Care Home: 33 Station Road

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What the care home does well The care home finds out what people need and write this down. Staff read these reports so that they can help people to keep healthy and as active as possible.People were helped to have interesting lives. Staff gave them individual attention and they were treated with respect.The care home`s policies and procedures kept people safe. Policies are rules about how to do things. Procedures tell people how to follow the rules.People were living in a comfortable, homely and safe environment.Staff have training so they understand how to meet people`s needs.The care home was well managed. People were safe and their rights were recognised. What has improved since the last inspection? New policies and procedures had been writtenMore staff had received training. What the care home could do better: All necessary records should be in place Some recording practices should be improvedStaff training should be improved Key inspection report Care homes for adults (18-65 years) Name: Address: 33 Station Road Brimington Chesterfield Derbyshire S43 1JU three star excellent service The quality rating for this care home is: 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: Anthony Barker Date: 0 8 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983   Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Information about the care home Name of care home: Address: 33 Station Road Brimington Chesterfield Derbyshire S43 1JU (01246)205801 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): None United Response Name of registered manager (if applicable) Mrs Valerie Raybould Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Date of last inspection 1 3 1 0 2 0 0 6 A bit about the care home 33 Station Road is a large semi detached house situated close to local amenities on a regular bus route to Chesterfield town centre. The Service has a large garden area that is accessible for the people living here. The accommodation comprises six single bedrooms, domestic style lounge and dining areas and adequate bathroom and toilet facilities. Care programmes are developed with each person and external specialist support obtained as required. The advanced age of several of the people living here has been assessed and necessary aids and adaptations provided. A shaft lift is also provided. 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: three star excellent 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 How we did our inspection: This is what the inspector did when they were at the care home The inspector visited without telling the care home before he arrived. The last key inspection at this care home was on 13th October 2006. We had asked the Manager to complete a questionnaire about the care home, before this inspection. We had asked other people to tell us what they think about the care home. 12 people sent us their views. We looked at what staff had written about two peoples lives. We also looked around the care home and at two bedrooms. We spoke with two people who live in the care home and we saw how staff treated people. We spoke to the Manager and to staff. The weekly fees at the time of this Inspection were £467 for each person living here. What the care home does well The care home finds out what people need and write this down. Staff read these reports so that they can help people to keep healthy and as active as possible. People were helped to have interesting lives. Staff gave them individual attention and they were treated with respect. The care homes policies and procedures kept people safe. Policies are rules about how to do things. Procedures tell people how to follow the rules. People were living in a comfortable, homely and safe environment. Staff have training so they understand how to meet peoples needs. The care home was well managed. People were safe and their rights were recognised. What has got better from the last inspection New policies and procedures had been written More staff had received training. What the care home could do better All necessary records should be in place Some recording practices should be improved Staff training should be improved If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Tony Barker CQC Citygate Gallowgate Newcastle Upon Tyne NE1 4PA Tel: 0300 061 6161 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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. Individual written needs assessments were in place before people were admitted to the Service so that their diverse needs were identified and planned for. Evidence: Three of the six people living at this Service had been admitted within the past 12 months. We examined the support records of one person we case tracked and found a comprehensive recorded assessment of their needs, made prior to their admission, completed by Social Services. This person had made two visits to the Service, before admission, and one over-night stay. The questionnaire completed by the Manager, before this inspection, stated that, we have been working with the people we support to choose three new tenants...the people we support have full involvement with this by using tenant matching tools. The Manager described this process to us - it includes the tenants describing the kind of person they think will fit in. We saw documented evidence of this process. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the Service had comprehensive and individual plans of care which demonstrated that their health, personal and social care needs were being met. They were being fully enabled to make decisions about their lives. Evidence: We examined the support files of both people we case tracked. They contained good quality records that were person centred, holistic, comprehensive and up to date. Peoples likes, dislikes, hopes and dreams were recorded. There was an excellent range of recorded support assessments relating to areas that included relationships, intimate & personal care, and social activities. Support/care plans were being reviewed annually, at person centred review meetings, and at intervening six-monthly in-house key worker reviews. One Social Services worker told us, in a pre-inspection survey, that the Service was good at, person centred reviews. The questionnaire completed by the Manager, before this inspection, stated that, We have regular reviews that the people we support arrange themselves...support plans are written with the people concerned so all routines are carried out specifically to how the individual wants them to be. We saw supporting evidence of this from records examined at this inspection. For example, one case tracked persons My Meeting Booklet showed the topics the person wished to discuss at the following six-monthly review, held on 7 October 2009. The persons key worker had handwritten notes from the review and the person concerned had signed below these notes. This person told us, Staff tell me what they write in my file. Daily diary records were seen to be of a good standard. The questionnaire completed by the Manager, before this inspection, told us that, We have a self advocacy group (Spire Voice)...