Care Home: 1a West Avenue

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What the care home does well Staff are friendly to the people living there and show that they can meet their individual needs. People are well dressed in clothes that are suitable to their age, the weather and the things they do. Staff have received training that helps them to meet the needs of the people who live there. The people who live there are helped to make choices and decisions about their lives so that they have some control about things that are important to them. Medication systems are good and ensure people get the medication they need to be well. Staff get good support so they know how to do their job and help the people who live there. What has improved since the last inspection? Monthly reports are written by the person`s key worker so it is clear how they are being helped to achieve their personal goals. People do more activities that they enjoy. The people living there now get the benefits they are entitled to so they have the money to spend on the things they need. What the care home could do better: People must be offered a nutritious and balanced diet so that they can be helped to keep well. Repairs to the home must be done quickly to make sure the home is safe for people to live in. More staff must be recruited so that the people living there always know the staff that are working with them. The service users guide should be available at all times so that people have the information they need about the home. The people who live there have not had the opportunity to go on holiday. This should be arranged for people who would like to go. There should be more staff meetings so that staff know what is happening in the organisation and how to meet people`s changing needs.Staff should be able to attend the training they need so they know how to help the people living there to meet their needs and be safe. A representative from Accord should visit the home monthly and write a report of their visit. This will help to make sure that things are done so that the home is run well and better for people to live in. Staff should check that people are not at risk of being scalded by the hot water. They should report to the maintenance team if the water is too hot. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1a West Avenue Castle Bromwich Birmingham B36 0EB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Bennett     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 1a West Avenue Castle Bromwich Birmingham B36 0EB 01217484274 01217481645 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Accord Housing Association Ltd care home 3 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 3. The registered person may provide the following category of service only: Care Home Only (Code 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) 3 Date of last inspection Brief description of the care home 1a West Avenue is a modern bungalow situated in a residential area of Castle Bromwich in Solihull. The home provides a service to three adults with a learning disability all of whom are male. The home has a large lounge with patio doors to the garden, separate dining room and kitchen. There is a smaller separate lounge. Two bedrooms have an en suite toilet and one has an en suite bathroom. A shared bathroom is available also. The home is set in spacious grounds. Shops, places of worship and public transport are situated within walking distance of the home. The manager said that the fees charged are stated in the service users guide as 135 pounds per week payable to Accord. Other fees of the local contract price are paid by the persons placing authority to the Provider. The CSCI inspection report is available in the home for visitors to read if they wish to. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Care Homes for Adults (18-65 years) Page 5 of 30 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: The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. The visit was carried out over one day. The home did not know we were going to visit. This was the homes key inspection for the inspection year 2008 to 2009. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Care Homes for Adults (18-65 years) Page 6 of 30 Prior to the fieldwork visit taking place a range of information was gathered to include notifications and the Annual Quality Assurance Assessment (AQAA) that provides information about how they think they are meeting the regulations. Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The people living there, the manager and the staff on duty were spoken to. As the people living there are not all able to give their views of the home because of their needs time was spent observing care practices, interactions and support from staff. We looked around the home. Care, staff and health and safety records were looked at. What the care home does well: What has improved since the last inspection? What they could do better: People must be offered a nutritious and balanced diet so that they can be helped to keep well. Repairs to the home must be done quickly to make sure the home is safe for people to live in. More staff must be recruited so that the people living there always know the staff that are working with them. The service users guide should be available at all times so that people have the information they need about the home. The people who live there have not had the opportunity to go on holiday. This should be arranged for people who would like to go. There should be more staff meetings so that staff know what is happening in the organisation and how to meet peoples changing needs. Care Homes for Adults (18-65 years) Page 8 of 30 Staff should be able to attend the training they need so they know how to help the people living there to meet their needs and be safe. A representative from Accord should visit the home monthly and write a report of their visit. This will help to make sure that things are done so that the home is run well and better for people to live in. Staff should check that people are not at risk of being scalded by the hot water. They should report to the maintenance team if the water is too hot. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People do not have all the information they need available to them at all times so they know what the home provides and the terms and conditions of their stay. Evidence: The statement of purpose included the relevant and required information so that people have the information they need to make a choice as to whether or not they want to live there. The service users guide was not available as it had been borrowed by a colleague. At the last inspection it included the relevant information and was produced using pictures making it easier to understand. The manager said that no changes had been made to it since then as the information was still relevant. It should always be available in the home so that people have the information they need. The people living there have lived there for a number of years. There have been no people admitted so the standard relating to assessment of peoples needs before they Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: move in was not looked at. Care Homes for Adults (18-65 years) Page 12 of 30 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. Staff have the information they need so they know how to support individuals to meet their needs and achieve their goals. Evidence: The records of two of the people living there were looked at. These included an individual care plan. The care plan detailed how staff are to support the individual to meet their needs and achieve their goals. Care plans had been reviewed monthly and where there were changes to the indivduals needs they were updated so that staff knew about these. The people living there are unable to verbally communicate. Care plans showed how the individual communicates using gestures, facial expressions, sign language and by taking staff to what they want. Some people use objects of reference which are everyday objects such as a cup to indicate that the person wants a drink. The objects that people use and what they mean for that individual were detailed in their records. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: The Speech and Language Therapist had been working with individuals. This helps staff to communicate effectively with the person so they could make their needs known so helping to reduce their frustration. Records sampled showed that as much as possible people are able to make choices in their everyday lives. This may be limited due to their needs but people choose what they wear, what they eat and drink and whether they go out or stay in. Each person has a team of key workers allocated to them. They have responsibility for ensuring that the care plans are updated and ensure all staff know how to support the individual. Key workers complete a monthly report on the person to show what they have been doing, how they are making choices and decisions about their life and what, if anything needs to happen to make their life better. Records sampled included individual risk assessments. These detailed how staff are to support the individual to be as independent as possible and take risks whilst minimising any harm to their safety and well being. They included what support the person needed to go out in the community. For example one person who has a phobia of dogs needs more support when out in the community because if they see a dog they will run. This is likely to be a high risk to their safety as they have limited sense of road safety. The risk assessment detailed what staff need to do to minimise these risks. Care Homes for Adults (18-65 years) Page 14 of 30 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. The people living there experience a meaningful lifestyle. They are not offered a healthy diet which could impact on their health and well being. Evidence: Records sampled showed that people are supported to take part in activities they enjoy in the home and the community. Records showed, it was observed and staff said that activities within the community can sometimes be limited if there are not enough staff on duty. Two people need two staff to support them when out and one person needs three staff. At the beginning of the visit as one staff was off sick there were only three staff on duty so it was not possible for people to go out. When the manager came in staff took one person out shopping and for a walk by the canal. The manager said and records showed that people had attended college courses in the Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: past but these had now ended. They are looking at other courses that people may benefit from and enjoy in the future. Last year people did not go on holiday because of lack of staffing to support them. The manager and staff said that they plan to make it a priority for people to go on holiday this year if they want to. Records sampled showed, it was observed and staff said that people are supported to keep in contact with their family and friends. This may be through visiting them, telephone calls, visits to the home from family and sending cards and presents for special occasions. This ensures that people can maintain relationships that are important to them. Records sampled showed and it was observed that people take part in household tasks including doing their laundry, cleaning their bedroom and communal rooms, gardening and clearing up after meals. This helps people to be as independent as possible and take part in the running of their home. Food records and menus sampled did not show that people are always offered a healthy diet. One persons records indicated that they had gained weight over recent months. The manager said that staff try to ensure that the person does not eat too many fatty or sugary foods. However, their food records showed that they often eat chips, pies, pastries and cakes. They did not have the recommended five portions of fruit and vegetables each day to ensure they have a healthy diet. This remains outstanding from the last inspection and needs to improve to ensure the health and well being of the people living there. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living there are supported to meet their health needs so ensuring their well being. Evidence: The people living there were dressed appropriately to their age, gender, cultural background and the activities they were doing. Care plans stated how people are to be supported with their personal care. This included how much the person can do for themselves so they can be encouraged to be as independent as possible. Care plans included how staff are to support the person to be well and meet their health needs. As part of the Governments White Paper on Valuing People all people who have a learning disability should have a Health Action Plan. This is an individual plan about what staff need to do to support the person to meet their health needs and access healthcare services. This was not a separate plan but the information in care plans included the information staff need to support people to meet their health needs. Records sampled showed and staff said that health professionals are involved in Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: individuals care where appropriate to ensure that staff have the advice they need to know how to support people to be well. Records sampled showed that each person is registered with a local GP. Staff take people to see the GP if they are unwell and follow any advice given. People have regular dental and eye checks and where needed have regular appointments with a chiropodist. Medication is stored securely so that people do not have access to medication they are not prescribed which may cause them harm. Boots supply the medication in pre packed blister packs. This helps staff to know what to give each person and when so helping to reduce any errors. Staff said that only staff who have received training in medication can give it to people. Two staff give out medication so they can double check that they are giving the right medication to the right person. Some people are prescribed as required (PRN) medication. For each medication a protocol signed by the GP was in place that stated when, why and how much of the medication should be given. This helps to ensure that people are given only the medication that they need and it is not over used. Staff had signed Medication Administration Records appropriately when they had given people their medication indicating that it had been given as prescribed. Care Homes for Adults (18-65 years) Page 18 of 30 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. Arrangements ensure that the views of the people living there are listened to and that people are safeguarded from abuse and harm. Evidence: The complaints procedure of the South Birmingham Primary Care Trust and Accord were available in the home. This helps to ensure that the people living there and their relatives know how to complain if they are unhappy with the service provided. The AQAA stated and the manager said that they have not received any complaints since our last inspection. We have not received any complaints about the service since then. Records sampled included information in an easy read, picture format about how the person is safeguarded from abuse and harm. Staff training records sampled showed and the manager said that all staff have received training in safeguarding. This helps staff to know how to safeguard the people living there from abuse and what to do if they suspect abuse is happening so that action can be taken to keep people safe. The finance records of two people were looked at. Each person has their own bank account that their benefits are paid into. Records showed that people spend their money on personal items not on things that should be provided by the home as part of the fees they pay. Receipts are kept on everything that peoples money is spent on and these cross referenced with the record. Monies are held securely in the home. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Staff check each persons money at the handover of each shift to make sure it is kept safe. The people that live there can display behaviour that others may find difficult to manage. Records sampled included care plans on how to manage individuals behaviour so that the risks of harm to themselves or to others is reduced. Records sampled showed that staff follow these plans so that people do not become frustrated or agitated because staff have not communicated with the person in the right way. Throughout the day the people living there were observed to be calm and relaxed in their home and with the staff supporting them. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people live in a comfortable, clean and safe home that meets their individual needs. Evidence: There is a lot of communal space in the home including a lounge, smaller lounge, snoozelen (sensory) room, dining room and kitchen. This means that people can spend time away from others if they want to. The home was well furnished in contemporary style that reflected the age of the people living there. Some of the decoration was looking worn. The manager said that it is planned for the home to be redecorated in the next financial year. A new kitchen had been fitted since the last inspection. Repairs had been made to the roof and the manager said this is to be replaced in the next financial year. Each person has their own bedroom. Two people have their own toilet and wash hand basin and there is a separate bathroom they can use. One person has their own bedroom, separate sitting room and their own bathroom. Bedrooms were personalised and reflected the tastes and interests of the individual. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The manager and staff said that some repairs can take time. It was worrying that a repair to a fire door had been reported at the beginning of December 2008 but was only completed the day before. The issue of waiting a long time for repairs to be done was raised at the last inspection and must improve to ensure the safety of the people living there. The home was clean and the people living there are involved in this so helping to develop their independence skills. There were no offensive odours making it comfortable for people to live in. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangements for staffing, their support and development are variable which could impact on the well being of the people living there. The recruitment practices ensure that the people living there are protected from harm. Evidence: The AQAA stated that all staff have completed or are currently doing National Vocational Qualification (NVQ) level 2 or above in Care. One support worker is doing NVQ 3. The two senior care staff are doing NVQ level 4. This exceeds the standard that at least half of the staff team have this qualification so ensuring that staff have the skills and qualifications to meet the needs of the people living there. At the start of the visit there were three staff on duty as one member of staff had phoned in sick. Staff said there are usually four staff on each shift and with only three staff the people living there are not able to be supported safely in the community. The manager was on annual leave but came