Care Home: 162 Wellington Hill West

Similar services:

• Radfords
• Honeybourne House
• 32 Beaumont Way
• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road

What the care home does well It is noted that after a period of change within the home with regard to management of the service there is now new arrangements where a Senior Support worker is in day to day charge of the home. This has resulted in our view a greater degree of stability for individuals who live in the home and importantly staff who commented on the improved morale. From observing staff in their interaction with individuals and from talking with staff it was evident that over the years there has been established good relationships and understanding of the needs of those who live in the home. There has been historically a stable staff group and whilst this has changed over the last year with recruitment of new staff members there has been a real continuity for those living in the home. This is further helped by the fact that there has been the same group of individuals living in the home for over 15 years. Staff illustrated a knowledge of the personalised and individual needs of those living in the home from knowing the importance of particular routines and habits of individuals to how to response positively to varying and at time challenging behaviour. There is a homely and welcoming environment which has been adapted to meet the changing needs of individuals in terms of their potential increased frailty associated with age. There is a good basis for care planning and identifying specific health and social care needs of individuals with a focus on providing a person centred service. This being an area the home has identified as an area for continued improvement. What has improved since the last inspection? A number of requirements were made at the last inspection and we looked at these and found that they had been met. This has resulted in improved facilities in terms of addressing the at the time difficulties in showering facility. A real improvement has been the providing of a mini bus which has meant there is greater opportunities for individuals to use community resources and participate in trips outside of the home. This has been of particular value to those individuals whose mobility is limited or restricted. The home has also improved the arrangements where individuals are assisted with their finances and this helps in protecting individuals financial affairs. What the care home could do better: We have identified a number of areas of practice in the home which need addressing and have made two requirements about these issues. Records showed that there was a failure to ensure that health needs of individuals are being addressed where they are identified as risk areas such as chiropody treatment or visits from health professionals. It is noted that we found no direct evidence that individuals well being or health had been affected. However the failure to illustrate or evidence the providing of this level of support with individuals care reflects a significant shortfall in practice and potentially represents a risk to individuals health. There was no evidence that for some individuals their care needs and plans had been reviewed on a regular basis to make sure that they accurately reflect the current needs of the individual. We have also made a requirement about the practice of the home in relation to administering of convert medication and their use in relieving anxiety. We did not establish any evidence that this practice is being used to the detriment of the individuals concerned and has we understand been a long standing practice in the home. However good practice would now dictate that there is a clear evidence trial for such practice and importantly that such decisions are taken within a multi disciplinary framework. Further that mental capacity and best interests assessments are undertaken to evidence the need for these arrangements. We also believe from our visit and inspection that there could be improved efforts to use advocacy services to support and assist individuals particularly in one instance where the individual has no living relatives or identified representative. In these circumstances the provision of the Mental Capacity Act in regard to IMCA maybe of relevance with regard to specific choices and decisions. Key inspection report Care homes for adults (18-65 years) Name: Address: 162 Wellington Hill West 162 Wellington Hill West Henleaze Bristol BS9 4QP     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: John Clarke     Date: 1 6 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 25 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 25 Information about the care home Name of care home: Address: 162 Wellington Hill West 162 Wellington Hill West Henleaze Bristol BS9 4QP 01179859918 01179699000 louise.westlake@brandontrust.org www.brandontrust.org The Brandon Trust care home 5 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 can be accommodated is 5 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home 162 Wellington Hill West is operated by the Brandon Trust and is registered with the Commission for Social Care Inspection (CSCI). The manager is Ms Louise Westlake. The home provides care to 5 residents aged 45 years and over in the learning disability category. The categories of registration are: Learning Disability (LD) 4, Learning Disability over 65 years (LD(E)) 1. The residents have lived at the home for many years and the Trust have taken the decision to extend and adapt the property to better suit the aging residents? needs. Residents have complex communication difficulties. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 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: This was an unannounced visit to the home as part of our inspection of the service. As part of this inspection we looked at a number of documents and records relating to how the service is run including care plans, management of medication, training. We were also able to talk with staff and observe how they interacted with individuals who live in the home. Because of the communication difficulties of those that live in the home we were not able to talk with people about their views of the quality of the service they receive. As part of this inspection we received from the manager their Annual Quality Assurance Assessment which told us what changes and improvements they have made and areas of the service they aim to improve. This helped us in making a judgement about the quality of the service. Care Homes for Adults (18-65 years) Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: We have identified a number of areas of practice in the home which need addressing and have made two requirements about these issues. Records showed that there was a failure to ensure that health needs of individuals are being addressed where they are identified as risk areas such as chiropody treatment or visits from health professionals. It is noted that we found no direct evidence that individuals well being or health had been affected. However the failure to illustrate or evidence the providing of this level of support with individuals care reflects a significant shortfall in practice and potentially represents a risk to individuals health. There was no evidence that for some individuals their care needs and plans had been reviewed on a regular basis to make sure that Care Homes for Adults (18-65 years) Page 6 of 25 they accurately reflect the current needs of the individual. We have also made a requirement about the practice of the home in relation to administering of convert medication and their use in relieving anxiety. We did not establish any evidence that this practice is being used to the detriment of the individuals concerned and has we understand been a long standing practice in the home. However good practice would now dictate that there is a clear evidence trial for such practice and importantly that such decisions are taken within a multi disciplinary framework. Further that mental capacity and best interests assessments are undertaken to evidence the need for these arrangements. We also believe from our visit and inspection that there could be improved efforts to use advocacy services to support and assist individuals particularly in one instance where the individual has no living relatives or identified representative. In these circumstances the provision of the Mental Capacity Act in regard to IMCA maybe of relevance with regard to specific choices and decisions. 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 7 of 25 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 8 of 25 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 has procedures in place to undertake assessments of perspectives individuals who wish to live in the home so that the home can make an informed decision about their capacity to meet the needs of the individual. Evidence: The individuals who live in the home have been resident for a number of years having been transferred from other care settings. No new admissions have taken place for a number of years. There are procedures and policies in place in the event of a new admission and assessments would be undertaken to establish the suitability of the perspective individual. Care Homes for Adults (18-65 years) Page 9 of 25 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. Peoples care needs are clearly identified in their individualised care plans enabling staff to have clear information to help staff meet identified needs. However the reviewing of care plans needs to improve to make sure they are up to date and reflect accurately the needs of the individual. Financial procedures are in place to protect the financial affairs of individuals. Individuals are supported in making informed choices about their daily lives this could be improved by the use of independent advocates. The home completes risk assessments so that individuals are supported to take risks in their daily lives but within a risk assessment framework so that their safety and welfare is protected. Evidence: We looked at a number of care plans and they showed good person focused information about the individuals needs relating to health, diet. Communication Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: Passports had been completed with choices books (though no evidence these had been reviewed). For one individual there was information about People In My Life and Things I Say about myself. Person Centred Plans had been completed and there was evidence of reviewing of care plans on monthly basis however last recorded review was 20/04/08 and for another person care plan was last reviewed 20/11/08. No evidence of reviews being held with the individual or their representative. Individuals are supported in making choices about their daily lives and one individual who enjoyed going out every day was supported to do so by a Support Worker. This had become part of their daily routine. For another individual it was recorded that they had made a choice about attending the local church less frequently. Staff we spoke with were very clear about wherever possible enabling individuals to choose what they wanted to do and how they spent their time. One told us about an individual who has strict routines in terms of their daily activities and this is acknowledged as important for the individuals emotional well being and mental health. For one individual who has no known next of kin there had been no arrangements to look at their having an independent advocate and generally there was no evidence that the use of advocacy services or advocates had been explored. Records were looked at relating to individuals financial affairs where the home assists in the management of individuals monies. Financial cash records are checked and signed by two members of staff on a daily basis. We looked at records for one individual who has a trust fund and the home has accessed this fund. There was communication with the trust fund regarding the expenditure and receipts had been sent however there was no signed copies of receipts on the individuals file. Risk assessments had been completed for individuals relating to activities in the community, using transport, financial affairs (individual had no concept of value of money). Care Homes for Adults (18-65 years) Page 11 of 25 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. Individuals who live in the home are offered opportunities to undertake activities and be part of the local community. Contact with family and friends is well