Care Home: 11 Lane End

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What the care home does well The home environment is comfortable, homely, and provides the residents with good private and communal spaces to live in. Staff support the people living in the home to enjoy new experiences, such as holidays and other activities, and to continue with learning new skills. What has improved since the last inspection? Improvements in the management of the medications administered in the home have ensured that the people living in the home are better protected by safer practices. What the care home could do better: They could improve how the provide the evidence that safe recruitment practices have been carried out for any new staff they employ. The service has not ensured that the safety of residents and staff has been protected. A damaged garden pathway that was identified in the inspection process two years ago remains of concern. Improvements to the bathroom facilities also identified previously as needing to be put in place, although carried out, have not been implemented to a good standard. Therefore residents are using facilities with an environment that staff struggle to keep clean and odour free. Also one bathroom has a toilet that is not fitted appropriately and could make it uncomfortable for people to use . Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 11 Lane End 11 Lane End Crowmarsh Hill Wallingford Oxfordshire OX10 8DG     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: Ruth Lough     Date: 1 9 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. 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 29 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 29 Information about the care home Name of care home: Address: 11 Lane End 11 Lane End Crowmarsh Hill Wallingford Oxfordshire OX10 8DG 01491826794 Telephone number: Fax number: Email address: Provider web address: stephenrees@milburycare.com Name of registered provider(s): Type of registration: Number of places registered: Milbury Care Services Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 11 Lane End, situated between Oxford and Reading, is run by Milbury Care Services Limited. It is an ordinary house in a small, modern, residential development. It accommodates six men with learning disabilities, five of whom have lived together since 1992 when the home was first registered and the residents were relocated there from a large institution. The home provides 24 hour staff support for them. The current manager was registered in 2006. No new residents have been admitted in recent years and it is not anticipated that any will be in the foreseeable future. The fees for this service range from £885.95 to £1083.46 per person per week. Extras include chiropody, haircuts, toiletries, activities and a contribution to petrol and aromatherapy. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 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: This was an unannounced key inspection process generated from the good findings identified at the last assessment of the quality of the service by the commission in November 2006. This inspection process included reviewing information provided by the service before a one-day visit to the home. During the day the records for care planning, recruitment, and administration of the service were assessed. The people who use the service were consulted about their opinion of what is provided, through surveys assisted by staff. Observations of the relationships, communications, and the interactions of residents with staff were also Care Homes for Adults (18-65 years) Page 6 of 29 used as to assess the outcomes for the people receiving support. This was the most effective way of establishing the information required as none of the residents are able to use verbal communication skills well or use any other form of expressing their opinions. From this visit it was found that there were a few areas that they will need to improve as to protect the people they support and make sure that their environment is fit for purpose and pleasant to live in. Four requirements were made to reflect this. A small number of good practice recommendations were given at the time of the inspection and can be found in the body of this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be confident that their needs will be assessed before a place in the home is offered to them. Evidence: The home has not admitted any new residents for a considerable period of time and does not plan to change this in the near future. However, should they choose to admit a new resident they have the necessary policies, procedures, and documents to do so. Care Homes for Adults (18-65 years) Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the person concerned are reviewed regularly, the care planning reflects the changes as and when they occur. Evidence: The residents we met during the day appeared to be cared for well and liked the companionship of the care staff. Two care planning records were sampled to see how the individuals long term needs are identified and how the staff intend and carry out the support to meet them. The manager provided information that the current care planning records were in the process of being changed to a new format. The records that have so far been transferred will ensure that there is a consistent approach to the care records, so staff will be able to seek the required information easily. However, care must be taken to ensure that the persons life history, encapsulated in the records going to be archived, Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: is not lost. The manager was advised to look how they could address this. The care plans we reviewed showed that key areas were identified for achieving the activities for daily living such as personal care, communication, and individuals safety. Additional records were in place for health care support, medication, and nutritional needs. Throughout the documents it was apparent that personal choices of the person concerned had been identified, where possible. Usually this was recorded with interpreting body language or if able any verbal comment made. Much of the care planning has been developed over a long period of time as staff have gained experience and knowledge about the individual. Risk assessments are in place for some of the daily activities, involvement with new experiences, and contact with others. From what was seen these and the other care records are reviewed regularly. Care Homes for Adults (18-65 years) Page 12 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. The individuals are supported to continue with activities, have new experiences and interests. They are supported to maintain and develop their relationships with their families and given the opportunity to be part of the local community. Evidence: The people we met appear to keep active and involved in both what is going on in the home and with interests outside. The residents all have their own activities plan that incorporates maintaining and learning personal skills and enjoying social activities. The weekly plans that were seen are based around the abilities and wishes of the person concerned. None of the residents are able to undertake any employment but have in the past enjoyed learning new skills including cooking and art-work. Some continue to attend a day centre as to be involved with the activities on offer there. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Each person has a recorded daily routine plan although through discussion with staff this flexible to the choices made by the person at the time. Staff were seen to enable residents to make on the spot decisions and also meet the planned schedule of events. Although there is a significant gap in ages of the gentlemen living in the home they appear to like each others company, but also enjoy being independent. Staff have implemented activities that enable them to participate together, such as cooking sessions others are more focussed on the personal choices of the individual. If a resident wishes to attend a local church they are helped to do so Some of the household chores are included in the personal activity plans of the individual, although this is dependent on their ability and choice to participate. Staff are very supportive for residents to maintain contact with their families and friends. They have encouraged relatives to visit and join in events going on in the home and have supported some residents to go to visit their family themselves. All the residents have participated in holidays away and from the photos and information provided by the manager they have, including staff, had a pleasant experience. The last holidays were in Butlins in Minehead, and the manager stated that they were already researching a new destination for next year. Residents are assisted either to go independent from the others living in the home or in pairs as to give them a variety of companionship. Last year some of the residents went on a Turkey and Tinsel holiday. Meals and menu planning is undertaken with reference to the dietary needs of the residents and any specific preferences they may have. They are encouraged to participate in the shopping and preparation of some of the meals. The home can use pictorial descriptions, if required, for the planned menus as to assist the residents in their decision-making about choices. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are supported to obtain the health care that they need and where required, assisted with their personal care. Evidence: From the records we looked at, it could be seen that the health care needs of the individuals have been identified and action taken to meet them. This was in regard to either a specific health need, where the appropriate medical practitioner is involved such as District Nurse and with the routine monitoring for eyesight, dental and chiropody care. Risk assessments have been carried out and an intervention plan developed by the staff to assist with aiding medical treatment for one resident who finds it difficult to manage the situation when it occurs. Only one resident requires greater assistance with personal care and the others are given prompts and reminders to care for themselves. However, this may change as individuals age. The records for medication administration were reviewed, as this was an area of Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: concern that was identified at the last inspection visit to the home. From what was seen the staff are now recording any administrative process correctly. The manager was able to inform that medication administration training was included in the induction and training programme for staff. The home is subject to regular medication audits from the supplying pharmacist as ensure that safe storage and management are carried out. The manager did identify in the information supplied in the Annual Quality Assurance Assessment, self-assessment document that they were looking at what future support the residents may need. This was in particular to their ageing, ill health, and possible death. As yet they have not formally approached this topic but have obtained a little advice and support from the residents families. This is mainly with reference to after death and the care that they may need. Care Homes for Adults (18-65 years) Page 16 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. The staff are aware of how the residents are able to express a concern or a complaint and have been provided with the necessary knowledge to protect them from possible harm or abuse. Evidence: From observing the staff with the residents it was apparent that they had a good understanding of the individuals and have positive relationships with them. Staff have recorded in detail in the care plans the specific body language, behaviour and any verbal communications as to be able to interpret the individuals responses. A formal complaints process is in place and has been provided to relatives and others in contact with the home should they wish to raise a concern. Staff are able to provide a pictorial complaints procedure should a resident express a concern. The manager has recorded a complaint in the complaints log that has been received by the home since the last inspection process. However, on closer examination and in discussion it was a communication from a relative outlining some confusion over contact, not necessarily a complaint. From the included information and that from the manager the situation was handled well, sensitively, and in the best interests of the people concerned. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: The commission has not been in receipt of any concerns or complaints about the service in the intervening times between inspection visits. The home has information available for staff in regard to safeguarding them from possible harm or abuse. They have a copy of the local interagency procedure and have accompanying core policies around whistle-blowing and handling residents money. A new member of staff confirmed that within the first few days of employment he had been provided with the basic principals of protecting the residents from possible abuse or harm. The manager provided information that training for this is included in the regular training programme. Recently some staff have attended training on the Mental Capacity Act, as to enhance their knowledge. Care should be taken to store personal identification records (birth certificate) in a secure place, as items such as these should not be left in the individuals care records. The potential for identity theft or loosing them is high. The manager confirmed that the one item seen during the day would be secured as soon as possible. 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. The home provides a homely environment for the residents to live in and at present, suitable for the residents current needs. Some of the facilities need to be improved to make their experiences more comfortable and pleasant and to minimize the possible spread of infection. Evidence: The home is a large family home in a quiet residential area, and provides reasonably good-sized accommodation to the residents who live there. There is a garden to the rear and the side of the building that is secure and is mainly laid to lawn. Staff, with the support of the residents, had developed two raised beds for growing vegetables during this last summer. Individual bedrooms are personalised as the resident wishes and the communal lounge is able to accommodate the needs of the people who live there. The kitchen diner is pleasantly decorated and is a bright sunny room for residents to enjoy having their meals and be involved with cooking and food preparation. Outside, the area of damaged uneven paving that was seen to the side of the building during the last inspection has still not been repaired. A requirement was made by the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: commission at the time for the pathway to be repaired as to ensure the safety of the residents. However, within the first few minutes of the commencement of the inspection visit to the home, contractors arrived to appraise the work to be carried out. Throughout the majority of the home was clean and tidy but there were some areas that need better attention to maintain a good standard and pleasant environment. Some of the bedrooms require repairs to the vanity units as the edges of the veneer are chipped and residents could damage their skin on them and at present they are difficult to keep clean. Care should be taken with ensuring that regular checks of the bedrooms by staff are made, as there was possible soiling of faeces on a carpet in one room. Additionally, on the ground floor more care should be taken to keep areas of paintwork on doors, and door-frames, regularly cleaned. The bathrooms in the home were of need of improvement at the last inspection process. Although the manager did state repairs and refurbishments had been carried out in one bathroom since then, they remain in need of refurbishment. The main areas of concern are the flooring in all three as this is stained and is difficult to keep clean. Gaps in the flooring around the toilets allow moisture to remain and minimize the staffs ability to reduce the odour and clean effectively. The smell of stale urine was apparent close to the front door as you go into the home. The poor flooring and drainage for the wet room in this area may be the cause of this. Upstairs the repair to on bathroom has not been carried out to a good standard. The toilet is not level, possibly making it uncomfortable and not safe to use. The wall covering and the boxing to the pipe-work behind this toilet have not been sealed effectively so moisture has damaged the surface and staff have an impossible job of keeping it clean and free from being a source of infection. Liquid soap had been provided in the bathrooms, toilets, and kitchen for people to wash their hands. However, they must replace the cloth hand towels with a paper variety as to assist with good hand hygiene. The gentlemen we saw during the day appeared to be able to use all areas of the home as they wished. This included the office area where they joined in with part of the inspection process. 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 a sufficient number of staff employed in the home to meet the needs of the people who live there. The records held in the home to show that staff have been recruited appropriately do not indicate that this has been done robustly and fully protects the vulnerable people they support. There is a good training programme that will ensure that staff have been given the necessary knowledge to carry out their roles. Evidence: The staff who were working in the home at the time of the inspection had a friendly companionable approach to the people living there. They were seen to give people time to respond to communications, not rush them, and encourage them to join in with what is going on in the home. A sample of the records for recruitment and employment were reviewed. The home keeps in accordance to company policy and an agreement with the commission a copy of the front sheet of the employment records that should show the key information has been obtained. The main copies of the records are kept centrally at the local area office. The manager provided a file with records for a number of staff. Some of whom do not work in the service but are managed by the same manager in a supported living service. These should be kept separate for data protection. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The records for one recently employed member of staff who had been working in the home since 29th October, four weeks previously was not available immediately. However, they were faxed to the service before the end of the inspection. An additional record for a member of staff who had been working in the home for over a year was also reviewed as to see what information is provided. Both records supported that the Criminal Records Bureau and references had been obtained. However, the quality of the references could not be assessed or information noted that they were from the most recent employer. Likewise other records such as interview outcomes, full work history, or verification as to the reason for leaving a last employment in care could not be reviewed. The information available did not indicate that the decision to employ had been made on the persons ability to meet the job description or that they had the skills or potential competencies to meet the needs of the people they were to support. The form used by the organisation to evidence these had not been completed sufficiently to show that these areas had been part of the recruitment process. We were informed that all these original documents including the application form, copies of proof of identity and health declaration are not kept in the home. A photograph of one the staff member, who had been working in the home for some time had been obtained and kept with the relevant information. No photo was available for the new employee. Copies of any training or qualifications certificates staff may have are kept in the home. Any training needs are identified in the induction process given to staff and followed through in the supervision and appraisal process. The home is the first to complete a new training programme organised by the provider with all staff, with the exception of the new employee and some bank staff, completing the nine key topics provided. Much of the new training programme includes modules that the staff can learn through using the on-line resources. This is in particular to the induction training available to support the practical going on in the home. The new employee confirmed that he found this easier to undertake, flexible and enjoyed finding the information out. The manager provided information that she had obtained further training in subjects such as the Mental Capacity Act, Investigating Incidents in regard to Safeguarding Adults, and Non Violent Crisis Intervention. She also stated that it was intended that all staff attend training in the Mental Capacity Act. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Information about qualifications that staff may have supported that there are approximately half of the staff with an NVQ in care. All NVQ training is provided through the provider organisation. The number of staff wishing to continue with their studies is good but the manager stated she is finding it difficult to get commencement dates for these. Care Homes for Adults (18-65 years) Page 23 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. The home is managed on a day-to-day basis well and generally in the interests of the people who live there. The provider has been slow to ensure that the environmental standards continue to support the well-being and safety of the people living there. Evidence: The manager has been working within her role since 2002. She has obtained her RMA (Registered Managers Award) and has a broad experience in care provision. As previously stated she has ensured that she has had training since the last inspection to develop her role. The processes for quality assurance and consulting with the residents about the service were review to see what is in place and how staff able to achieve this with the residents who have non- verbal communication only. There are several formal processes that include surveys with staff assisting the person Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: concerned to record their responses, home meetings and annual reviews of care. Informally staff observe the residents responses to situations and record outcomes to specific events that the person has participated. Staff try to maintain contact with the relatives and supporters of the residents they support as to obtain feedback from them when they visit. Discussion and comments from them are noted in the individuals care plans and where necessary action taking to implement changes. The home is regularly visited by a representative of the provider organisation, as to carry out a review of the service to be compliant to Regulation 26, Care Home Regulations. The records for this could be seen in the home. They show that a sample of record keeping, staff management and the environment are all areas reviewed during this process. Regular checks are carried out for the medication administration, by the providing chemist and any residents finances are audited by the finance department of the organisation. The manager has ensured that the staff working in the home, have been provided with the necessary training for safe working practices. A sample of the records for safety checks, were reviewed, as to see what the home have in place. The systems for regular safety and maintenance for the equipment used for bathing the one individual who requires help and for the fire safety in the home show that these are carried out routinely. The slow response to repairing the risks to residents and others for the paving at the rear of the building is of concern. Likewise, the quality of the repairs and refurbishment to the bathroom and toilet facilities is poor and remains putting residents at risk from areas that cannot be kept clean and fit for purpose. Care Homes for Adults (18-65 years) Page 25 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 26 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 24 13 The flooring and some of the 31/03/2009 fittings in the bathrooms are worn and unfit for purpose. You should ensure that the people you support are provided with bathrooms that are fit for purpose and can be kept clean. This will also assist staff to maintain a good standard of hygiene and minimise the spread of infection. 2 24 13 That the paving in the garden to the rear of the property is made safe and ensures that residents and others are not at risk from trips or falls. You should ensure that people who have access are not at risk from injury from the uneven paving in the garden. 31/01/2009 Care Homes for Adults (18-65 years) Page 27 of 29 3 30 13 Appropriate hand drying faciities should be placed in bathrooms and communal areas where people need to wash their hands. You should ensure that you have strategies in place for managing the control of infection in the home. These should be in accordance to the Department of Healths Guidence, Control of Infection for Care Homes 2006. 31/12/2008 4 34 19 Evidence that the responsible provider has obtained the required information to support that an individual is fit to work in the home should be available and open to inspection. You should ensure that you have evidence that you have carried out an appropriately thorough recruitment practice for new staff as to protect the people they may support from possible harm. 31/01/2009 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 Care Homes for Adults (18-65 years) Page 28 of 29 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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