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Inspection on 14/05/09 for Wilkinson Park Residential Care Centre

Also see our care home review for Wilkinson Park Residential Care Centre for more information

This inspection was carried out on 14th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Good systems are in place to make sure that people have enough information about the service before they come to live in the home. People have good opportunities to take part in varied activities that suit their interests. People living at the home are able to enjoy full and stimulating lives that suit their abilities to participate in daily life. The food is varied, well cooked and presented. It provides a healthy diet that suits the needs of the people living in the home. Good procedures and practices in handling medicines protect the people living at Wilkinson Park. People feel able to make their views about the service known and have plenty of opportunities to raise issues with the manager and staff. Good systems are in place for dealing with complaints and safeguarding matters. Staff are aware of these. People have access to comfortable sitting and dining areas. The games area is well equipped and people enjoy using the facilities provided. Staffing levels are generally good.

What has improved since the last inspection?

There has been some improvement in peoples` day to day programmes to show how they contribute to their individual development and meets their assessed need, but this is not being done consistently for everyone. Some work has been done to improve risk assessments for holidays, outside work and daily programmes, but these assessments still need further work to provide clear information. Staff have discussed the guidance on service users visiting staff at their own homes and all staff are now clear about this. Steps have been taken to ensure that people are protected when visiting the swimming pool and gym and the manager said that trained staff are present at all times when these visits take place.

What the care home could do better:

Peoples` needs are not always assessed before and after they move in to ensure that staff are able to provide the appropriate care and support to meet their needs. Each person must have an individual plan in place that is based on a centralassessment that identified their needs and how these will be met. These plans must be regularly reviewed. This will ensure that staff are clear about the support needed by individuals. Risk assessments must be clearly recorded and regularly update for each person living at the home. Employment gaps and employment history should be explored with candidates before they are appointed and records should be kept of responses to these inquiries. This will protect people living in the home. All staff should have regular recorded supervision at least six times per year. Staff training records should be kept in an appropriate form so that there is clear evidence that staff have received adequate training opportunities. A training needs analysis should be available to identify the benefits of staff development. This will ensure that people receive appropriate care from well trained staff. Quality monitoring should include checks of individual records to ensure that there is regular checking of the quality of support offered to people using the service. Training in safe working practices must be clearly recorded to ensure that there is evidence that staff have completed appropriate training to provide safe care

