Care Home: 1 Old Station Close

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What the care home does well The registered manager and staff team have worked hard to meet many of the requirements made at the previous inspection. The expert by experience commented on the general feeling of optimism among people living and working in the home. On the day of the inspection there was a happy and relaxed atmosphere. The people who live in the home said that staff listen and act on what they say. People are given opportunities to prepare their own snacks and drinks and to get involved in cooking main meals with staff support. Some people are undertaking college courses to further particular interests and all people in the home have had the opportunity to go on holiday this year, with staff support. People`s health care needs are well met, with staff supporting people to access local, optical, GP and dental services. People are also supported to access more specialist services such as psychologists. The service offers a good standard of physical environment with all communal areas being well decorated and furnished and good standards of cleanliness being maintained. People who are thinking of coming to live at the home are given the opportunity to visit first, to have a meal and to make over night stays. This helps them to make an informed decision about whether the service can meet their needs. Good systems are in place for supporting people to manage their finances and detailed and accurate records are kept of all transactions. What has improved since the last inspection? Seven out of eight of the requirements made at the previous inspection have been met. The information in the service users` guide has been updated so that it now accurately reflects the current management and staffing provision. This should assist people thinking of moving to the service to make an informed decision about whether the home can meet their needs. People`s support plans and risk assessments are now written in an easily understood way and information about how to meet people`s needs is readily accessible to staff. A communication plan for one person with a hearing impairment has been put in place but this would benefit from changes in presentation. How one-to-one hours are allocated and met for some people living at Old Station Close is now clearly identified and recorded. This information is also supplied to commissioning workers. A record of the food served in the home is being kept and people are being given opportunities to take part in its preparation. Medication records are fully completed, with reasons for medication not administered being clearly stated.Staff have received training in supporting people with mental health conditions as required at the previous inspection and in understanding and supporting people with diabetes, as recommended. Recommendations to update training in safeguarding adults and how to manage behaviour that may challenge have also been met. What the care home could do better: A requirement was made at the previous inspection to review staffing levels and the way staff were deployed to make sure that they were sufficient to meet people`s needs and to ensure the safety of the people who live and work in the home. The Provider`s response to the draft inspection report stated that one day staff member would work until 10pm each evening to ensure that there were more than two staff to meet people`s needs between 8pm and 10pm each evening. At this inspection the staff rota showed that this was only being implemented on one or two days per week. The registered person was asked to look at this immediately and we received a response on the day following the inspection, saying that this would be looked at again with a view to increasing the days when three staff were on duty between 8pm and 10pm to "potentially all 7". The response to this requirement will be monitored. There have been some changes in the Regulations about how certain drugs (called controlled medication) should be stored in care homes. This means that the people who own Old Station Close must make sure that they have a special metal cabinet, fixed to a solid wall, so that they can store these drugs if any of the people living in the home need to take them in the future. The home may already have a suitable cabinet. It must provide us with evidence that the cabinet is suitable or ensure that one is put in place. Some people take medication `as required`. Under what circumstances this medication is given should be stated clearly in the person`s support plan as well as in the medication record. Who has prescribed the medication should also be stated. People, such as relatives and commissioning social workers, should be asked what they think about the quality of service provided in the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Old Station Close 1 Old Station Close Shepshed Leicestershire LE12 9NJ     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: Ruth Wood     Date: 1 5 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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: 1 Old Station Close 1 Old Station Close Shepshed Leicestershire LE12 9NJ 01509506218 01509506441 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Bernadette Moscrop Type of registration: Number of places registered: Prime Life Ltd care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: No person falling within category LD to be admitted to the home unless that person also falls within the category of MD - ie dual disability. No person to be admitted to the home in the category MD/LD when 7 persons in total in this category are already accommodated in the home. Date of last inspection Brief description of the care home 1 Old Station Close is a residential care home for a maximum of 21 people who have either mental health illnesses or learning disabilities. The home is purpose built and is separated into three smaller units named Peach Abbey, Strawberry Manor and Cherry Lodge, all linked by an adjoining corridor, with the main office located off this corridor. Each unit has its own garden, kitchen, lounge and dining area. All communal accommodation is located on the ground floor and bedrooms are located on the first and second floors. The home is located in Shepshed, Leicestershire and is close to the Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 0 7 21 Brief description of the care home town centre and local amenities. Fee levels are arranged directly with local authorities and additional payments are made for some service users for one-to-one support. Information about the home and the support and services included is available in the service users? guide. 