(and) regular tenants meetings run by the Evidence: people we support, when they choose menus, decoration and furnishings. We found plenty of other evidence of people being enabled to make decisions about their everyday life - for instance, their involvement in the recruitment of new staff. We also directly observed the Manager naturally holding back from making any decisions for one case tracked person or from answering for the person when we were in discussion with them. Another staff member was seen encouraging another person to make their own cup of tea. It was clear from discussion with the Manager, support staff and the people who live at the Service, and from observation, that people have high levels of participation in all aspects of their life. In one persons bedroom there was a certificate displayed that had been presented to the person in respect of the Spire Voice Fun Run in August 2009. One case tracked person told us, I have more independence here than (the accommodation I came from)...they listen to me here...I am able to do as much as I can. Recorded risk assessments documented a good range of activities to which people, living at the Service, were exposed to risk. These indicated the measures taken by the Service to minimise these risks. A support worker told us of one person taking the bus to a day service provision - clearly, an example of taking a responsible risk in order to develop their independence. Most of the people living at the Service were over retirement age and had varying degrees of physical disability, so many activities involved a degree of risk. For instance, one person was a wheel chair user and another was registered partially sighted. We noted that, wherever possible, people were encouraged and enabled to partake in a wide range of activities. 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. The Service provided activities and services that were age-appropriate and valued by the people who live here, and promoted their independence. Evidence: There was evidence of each person living at the Service having a person centred timetable. We saw one case tracked persons weekly timetable displayed on their bedroom wall. This person spoke of their enjoyment playing the organ in their room and played us several tunes. We were also told by this person how much they were looking forward to going on a weeks holiday to York the following day, with one other person living at the Service and two support workers. The support worker we spoke with gave examples of people being involved in valued and fulfilling activities: for example, planning a forthcoming holiday - when they showed excitement. A second case tracked person described how they enjoy keeping in touch with whats going on in the Chesterfield area through reading the Derbyshire Times and listening to the news on the radio. This person also told us, Im looking forward to going out to lunch today (with my support worker). The questionnaire completed by the Manager, before this inspection, stated that, The people we support are greatly involved in organising events in the community and United Response. The Manager told us of people being involved in organising The Big Lunch, held at the Service in August 2009 - part of a series of local events arranged nationally where family, friends and neighbours have lunch together. The support worker we spoke with told us of differing levels of involvement in the local community by people living at the Service. The picture emerging from this conversation was that of staff encouraging everyone to participate in local activities and not just accepting inactivity as reflecting Evidence: personal choice. The support worker also described to us how staff encourage contact between the people living at the Service and their relatives. At this Inspection we spoke to one persons relative who told us he visits every week. One person told us, I get on well with everyone here...I go to church every Sunday and have made friends there. The questionnaire completed by the Manager, before this inspection, told us that, The people we support have devised a Household Chores Board with staff support. At the Inspection we saw that this board uses peoples photographs, rather than their names beside each domestic activity, to provide more understanding to people. The support worker spoke of routines being flexible, such as one persons shower routine. It was also clear to us that routines, in which people were involved, promote their independence. For example, all the people were all involved in food shopping and meal preparation/clearing up. On the day of this inspection, we observed one person preparing lunch with their key worker. The support staff spoke to us of the importance of allowing people their personal space and said staff always knock on bedroom doors. We observed the Manager knock on a bedroom door and wait until the person invited them in. Privacy locks were fitted to bathroom and toilet doors. We observed a lunch-time meal being eaten in the dining room. This was a relaxed occasion for four people and two staff members - one other person had chosen to eat in the lounge. The Manager told us, in the pre-inspection questionnaire, that, We have used outside professionals to help the people we support maintain healthy diets. She explained to us that this had been in respect of one persons rapid weight loss and two other peoples diabetes. The Services written four-week rolling menu indicated that people were being provided with a nutritious and balanced diet. There were photographs in a book to help some people recognise the food they were about to prepare for a meal. The two people we spoke with were positive about the food they ate. The larder cupboards and refrigerator/freezer were adequately stocked and fresh fruit was available. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service was providing people with personal support in the way they preferred and required and was meeting their physical, emotional and health needs. Evidence: Support plans detailed individual preferences as to how the people living at the Service wish to receive support. The questionnaire completed by the Manager, before this inspection, told us that, We have used outside professionals to help people stay independent even though their mobility has deteriorated...we have successfully supported a wheel chair user to maintain mobility by moving to a downstairs bedroom. We spoke to this person who was very pleased with this move. We saw their electric rising bed and, recently acquired, self-propelled wheel chair that provided them with increased independence. Handrails were fitted to one wall on the first floor corridor and in the ground floor toilet. Both shower enclosures were of a walk-in design. There was evidence of the Service considering the Mental Capacity Act (MCA)/Deprivation of Liberty Safeguards legislation and looking responsibly at each persons mental capacity to make decisions. The Manager said the Service had made no applications for assessments under the MCA, though she had involved an Independent Mental Capacity Act (IMCA) advocate with respect to one person living at the Service. She told us she had attended MCA training and plans to cascade this to the staff team. One Social Services officer, who completed our pre-inspection survey, told us that staff are, very respectful to (my clients) needs, wants and wishes. One relative, who completed a similar questionnaire, was very positive about the way the Service had addressed the disability needs of the person living here, ending with the comments, Staff are very pleasant and helpful...(my relatives) needs are always put first. The degree of individualised personal support being offered to the people living at the service is commendable. Each person living at the Service had a person centred My Health File. The ones we Evidence: examined were fully completed. We also examined a partially completed Medical Profile and we queried with the Manager whether this document was necessary. Medical appointments were also recorded in each persons main support file. There was good evidence, on the two case tracked peoples support files, of involvement of a range of external health professionals. The Service had written a policy on continence promotion following a recommendation made at the last inspection. The questionnaire completed by the Manager, before this inspection, told us that, We have recently introduced Hospital Passports to give health care professionals a better understanding of peoples support needs. We examined a copy of this useful document at this Inspection. There was a good medicine recording system in use, and a system to monitor this recording and the ordering and disposal of medicines. A safe system of administering prn (as and when required) medicines was described by the Manager and we also saw supporting evidence of this. A local pharmacy has visited once to undertake a check of these systems. The Manager said she hopes that this will become a regular occurrence. Medicines were securely stored in individuals bedrooms. No controlled drugs were in use. Staff training records confirmed that all staff had received training in the use of medicines during the past three years. 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. Good procedures for handling complaints and abuse were in place ensuring that people were fully protected. Evidence: Copies of the Services complaints procedure were kept in the files of the people who live here. These files were kept in their bedrooms. These copies of the complaints procedure were of a good pictorial format: more understandable to the people living at the Service than procedures in text. However, one written in text was not available to visitors, displayed in a prominent position. The Manager stated that there had been no complaints received by the Service since the last inspection. A well worded complaints record form was available for such use. The Manager told us of a new person centred system of recording the concerns of people living at the Service. This is called My Concerns/Complaints Communication Chart and includes sections such as, What upsets me or makes me angry and How I would tell you or show you that I am unhappy. There is an associated Learning Log for staff to complete. Safeguarding Adults Procedures and a Whistle Blowing Policy were in place to ensure that people living at the Service are kept safe from being abused. There were also Reporting Sheets to send to Social Services in the event of suspected abuse. However, there was no copy of the Derbyshire Joint Agencies Safeguarding Adults Procedures available. The Manager said she had received training in keeping people safe in December 2007. Staff training records showed that most of the staff group had received this training within the past three years. This training ensures staff understanding of adult abuse and its risk management. The support worker spoken with showed a good awareness of safeguarding procedures and of the Services whistle blowing policy. Since the last inspection the Service had updated its nurse call system. One case tracked person told us that they felt safe living here. There was an emergency call point beside this persons bed and the other case tracked person had an emergency bleeper worn around their neck. This person told us they knew how to use this. Emergency call points were situated elsewhere around the premises. Record sheets of personal monies Evidence: belonging to the two people we case tracked were examined and the current balance of monies was cross referenced against cash held. Matters were found to be satisfactory. There was only one staff signature against each transaction - a second signature would improve monitoring and safety. 