Care Home: 27 Graham Avenue

Similar services:

• Insight - Eastchurch
• Southfields
• Thorndene
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well The comfortable, relaxed and welcoming environment has evolved over several years and reflects the general stability and commitment within the staff team and the open and inclusive management style. Through working closely and consistently with service users, staff have developed a sound understanding of their individual care and support needs. Service users are encouraged and supported to make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. The acting manager and care staff continue to be supported and valued by the senior management. What has improved since the last inspection? The recent appointment of a competent and experienced member of staff from within the organisation, as the acting manager of the home, is welcomed. What the care home could do better: An accurate and updated Statement of Purpose must be developed and implemented, to include current information about the service,including revised manager details. Before moving in to the home, any prospective service user must undergo a full assessment of their care and support needs, carried out by someone competent to do so. Service users` individual care plans, including risk assessments, must be kept under regular review and updated to reflect any changing needs and circumstances. There must always be sufficient, suitably experienced staff on duty within the home to meet the care and support needs of the service users. A suitably experienced and qualified person must be registered as manager of the service. The current quality assurance system must be improved and extended by seeking the views of service users` relatives, stakeholders and other visitors to the home. It is hoped that with the acting manager`s evident commitment to raising standards and ultimately improving outcomes for service users, these acknowledged shortfalls will be addressed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 27 Graham Avenue 27 Graham Avenue Brighton East Sussex BN1 8HA     The quality rating for this care home is:   one star adequate 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: Nigel Thompson     Date: 0 7 0 5 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. 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. 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 31 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: 27 Graham Avenue 27 Graham Avenue Brighton East Sussex BN1 8HA 01273503058 01273552626 admin@rogate.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hallcreed Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home 27 Graham Avenue is registered to accommodate up to four people with a learning disability; it does not provide nursing care. The home is situated in a pleasant residential area of Brighton close to local shops and pubs. It is convenient for bus services into Brighton and other areas, and Preston Park train station is also nearby. The building is a three-storey semi-detached property with large rooms and has a patio area with a barbecue in the long rear garden. Residents have the use of a large lounge, a kitchen/dining room and a music room. They also have the advantage of the use of a hydrotherapy pool at one of the other properties owned by Hallcreed Ltd. Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home There is ample free parking in the road outside the home. Information about the service, including the Statement of Purpose, Service Users Guide and CQC reports is made available to prospective service users or their relatives, on request, as part of the admission process. The current range of fees at 27 Graham Avenue, as of May 2009, is £90.40 - £120.00 per day. Care Homes for Adults (18-65 years) Page 5 of 31 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection took place over five hours in May 2009. It found that many of the key National Minimum Standards that were assessed had not been met or only partially met and the overall quality of care provided was adequate. The home itself was evidently going through an unsettled, transitional period, with the previous registered manager having stood down, since the last inspection, and been replaced by an experienced member of staff from within the organisation. Care Homes for Adults (18-65 years) Page 6 of 31 The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were three service users living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the homes records and discussion with the recently appointed acting manager. Information about the service, contained in the recently completed Annual Quality Assurance Assessment (AQAA), has also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. 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 set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 31 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 31 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 31 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. The admission policy and procedure, although in some need of updating, ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users do not always have the accurate information they need to make an informed choice. Evidence: According to the acting manager there have been no new admissions at 27 Graham Avenue since 1998. There is currently one vacancy, although there has evidently been no pressure from the head office to move someone in. A service user currently living in another home within the group has been identified as a possibility, although the acting manager added that before anyone is admitted they wouild need a full assessment to ensure that their needs could be met. He also emphasised the importance of compatibility with existing service users, however he was unable to provide an appropriate asesssment form to be used. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: The acting manager confirmed that any prospective service user would have the opportunity to visit the home, to look around and meet with existing residents and staff. Information provided for existing and potential service users, including the Statement of Purpose and Service User Guide was examined. It was noted that, in view of the variable and limited communication of people living in the home, the Service User Guide has been thoughtfully and imaginatively produced and information made more accessible with the use of pictures and symbols. As discussed, the Staement of Purpose clearly needs reviewing and updating to acuurately reflect the current situation within the home. It is also important that, in line with many other of the homes policies (some have evidently not been reviewed since 1997), the admission policy and procedure is reviewed and updated Care Homes for Adults (18-65 years) Page 12 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cumbersome and disorganised care plans mean that the individual support needs of service users are not met in a structured and consistent manner and plans do not always reflect their changing needs. Service users are treated with respect and encouraged and enabled to make decisions about their day-to-day living. Evidence: The acting manager has not been in post for long and readily