Care Home: 18 Hawthorn Crescent

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What the care home does well The home offers a homely attractive and well equipped environment and people told us that they were happy living in the home. People have their needs assessed and recorded and there are very detailed care plans in place that guide the staff team to individual needs and choices and these are kept under regular review. The home works well with a wide variety of other healthcare professionals in order to ensure that people have good healthcare support and people have the equipment they need in order to maximise their choice and independence. The home excels in the variety of choice of day and social activities being provided for people and they are offered a choice of menu and have regular meals out. There are organisational quality audits regularly carried out in order to monitor the quality of the service being provided in the home. People are being supported by a caring and competent staff team and the home is being well managed. What has improved since the last inspection? Improvements have been made to the quality of care plans and service user records in the home. People have all had a recent health care assessment and Health Action Plans have been updated. A survey returned from a Dietitian said, ` the service has improved the documentation regarding the food and meals eaten by residents`. Improvements have been made to the environment in order to make it more accessible for service users and there has been a programme of redecoration and updating the home in place. What the care home could do better: No Requirements have been made as a result of this inspection. Identified areas that would improve the service on offer are the registration of the manager, staff training records being on individual files to ensure they are easily tracked and a more independent way put in place of managing service users` personal monies. Key inspection report Care homes for adults (18-65 years) Name: Address: 18 Hawthorn Crescent 18 Hawthorn Crescent Worthing West Sussex BN14 9LU     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: Annie Taggart     Date: 2 1 0 8 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 27 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 27 Information about the care home Name of care home: Address: 18 Hawthorn Crescent 18 Hawthorn Crescent Worthing West Sussex BN14 9LU 01903821868 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: wwl2_hawthorn@btopenworld.com www.caremanagementgroup.com Care Management Group Ltd care home 4 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: 4 The registered person may provide the following category 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 category: Learning disability Date of last inspection Brief description of the care home 18 Hawthorn Crescent is a care home that is registered to provide care for four adults with learning disabilities between the ages of 18 and 65. The Registered Provider is Care Management Group Ltd. There is no registered manager in post at present. The current scale of monthly charges are from 1450.00. There are additional charges for hairdressing, toiletries, trips out, holidays and clothes. The home is a semi-detached property, situated in a quiet residential street, just outside Worthing town centre. There is easy access to all community facilities, including local rail and bus stations. The home underwent major upgrading work last year that has included changing the internal structure, providing new toilet and bathing facilities and decorating throughout. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 2 8 0 8 2 0 0 8 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: In order to plan for this inspection an Annual Quality Assurance Assessment (AQAA) was sent to the manager of the home for completion and surveys were sent to service users, staff members and other professionals involved with the home. The completed AQAA was returned within the given timescales and it contained clear information about the services being provided in the home, four service user, four staff and two professionals surveys were returned and all made positive comments about the home. The unannounced inspection was carried out on Friday 21st August 2009 at 2.30pm and the visit lasted for three hours. During that time we spent time with service users in communal areas and in their private bedrooms and we spoke with the staff on duty. Care Homes for Adults (18-65 years) Page 5 of 27 We tracked the care plans and all supporting documentation such as risk assessments and daily records for two for the four people living in the home and we tracked four Health Action Plans. We looked at the system for recording and administering medication and the process for managing service users personal monies. Four staff files were tracked and we saw that all of the required documentation was in place. Records for the running of the business were seen and this included complaints, incidents and accidents, Regulation 26, Registered Providers visit and health and safety records. The manager of the home was away on leave at the time of the visit and we were assisted by the senior carer who had a good knowledge of the running of the home and was able to produce all the required documentation. Feedback was given to the senior carer following the visit. Care Homes for Adults (18-65 years) Page 6 of 27 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 7 of 27 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 27 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. There is clear and accessible information available about the services on offer in the home, people have their individual needs and wishes assessed and recorded and contracts of terms and conditions of residency are agreed. Evidence: There is clear information available to guide prospective service users and their families to the facilities on offer in the home. We saw that these documents are produced in pictorial and other accessible formats and each service user had a copy on their file. We tracked the records of two of the four people living in the home and saw that a comprehensive pre admission process is carried out and that service users, their families and other professionals are involved. People have their individual needs and wishes recorded and this includes personal care support, emotional, social and medical needs and issues regarding personal choice and diversity are addressed. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: We saw that for the four people living in the home there are contracts of terms and conditions of residency in place, they were in an accessible, pictorial format and had been signed by the service user or their representative. Care Homes for Adults (18-65 years) Page 10 of 27 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. There are comprehensive and clear care plans in place that guide the staff team to the individual needs and wishes of the people they are supporting. Risk assessment are completed and kept up to date and care plans are kept under regular review. Evidence: For each of the four people living in the home there are clear and detailed care plans in place. We tracked the care plans for two people and found them to be person centred clear and comprehensive. Care plans recorded very clear information for the staff team to follow regarding all areas of peoples lives. There are individual personal profiles, guidance on preferred routines, manual handling risk assessments and information on how to use each persons individual equipment. There are also communication profiles, details of dietary needs, the support people need with eating and drinking and the plans also address peoples emotional needs and community support. Where there are activity plans in place, for example to assist people with movement Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: and exercises, there was detailed guidance in place and the documents were also produced in pictorial form to enable service users to follow. Peoples individual needs and choices are clearly recorded, care plans are updated monthly following key worker meetings with service users and we saw that there are full annual reviews held that include the service user, families and other professionals involved in peoples care. One review had been held on 20/5/09 and the other 5/6/09 Care Homes for Adults (18-65 years) Page 12 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are being supported to enjoy a fulfilling lifestyle that meets their individual needs and choice and they are part of their local community. There is a choice of menu on offer, people also go out for meals and they have the equipment they need to support their independence. Evidence: There is clear evidence in the home to show that the people living there are having a fulfilling lifestyle that matches their individual preferences, choice and skills. For each person there is a weekly activity programme in place and a pictorial version of the plan is also kept in their bedroom. From looking at the plans and daily records we saw that people attend day centres and educational options and one person has one to one support to achieve this. There Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: are also records that detail how people are supported with their religious beliefs. From talking to service users and looking at records we saw that people are also supported in a wide range of community options and outings. Some examples of this are, for one person in the past month they had been for meals out, to a cream tea, ice skating, shopping, to an air show to the theatre, a market in London and to a music festival. For other people we saw that they enjoy horse riding, visits to their families and friends and going to the cinema. We also saw that a pet therapist visits the home on a regular basis and photographs in peoples rooms showed that they really enjoyed this experience. In the service user meeting minutes we saw that one service user had suggested a garden party where family and friends could be invited. We saw that the staff team had supported this to be arranged for September and the person was being assisted to make invitations on their computer. The people living in the home are young adults and we saw that they were involved in age appropriate activities and entertainment options. Examples of this are that people have computer and music equipment in their rooms. One person has a communication aid and a specially adapted computer and there is a detailed programme in place for staff to support the person with using this. During the visit one person was being assisted to download music onto their computer as they had received a gift voucher to do this and the staff assisting them were very patient and supportive. People are also assisted to have holidays, two people had recently been away on a cruise with staff support. All of the people living in the home need a high level of support to assist them to take part fully in their chosen lifestyle and this includes the use of equipment such as hoists, communication equipment, and close staff observation. For all of these areas there are very clear guidelines in place and daily records are clear and comprehensive. From looking at records and talking to service users we saw that people are offered a variety of home cooked meals and people also enjoy meals out. There are very clear guidelines in place to assist some people with eating and drinking and these include risk assessment and plans devised with assistance from a Dietitian and the Speech and Language therapist Care Homes for Adults (18-65 years) Page 14 of 27 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. People have their health care needs assessed, recorded and kept under regular review. There is input from a variety of health care professionals and medication is being safely managed. Evidence: For each of the people living in the home there is a detailed health assessment carried out that then has been transposed into a full Health Action Plan. We looked at the plans for all of the people living in the home and saw that they had all recently been reviewed and updated, two had been updated in January 09, one in February and another in March. The Health Action Plans and other healthcare guidelines for people were very clear and detailed and gave the staff team concise information on how to support each persons individual needs. Examples of this were clear epilepsy plans for one person that detailed what the seizure looked like, how to respond and record and at what stage to telephone 999 for assistance. For another person there were very clear guidelines on how to support the person with eating and drinking and this plan addressed breathing difficulties when eating and how they were to be managed and recorded. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: There were plans in place for the use of specialist equipment including communication aids, electric wheelchairs and the use of safety lap straps, hoists and colour coded slings and there were risk assessments in place for addressing areas such as falls or accidents. From looking at peoples records we saw that there are a variety of healthcare professionals involved in their lives and these included, Physiotherapists, Speech and Language Therapist, local doctors and district nurses, Aromatherapist, Psychologist and an Osteopath. There was evidence to show that people also had regular medication and health reviews and that they also saw Chiropodists and dentists. There are policies and procedures in place regarding the management and administration of medication, we saw that the staff team have received the relevant training and there is a list of medication handlers on file. Medication was safely stored in a locked cabinet and Medication Recording Sheets (MAR) were up to date with no gaps in signing. Where people are receiving supplements, for example thickening agents in drinks, this is recorded and there are guidelines in place for the staff team to follow. We asked the senior carer what would happen if there was a medication error in the home and he told us that this would be recorded as an incident, investigated and appropriate action taken by the manager. From looking at records we saw that end of life issues had been addressed with assistance from other professionals and families and we saw that one person had a clear plan in place that recorded their personal wishes. Care Homes for Adults (18-65 years) Page 16 of 27 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. People have their complaints and concerns recorded and acted upon and the homes policies, procedures and working practices are designed to protect people from risk of abuse or harm. Evidence: The home has a complaints procedure, a copy of which is included in the Service User Guide and also displayed in the home in an accessible, pictorial format. From looking at records we saw that all complaints and concerns are recorded and acted upon and they are also audited at the monthly Regulation 26, Registered Providers visit. As some of the people living in the home sometimes use non-verbal communication, the complaints book also records occurrences where staff might notice a change in a persons behaviour or an interaction between people, this is then recorded both in the daily records and in the complaints books and investigated by the manager. From looking at staffing records we saw that all of the staff team have attended training in the protection of people from risk of abuse or harm. We spoke to two staff members and asked them what they would do if they ever heard the manager of the home shouting at a service user. Both people said that it would not happen but if it did they would report it to the area manager straight away. We also saw that there was a Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: pictorial pamphlet in place for service users entitled Say No to Abuse In the AQAA we are told that there has been one formal complaint that has been investigated and upheld and one safeguarding referral that has now been closed. Care Homes for Adults (18-65 years) Page 18 of 27 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. The home provides a comfortable, clean and homely environment and service users have the specialist equipment they need to support their individual care and independence. Evidence: The home is a purpose built bungalow and is situated in a residential area close to local amenities. there is a large lounge and dining area that is homely, attractive and well furnished and people have access to an enclosed garden to the rear. Peoples personal bedrooms have been personalised with their belongings such as musical equipment, televisions, computers and evidence of hobbies and interests and for one person there has recently been added an aquarium, potted plants and sensory equipment in order to provide a restful and therapeutic environment. Each person has a large en-suite bathroom with specialist bathing equipment and both bedrooms and bathrooms have overhead trackways and hoists fitted. People also have such equipment as specialist chairs and beds in place and there are bed sides fitted for safety. There are risk assessments in place for the use of all equipment and for the use of bed sides and we saw evidence that guidance had been sought from an Occupational Therapist. Bed sides agreements have at the present time been signed Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: by the manager of the home, we advised the person in charge at the time of the visit that they should also be signed by a healthcare professional and he said that this would be done. Where people have specialist equipment in use there are very clear guidelines in place for the staff team to follow, for example the size and colour of hoist slings to be used and how people are to be positioned, there was guidance for addressing infection control issues and we saw that temperature charts are completed each time a service user bathes or showers. In the past year there has been a programme of refurbishment and redecoration in place and the home throughout was bright, comfortable and homely. In service user meeting records we saw that new carpets are to be purchased for communal areas and that service users have been involved in the choice of colours. Service users told us that they were happy living in the home and that they enjoyed their private space. Care Homes for Adults (18-65 years) Page 20 of 27 