Care Home: 137a Tentelow Lane

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What the care home does well The home continues to offer the residents a choice of things to do each day. Some activities are in a group and others are offered on a one to one basis. The staff team has altered only slightly, therefore the staff team continue to provide consistent support to the residents. The staff team are encouraged to develop their skills and have a clear awareness of residents` needs. Feedback from the people living in the home was positive, with people saying they were happy living in the home. What has improved since the last inspection? The staff team had worked hard to make further improvements on the information written about the residents. Care plans were detailed, up to date and recorded that residents are part of the development of these care plans. One resident confirmed they were aware of the information written about them. Risk assessments had also improved recording potential identified risks. The Meal provision had improved with more fresh produce offered on a daily basis. The Manager had sought to make improvements to the environment and those identified at the previous visit had been addressed. A new kitchen had been fitted. See the next section for further findings on the environment. All maintenance checks and tests were now up to date. What the care home could do better: The environment continues to need attention. Areas such as the flooring which was lifting needed attention, the two bathrooms in the home were in need of a full update and the fridge top in the new kitchen was lifting and cracking. The Manager needs to review the rota regarding some members of staff to ensure they do not work excessive hours and days in a row without having a day off. Key inspection report Care homes for adults (18-65 years) Name: Address: 137a Tentelow Lane Norwood Green Southall Middlesex UB2 4LW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Middleton     Date: 3 0 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 28 Information about the care home Name of care home: Address: 137a Tentelow Lane Norwood Green Southall Middlesex UB2 4LW 02088936634 02088936634 mettlelus@aol.com www.milburycare.com Milbury Care Services Ltd care home 4 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who may be accommodated is: 4 The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Female Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home 137a Tentelow Lane is a home for four female residents with learning disabilities. One has a hearing and sensory impairment, in addition to a learning disability. The home is a four bedroomed, semi-detached house, located on a busy road between Southall and Hounslow. There are local shops nearby and Southall, Ealing and Hounslow shopping centres can be accessed by car. There is a car and a larger people carrier for the house as there are no trains or bus routes close by. The adjoining house (137b) is for four male residents, whose Registered Manager is also the Registered Manager for 137a Tentelow Lane. 137a has four single bedrooms. One is on the ground floor and has its own shower. There is a shared toilet nearby. One first floor bedroom is en-suite, with its own bath. The two further bedrooms on the first floor share a bathroom and toilet. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 4 Brief description of the care home There is a rear garden, which is mostly lawn with a patio area. There is parking at the front of the property for both houses. There is a joint staff team for 137a and 137b Tentelow lane, and staff work between the two houses. 137a is staffed twenty-four hours a day. Fees range from £1,100 - £1,300.00 per resident, per week. Care Homes for Adults (18-65 years) Page 5 of 28 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: An unannounced visit was made on 30th June 2009. We were accompanied by a National Provider Relationship Lead, who was observing the inspection process and has not written this report. Before the visit we looked at: Information we have received since the last visit on the 10th July 2007. The Annual Quality Assurance Assessment (known as the AQAA). The AQAA gives the Care Quality Commission evidence to support what the home says it does well and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any incidents since the last visit. The Providers view of how well the home cares for people. The views of the people who live in the home (they will be referred to as residents in this report). During the visit we: Talked with the residents who live in the home, staff and the Manager. Looked at information about the residents and assess how well their needs Care Homes for Adults (18-65 years) Page 6 of 28 are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the residents they care for. Looked around the building and parts of the home to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the Registered Manager (referred to in this report as the Manager) what we found. Care Homes for Adults (18-65 years) Page 7 of 28 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 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 8 of 28 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 28 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. New potential residents are assessed before admission to ensure their needs can be planned and met at the home. Evidence: The home had not had any new admissions for some years. On previous visits we had been satisfied that the home has a pre-admission assessment in place. The Manager confirmed that this remains the situation. The Manager would assess any potential new resident before a decision is made. As there have been no new admissions, we discussed with the Manager the possibility for the senior staff team, (which is the Deputy Manager and 2 senior