acknowledged the shortfalls in the care planning systems within the home. He confirmed that it is a priority for him and remains very much work in progress. All three service users individual care plans were examined and it was evident that, despite previous concerns, little has changed or improved since the last inspection. Information is currently held in at least threee separate files, in different locations in the home. As discussed, it is recommended that this information be amalgamated and Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: service users care plans made more person centred, organised and structured, making information more readily accessible. In service users individual care plans that were examined it was evident that plans, including risk assessments, are also not being kept under regular review and updated to reflect changing needs and circumstances. The acting manager confirmed that, despite the variable and limited verbal communication of service users, effective and regular interaction and consultation continues to take place constantly throughout the home. This is evident from direct observation of staff supporting service users in a professional, sensitive and respectful manner. Care Homes for Adults (18-65 years) Page 14 of 31 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. Service users are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. Evidence: The acting manager confirmed that, where appropriate, service users family links continue to be encouraged and supported. One service user has weekly contact with their family and regular contact is maintained with the family of another. Visiting to the home is largely unrestricted and relatives and friends continue to be made welcome at any reasonable time. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: As previously documented, despite the limited and variable communication skills of service users, staff have evidently worked closely and sensitively with individuals to develop effective levels of interaction. The recreational and leisure interests of service users are identified and recorded in their individual care plan and they continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Activities and facilities regularly accessed by service users include attending a local day centre, various trips out, swing ball, swimming and a variety of other leisure activities. Although service users continue to be supported to access such activities and facilities, the continued minimal staffing levels inevitably impact on the social opportunities available for individuals. This was evident from examination of the staff duty rota that indicated on occasions, including weekends, only one member of staff was on shift. The acting manager confirmed that menus are varied and balanced and are based on service users identified likes and preferences. An alternative to the main meal is always available and a copy of the menu is generally displayed in the kitchen. Service users are not generally involved in meal preparation. Care Homes for Adults (18-65 years) Page 16 of 31 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. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual care and support needs. Service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. Evidence: Staff have developed close working relationships with individual service users and are consequently aware of changes in mood or behaviour. The key worker system has been developed and implemented within the home. The acting manager confirmed that an individual Health Action Plan has been developed for each service user and is almost ready for implementation. Service users have the choice of using private facilites on their own or requesting assistance with their personal care. Documentary evidence was in place to demonstrate that the health and emotional care needs are continuing to be met within the home. All service users are registered with Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: local GPs and have access to other health care professionals, including district nurses, dentists, physiotherapists and chiropodists, as required. However it was noted, in care plans that were examined, that not all appointments with, or visits by, health care professionals are recorded. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. The acting manager confirmed that, following risk assessments, no service user currently self-administers their own medication. Care Homes for Adults (18-65 years) Page 18 of 31 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. The homes complaints procedure ensures that service users, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Service users are protected, through relevant staff training and policies and procedures relating to safeguarding vulnerable adults. Evidence: A copy of the homes complaints procedure is now in place in the entrance hall, for the benefit of service users relatives and other visitors to the home. Members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. For the benefit of service users living in the home, a simple illustrated complaints procedure has been developed, with the use of symbolls. It was noted that there have been no concerns or complaints recorded by the home since the last inspection. The organisation has produced detailed policies and procedures relating to adult protection and abuse, including a whistle blowing policy. However, as previously Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: documented, it is understood that, in line with many other polcies and procedures, these documents are currently being reviewed and updated, as part of a general overhaul of policies and procedures within the home. Staff are evidently made aware of relevant policies and procedures relating to abuse and safeguarding adults through their induction training. The acting manager confirmed that since the last inspection staff have undertaken specific adult protection training, in accordance with the multi agency guidelines for safeguarding vulnerable adults. This was evidenced through individual training records examined. Care Homes for Adults (18-65 years) Page 20 of 31 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 service is accessible, safe and clean and remains clearly suitable for its stated purpose. Service users benefit from all necessary specialist equipment and pleasant accommodation that is comfortable, well maintained and decorated to a satisfactory standard. Evidence: It is evident that there has been little change in the physical environment of the home since the previous inspection and standards remain satisfactory throughout. During my guided tour of the premises it was evident that the generally well maintained decor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for service users. The home also provides service users with adequate and accessible communal areas including a spacious lounge, a good sized kitchen diner, with a newly installed cooker and a music room. At the rear of the property is a patio area with a long well maintained garden. The acting manager confirmed that several maintenance people are employed by the Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: organisation to work across the homes, including a general handyman