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 people living in the home are supported by a well trained and competent staff team and they are being protected by there being a robust recruitment process in place. Evidence: In the AQAA we are told that there is a stable staff team with diverse life experiences and with a good skills mix to support people. From looking at staffing rotas and talking to the staff on duty we saw that that the staffing rotas are flexible to meet service user needs. There are two to three people on the early shift as most people go out to some form of day care and there are three staff in the afternoon and evenings with one person awake at night. We asked what this person would do if there was an emergency during the night and we were told that there is a on call system in place. One staff member comes on duty at 12:00 to support a service user with their lunch time meal and another supports a person at day care. We looked at the records for four members of staff including two who had recently been recruited and this showed us that a robust recruitment process is carried out. All of the files had the required documentation such as references and a current Criminal Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Bureau Check (CRB) in place and we saw that gaps in employment history were explored at interview. All new staff undergo an in-house induction and a formal induction in line with Skills for Care and we saw completed work books on file. During their probation period new staff undertake mandatory training such as first aid and food hygiene and we also saw that there is a programme of training in place that includes learning disability awareness, epilepsy care, core values and equality and diversity awareness. At the present time most staff training records are on the homes computer and on a training matrix and we were told that the organisation is currently producing individual training plans that will be kept on staff files. We saw that there are regular staff meetings and there are also records of monthly supervision meetings that cover all areas of responsibilities and work practice. The staff members on duty at the time of the visit showed a very clear understanding of the needs of the people they are supporting and they treated people with respect, offering them choice. In a returned survey from a healthcare professionals we are told, the home offers a client centred approach. A returned survey from a staff member said, with the right support and interventions the service users have become successful adults, they have a different way of learning but we identify with their strengths and talent and encourage them to develop. Care Homes for Adults (18-65 years) Page 22 of 27 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 new manager has the skills and qualifications to manage a home for people with learning disabilities, there are systems on place to monitor the quality of care being provided in the home and health and safety issues are being addressed. Evidence: In the AQAA we are told that the new manager of the home has previous experience of working with people with a learning disability and holds NVQ 4 and the Registered Managers Award. The manager was on leave at the time of the visit but from information in correspondence and in the Regulation 26 visits reports we saw evidence that the manager has started the process to be registered by the Commission. The staff on duty were complimentary about the skills and management style of the manager and comments included, the manager is very strict about things being done correctly and he is very client centred, even small occurrences are recorded and discussed at staff meetings in order to minimise risk to service users and staff and the manager is very good and he helps out and is not always in the office. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: From looking at records we saw that there are monthly Regulation 26 visit carried out in order to monitor the service. Detailed reports are produced with areas for improvement identified and timescales given for action to be taken. There is an organisational quality assurance process that is undertaken annually and there is also a three monthly quality audit carried out on identified standards in the home. We saw that service users, families and other stakeholders in the home are involved by the use of surveys, outcomes have been collated and used to inform a development plan for 2009. records show that the views of service users are gained by key worker meetings and service user meetings and there was pictorial guidance in the home for a local advocacy service. We looked the system of money management for service users in the home and saw the records of two people. At the present time a senior member of staff has been designated as the appointee for people but we were told that the organisation is currently looking at a different system for the management of service user monies. The records we tracked were up to date with all transactions being recorded, receipts were held on the service users file and the monies kept matched records. We looked at how incidents, accidents and health and safety are managed in the home a saw that risk assessments, both personal and environmental were in place and that regular checks such as fire and equipment safety are undertaken and recorded. There was guidance for infection control, staff had the equipment they needed and sanitising hand gels were in use. No Requirements were made at the key inspection visit. Areas identified that would improve the service being offered in the home are the registration of the new manager with the Commission, staff training records being on individual files so that they are easier to track and a more independent way of managing service users monies to be put in place. Care Homes for Adults (18-65 years) Page 24 of 27 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 27 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 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 26 of 27 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 27 of 27 - 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!