Care Home: 26 Shakespeare Road

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What the care home does well This home ensures that peoples needs are assessed prior to them being offered the opportunity to visit the home or move in on a trial basis. Peoples care plans are based on the assessment process and are holistic. Care plans and care records are reviewed on a regular basis and contain the guidance that staff to follow to ensure the support they provide is safe. People who live here are supported to make their own choices and live the lifestyle they choose. People are able to participate in the running of the home and are responsible for doing their own laundry. What has improved since the last inspection? Since the last inspection improvements have been made in relation to how people receive their medication. People are now receiving their medication as prescribed by their General Practitioner (GP) and medication records are now accurately maintained. Daily auditing of medication now takes place and there is a robust system for checking in medication that has been ordered from the pharmacy. Guidance is now in place for staff to follow when administering peoples `as and when` or `PRN` medication. Improvements have been made in the number of staff who have completed mandatory training and the majority of staff have now received all the training they are required to or have been booked onto courses. Improvements have been made to staff personnel files which are now kept at the home. All permanent staff have 2 forms of ID on file. What the care home could do better: Not all staff that administer medication have had an assessment in respect of their competency to do so. The registered provider must ensure that only staff who have been assessed as safe to do so administer medication. The registered provider must ensure that two forms of identity are obtained for every person employed to work in the home. The registered provider must ensure that all staff, including bank staff, receive mandatory training and the specialist training, such as diabetes care and management, that they need so that they can provide safe support to the people who live in the home. All staff, including bank staff must complete all their mandatory training. The registered provider must ensure this takes place within the timescales given. The registered provider must ensure that all staff, including bank staff, who regularly work in the home must receive supervision on a regular basis and a minimum of 6 times a year. Key inspection report Care homes for adults (18-65 years) Name: Address: 26 Shakespeare Road 26 Shakespeare Road Worthing West Sussex BN11 4AS     The quality rating for this care home is:   one star adequate 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: Elaine Green     Date: 2 3 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 26 Shakespeare Road 26 Shakespeare Road Worthing West Sussex BN11 4AS 01903230029 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): psmith@sussexoakleaf.org.uk www.sussexoakleaf.org.uk Sussex Oakleaf Housing Association Ltd Name of registered manager (if applicable) Mrs Phillipa Smith Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home 26 Shakespeare Road is a care home registered to provide accommodation and personal care for up to eight persons with mental disorders. The home currently accomodates eight people who are between fifty and seventy years of age. The service is provided by The Sussex Oakleaf Housing Association Ltd for whom the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 2 3 0 2 2 0 0 9 Brief description of the care home Responsible Individual is Mrs Tracey Faraday-Drake. The registered manager, Ms Philippa Smith, commenced Maternity Leave on the 4th January 2010. A newly recruited manager has been appointed to manage the home until the registered manager returns in January 2011. The property consists of a large semi-detached house in a residential area of Worthing with local shops and other amenities such as the seafront and beach within easy walking distance. The fees charged range from £668 to £798 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: An Unannounced visit was made to this home over a 4.5 hour period on the 23rd April 2010. Before the visit to the home we looked at all the information we have received from the them. This information included an Annual Quality Assurance Assessment (AQAA) which is a document completed by the home. This document gives the home the opportunity to say what it does well and provide evidence of that. It also gives them the opportunity to say what they feel they could do better and what their future plans are, how it dealt with any complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of the people who live at the home, their relatives and staff who work at there. The recently recruited manager facilitated this inspection. Care Homes for Adults (18-65 years) Page 6 of 28 We looked at information about the people who live at this home and how well their needs are met. We looked at other records that must be kept and checked that staff had the skills, knowledge and training to meet the needs of the people they support and care for. We also looked around the office and saw the equipment and facilities staff have access to. We sent surveys to all the people who live at the home and 5 completed forms were returned to us. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Not all staff that administer medication have had an assessment in respect of their competency to do so. The registered provider must ensure that only staff who have been assessed as safe to do so administer medication. The registered provider must ensure that two forms of identity are obtained for every person employed to work in the home. The registered provider must ensure that all staff, including bank staff, receive mandatory training and the specialist training, such as diabetes care and management, that they need so that they can provide safe support to the people who live in the home. All staff, including bank staff must complete all their mandatory training. The registered provider must ensure this takes place within the timescales given. The registered provider must ensure that all staff, including bank staff, who regularly work in the home must receive supervision on a regular basis and a minimum of 6 times a year. Care Homes for Adults (18-65 years) Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into this home undergo a full needs assessment prior to moving in. People are able to visit the home and stay on a trial basis prior to making a decision as to whether the home is right for them. Evidence: We looked at the care records relating to the recent admission of someone to the home. These records confirmed that there is a comprehensive assessment process in place. People are first visited and assessed to ensure the home can meet their needs. Information is sought from health professionals and social workers and this information is drawn together to form the basis of a care plan. People are invited to visit the home to determine the suitability of the home for them and the other people who live there. People are admitted on a trial basis and reviews are held regularly with the person so that any potential problems are identified as soon as possible and changes made accodingly. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at this home are encouraged to be independent and make their own choices in relation to how they lead their lives and the support they receive. Evidence: The routines of daily living are discussed with people during the assessment and admission processes. Care plans illustrate that peoples preferences are catered for where possible. The care and support plans seen were holistic and had been written and developed with the input of the person. Each person who lives in the home has a key worker whom they meet with on a regular basis. The key worker ensures care records are maintained, up to date and accurate and are summarised monthly basis. The home encourages the individual to pursue activities of their choice and this is clearly seen in care plans and records. People are encouraged to be independent and shop and to cook for themselves where it has been risk assessed as safe to do so. Hot and cold drinks drinks are available throughout the day and the people who have their own cooking facilities are given the option each day whether to cook for themselves or Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: to have a main meal with the other people who live there. People who use the service have choice and control over their daily lives. Family involvement is encouraged and people can bring their own personal possessions into the home. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live the lifestlye they choose and are provided with food they enjoy. Evidence: The manager told us that the people who live at the home are given the opportunity to access the community. On the day we visited the home we saw people coming and going throughout the day. The home is within walking distance from the beach, town centre and local shop and care records confirmed that those who wanted to do access the community and were doing so on a regular basis. One person, who had very recently moved into the home, told us that they had been out on their own for the first time since they had moved in and were pleased to have found the local barbers, beach and local pub on their own. People are supported to access a variety of social and leisure resources in the community such as meals and drinks out in local pubs and coffee shops, attending the cinema, gym and various day centres. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Staff were heard encouraging people throughout the day to be as independent as possible and to choose how they spend their day. Staff told us about the different times of day that people like to get up, eat and go to bed. The people who live here do their personal laundry some independently and some with support from staff. They are also involved with some of the house work such as loading and unloading the dishwasher, vacuum the communal areas of the home, cleaning drinks area, cleaning toilets and empty bins. These chores are discussed and allocated out at resident meetings. Some people have their own cooking facilities and make their breakfast, lunch and snacks independently. The main meal of the day is in the evening and those people with their own cooking facilities and can choose whether to cook their own meal or to join everyone else for this meal. Should they want to eat with everyone they put their name onto the board so that staff are aware of the number of people eating. On Sundays everyone who live at the home chooses their food for the week from a set menu, there are two choice for each meal. People are then supported by staff to buy the provisions. Feedback from people in relation to the food they are provided with was positive. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to access health care professionals and people receive their medication as prescribed. Evidence: The feedback from people who live at this home was that they are happy with the health care and support they receive. People have access to health care professionals such as psychiatrists, dentists, opticians and chiropody and staff support appointments as needed. Records are kept of when someone attends an appointment and planned appointments are included in the daily planner so that staff are aware. We saw a member of staff administer medication, check and count tablets and complete the Medication Administration Records(MAR). The MARs seen on the day we visited the home were complete and accurate. Staff explained that medication that is on a repeat prescription is ordered and received on a monthly basis. The medication is checked upon receipt and if there are any errors then it is returned to the pharmacist to be corrected. Some medication is provided in blister packs which are colour coded and some is in individual packs. All the medicines that are in individual packs are counted everyday and records kept. Each persons individual medication is kept in a Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: box with their name on in the medication cupboard. Since the last inspection improvements have been made and records show that medication is now given as prescribed. Staff told us that the medication cupboard has moved from the lounge where there were many distractions into the staff sleeping in room. This helps them to focus on what they are doing. There are now guidelines in place for staff to follow in relation to when as and when or PRN medication should be given. Records show that where a General Practitioner (GP) has given verbal instruction for medication to be altered e.g. frequency changed, then this had been recorded on the MAR sheet. On the guidelines for one persons as and when or PRN medication it states that the GP had instructed that this person should take this particular PRN medication twice a day every day for a period of time. This amendment had been recorded on the MAR sheets and they confirmed that this medication had been administered as instructed by the GP. The manager informed us that this person was due a medication review and that this would include whether or not this medication would revert to being PRN or not and that following that review guidance for staff and the instructions on the MARs would be updated accordingly. We looked at the staff training records for the permanent staff and bank staff who administer medication and all of them have attended training in the administration of medication. However this training did not include an assessment of their competency. The management of the home had completed a competency assessment for all full time staff and the majority of bank staff. There was no evidence that the person seen administering medication on the day we visited the home had had their competency assessed but they were able to explain the medication administration procedures followed by the home and were observed to be following them. Following the inspection the provider did inform us that they had located records showing that competency assessments for this person had been completed by the then appointed manager in July 2009 and January 2010. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live here have access to a simple and accessible complaints procedure. The policies and procedures in relation to safeguarding people from harm are not always followed in a timely manner and this places people at risk. Evidence: When we visited the home we looked at the complaints procedure. This procedure is easy to understand and accessible within the home. It includes the contact details for the Care Quality Commission. The manager has introduced a complaints / compliments book which is kept in a communal part of the house. This has been used by some of the people who live here and the comments taken into consideration. The manager stated that most people make their views known to the staff if they are not happy about something and that usually any complaints are dealt with there and then. Since the last inspection the majority of the bank staff that are used by the home have had training in safeguarding vulnerable adults and which includes how to raise a safeguarding alert. Those staff who have not had this training within the last 12 months are booked onto a courses in April & June 2010 evidence of this was seen on the staff rota and a training plan. Since the visit to the home the home informed us that they have raised a safeguarding alert with the local authority in relation to an allegation made. Whilst it was appropriate for the home to raise an alert the manager had been aware of this Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: allegation for several days before an alert was raised. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is clean, hygenic and domestic in character. Evidence: Feedback on surveys is that people are happy with the home. On day of site visit invited into one persons own room. This was decorated in their own style and contained their personal possessions and photographs. While at the home we saw into the staff sleeping in room, the lounge, kitchen, stairways, hall, entrance, the managers office on the top floor and one persons own room. The home was clean tidy, free from odours and domestic in style. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes policies and procedures in relation to staff recruitment are now followed, however the lack of robust identity checks and the fact that not all staff have received all their mandatory training still places people at risk. Evidence: The registered manager has been on maternity leave since January 2010. A new manager has been appointed to manage the home from the beginning of April 2010 until the registered manager returns to work in January 2011. This home employs five permanent full time staff members, two of which are seniors and one manager. In addition to this they also have five bank staff with which to cover their rota. The rota is made up of one person sleeping in at night and two people on duty during the day. At the last inspection of the home in January 2010 the home was using bank staff on a regular basis to cover up to ten shifts per week. At the site visit on the 23rd April the staff rotas showed that the number of shifts covered by bank staff has reduced week on week and that for the next few months the home plans to cover two or three shifts a week with bank staff. At the last key inspection of this home shortfalls were identified in relation to staff training and a requirement was made that staff, including the registered manager, Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: have mandatory training and updates as needed, including moving and handling, food hygiene and safeguarding, additionally it was required that staff receive training on diabetes care and management. As the registered manager is now on maternity leave and the timescale set by which all staff must have received this training was the end of May 2010, it was not possible to fully assess whether or not this requirement had been met. However shortfalls were identified in relation to training and a new requirement has been made with a new completion