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. People were living in a comfortable, homely and safe environment. Evidence: The Services environment was homely, well furnished and generally well decorated. The two case tracked peoples bedrooms were viewed and were found to be well personalised, comfortably furnished and decorated. The pre-inspection questionnaire states, people we support were supported to obtain their own quotes for redecoration and new furniture in the lounge. The Manager explained that staff accompanied people to furniture shops and supported their personal choices. She spoke of plans to install this new lounge furniture before Christmas and to repaint the lounge walls. Perspex sheets had been affixed to ground floor corridor walls to prevent damage from one persons wheel chair. There were a number of wall mounted photographs, in communal areas, of the people living at the Service. Most room doors had a photograph affixed to show the function of the room and bedroom doors had a photograph of the person accommodated there. Two bathrooms were available to the people living here and a choice of bath or shower. There was an additional toilet on the ground floor near to the lounge area. The passenger lift, between the two floors, was used by several people who would have difficulty with the stairs. One person was seen to use the lift independently. There was a large garden to the rear of the premises containing a pond that had been made safe by railings. The Manager spoke of plans to pave the area around this pond so that people could safely stand beside it. The grounds were fully accessible with the use of ramped areas. The premises were clean with no unpleasant odours. Items brought to the laundry room did not have to pass through lounge, food storage or preparation areas. There was a sluicing facility on the washing machine. The support worker described good facilities and hygienic practices regarding the transportation and disposal of infected material. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service had a group of well trained staff to ensure that people living here were safe and their needs were met. Evidence: The Manager confirmed that 75 of the care staff group had achieved a National Vocational Qualification (NVQ) in care at level 2. This met the requirement to maintain a staff group with at least 50 qualified staff. The Manager stated that there were normally three members of staff on duty on the early shift and two on the late shift with one waking staff at night. We examined the Services staffing rota and confirmed this. The Manager stated in the pre-inspection questionnaire that, We have a regular relief staff team who have worked here for at least 2 years, rising to 13 years. Other aspects of this Standard were not assessed. The personal file of a support worker, recently appointed, was examined. It was found to meet all the Regulation requirements. The Manager showed us Staff Matching Sheets dated March 2009 and August 2009. These were documents, created with the people who live at the Service, prior to staff interviews - reflecting the views of these people as to the kind of staff they wanted to support them. The support worker we spoke with said she had had a very good induction training when she was appointed just over a year ago. She confirmed that she had undertaken induction training to the required Common Induction Standards (CIS). Training records showed that all staff had been provided, within the past three years, with First Aid and Basic Food Hygiene training, and all but one staff had received Moving & Handling training. In September 2008 all staff had undertaken fire training. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service was well managed so that people living here were protected and their best interests were promoted by the systems in place. Evidence: The Manager of the Service had 15 years experience of working with people with learning disabilities and had been managing this Service since April 2008. She was approved by us, as the Registered Manager of this Service, on June 1st 2009. She informed us that she had not yet started studying for the Registered Managers Award. The Manager said she felt she had insufficient time allocated to her, by United Response, to fully undertake all the necessary administrative duties of a Registered Manager, including staff supervision and record monitoring. Monthly independent audit visits to the Service, on behalf of the Registered Provider, as required by Regulation 26, were taking place. The Service did not have its own Service Plan but was part of the Spire Service Plan which covered all United Response services in the Chesterfield area. Staff were being periodically sent quality assurance questionnaires by United Response Headquarters, in order to assess their opinions on the quality of service provided. No quality assurance questionnaires had been sent to relatives or external professionals to elicit their views. We had considerable evidence at this Inspection that the views of the people who live at the Service are sought at every opportunity. The Manager confirmed, in the pre-inspection questionnaire, that equipment was being maintained, and Health and Safety checks made, at required intervals. Well documented environmental risk assessments were in place, in the form of Monthly Hazard Inspection sheets. Cleaning materials were being stored securely in a locked cupboard along with Evidence: safety information required by the Control Of Substances Hazardous to Health (COSHH) Regulations. The latter was being updated every six months. Washing powder was being kept on the worktop in the laundry. The Manager said this was not a hazard to the group of people living at the Service but accepted that a risk assessment had not been written to support this. Safe food hygiene practices were being followed in the kitchen. Monthly fire drills were being held, with two of these each year being held during hours of darkness - the time when the people living at the Service are most vulnerable. Fire alarm break-glass points were being checked weekly. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 22 23 23 A written complaints procedure should be prominently displayed for visitors to the Service. A copy of the Derbyshire Joint Agencies Safeguarding Adults Procedures should be kept at the Service. Wherever possible, a second staff signature should be placed against each financial transaction on personal monies sheets. All staff should be provided with an annual training course in fire safety. The support worker who received Moving & Handling training in June 2006 should be provided with a refresher course. The Manager should start studying for the Registered Managers Award as soon as possible. Quality assurance questionnaires should be sent to relatives and external professionals to elicit their views on 4 5 35 35 6 7 37 39 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 the Service. 8 9 39 42 The Service should develop its own Service Plan. A risk assessment should be written to address the potential hazard created by the ready availability of washing powder kept on the worktop in the laundry. Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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