maintained and the rights and choices of individuals is encouraged and respected. Evidence: In talking with staff and looking at records it was evident that individuals where able are supported to undertake community based activities, attending local clubs. One individual as part of their care plan had Work, Learning and Leisure Planning which identified a number of activities for the individual: working in an allotment, going to the local cafe, dog walking. One individual had attended a local college and completed a cookery course though when a staff member was asked whether the individual did any cooking in the home the inspector was told No he takes along time. In the inspector view this is not the attitude when trying to encourage individuals to maximise their skills and participate in the life of the home. The home now has a Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: vehicle which has been used for individuals to go out for trips and other activities (sadly a mini bus which has an institutional feel rather then say a people carrier). Each individual is supported by an external Day Care Support worker who accompanies individuals as a group or one to one in undertaking activities in the community. We spoke with a support worker and they spoke highly of the home and the welcoming environment and caring staff. They also told us that they felt their involvement had improved an individuals confidence in leaving the home and using local facilities. There was a sense from talking with the home staff that they felt their role in supporting individuals was very much confined to the home. They spoke of wanting to be able to undertake and involve individuals in such tasks as shopping. However there was limited staffing time available and their roles and tasks such as being responsible for the domestic side of the home (cooking of meals,laundry and cleaning) restricted the time they had available.Staff availability namely generally only two on duty again limited their ability to leave the home with individuals. The home encourages contact with family and friends and individuals are supported where this is needed in maintaining this family contact. The home organises house meeting where effort is made to involve individuals who live in the home about making choices about activities and other issues about the life of the home. We were also told that individuals were asked about decorating of their rooms and the colours they would though in the event none expressed a preference and staff have made the decision based on their knowledge of the individuals likes. Menus were looked at and showed a good variety of meals being provided in the home. Staff were observed giving choice to an individual and offering foods they knew the individuals liked. One of the areas identified for improvement by the home is that of enabling greater choice of meals. Care Homes for Adults (18-65 years) Page 13 of 25 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 arrangements for meeting the health care needs of individuals needs to be more robust so that the health and welfare of individuals is fully protected. The medication arrangements need to make sure that there are procedures in place to evidence that the appropriate practice takes place and is in the best interests of the individuals living in the home. Evidence: We looked at records relating to health needs of individuals, OK Health Checks had been completed though in two instance this was dated 07 with no evidence of review. They identified specific needs of the individuals i.e. dental, physical and mobility, optician and other health needs related to specific conditions such as diabetes, high blood pressure. One individuals Health Check identified need to see chiropodist regularly but no record of visit and for same individual last optician visit recorded 22/11/06. Last recorded weight for this individual 19/09/07. One individual seen by chiropodist 24/4/09, 26/09/08, had flu jab and blood sugar monitoring because of diabetes. Last record of weight 23/11/07. Health Check dated 25/05/07 no evidence of review since Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: that date. One individual identified need to see community nurse at 6 monthly intervals last visit was recorded 02/05/08 with no records of other visits. One individual Dietary Intake assessment indicated low body weight and aim was weight of 8 stone, individual had been weighed monthly as stated in care plan. An individual with epilepsy has support plan in place and profile reviewed 10/10/07. There was Seizure Record. Action Plan stated that ambulance to be called if seizure lasted longer then 4 minutes and staff had called ambulance on one occasion when this happened. Staff have received training in this area. We looked at the arrangements for the management and administering of medication. Storage is in locked cupboard though there was not a Controlled Drug cupboard or Controlled Drug Register. MARS sheets were looked and showed no gaps in the recording of administered drugs. Returned medication record is kept. For one individual medication is given covertly in their food however there was no written agreement for this method of administering medication. The same individual has medication prescribed to relieve anxiety before medical treatment and there were two occasions when this had been given. A risk assessment had been completed and identified actions as 1) all possible treatments at home 2) by direction of GP medication 1 hr prior treatment. There was no capacity assessment in place to evidence this was in individuals best interest. There was also another individual where this arrangement was in place though it had not been necessary to administer medication and indeed none was in stock however again there was no evidence of capacity assessment. Care Homes for Adults (18-65 years) Page 15 of 25 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. Individuals who live in the home are supported in making a complaint or voicing their dissatisfaction about the service however this would be improved if there were independent advocates available for all individuals living the home. There are procedures in place to respond to any allegation of abuse, staff have undertaken training in this area and this helps in protecting