date set. We looked at the staff training files for the permanent staff and the bank staff who have worked unsupervised in the home since January 2010. These records confirmed that the majority of staff have attended all the mandatory training and refresher courses within the timescales required. Where there were gaps, for example some people had not had moving and handling refresher training since March 2009 and some people were yet to have diabetes awareness training, these courses had been booked for April and June 2010 and staff were showing on the rota as coming in to work that day for training. None of the people who currently live in the home require staff to assist them in moving and handling however all staff should still receive annual training or refresher training. At the last key inspection we found that only one of the five permanent staff files contained any proof of identity (ID) and none of the five bank staff files contained any form of ID. At this site visit we looked at the recruitment files for all members of staff and can confirm that there is evidence that all the required ID and security checks have been completed for permanent members of staff including two forms of ID one of which is photo ID such as a passport or driving licence. However, for most of the bank staff including those who regularly cover shifts at the home and sometimes work unsupervised whilst sleeping in, there was only one form of ID present. since this inspection the provider has informed us that all staff employed by the home now have two forms of ID present. We looked at the frequency that all members of staff including bank staff who regularly provide cover at the home, receive supervision. These records confirmed that none of the staff employed have been receiving supervision on a regular basis nor were they on track to receive it the minimum of 6 times per year. We spoke the the manager about this who told us that although they had only been in post for 2 weeks they had already started putting together a schedule for all staff to receive supervision and met with some staff. We saw evidence to confirm that some supervisions had taken place and that issues relating to medication and training had been discussed at these meetings. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Albeit the management and administration systems recently adopted by this home ensure that people are better protected, shortfalls identified continue to place people at risk. Evidence: As stated in the previous section of this report the registered manager is on maternity leave and due to return to work in January 2011. A person who has experience in managing a care home for younger adults has been recruited to manage the home until that time. We discussed the shortfalls identified at the last inspection with the appointed manager. The manager explained to us what improvements have been made so far in relation to medication, staff personnel files and staff training and these improvements are referred to throughout the report. However in order to protect people from harm and abuse further improvements are still needed. The manager told us that various quality audit systems were in place to enable the Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: people who live in the home and those who work there are able to make their views known. Regular meetings are held for staff and for the people who live in there. Records confirm that these meetings take place. The manager told us that one designated member of staff is responsible for completing health and safety checks and another is responsible for fire safety. In addition to the daily medication checks the manager and a senior member of staff also complete medication audits weekly. Since the last inspection in January 2010 Regular reports in line with Regulation 26 of the Care Home Regulations have taken place at the required monthly intervals. These reports were seen. They showed evidence that internal and external fabric of the building and the lifestyle and choice of the people who live in the home had been looked at as well as the shortfalls identified at the last inspection in relation to staff files, staff rota, staff training and medication records. We looked at the system used by the home to support people with their finances and this is safe. The home has the policies and procedures in place to ensure the health safety of welfare of the people who live and work at this home are protected, these are reviewed on a regular basis and updated as needed. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 18 The registered person must ensure that all staff who administer medicines have received medication training and this must include a competency assessment. To ensure that people are supported to take their medicines safely. 31/05/2010 2 23 12 The registered person must ensure that information in relation to allegations and concerns are shared with and passed onto the local authority to investigate without delay. To ensure that the people who live in the home are protected from harm and abuse. 31/05/2010 3 34 19 The registered person must ensure that 2 forms of identity are kept on file for each person employed to work a the home. 31/05/2010 Care Homes for Adults (18-65 years) Page 26 of 28 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action To protect the people who live at the home form harm and the risk of abuse. 4 35 18 The registered person must ensure that all staff, including bank staff, receive mandatory training and the specialist training such as diabetes care and managment, they need to support the people who live in the home. To ensure that staff have the skills they need to support people safely. 5 36 18 The registered person must ensure that all staff including the manager and bank staff who regularly provide cover in the home receive supervision a minimum of 6 times a year. To ensure that the support provided by staff is safe. 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 30/06/2010 30/07/2010 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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