Care Home: 14 Beckley Close

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What the care home does well The home is well maintained and decorated to a good standard. Care plans provide detailed information about the complex needs of the residents and how they are to be met. In addition there is a health action plan in place for each resident detailing how their health care needs are to be met. A staff member spoken with felt well supported and stated that `supervision sessions are very helpful`. Staff are given regular opportunities to attend training and to update their knowledge and skills and a staff member advised that they value this. Residents have opportunities to take an annual holiday and at the time of inspection three of the residents were on holiday abroad for the first time. What has improved since the last inspection? A staff member stated that team meetings are very useful and that staff are able to contribute freely and share their opinions on the running of the home. Since the last inspection work has been carried out in the garden area to move some of the retaining wall and create additional patio space making the area much more accessible to residents. A new built in barbecue area has also been added and with the addition of pot plants and hanging baskets the areas is now very homely. In September residents will be supported to attend a `drop in` session at the head office which will be run by the local SALT (speech and language therapy) team. There they can view various communication tools and consideration could be given to providing further SALT support if it is assessed that this could be beneficial for residents. In addition a local advocate is going to join the home in reinstating residents` meetings on a regular basis. Staff recruitment and retention has also improved and the home no longer has to rely on agency staff. Nine of the thirteen staff have completed NVQ (national vocational qualification) at level two or above and another two staff members are about to commence studying one at level two and one level three. . What the care home could do better: Of the seven requirements made at the last inspection of the service carried out on 11 July 2008, four were fully met and three partially met. In relation to two of these, that is, ensuring that all staff receive regular supervision and ensuring that effective monitoring is achieved through Regulation 26 visits it is evident that the Trust is now addressing these areas and it is anticipated that this will continue to improve once the new manager is in place. One requirement has therefore been reworded to ensure that the organisation is clear about what is required to improve standards in the home. This relates to the need to ensure that residents have access to a varied programme of meaningful and stimulating activities. Key inspection report Care homes for adults (18-65 years) Name: Address: 14 Beckley Close St Leonards On Sea East Sussex TN38 9TA     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: Caroline Johnson     Date: 0 9 0 7 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 29 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 29 Information about the care home Name of care home: Address: 14 Beckley Close St Leonards On Sea East Sussex TN38 9TA 01424855873 01424751641 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hastings and Rother Primary Care Trust 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 14 Beckley Close is a purpose built bungalow situated in a residential area of St Leonards-on-Sea, with nearby access to bus and rail routes. The home is registered to accommodate six adults with learning disabilities, some of whom have physical disabilities and complex needs. Accommodation consists of six bedrooms, four of which have en-suites and two that share communal bathrooms located adjacent to these bedrooms. Communal rooms comprise of two lounges, a dining room, kitchen, bathing and toilet facilities, laundry room and conservatory. There is under floor heating throughout and all facilities are at ground floor level. The loft area is purely used for storage. Prior to the home opening, Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 Brief description of the care home bedroom accommodation was built slightly undersized for people in wheelchairs. There is a raised garden with small patio to the rear. High railings surround three sides of the property. Off road parking is available at the front of the home. In April 2008 Hastings and Rother PCT became the registered providers for this service. The Trust manages nine other homes within the Hastings, St Leonards and Rother area. The property is owned by the Trust and managed by a housing association. The housing association has been given notice for termination of contract and the Trust is currently looking for another housing association to take on this role. Fees for the service range from 1331 to 1366 pounds per week for a block contract. 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: 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: For the purpose of this report the people living at 14 Beckley Close will be referred to as residents. As part of the inspection process a site visit was carried out on 09/07/09 and it lasted from 10:15am until 15:45pm. A manager that has been appointed on an interim basis facilitated the inspection. Over the course of the inspection there was an opportunity to meet with and observe some of the residents in their surroundings. In addition time was spent with a member of care staff in private. Two care plans were examined. In addition records seen included; staff rotas, training, medication, menus, health and safety, quality assurance and leisure activities. Since the last inspection the registered manager has retired from his position. A senior manager from within the Trust was then appointed on an interim basis until a manager was recruited to the position. A manager from one of the other homes within the Trust Care Homes for Adults (18-65 years) Page 6 of 29 has since been appointed and is due to transfer to the home on 13 July 2009. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Of the seven requirements made at the last inspection of the service carried out on 11 July 2008, four were fully met and three partially met. In relation to two of these, that is, ensuring that all staff receive regular supervision and ensuring that effective monitoring is achieved through Regulation 26 visits it is evident that the Trust is now addressing these areas and it is anticipated that this will continue to improve once the new manager is in place. One requirement has therefore been reworded to ensure that the organisation is clear about what is required to improve standards in the home. This relates to the need to ensure that residents have access to a varied programme of meaningful and stimulating activities. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that they can meet the assessed needs of the residents in the home. Evidence: There is a detailed statement of purpose in place that has been updated recently. It was noted that the stated registered provider is not the same as the name on the registration certificate. The appointed manager agreed to clarify this. The Registered Social Landlord has given notice to the Trust and no longer carries out this role. Interim arrangements have been put in place and the Trust is now looking for a new landlord to take on this role. The terms and conditions of residence/licence agreements have still not been updated since the home was taken over in April 2008. A number of factors have prevented this work being carried out but the manager advised that the Trust is currently working on the document and hopes that it will be out for consultation in the near future. There have been no new admissions to the home since the last inspection. Residents Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: abilities and needs are assessed at regular intervals. The home are currently looking into compatibility issues regarding one resident and a referral has been made for an assessment of needs to be carried out. A referral was made on behalf of all residents to the SALT (speech and language therapy) team. As a result in September the SALT team will hold a drop in session and staff will be able to support residents to attend. During this session they will be able to view a range of communication tools and a therapist will consider if a referral for more indepth work would be beneficial. Care Homes for Adults (18-65 years) Page 12 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. Care plans provide detailed information about the abilities and needs of the residents. They could be enhanced further by ensuring that goals and aspirations, where assessed as appropriate, are clearly stated with advice for staff on how to support residents in achieving them. Evidence: Two care plans were examined in detail as part of this inspection. Both contained a wealth of information and advice and guidance for staff to follow to ensure that each residents needs are met. Where risks are identified or perceived there is a detailed risk assessment in place. A requirement was made at the last inspection in relation to ensuring that the goals set for individual residents were meaningful and achievable and that progress could be easily measured. The manager advised that all goals that had been set were taken out from care plans and the staff team have now been asked to look for goals that are achievable. In some cases a decision may be reached that rather than a skill building Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: goal it may be more appropriate to agree wishes and aspiration targets. Records showed that person centred planning meetings are held regularly and relatives and care managers are invited to attend. In addition health action plans are also reviewed at these meetings. From the meetings, a list of action plans are drawn up and records show who is responsible for carrying out each action. Work has been undertaken to identify how best to involve each resident in their meeting. It was noted that in relation to one resident, although registered blind, staff found that by presenting the meeting in sections using a pictorial format, staff were able to explain each section clearly and the resident was able to indicate their understanding of what was being said. Residents meetings are not currently held but it was reported that there are plans to introduce them again with the support of a local advocate. Meetings are due to begin in July and following the first meeting a review will be held to decide how best to run the meetings and this will be continued until the best approach is found. Staff reported that two residents are able to give a yes/no response but that the rest of the residents use facial/vocal expressions and choices and decisions are often about staff knowing each residents likes and dislikes. One resident has a communication passport but this was with them on holiday and therefore not seen during the inspection. Care Homes for Adults (18-65 years) Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Work needs to continue to ensure that residents receive varied, meaningful and stimulating activities. Evidence: A number of changes have been made to the way in which activities are organised in the home. The home has a contract with a day care provider to provide each resident with three hours support each week. However this contract has not been working in practice and the provider has been given notice of termination of the contract. The contract is due to end at the end of August. Staff advised that although the day care provider is still meant to be providing a service until then, there are regular problems in attendance and communication remains poor. The Trust is reviewing how activities are to be provided and one possibility that they are considering is to increase staff levels to more effectively facilitate residents attendance at chosen activities. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Another change noted was that instead of planning activities in advance each resident now starts the week with an almost blank planner. There are a few set activities but instead activities are now arranged spontaneously and flexibly and staff reported that they can respond to individual wishes on a daily basis. By the end of the week the activity programme shows the activities that the residents have taken part in. In the programmes seen it was noted that residents had regular weekly aromatherapy. Other activities included relaxing, listening to music, time in the garden, aromatherapy, observation of meal preparation, tactile and sensory activities. In addition staff try to ensure that each resident has an opportunity to go out once each day and it was noted that this is often for a drive or for shopping whether this is for the house or a personal shop. As stated at the last inspection of the home the lack of planning in advance for activities means that residents do not get as much out of activities as they could. Record keeping will generally show that the resident enjoyed the trip but no reference will be made to any other outcome achieved. For one resident three activities in the one week were stated as exercise programme. However, the exercise programme is meant to be part of the daily morning routine and therefore seven days a week and not classed as an activity. It can appear on occasions as if residents are fitting into the staff activities for example a drive to another home to pick something up or house shop rather than activities being really person centred. However, it is hoped that this will all change and that with greater staffing levels, more person centred activities can be arranged. Staff are already beginning to explore new activities. One resident attended a local music gym but didnt appear to enjoy the session. Another resident went the following week and loved the session. The home are also looking to arrange regular swimming sessions at a local hydro pool for some of the residents. At the time of inspection three of the residents were on holiday at Eurodisney. This was their first holiday abroad and reports back to the home were that the holiday was going very well and the residents were really enjoying themselves. One resident is supported to go to Church on a regular basis and other residents attend intermittently. All of the residents have contact with families and where appropriate staff support residents to visit with their relatives. Menus seen were varied and well balanced and records show details of the meal provided and how much was eaten. if an alternative is given this is recorded. A cooked Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: breakfast is provided one day at the weekend. Care Homes for Adults (18-65 years) Page 17 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 systems in place ensure that residents healthcare needs are met. Evidence: The arrangements in place for the storage and handling of the current medication were in order. Some of the residents receive specialist advice and support in relation to their health care needs. Detailed guidelines are in place in relation to meeting these complex needs such as epilepsy, peg feeding and nutritional care. Each of the residents has a health action plan in place. A health action plan meeting is held every six months to ensure that individual needs continue to be met. In relation to the meeting notes it could not always be seen that issues identified had been carried out but on further exploring through records there was evidence that this was so. Staff observed in the course of their duties showed respect for the residents and there was a warm and friendly atmosphere in the home. Residents are supported to attend healthcare appointments such as chiropody, dental and opticians on a regular basis. A monthly check is also kept of each residents weight. All staff receive training on the administration of medication and then attend yearly Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: refresher courses. It was reported that the new manager is qualified to provide training on this subject and will hold a course for all staff once he commences in post. Care Homes for Adults (18-65 years) Page 19 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. Systems are in place to enable anyone wishing to make a complaint to do so. Evidence: The manager advised that there have been no complaints since the last inspection of the home. There is a detailed complaint procedure in place along with a simplified version of the complaint procedure that is included in the service user guide. In addition there is an audio version in place for one resident who has a visual impairment. There is a detailed procedure in place on adult protection and prevention of abuse. All staff are expected to receive training on the subject as part of their induction to the home. Records were seen in relation to the management of two of the residents finances. The records seen were in order. The arrangements in place for the management of residents DLA (disability living allowance)payments have changed and the allowance is now paid directly into individual bank accounts. It was noted that although the Trust has revised how they manage the DLA, their policy on the management of finances had not been changed. However following the inspection confirmation was received in writing that the service user finance protocol has been reviewed and would be sent for ratification and reissue. Care Homes for Adults (18-65 years) Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well maintained and decorated to a good standard. Evidence: Since the last inspection work has been carried out in the garden area to move some of the retaining wall and create additional patio space making the area much more accessible to residents. A new built in barbecue area has been added and there are lots of pot plants and hanging baskets making the area very homely but also creating a sensory area. No decision has been reached yet about removing the large railings that surround the property. The garden area to the front of the property has been cleared and has been made ready to plant flowers and shrubs. The Registered Social Landlord would normally have responsibility for the maintenance and redecoration of the home. However, as stated previously this arrangement is not currently in place so in the interim all work is now carried out via the Trust through an agreed contractor. Staff stated that the new arrangement is working well. Some works that had been identified as needing to be carried out when the previous arrangement was in place are still being pursued by the Trust. Two bedrooms have been identified Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: as needing to be redecorated. The sensory bath has been lowered and the home are now making arrangements to obtain a suitable seating aid. All areas of the home seen during the inspection were clean. There are suitable laundry arrangements in place. The manager advised that the PCT carry out an infection control audit periodically. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a dedicated staff team that are well trained and equipped to meet the needs of the residents. Evidence: Staffing arrangements have improved since the last inspection and at the time of this inspection there were no vacancies. It was also reported that there are a number of bank staff that can be called upon as necessary to cover sickness and annual leave. As a result there has been no need to use agency staff. There are three care staff on duty on each shift through the day. The managers hours are in addition to these numbers. The current manager works three days a week but the new manager will work five days a week. There is one waking night staff member at night. It was reported that twelve staff have completed the common induction standards. Nine have completed NVQ (national vocational qualification) at level two or above and two staff members are about to commence studying one at level two and one level three. Recruitment records were not examined on this occasion but information provided in advance of the inspection showed that the Trust ensures that thorough recruitment procedures are followed. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: There is a staff training matrix in place showing the courses that staff are expected to attend and the frequency. In each subject area there are a couple of gaps but arrangements are being made for staff to attend the relevant courses. A supervision chart is also on display in the office and this showed that there were gaps in ensuring that all staff receive regular supervision. The manager was confident that with the new manager in place full time this would be addressed. A staff member spoken with stated that they find their supervision sessions helpful. Care Homes for Adults (18-65 years) Page 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some good systems in place to ensure that the home is managed well and these are continuing to be developed and improved upon. Evidence: Since the last inspection of the home the registered manager has retired from his position as manager. A service leader was appointed to the position on an interim basis until a new manager could be appointed to the post. A manager from one of the other homes within the organisation has since been appointed and is due to take up his position on 13 July 2009. He is already familiar with the home, but has spent some time in the home recently with residents and staff in preparation for taking on his new role. Staff meetings are held periodically. Records showed that two staff meetings have been held this year. It is expected that once the new manager takes up his post the frequency of meetings will increase. A staff member stated that team meetings are very useful and that staff are now able to contribute freely and share their opinions on the running of the home. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Staff spoken with stated that the current manager is very supportive and approachable and they are looking forward to this continuing when the new manager commences in post. There are various procedures in place to monitor the quality of care provided. A member of the senior management team visits the home once a month unannounced to report on the conduct of the home. It was noted that the reports for the visits carried out in the previous three months were not in the home. Copies of these reports were sent to the Commission the day following the inspection. It was also noted that from November 2008 to February 2009 there were no visits undertaken. The manager advised that this is being taken up with the person that had been delegated responsibility for carrying out this task. There are a number of satisfaction questionnaires that are carried out with residents to seek their views on the quality of the care they receive. From the questionnaires an action plan is then drawn up and more recently these action plans are included at residents pcp (person centred planning) meetings to ensure that all areas raised have been addressed. Families and visiting professionals are also issued with questionnaires to seek their views and responses received were positive. Within the file there were also compliment slips that any visitors to the home had completed. It was noted that none of these forms were dated. A wide range of audits are also carried out in relation to the records kept. There are a range of systems and procedures in place to ensure the health, safety and welfare of the residents accommodated. A number of records were sampled and evidence supplied in advance of the inspection showed that equipment is serviced at regular intervals, water temperatures are monitored and risk assessments are updated at regular intervals. Care Homes for Adults (18-65 years) Page 26 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 27 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 14 16 Regulation 16(m,n) The registered person must ensure that residents have access to meaningful and stimulating activities. Residents must have opportunities for personal development. 29/09/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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