individuals who live in the home. Evidence: The home has a complaints procedure in place however because of the communication difficulties of individuals who live in the home it would not be accessible and there are pictorial versions available. Staff were asked how they know if individuals were unhappy about anything and they were clear about what to look for for example body language, challenging behaviour, increased anxiety. Staff have undertaken safeguarding training and we asked staff how they would response if they had concerns about possible abuse. They were very clear they would report to the manager I would certainly do something about it. Care Homes for Adults (18-65 years) Page 16 of 25 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. Individuals who live in the home benefit from a homely, comfortable and safe environment with facilities to meet their needs. Evidence: In looking around the home it was evident that the facilities are as required to meet the needs of individuals that live in the home. Individuals rooms were all personalised and the communal areas lounge and dining area were homely and offer space for the people to spend their time if they wish in these areas. At the time of our visit all of the individual rooms were being decorated. There is a pleasant outdoor garden with level access to a patio with seating area. There are shower facilities with level access and additional bathroom. There are stairs to the upper floors of the house and currently there is no stair lift however there are two rooms on the ground floor which provide accommodation for those individuals whose mobility is limited. The home was clean and well maintained and there are infection control procedures in place. Care Homes for Adults (18-65 years) Page 17 of 25 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. Individuals who live in the home benefit from a competent and committed staff team who have the necessary skills and knowledge to meet identified care needs. Evidence: Staff we spoke with were clear about their role and responsibilities and there was real sense of their working as a team to support the individuals in the home. We looked at training records for a number of staff and found they had completed a range of training including Safeguarding Adult, Moving and Handling, Epilepsy, Health and Safety. Staff have or are completing NVQ Level 2 or 3. The senior in charge of the home has NVQ Level 3. No staff had completed training specifically relating to older people. Staffing rota identified that generally there are two staff on duty at all times with one sleep in. The arrangements regarding the completing of domestic and cooking of meals was discussed with the manager in that currently this forms part of care staff duties. We did not look at recruitment records in that these are kept at Brandon trust headquarter and are examined periodically. We are satisfied that the necessary checks Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: take place including Criminal Record Bureau check. Care Homes for Adults (18-65 years) Page 19 of 25 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 home is managed in a competent and professional manner with systems in place to protect the health and welfare of individuals who live and work in the home. Evidence: The home manager was present for part of our visit and we were able to discuss the running of the home and some of the areas raised from our visit. Staff we spoke with were positive about the approach of management and also how they felt the home was providing a settled, secure and safe environment. They told us that they felt morale was good and that they work well as a team. One individual told us that morale had been low but was gradually improving. We were told that the homes holds regular residents meetings however there was no other quality assurance available to individuals who live in the home. We did not establish if there are independent quality assurance questionnaires or other ways of getting the views of individual and other interested parties such as relatives and stakeholders about the service provided in the home. Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: Records we looked at about the health and safety practice of the home showed that there are regular fire drills, weekly tests of fire alarm and monthly checks of emergency lighting. Fire Risk Assessment for the home has been completed and there are risk assessments in place for all areas of the home (though they need to be reviewed). A Environmental Health inspection was carried out in October 2008 and was satisfactory. Care Homes for Adults (18-65 years) Page 21 of 25 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 22 of 25 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 6 15 The registered manager shall make sure that service users care plans are kept under review and where appropriate and, unless it is impracticable to carry out such consultation, after consultation with the individual or a representative revise the care plan. This refers to the undertaking of regular care plans reviews toensure they accurately reflect the needs of the individual and also involvement of the individual or their representative. this will address issue of changing needs of the individual. 30/08/2009 2 19 12 The registered manager to make sure that the care home is conducted so as to promote and make proper provision for the health and 30/09/2009 Care Homes for Adults (18-65 years) Page 23 of 25 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 welfare of individuals living in the home. This refers to the need to make sure that identified health needs are being met i.e. health visits, monitoring of weight. 3 20 13 The registered manager to 30/09/2009 make sure that there are arrangements for the safe administering of medication. This relates to the practice of giving medication in a convert manner and to use as a means of alleviating anxiety. Any such actions to be undertaken following mental capacity and best interests assessment. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Look at the use of independant advocates for individuals too support them in making decisions about their lives. Care Homes for Adults (18-65 years) Page 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!