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 quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. The previous inspection of the service took place on 26th February 2008. This inspection took place on Monday 15th September 2008 between 10:00 and 15:30. Two inspectors and an expert by experience conducted the inspection. An expert by experience is someone who has personal experiences of services for this registration category. As well as this visit, information to inform this report was also drawn from the following Care Homes for Adults (18-65 years) Page 6 of 31 sources: The Annual Quality Assurance Assessment (AQAA); This is a self-assessment, that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Responses from 9 people who live in the home to questionnaires sent out by the Commission for Social Care Inspection, asking for their opinions about living at Old Station Close. Responses from three staff members to questionnaires about the quality of management, training and support they receive. During the inspection visit, three peoples support plans were looked at in detail and their support needs discussed with the registered manager and other staff members. Inspectors spoke with these and other people who live at the home to find out if their needs were being met and if they were satisfied with the care they were receiving. Interaction between the people who live at the home and staff members was observed and discussion was held with staff about the training they had received and their understanding of procedures in the home which help to keep people safe. A variety of records were examined, including those relating to staff recruitment and medication. The services progress in meeting requirements made at the previous inspection was also assessed. Current fee levels at the home range from 297 to 1,192 Pounds What the care home does well: What has improved since the last inspection? Seven out of eight of the requirements made at the previous inspection have been met. The information in the service users guide has been updated so that it now accurately reflects the current management and staffing provision. This should assist people thinking of moving to the service to make an informed decision about whether the home can meet their needs. Peoples support plans and risk assessments are now written in an easily understood way and information about how to meet peoples needs is readily accessible to staff. A communication plan for one person with a hearing impairment has been put in place but this would benefit from changes in presentation. How one-to-one hours are allocated and met for some people living at Old Station Close is now clearly identified and recorded. This information is also supplied to commissioning workers. A record of the food served in the home is being kept and people are being given opportunities to take part in its preparation. Medication records are fully completed, with reasons for medication not administered being clearly stated. Care Homes for Adults (18-65 years) Page 8 of 31 Staff have received training in supporting people with mental health conditions as required at the previous inspection and in understanding and supporting people with diabetes, as recommended. Recommendations to update training in safeguarding adults and how to manage behaviour that may challenge have also been met. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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. Good assessment procedures help to ensure peoples needs are met. Accurate and accessible information is available about the home, enabling people to make an informed decision about living there. Evidence: The statement of purpose and service user guide have been updated to accurately reflect the current management and staffing provision. The service user guide is also available in an accessible, easy-read format. Additional information on local facilities and services is also included. The care files of a person who has recently come to live in the home demonstrate that consultation took place with the person themselves, their family and their commissioning social worker before they moved in. An assessment of their needs was in place and the person visited Old Station Close before moving in. They were assessed as requiring one-to-one care and this is being provided; the person expressed satisfaction with this. Care Homes for Adults (18-65 years) Page 11 of 31 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. Support plans and risk assessments contain sufficient, easily accessible information to enable staff to meet peoples needs. Evidence: The manager and senior staff have spent considerable time in improving the quality and accessibility of support plans and risk assessments. Three peoples plans were examined in detail, together with elements from a fourth plan. All plans have been updated to ensure that the information in them is easy to read and accessible to staff and the person themselves. How peoples needs should be met is outlined and risk assessments identify the particular risks relating to each individual and how they should be managed. One persons support plan now contains information about their communication needs (this was a recommendation at the previous inspection). This would benefit from some modification in how it is presented. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Staff, both in response to the Commissions survey and on the day of the inspection said that they could access information about the people who lived in the home and that they were informed of any changes to care plans. The managers or seniors always tell me of any changes to care plans. We also have a meeting with seniors and the manager about the needs of new clients. One to one hours (for those people allocated them) are now clearly identified on the staff rota, together with the person responsible for providing them. A daily log is kept of how these are used for each person and the manager said that this information is sent to the persons commissioning worker. People who live in the home said that they could make decisions about how they spent their time during the day and six out of the nine people who responded to the Commissions survey said that they could do what they wanted during the day, at evenings and weekends. One commented that, I discuss each day what I want to do with my key worker. 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. People are provided with opportunities to be involved in the day to day running of the home and with social and educational activities that match their expectations. Evidence: Arrangements are in place to ensure that the people in the home have a healthy diet and are involved in meal preparation. People said that they make their own breakfast, were observed making their own drinks and asking staff to support them in making snacks before lunch. Staff said that if people wanted to help make meals they were encouraged to do so. Menu records show that a healthy and balanced diet is served, with two choices being available for the evening meal. Staff said that one choice was prepared in one kitchen with another kitchen making the second choice. People then decide which option they Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: want and food is transported from the appropriate kitchen to them. People said that they were happy with the food choices they have. One person said that the food was very good. Peoples likes and dislikes are displayed on kitchen notice boards and accommodated in menu planning. People are involved in a variety of social and some educational activities; one person regularly attends a local church, one person was observed going for a pub lunch with their one-to-one carer on the day of the inspection. Several people are to attend courses at local colleges. Two people said that they had an interest in cooking and art and they had been booked on courses to support this interest. Other people had been booked on healthily living/activity courses. Regular meetings are held for the people who live in the home and records of the meetings show that they are asked for their ideas and opinions about the kinds of activities they would like to take part in. Everyone had the opportunity to go on a summer holiday in August, with staff support and the majority of people had taken advantage of this, although some people had chosen to stay at home. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and health care support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are well met Evidence: All three support plans contain details of how people should be supported with their personal care needs. Plans also contain information and documents showing that they receive appropriate health care support. Details of visits to dentists, doctors, opticians and other health care professionals are recorded and optical prescriptions and letters showing appointments are in place. All people who live at the home are currently being given the opportunity for a full health examination We looked at an action plan drawn up with a persons social worker, in response to their ongoing physical and mental health needs. This included referrals to appropriate professionals and arrangements for a series of tests and medical investigations. Training records show that staff have received training in the understanding of diabetes (as recommended at the previous inspection) and one staff member was able to explain how they support a person with this condition. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: Arrangements for the administration and storage of medication for three people were looked at in detail. Clear photographs to help identify the person were in place and medication records were completed fully with no gaps. Where a person has not received their medication, the reason for this is stated on the record. Two people who were case tracked were prescribed medication to be taken as required. Discussion with the senior care worker indicated that there was occasionally a lack of consistency as to when this was administered for one person. It is recommended that clear protocols are put in place for all people taking as required medication, which state who has prescribed the medication and under what circumstances it should be administered. Amendments to Regulations relating to the Misuse of Drugs mean that all registered care homes must have separate storage for controlled medication. This should be a metal cupboard of specified gauge with a specified double locking mechanism. It should be fixed to a solid wall or a wall that has a steel plate mounted behind it with Rawl or Rag bolts. It is possible that one cabinet already used for storing medication, meets these requirements. The registered person must provide evidence that this is the case or provide additional storage that does meet the requirements. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of the people who live in the home are listened to and procedures and practice in relation to safeguarding are sufficient to ensure that people are protected. Evidence: There was a relaxed and happy atmosphere in the home. Staff engage well with people and were observed talking and listening to them. Only one person spoken with said they were unhappy at the home;staff were aware and taking action to address this. Information about how to make a complaint is displayed on notice boards in the homes kitchens and all nine people who responded to the Commissions survey said they knew who to speak to if they werent happy and knew how to make a complaint. All nine people said that staff listen and act on what they say. Three staff recruitment records examined showed that all staffs names had been checked against the vulnerable adults register before they started work in the home and all staff had Enhanced Criminal Records Bureau (CRB)checks in place. The 3 staff who responded to the Commissions survey confirmed that CRB checks and references had been received before they started work in the home. Such recruitment checks help to ensure that only suitable people work at the home. Good systems are in place to ensure that peoples money is safe. For those people Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: requiring support in this area, all transactions are recorded and two people (two staff or staff and service user) sign to confirm each transaction. Balance of monies held is checked at least weekly and records are regularly audited by the provider organisation. Following recent investigations into safeguarding incidents at the home there have been improvements in practice, which should help to further protect people. For example the manager and senior staff are to undertake training run by Leicestershire County Council in safeguarding procedures and protocols. Staff on duty said that they had received training in safeguarding adults and the staff training matrix indicated that 8 staff members had received training in this area this year. Staff displayed understanding of how they should respond if they saw abuse happening in the home. Evidence was also available (a copy of a fax to a training company) that staff are to receive an update in their training in NAPPI (None Abusive Psychological and Physical Intervention). One respondent to the staff survey had commented that I feel training to help you to overcome people with aggressive behaviour should be introduced. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Old Station Close is a clean, comfortable and spacious environment to live in. Evidence: All communal areas and five peoples bedrooms were seen. These were well maintained, clean and comfortable, with bedrooms being decorated to suit the individual preferences of the people who live at the home. The garden areas are wellmaintained and have seating areas which are well used by the people living in the home. One en-suite toilet seat was found off its hinges, but this had already been reported in the maintenance log to be fixed; there was a nearby communal bathroom to which the person had access until the repair was complete. All 9 people who responded to the Commissions survey said that the home was always clean and tidy. The homes Annual Quality Assurance Assessment said that all staff had received training in infection control The people who live at Old Station Close have named the three areas of the home e.g. one area is known as Peach Abbey. However during the inspection we observed that Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: both they and staff routinely referred to each area as either Block, A, B or C. This seemed very institutionalised and went against all other observations, which were about making the service as homely as possible. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment and training practice help to ensure that staff are suitable and competent to support people. Sufficient numbers of staff are not always available in the evening to meet people’s needs. Evidence: All three staff who responded to the Commissions survey said that they had Criminal Records Bureau (CRB) and reference checks before they started work. The three staff records checked, showed that these staff had undergone CRB checks, their names had been checked against the vulnerable adults register and two written references had been obtained before they started work. These pre-employment checks help to ensure that only suitable staff work at Old Station Close. Two of the three staff who completed the Commissions survey said that their induction covered everything they needed to know about the job and one person felt that it mostly did, commenting that My induction did not help to overcome people with challenging behaviour. All three felt that they had received training which had helped them to meet peoples individual needs, including training in working with people with learning disabilities and people with mental health needs. Five staff have completed training in the latter area and other staff are currently undertaking this Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: training, which involves reading specially produced booklets and answering questions. These are then marked and discussed with senior staff. Staff supervision is mostly task based, focusing on aspects such as gaining competency in medication management. Supervision is recorded. Two staff who responded to the survey said that the manager met with them regularly, one commented My manager is very good, always asks me how I am and if I need anything I can go to her - very easy to talk to. Eight of the 17 staff have achieved National Vocational Qualifications at level 2 or above and a further 7 staff are working toward this qualification. Staff were observed to speak with the people who live at the home with consideration and respect and the 9 people who responded to the Commissions survey said that staff always treat them well. The staff rota over a four week period was examined. The staff allocated to work with people requiring this support was clearly shown. A daily log is kept of how these hours are used for each person, and the manager said that this information is sent to the peoples commissioning workers. A requirement was made at the previous inspection to review staffing levels and deployment to ensure that these were sufficient to meet peoples needs and ensure the safety of people that live and work in the home. The compliance date for this Requirement was 04/04/08. The Providers response to the draft inspection report stated that,one shift would be staggered, such that support workers start later, i.e. 10am and the shift would consequently finish later in the evening at 10pm, giving more staff availability to the people in the home later on in to the day. The staff rota showed that this had only been implemented for a maximum of two shifts per week, with the shift finishing at 09:30pm. The manager said that this was because it was difficult to find staff who would work these hours. Given the complex and sometimes challenging needs of the people who live at the home, 2 staff members on duty between 8pm and 10pm would appear to be insufficient. An immediate requirement was issued for staffing levels to be reviewed. A response was received from the Responsible Individual the following day stating that following consultation with staff they were looking to extend the number of days when a day staff member worked until 10pm, potentially to all 7. The ongoing response to this requirement will be monitored. Care Homes for Adults (18-65 years) Page 24 of 31 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 views of people who live in the home inform the way the service is run Evidence: An inspection of Old Station Close by the Leicestershire Fire Service took place on 17th June 2008 and the service was found to be safe, a low risk and no further action was required. Some verbal recommendations were made on the day of the inspection, which should be considered. A record of visits made by the representative from the organisation was in place and the manager confirmed that they visit the home on a regular basis, usually every week. An environmental health officer visited to inspect the service on 22nd July 2008 and found that one of the homes refrigerators was not working correctly and monitoring of temperatures had failed to pick this up. The registered manager said that the refrigerator was now working. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: Monthly meetings are held with the people who live in the home and recorded. People are asked if they are unhappy or concerned about anything in the home and for suggestions for outings, activities and for changes in the menu. The registered manager said that she or are staff member would speak individually to those people who did not like to attend meetings. Staff meetings are also held in the home, and again are recorded. The registered manager said that she believed the organisations formal quality assurance system was being updated. The views of other stakeholders and the representatives of people who live in the home (such as commissioning social workers and relatives) should be sought as part of a process of ongoing assessment and improvement of the quality of the service. Staff told us that there had been problems at the home and this had affected the morale of staff and the people living there. We were told that the new manager had worked hard to turn things around to ensure that people living at the home got the service they needed. Staff spoken with were very complimentary of the new management and of the support they had received to help them to undertake their roles. The expert by experience who was part of the inspection team commented particularly on the air of optimism from both the people who live at the home and the staff team. Conversations with staff, examination of training records and responses to the Commissions survey indicated that staff had received training in food hygiene, moving and handling, health and safety and fire safety. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 33 18 (1) Given the complexity of the needs of some service users and their need for one-toone input, staffing levels must be reviewed to ensure that they are sufficient to meet the needs of service users and ensure staff and service users? safety. 04/04/2008 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 1 33 18 Given the complexity of the needs of some service users and their need for one-toone input, staffing levels must be reviewed. To ensure that staffing levels are sufficient to meet the needs of service users and ensure staff and service users’ safety 25/09/2008 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 20 13 The registered person must 31/10/2008 provide evidence that the current storage for medication is suitable for the storage of controlled medication To ensure compliance with the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 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 Care Homes for Adults (18-65 years) Page 29 of 31 1 20 It is recommended that clear protocols are put in place for all people taking as required medication, which state who has prescribed the medication and under what circumstances it should be administered. The home’s quality assurance process should also seek the views of involved stakeholders such as relatives and commissioners of services. 2 39 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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