support workers), to go out with another Manager from a nearby home, to observe the assessment process. The Manager will consider this as part of the senior staff teams development. New residents would be encouraged to visit the home to meet with other residents and staff before they decide if they want to move into the home. One resident spoken with said they had seen other homes and they had chosen the best one to live in. Care Homes for Adults (18-65 years) Page 10 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans and risk assessments are well maintained and person centred. Residents are supported to make decisions about their lives. Evidence: We viewed two residents files. Information on each resident was detailed, informative and personal to each resident. We saw that residents daily routines had been recorded and their likes and dislikes. Overall the residents health, social and personal care needs were clearly recorded and reviewed on a monthly basis. One resident said they met with their keyworker and were aware of their care plan. Risk assessments were also seen and these considered potential risks the residents faced in daily life or posed towards others.The information was relevant and gave the staff team the details they would need to safely and appropriately care for a resident. The Manager explained that the kitchen was now locked and that two residents had a key and two did not. Reasons for when the home decides to restrict a residents choice Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: to freely move about the home had been documented and the Manager had completed Deprivation Of Liberty forms for the Local Authority. The two residents with keys explained how they could enter this room and make drinks for themselves. One resident is involved with the local advocacy service and supports others to speak up and voice their views. Care Homes for Adults (18-65 years) Page 12 of 28 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. Activities are on offer for the residents on a daily basis. Activities take place both in the home and in the community. Residents are able to maintain social contact with family and friends. The meal provision in the home promotes a healthy diet for the residents. Evidence: We spoke with two residents who told us how they spent their time. Residents have the opportunity to do the activities they enjoy, such as attend the local College or day centre, bowling or swimming. Each resident has a plan of activities and this can be in a group or on a one to one basis. Residents are also encouraged to do chores around the home, such as clean their bedrooms and do their own personal laundry. Staff confirmed they support the residents to be as independent as possible. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Residents are supported to attend their preferred place of worship. Residents go on holidays and three residents had been to Paris with staff which had been a successful trip. The staff team encourage residents to maintain social relationships with their family and friends. Staff will take residents to see relatives so that there is regular contact. Relatives are also asked if they wish to attend reviews, which are meetings that look at the residents individual needs. The residents rights are promoted within the home. The residents can choose to spend time with others or alone. Staff were seen during the inspection visit to interact with residents in a positive and caring manner and this was fed back to the Manager. We had previous concerns with regards to the meal provision in the home. There had been too much processed and high fat foods on the menus seen. On this visit we saw that there had been much improvement, with residents continuing to choose the meals they wish to eat, but the meals were more freshly prepared. The staff team monitor the meals to ensure that residents enjoy their meals and maintain a healthy diet. One resident has a special diet and this is also checked by the staff team to ensure the home meets this particular health need. Where possible residents help the staff team with the preparation of meals. Care Homes for Adults (18-65 years) Page 14 of 28 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. Residents can receive personal care support in their preferred way. The arrangements for the handling, storage and administration of medication is good. Evidence: The residents, where needed, receive personal care support in private and with a female member of staff at all times. The residents need different levels of support and prompting. Residents can choose the clothes they wear with minimal guidance from the staff team. All residents have a GP and see other health professionals in the community. Health needs had been recorded on care plans and medical appointments are recorded on separate forms. This enables the staff team to monitor the health needs of each resident and to notice if there are any issues and/or changes. We looked at medication for two of the residents. The majority of medication is delivered in sealed blistered packs. We checked these along with counting medication that was in boxes. These were all correct. We noted that the amount from the Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: previous month had not been carried forward onto the new Medication Administration Record (MAR chart). This was brought to the attention of the Manager and we checked the previous months MAR chart to ensure the amount in the box was correct. We also noted that one medication had been accidentally taken out of its seal and then wrapped up in paper and sealed. The member of staff had recorded this in the homes communication book but they should have also recorded this error on the back of the MAR chart. Staff receive training on medication and once a year the Manager gives staff a