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wilkinson Park Residential Care Centre Wilkinson Park Residential Care Centre Rothbury Morpeth Northumberland NE65 7DP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 1 4 0 5 2 0 0 9 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 29 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Wilkinson Park Residential Care Centre Wilkinson Park Residential Care Centre Rothbury Morpeth Northumberland NE65 7DP 01669-650265 01669650265 Wilkinsonpark_03@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms S Harper,Mr R Turnbull Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 17 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 17 The maximum number of service users who can be accommodated is: 17 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability Code LD, maximum number of places 17 Date of last inspection Brief description of the care home Wilkinson Park is a large 2-storey house located in rural area of Northumberland approximately 7 miles from the village of Rothbury. Situated in the grounds of the home is a coffee/smoking area and a workshop, which is used as a base for activities, organised as part of the day care provided by the home. A large garden is situated at the rear of the home and other grounds amounting to 5.5 acres in all. At the front of the house is a car parking area. Ramp access is available at the entrance to the home. There is a separate flat for four service users and a cottage adjacent to the home Care Homes for Adults (18-65 years) Page 4 of 29 1 7 1 0 2 0 0 8 Brief description of the care home provides accommodation for two people. The home is registered to care for 17 people who have learning disabilities. All bedrooms are single. The home cannot provide nursing care. Fees charged by the home per week are between £635 - £1016.00. Extra charges include chiropody, hairdresser, toiletries, newspapers, and activities over & above the normal day services. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 stars. This means that the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & Care Homes for Adults (18-65 years) Page 6 of 29 concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 14th May, 2009. The visits lasted a total of seven hours. During the visit we: Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the deputy manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: Peoples needs are not always assessed before and after they move in to ensure that staff are able to provide the appropriate care and support to meet their needs. Each person must have an individual plan in place that is based on a central Care Homes for Adults (18-65 years) Page 8 of 29 assessment that identified their needs and how these will be met. These plans must be regularly reviewed. This will ensure that staff are clear about the support needed by individuals. Risk assessments must be clearly recorded and regularly update for each person living at the home. Employment gaps and employment history should be explored with candidates before they are appointed and records should be kept of responses to these inquiries. This will protect people living in the home. All staff should have regular recorded supervision at least six times per year. Staff training records should be kept in an appropriate form so that there is clear evidence that staff have received adequate training opportunities. A training needs analysis should be available to identify the benefits of staff development. This will ensure that people receive appropriate care from well trained staff. Quality monitoring should include checks of individual records to ensure that there is regular checking of the quality of support offered to people using the service. Training in safe working practices must be clearly recorded to ensure that there is evidence that staff have completed appropriate training to provide safe care 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.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 9 of 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are not always assessed before and after they move in to ensure that staff are able to provide the appropriate care and support to meet their needs. Evidence: A comprehensive needs assessment is undertaken before admission by staff, however for the most recently admitted person there is insufficient information about his needs in his individual file. For other people good information was available to show that their individual needs had been assessed and formed the basis of their care plan. Care Homes for Adults (18-65 years) Page 11 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are not always clearly identified within an individual plan which means that they may not receive the care and support they need. Peoples privacy and dignity is respected by staff. Evidence: Each person has not got a care plan that is based on a central assessment. Two people do not have adequate care plans in place to show how their needs are met. In all care plans recording is inconsistent and more information is needed about how peoples needs are met by staff. In some plans information identified in peoples care management assessements or pre-admission assessments is not reflected in care plans. Care plans were not all up to date and there is evidence of inconsistent systems for reviewing plans. There is regular discussion about peoples care at staff meetings so that all staff are clear about any changes for individuals. Risk assessments are inconsistently recorded and in the case of the person most Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: recently admitted there are none. Others had risk assessments that had not been updated to reflect information identified within care management referrals. Care Homes for Adults (18-65 years) Page 13 of 29 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 have a good quality lifestyle and links with family and the local community are fostered. Good opportunities are provided for people to take part in appropriate leisure activities. Evidence: At Wilkinson Park people are encouraged to live an ordinary, meaningful life that is suited to their individual needs. Staff recognise the importance of enabling people to follow their own interests and to take an active part in life in the local community. Policies and procedures for staff at Wilkinson Park take account of the need to respect peoples rights and their equality and diversity. People living at the home are able to enjoy full and stimulating lives that suit their abilities to participate in daily life. Each person has a weekly planner that identifies his activities for the week and staff Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: support them with this. Planners do not always have enough information about the level of staff support needed by individuals. Outcomes for people are positive and people living in the home said that they like the staff and they get good support from them. People were relaxed and looked happy during the inspection. Staff were respectful towards people and it was evident that they knew peoples preferences. Staff said that service