in so that there were sufficient staff on duty. Staff work 12 hour days and said that this allowed the day to be flexible as they could go out with people and not need to get back for the handover to the next shift. The manager said that there are vacancies for 3.4 staff. As the home is changing over Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: to being owned solely by Accord the PCT are not recruiting to the vacancies. Until the changeover has taken place Accord cannot fill the vacancies. Bank and agency staff are used to cover vacancies. Sometimes permanent staff work extra hours as bank shifts to cover. This with using the same bank and agency staff helps to minimise the disruption to the people living there. Records showed and the manager said that regular staff meetings have not taken place. The manager said that staff are regularly supervised and this helps to keep them informed of changes to individuals needs and within the organisation. Staff supervision records sampled showed that staff had regular formal supervision with their manager. The quality of the recording of these was very good and showed that staff are supported in their role. However, regular staff meetings will give staff an opportunity to discuss as a team how they are meeting individuals needs and support each other in their role so helping to provide consistency to the people living there. The records of three of the staff who work there were looked at. These included the required recruitment records including evidence that a satisfactory Criminal Records Bureau check had been doen to enure that suitable people are employed. Staff records sampled included evidence of the training they have done. These showed that staff had generally received the training they need to meet the needs of the people who live there. Some staff needed updated training in minimising confrontation and risk asssessment as they had done this several years ago. The manager said that it is difficult to get staff booked on training because of the changeover to Accord. Given the needs of the people living there if the changeover is not as quick as proposed then staff should be able to do this training so they are updated and can meet individuals needs. Care Homes for Adults (18-65 years) Page 24 of 30 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. Arrangements generally ensure that the people living there benefit from a well run home and their safety and welfare is promoted and protected. Evidence: The manager has many years experience of working with people who have a learning disability. He is a qualified learning disability nurse and has NVQ level 4 in Management and Care. The manager said he is currently doing the Registered Managers Award. As stated earlier in this report Accord are to be the sole provider as South Birmingham Primary Care Trust are withdrawing as the provider. This has been delayed due to legal isssues. This has caused anxiety to staff and difficulties in knowing who is responsible for the monitoring of the service and some budgetary issues which could affect the home being well run. A representative from Accord has visited the home to monitor the service provided although this has not been monthly and should be to ensure the home is being well run. Recently a representative from the PCT undertook a Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: quality assurance audit at the home and the report of this will be made available to Accord so they know which areas need to improve. All staff have completed first aid training and nine staff have completed a four day course in this so they have a lot of knowledge of how to deal with any accidents to keep people safe. Fire records showed that staff regularly test the fire equipment to make sure it is working. A fire officer from the PCT had recently visited to update the fire risk assessment. This ensures that staff know what action is needed to minimise the risks of there being a fire. There are regular fire drills so that staff and the people living there can practice what they would need to do if there was a fire. Staff test the water temperatures weekly to make sure that they are not too hot , which could put people at risk of being scalded. Records showed that in the last two weeks some temperatures were hot and could result in people being scalded. The manager telephoned the maintenance team to report this and ask for an engineer to visit to adjust the temperatures. However, staff should monitor these temperatures as they record them and report to the maintenance team. Staff test the temperatures of the fridge and freezer daily to make sure they are within the recommended temperatures for storing food safely. Records show that these were within the recommended limits so helping to reduce the risk of food poisoning. Care Homes for Adults (18-65 years) Page 26 of 30 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 30 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 17 12 The people living there must 31/03/2009 be offered a healthy and nutritious diet. To ensure their health and well being. 2 24 13 Repairs must be dealt with promptly. So that people are safe. 28/02/2009 3 33 18 Staff must be recruited to fill 31/05/2009 the vacancies. So that the people living there are supported by staff who know them well. 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 1 A copy of the service users guide should be available in the home so that people know what the home provides and the terms and conditions of their stay. The people living there should have the opportunity to go on holiday so they can experience new places and do things they enjoy. Page 28 of 30 2 14 Care Homes for Adults (18-65 years) 3 33 Regular staff meetings should be held so that staff know how to meet the changing needs of the people living there and can be kept updated with best practice. Staff should receive the training they need so they know how to support the people living there. A representative from Accord should now visit the home monthly and make a report of their visit. This will ensure that they are monitoring the service provided so that the people living there can benefit from a well run home. Staff should monitor the water temperatures as they record them and report where necessary to the maintenance team to ensure that people are not at risk of being scalded. 4 5 35 39 6 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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