test on various aspects of handling and administering medication. If a member of staff fails the test they have to re-take it or they do not administer medication until they are retrained. It was also noted that the home rarely uses medication that is prescribed on an as and when basis for residents who become anxious or aggressive. This is seen as a significant improvement and we were pleased to see that the staff team try other ways to calm a resident before using prescribed medication. We saw evidence that regular medication counts and checks take place. Care Homes for Adults (18-65 years) Page 16 of 28 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. Complaints procedures were in place and residents felt they could voice their concerns. The home has procedures in place so that staff know what to do should they suspect any abuse had taken place, so helping to ensure that the residents were protected from abuse. Evidence: Residents have been provided with information about how to make a complaint. Those residents spoken with knew to speak with the Manager if they wanted to make a complaint. The home has not received any complaints since the last visit. The Manager confirmed that he would keep details of a complaint, if it contained sensitive information, locked in a secure place. Staff had undertaken Safeguarding Adults training and were aware of the need to report any concerns to the Manager. The home has a copy of the Local Authoritys policy on Safeguarding Adults. We advised the Manager to obtain the updated No Secrets document when it is published. There had been one safeguarding concern made to the staff team. The Manager had dealt with this concern appropriately and informed the relevant agencies. We suggested to the Manager consulting again with the Local Authoritys Safeguarding Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Co-Ordinator and any other relevant agencies to ensure he is fully satisfied that there can be no further investigations. We counted two residents personal money and found this was correct. Staff count the money at each handover and two staff sign for transactions made. Residents, where possible, are encouraged to hold onto their own money. Care Homes for Adults (18-65 years) Page 18 of 28 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 has had some areas maintained and updated but there are still several areas needing attention. These need to be looked at so that residents live in a welcoming and safe home. Evidence: A tour of the home revealed that the home was clean and some areas of the home were well maintained. The home had a new kitchen which was modern and functional. The extractor fan in the laundry room, we were informed, had been fixed after the last inspection but had recently broken down again. The washing machine had broken but was due to be fixed soon. We advised the Manager to ensure the utility room is kept closed as the top of the washing machine had been taken off and had very sharp corners. The flooring in the hall, ground floor toilet and first floor bathroom had been replaced. However we noted several areas needing attention. The top of the fridge was broken and cracked and several window handles around the home were either missing or broken. The flooring in the small hall leading to the living room was lifting, as was the flooring in the living room. The cupboard door in the utility room was coming off its hinges. There were various mats and rugs around the home that had not been fitted with non slip material and could be a trip hazard. The first floor bathroom had Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: cracked/missing tiles, the bath was chipped, there was no shower rail to enable residents to have a stand up shower without making the floor very wet and a nail was sticking out of the wall which could cause harm to the residents. Overall this main bathroom needed a complete refurbishment. We also viewed with a resident their ensuite bathroom. This bathroom would also benefit the resident if it was refurbished and updated. They also had no shower curtain rail for them to have a safe stand up shower. We raised these points with the Manager who was keen to address the environmental shortfalls. The home needs to be welcoming, homely and safe in all areas and it is expected that the maintenance of this home is improved. We visited and inspected the other registered home next door to this one two days later and saw that the handles around the homes were being replaced and fixed and that the utility cupboard door had been fixed. Care Homes for Adults (18-65 years) Page 20 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team is stable and provides consistent support to the residents. Some staff are working several days in a row without a break. The staff team receive an induction to the home and training for the work they are to perform. Recruitment checks are in place to protect the safety of the residents. Evidence: The staff team are stable with staff coming from a range of backgrounds and experiences. Overall staff said they all worked well together as a team. One staff member said that at times communication could be better. Those residents spoken with talked highly of the staff team. Staff are encouraged and supported to study for the Learning Disability Qualification and then for an NVQ. The majority of the staff team had obtained a NVQ level 2 or 3. Team meetings are held monthly and one was held on the day of the inspection. We checked the rota and saw that two staff work on an early or late shift with an additional member of staff sometimes working between the two homes which are next door to each other. The Manager informed us that he has several staff vacancies but Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: that these vacant hours are filled by the staff team and bank (casual) staff. The home does not use external agency staff which is good practice as the residents are supported by a consistent familiar staff team. We viewed the rota and saw that two members of staff were working excessive days in a row and some of these working days were long days. This was raised with the Manager and needs addressing to ensure staff have a break between a long row of working days. The Manager must be confident that the staff team are effectively working and have sufficient time off in between working their contracted hours and any overtime they wish to work. The Manager agreed to review the rota to meet this requirement. We viewed four staff employment files. These contained all the necessary checks and information such as references, medical declaration, and Criminal Record Bureau checks (CRB). These checks showed that the Provider checks only against the Protection of Vulnerable Adults list. It would be good practice, even though staff are only working with adults, to request checks against all the lists so that the Provider has obtained all the information they can about a new member of staff. We inspected the training records. We saw that new staff work through an induction so that they are familiar with the home and know what is expected of them. New staff also work through an induction via the Provider which is done electronically using the L-Box. Overall staff said they were getting used to using the L-Box as a method of learning. Staff individual training records were seen and overall staff had received relevant up to date training on core subjects. The Manager had attended a course on the new Mental Capacity Act 2005 and would be attending a course on the Deprivation of Liberty Safeguards. He would ensure that the staff team were aware and familiar with these. Staff would benefit from additional specialist training in subjects such as Dementia. Some staff had attended training on Autism and this should be offered to all members of staff. This was discussed with the Manager who was also advised to ensure any in house workshops are also recorded on training records as these also form part of a member of staffs professional development. Care Homes for Adults (18-65 years) Page 22 of 28 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 Manager is providing clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities. Residents are supported and encouraged to voice their views about the home. Health and safety checks are in place to ensure residents live in a safe home. Evidence: The Manager had been in post for several years and was very aware of the needs of the residents and staff team. He has an NVQ level 4, the Registered Managers Award and a Post Graduate in Personnel Management. Staff confirmed they could talk with the Manager if they needed support. The home involves the residents in several ways. Weekly resident meetings are held where residents can voice their ideas about the home, for example this meeting is where they choose the meals they wish to eat. Once a year there is an opportunity for residents to meet with other Senior Managers to speak about the home. Relatives are Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: also invited to this open day. The Manager had produced a short report about the work the home has been doing and areas still to be addressed. This is seen as good practice as it is a way for the home to reflect on what has been happening in the home over the past year. As referred to earlier in the report, residents are supported to be involved in their own care plans and meet with their keyworker once a month. Servicing and maintenance agreements are in place for facilities and equipment in the home. Fire checks and tests had been carried out and the Manager is a fire warden and holds regular training sessions for the staff team. As noted in Standard 24, the home had several mats around the home. Bathroom mats, mats by the doors and a large rug in the living room. All of these could be a hazard to residents and people in the home and should be be made non slip to ensure the safety of all concerned. Care Homes for Adults (18-65 years) Page 24 of 28 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 28 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 23 The fridge needs replacing as the top of it was broken and chipped. To ensure the residents live in a hygienic home that has equipment that is not chipped and broken this piece of equipment needs to be replaced. 31/08/2009 2 24 23 The main first floor bathroom and the en-suite first floor bedroom must be refurbished. To ensure residents can bathe in a clean, welcoming and functional bathroom these rooms need to be updated. 02/10/2009 3 24 23 The flooring between the utility room and living room and in the living room needed to be made safe as it was lifting in places. 31/08/2009 Care Homes for Adults (18-65 years) Page 26 of 28 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 To ensure residents live in a safe and homely place the flooring must be looked at and fixed. 4 33 18 Staff must not work excessive days in a row without a day off. To ensure residents are supported by an effective staff team staff must not work too many days and long days without taking a day off. 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 31/07/2009 1 34 It is good practice, when carrying out Criminal Record Bureau Checks, to check against all lists and registers, such as the POCA list, even though staff are working with adults and not children. Specialist training on subjects relevant to the needs of the residents should be provided on an ongoing basis for the staff team. Rugs and mats should be non-slip to ensure residents do not trip and fall over them. 2 35 3 42 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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