for repairs, a decorator, a gardener, an electrician and a plumber. The home continues to meet the requirements of the fire service and the environmental health department. The home has sufficient bathrooms and WC facilities for service users. One bedroom has an en suite bathroom. The acting manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of service users individual rooms, reflecting individual preference and interests. It was noted that infection control policies and procedures are in place and clearly adhered to. On the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory Care Homes for Adults (18-65 years) Page 22 of 31 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. There is not always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. Evidence: Despite previous concerns, there are evidently still issues remaining regarding the minimal staffing levels operated within the home and the potential impact that this has on the care and support of service users, as well as the inevitable affect on their social and recreational opportunities. This was confirmed by the actiing manager during the inspection. It is inevitable that when you are working on your own, people cant always go out individually, but we do have other staff who help out some eveinngs and weekends, when necessary. However this is clearly not being recorded effectively at present and certainly was not evidenced by the current duty rota, made available for inspection. This indicated that there is often only one member of staff on duty, both mornings and evenings, Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: particularly at weekends. As discussed with the acting manager, this situation is unsatisfactory and clearly does not always ensure that the assessed needs of service users are being met, or that their best interests are being served. Having worked in the home for some time he was aware that this was an ongoing situation but confirmed that it was being addressed. He added that despite recent changes more staff are currently being recruited, through the organisations head office. In addition to the comprehensive induction programme undertaken by all newly appointed staff, the acting manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This continues to be coordinated by the organisations trainig officer and was evidenced by individual staff training records examined. In accordance with company policy, the acting manager confirmed that formal supervision is now provided for all care staff on a regular basis. This was supported by individual supervision records, made available for examination. The organisation is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of service users. Individual files that were examined at the head office, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau and Protection of Vulnerable Adults disclosures. Care Homes for Adults (18-65 years) Page 24 of 31 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. Service users benefit from a competent and experienced acting manager and are protected by satisfactory health and safety procedures. Their best interests could be better safeguarded by improved quality monitoring systems. Evidence: The acting manager has extensive experience in the care and support of people with learning disabilities. He has been working for the organisation for 11 years and an application has recently been submittd to the CQC to register him as manager of the home. As part of the quality assurance system, the home continues to use a pictorial satisfaction feedback chart for service users to demonstrate how they are feeling about the service they receive. However there is still no evidence of feedback from service users relatives and stakeholders in the community being sought or formally obtained. The acting manager Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: confirmed that improved quality assurance systems are being developed but have yet to be implemented. The health, safety and welfare of service users and staff evidently remains of paramount importance within the home. The acting manager confirmed that a Health & Safety policy is in place. Staff training is provided in many aspects of safe working practices, including moving and handling, food hygiene, fire safety and first aid. This was also evidenced by staff training records that were examined. All portable electrical appliances are now regularly tested and risk assessments are carried out for all hazardous substances used in the home. The Heating system is regularly serviced and Legionella testing is carried out annually. In addition, window restrictiions have been fitted where necessary and the front door is security coded. Railings are in place for steps on to the patio and garden and there is a lock on the side entrance. COSHH assessments and guidelines are in place. Fire safety systems are appropriately reviewed and regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Care Homes for Adults (18-65 years) Page 26 of 31 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 31 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 1 4 It is required that an 31/07/2009 accurate and updated Statement of Purpose be developed and implemented. Inaccurate information including manager details. 2 2 14 It is required that, prior to moving in to the home, any prospective service user has a full assessment of their care and support needs, carried out by someone competent to do so. Outdated admission policy and procedure and no evidence of assessment tool. 31/07/2009 3 6 15 It is required that service 31/07/2009 users individual care plans be regualrly reviewed to reflect changing needs. In service users individual care plans that were examined it was evident that plans, including risk assessments, are also not being kept under regular Page 28 of 31 Care Homes for Adults (18-65 years) review and updated to reflect changing needs and circumstances. 4 33 18 It is required that, at all times, there are sufficient staff on duty to meet the care and support needs of the service users. The duty rota indicated there is often only one member of staff on duty, both mornings and evenings, particularly at weekends. It is required that a suitably experienced and qualified person be registered as manager of the service. Since the departure of the previous manager, there is currently no registered manager. 6 39 24 It is required that the current quality asurance system be improved and extended by seeking the views of service users relatives, stakeholders and other visitors to the home. There is still no evidence of feedback from service users relatives and stakeholders in the community being sought or formally obtained. 31/07/2009 31/07/2009 5 37 8 31/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of Care Homes for Adults (18-65 years) Page 29 of 31 improving their service. No. Refer to Standard Good Practice Recommendations 1 6 It is recommended that the currently disorganised information be amalgamated and service users care plans made more person centred, organised and structured, making information more readily accessible. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. Care Homes for Adults (18-65 years) Page 31 of 31 - 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!