users are out regularly in the local community using local services and facilities including shops, swimming pool, local walks, shopping and leisure facilities. People have regular holidays and one person said he was going on holiday shortly with another person and other people had plans for their breaks. Information about holidays was not clear in individual files and there were no risk assessments in place for this. On the day of the inspection some people were out shopping and others were in the workshop. Visitors are welcome at arranged times and links with family and friends are supported and encouraged. Menus show that meals are well balanced and nutritious and are based on healthy eating principles. Alternatives are available for people so that there is a choice, although individual likes and dislikes are well known to staff. Mealtimes are relaxed and allowed plenty of time making the meal a pleasant social event. The food served was well cooked and presented and people said that the food was always good. Good portions were available and people could have more if they wanted. Particular dietary needs are identified within individual care plans. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is generally planned and delivered taking account of multi agency intervention to ensure that peoples privacy, dignity and independence is respected, however on some occasions staff practice is not appropriate. Evidence: Most people have plans in place that record appropriate information about how personal and healthcare needs are met. One plan had insufficient information available about how this persons personal care needs were met. There was evidence of inappropriate practice and inconsistent approaches taken to deal with continence issues and these were brought to the Deputy Managers attention. At times there was evidence in individuals records that where concerns are identified plans are not in place to outline what staff will do about this. There was little evidence of peoples emotional needs being identified and met. The people using the service are registered with the local health centre and specialist support is provided. Records show that most people have regular access to healthcare services they need. There was no evidence of specialist continence support being Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: sought when a problem was identified. A bath aid has been provided for one person who had difficulty using the bath. Arrangements for the administration of medicines were satisfactory. Policies and procedures are in place for the administration of medicines. Staff have received accredited medication training before they start to give out medicines. Records were up to date and in good order. Arrangements for storage of medicines were satisfactory. Care Homes for Adults (18-65 years) Page 17 of 29 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 living at Wilkinson Park are protected by the homes procedures for dealing with complaints and allegations. Evidence: Wilkinson Park have in place appropriate policies and procedures for dealing with complaints. No complaints have been made since the last random inspection. Records are kept of all complaints, their investigation and outcome. People living in the home said that they were able to talk to staff if they were unhappy about anything. One person said that they would speak to the manager if they had a problem and she would deal with it. Staff were aware of the complaints procedure and how to help someone make a complaint. Staff have received safeguarding training. Two safeguarding referrals have been made in the past year. These matters have been satisfactorily resolved. Staff were aware of the procedure to be followed in the event of an allegation being made. Policies and procedures are in place for dealing with money held on peoples behalf. Care Homes for Adults (18-65 years) Page 18 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Wilkinson Park have spacious accommodation that is generally well maintained and suits their individual needs. The arrangements for helping people to clean their rooms need to be reflected within individual plans. Evidence: Wilkinson Park is large stone built house set in its own grounds in a rural area of Northumberland. There is a cottage across the courtyard to the side of the house that is also registered where people live more independently with support from staff. There is extensive gardens and a workshop that people use during the day. The house is generally well maintained although some issues were identified during the inspection. Since the last inspection the kitchen and servery has been refitted to a high standard. There is comfortable sitting and dining areas as well as a large games room on the ground floor. Furnishings and fittings in these areas are of a good standard. In most bedrooms people living in the home are responsible for cleaning their rooms with support from staff. There was little information available about the level of support each person needs and it was evident from some rooms that people require more help from staff to make sure that they have comfortable and suitable Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: accommodation that meets their individual needs. Each person has his own room. People are encouraged to bring in items from their previous homes and rooms were personalised to show individual taste and interests. During the inspection some issues were identified in individuals rooms. In two rooms an odour was evident and in one of these the mattress was marked with faeces. There was no valance and no sheet or mattress cover and staff said that these were at the wash. The person occupying the room was lying on the bed, despite the fact that it needed to be cleaned/or replaced and made up with fresh linen. There were some rooms with broken furniture including wardrobe, chest of drawers and in one case a broken door handle. In one room a carpet needed replaced. One room had a damp patch on the ceiling that had not been repainted when the leak was fixed. In another room cracks in the plasterwork were identified that have not been repaired. In one bathroom the liquid soap dispenser had come off the wall and the water temperature was high. There was no record of hot water temperature checks available. Some pull cords in bathrooms/toilets need replaced as they are marked and dirty. There are sufficient toilets and bathrooms to suit the needs of the people living at Wilkinson Park. The laundry is well organised and accessible to people living in the home. Staff said that they receive infection control training, however it was evident that the standard of cleanliness was not consistent throughout the home. Care Homes for Adults (18-65 years) Page 20 of 29 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. There are sufficient staff working at Wilkinson Park to meet the needs of those people living in the home, however it is not clear from records that appropriate training has been provided. Recruitment procedures are not always followed and this means that the safety of people living in the home may have been compromised. Evidence: Adequate staffing levels are maintained to meet the needs of the people living at Wilkinson Park. Staffing during the day is arranged to suit the needs of individuals and the activities going on. There is regular discussion with care managers about the support people need so that adjustments can be made to take account of individual circumstances. There is currently one waking night staff and two sleep in staff to provide cover during the night. People living in the home and staff said that the current staffing levels are enough. Staff recruitment procedures are in place. Staff records show that appropriate reference and police checks are made before any new staff start work. It was noted that one staff record did not contain a complete work history and that employment gaps had not been explored. In addition there was no evidence that identity checks had been carried out and the manager was not available during the inspection to Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: confirm if these had been done. Training records were not always completed and it was not possible to check that all required training has been completed by individual staff. The information supplied before this inspection provided details of courses completed including all the essential training for staff, but records in the home did not confirm this. Staff said that they had training opportunities that included Food Hygiene, De-escalating course, fire training, Safeguarding training, Epilepsy. The Annual Quality Assurance Assessment confirmed that all new staff receive appropriate induction training including the Learning Disability Award Framework. Three staff are working towards achieving national qualifications in care. There are 84 of staff who have completed national qualifications in care working in the home. Staff supervision is not happening at appropriate intervals and in one case five months had passed between supervision sessions. There are regular team meetings and staff said that they find these helpful. Staff supervision is not happening at appropriate intervals and in one case five months had passed between supervision sessions. Staff said that they felt able to raise issues at meetings or supervision and said the manager was approachable. Care Homes for Adults (18-65 years) Page 22 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems are in place for monitoring the quality of the service that take account of the views of the people living in the home, however these are not being used effectively to ensure that standards are maintained effectively. Evidence: The manager is experienced and qualified to run the home and meet its stated aims and objectives. She was only present for half of the day and was not available at the end of the day to receive feedback on the inspection. There are regular team meetings and staff said that they find these helpful. Staff said that they felt able to raise issues at meetings or supervision and said the manager was approachable. The system for quality assurance uses questionnaires for people living in the home, relatives and staff. This information is used to help plan for the future and a development plan is prepared annually. There are also regular checks of records and other areas of practice that inform the quality assurance process. At this inspection individual records are not up to date and reviews have not been completed, which Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: means that there has been slippage in the quality assurance systems. Staff said that the manager is open and responds positively to suggestions from staff. Good records of any money held on behalf of people living in the home are kept and appropriate procedures are in place for staff handling money. All transactions are recorded individually and money checked during the inspection balanced with the individual records. All working practices are regularly reviewed. Good systems are in place for checking on health and safety in Wilkinson Park. Records are kept in good order to show regular checks or tests of equipment. Risk assessments for the premises and for fire are in place. Fire alarm tests are carried out weekly and records were available to confirm this. Accident records are kept in an appropriate form. Care Homes for Adults (18-65 years) Page 24 of 29 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 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 Each person must have a comprehensive needs assessment completed prior to their admission to the home. This is to ensure that staff have enough information to ensure that they are able to meet the needs of the person concerned. 30/06/2009 2 6 15 Each person must have an individual plan in place that is based on a central assessment that identified their needs and how these will be met. These plans must be regularly reviewed. This will ensure that staff are clear about the care and support each person needs. 31/07/2009 3 9 13 Risk assessments must be clearly recorded and regularly update for each person living at the home. 31/07/2009 Care Homes for Adults (18-65 years) Page 26 of 29 This will help to protect people living in the home. 4 18 12 The arrangements for the provision of personal care must be reviewed and all care plans should provide clear information about how individuals personal care is delivered. This is to ensure that staff are clear about peoples care needs and how they are met. 31/07/2009 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 14 Risk assessments should be completed prior to individual holidays to ensure that all areas of risk are appropriately identified and minimised. Individual plans should include reference to how peoples emotional needs are met. Application forms should include a complete work history and all employment gaps need to be explored with applicants for posts at the home. This will ensure that people living in the home are protected from harm. Employment gaps and employment history should be explored with candidates before they are appointed and records should be kept of responses to these inquiries. This will protect people living in the home. Staff training records should be kept in an appropriate form so that there is clear evidence that staff have received adequate training opportunities. A training needs analysis should be available to identify the benefits of staff development. This will ensure that people receive appropriate care from well trained staff. All staff should have regular recorded supervision at least six times per year. 2 3 18 34 4 34 5 35 6 36 Care Homes for Adults (18-65 years) Page 27 of 29 7 39 Quality monitoring should include checks of individual records to ensure that there is regular checking of the quality of support offered to people using the service. Training in safe working practices must be clearly recorded to ensure that there is evidence that staff have completed appropriate training to provide safe care. 8 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: 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) Commission for Social Care Inspection (CSCI). 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