the unannounced visit. Evidence obtained during the inspection showed that the new manager has made good progress in improving the standard of care provided at the home. Although the provider has devised a safeguarding policy to help keep people safe from harm, it has not been updated to take account of recent developments in the field of adult safeguarding. The home has obtained a copy of the local councils safeguarding policies and procedures. This helps them to be clear about how they are expected to work with the local council when safeguarding issues arise. The majority of staff have received safeguarding training. Mrs Mowbray has made arrangements for new staff to access safeguarding training provided by the local council. The provider has also arranged for longer serving staff to update their safeguarding training. All staff interviewed were clear about the action they would take to keep people safe. There have been three safeguarding investigations since the last inspection. The new manager appropriately handled the most recent safeguarding concern and the Evidence: appropriate agencies were contacted and their advice followed. The Expert by Experience who attended the inspection said: ’The residents looked well cared for, but one resident does not like strange people in his home. The manager introduced us to him straight away so he felt safe. The windows were blacked out so the people inside could look outside, but you cant see in from the outside. I liked this because it protects residents privacy and so people that walk by dont look in.’ 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 home is well maintained and has been satisfactorily adapted to meet the needs of the people using the service. Evidence: The home is generally clean, tidy, hygienic and there are no unpleasant odours. The Department of Health infection control self-assessment checklist has not been completed. Using this checklist will help the manager to confirm that infection control is well managed in her home. The layout and design of Number 2 Warwick Road enables people to live together in a homely domestic environment. There is a pleasant garden area to the rear of the building that can easily be accessed from the dining room. Peoples bedrooms are attractively decorated and furnished. There are no shared bedrooms. Staff have supported people to personalise their bedrooms. One of the bedrooms visited has been fitted with visual stimulation equipment. The bedroom contains a bed that can be raised or lowered and there is sufficient space for staff to support the occupant to manoeuvre in their wheelchair. A specially adapted bathroom can be accessed from the bedroom. The communal areas are well-maintained and attractively decorated. The kitchen was clean, tidy and hygienic. There is a combined lounge dinner that contains comfortable furniture and good quality furnishings. Although the lounge room carpet was very stained it was professionally cleaned during the inspection. The manager said that the carpet is cleaned on a regular basis. The home has been adapted to meet the needs of the people living there. A range of specialist aids and equipment have been provided. For example, the bathroom has been fitted with a variable height bath, hoisting equipment and grab rails. The home has a mobile hoist, pressure relieving and visual sensory equipment. Evidence: The Expert by Experience who attended the inspection said: ’The home is a fairly new built bungalow with accommodation for four residents. It is homely, welcoming and spacious, especially the living room/dining area and the bathroom. The bedrooms have enough space for the residents. Residents chose how to decorate their rooms, and had their own furniture so they could personalise it. One bedroom belonging to a resident who is a wheelchair user had a height adjustable bed, and an adapted light switch so he is able to turn his light on and off when he wanted. There was visual sensory equipment on the ceiling, which I thought was good. There was a ceiling hoist leading into the bathroom, making it easier for both him and the staff for personal care.’ 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 are supported by qualified staff that have been subject to robust pre-employment checks. This means that staff are safe to work with vulnerable people. However, arrangements for supervising staff are not satisfactory. This means that people are not able to benefit from being cared for by staff that are properly supported and supervised. Evidence: Arrangements are in place to ensure that new staff are subject to robust preemployment checks. Personnel records confirm that staff have undergone Criminal Records Bureau disclosure checks. Two written references have been obtained. Each member of staff has completed an application form and provided a full employment history. Verification of identity has been obtained. Since the last inspection of the service, 12 staff have left their employment at the home. This means that there has been an 80 percent turnover of staff at the service, including members of the senior team. Difficulties in recruiting staff have led to an unacceptable reliance on agency staff. This has the potential to have a negative impact upon the quality and consistency of care provided. In 2008, the local authoritys contracts and care management teams expressed concerns about staff turnover and the high use of agency staff. However, since the arrival of the new manager, all staff posts have been filled. Mrs Mowbray indicated that although it had been necessary at times to use agency staff, those used have previously worked shifts at the service. Mrs Mowbray hopes that the staff turnover rate will improve as staff receive a good induction, follow up training and structured supervision. New staff are provided with opportunities to complete a specialist induction for carers working with people with learning disabilities. Providing staff with a specialist induction will help them to develop the skills and knowledge they require to work with people who have learning disabilities. Evidence: Over 60 percent of the staff team have obtained a National Vocational Qualification at Level 2 or above. A further member of staff is in the process of working towards this qualification. Another carer has completed a Level 2 Certificate in Working with People with Learning Disabilities. This means that people will be able to benefit from having qualified staff that know how to provide them with good care. There is a rota which shows what staff are on duty and at what times. A minimum of two staff are scheduled on duty throughout the working day. Extra staff are made available at busier times of the day. A member of staff sleeps over in the building in case people need support during the night. Catering and domestic duties are carried out by care staff. On the day of the inspection, there were sufficient numbers of staff on duty and people appeared well cared for. An Expert by Experience who attended the inspection said: ’The staff are friendly, very welcoming and interacted well with the residents. There are enough staff to care for the residents. The staff knew a lot about the residents, their care needs and what they like and dont like. The staff share information when changing shifts through putting information in a book and through talking to each other. Each resident has their own key worker and a co-key worker. A member of staff told me that the manager, key worker and co-key worker have meetings once a month to discuss residents needs.’ Staff have completed moving and handling, first aid, health and safety, food hygiene and fire prevention training. Staff are also able to complete more specialised training, which enables them to meet the individual needs of people using the service. For example, one member of staff has completed training in speech and language therapy, communication skills and the Mental Capacity Act. All staff have completed training in artificial feeding. Staff have not received regular formal supervision as recommended in the National Minimum Standards. This states that staff should receive supervision at least six times a year. However, since the appointment of the new manager, staff are now receiving more regular supervision. Written records of staff supervision records are kept. Of the five staff who returned surveys, all said that: -Their employer had carried out checks, such as obtaining a Criminal Records Bureau disclosure check and written references; -Their induction training had generally covered everything they needed to know to do their job when they started; -The training they receive is relevant to their role, helps them to understand the needs of the service users they care for and keeps them up to date with new practices; -The ways of passing information between staff works well; -There are generally enough staff on duty to meet peoples needs; -They have the right experience and knowledge to meet the different needs of people living at the home. Evidence: 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 . Good management systems are in place and staff follow safe working practices. This means that people can be confident that they will be kept safe and protected from harm. Evidence: Although a manager has been appointed since the last inspection, this person has not yet registered with the Commission. The home has been without a registered manager since June 2007. Mrs Mowbray is in the process of making application to register with the Commission. She has considerable experience of working with people who have learning disabilities within residential and day service settings. She has obtained a National Vocational Qualification at Level 3 and the provider is making arrangements for her to complete the Registered Managers Award and a suitable care qualification at Level 4. Mrs Mowbray displays a genuine desire and commitment to improving the quality of care provided at the home. The majority of staff who returned surveys said that Mrs Mowbray met with them on a regular basis. Staff spoken with said that the manager expected them to provide a high standard of care. The home has day-to-day responsibility for overseeing peoples money. Arrangements are currently being made to enable the local council to act as an Appointee for each person. Peoples money is kept separately and stored securely. Staff signatures are obtained for any money spent on peoples behalf and receipts are kept. Daily checks are made of the money held for each person. A check of peoples financial balance sheets against the actual money held on their behalf was carried out. In each case, the recorded balance was different to the amount of money held in the homes safekeeping facility. The manager later confirmed that each discrepancy was due to a recording error. Mrs Mowbray immediately rectified this concern. Evidence: There are arrangements for reviewing and monitoring the quality of care and services provided at the home. For example, the provider carries out:   A quarterly review of the home’s performance. A report is then produced and an action plan is sent to the home; Unannounced monthly monitoring visits to review how well the home is performing. These reports are made available to the Commission. However, the service has not devised an annual development plan. The preparation of such a plan will enable the home to set out how it intends to further develop the service. Quality questionnaires are usually issued to peoples families and other professionals visiting the home. However, this has not taken place during the last 12 months. During the last 12 months the local authoritys contract team have carried out regular monitoring visits to ensure contract compliance. Although concerns about the homes performance have been expressed in 2008, the contract team have informed the Commission that the home is much improved and people are now receiving a much better service. The provider has co-operated fully with the Councils contract team and is producing quarterly reports showing how the service is responding to any requirements that have been made. The Commission has stressed to the manager that it is crucial that the improvements that have taken place are maintained and good quality care is consistently provided. A tour of the premises identified no health and safety concerns. Annual risk assessments are carried out in a range of areas such as fire safety and food hygiene. There is an up to date fire risk assessment and a Personal Emergency Evacuation Plan has been devised for each person. Fire prevention checks are carried out at the frequency recommended by the local fire service. An independent contractor has tested the homes water systems for the presence of Legionella within the last 12 months. The home has current gas and electrical safety certificates. 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 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 20 18 Ensure that all staff receive 04/05/2009 accredited medication training. Documentary evidence of training provided must be kept. This will help to ensure that staff have the skills and knowledge required to safely handle medicines within the home. 2 36 18 Ensure that all staff receive formal supervision at least six times a year. A written record must be kept. This will help to ensure that people using the service are able to benefit from wellsupported and supervised staff. 01/09/2009 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 2 3 6 Ensure that support plans are available in a format that can be more easily understood by people using the service. Where appropriate, make arrangements for all people using the service to receive advocacy support. 12 Provide more in-house social activities in line with peoples known personal preferences and wishes. Explore ways of further involving people in choosing and planning social activities through the use of pictorial or other aids. 4 16 Explore ways of further involving people in menu planning and making food choices through the use of pictorial or other aids. Ensure that staffs competency to administer medication is assessed on a regular basis. Ensure that the homes safeguarding policy and procedures are updated to reflect current developments within the field of adult safeguarding. Complete the Department of Health infection control selfassessment checklist. Ensure that robust measures are in place to minimise the turnover of staff within the home. Submit an application to register the current manager. Devise and submit an annual development plan. The plan should identify how the service will address: findings from the home’s own quality assurance processes; requirements and recommendations made in Commission inspection reports; feedback from care management and the local council responsible for contracting with the service. Issue satisfaction surveys to people using the service and their families, staff and professionals who have contact with the service. Ensure that accurate financial records are kept for each person. 5 6 20 23 7. 8 9 10 30 32 37 39 11 39 12 41 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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