Care Home: 4 Bruddel Grove

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 4 Bruddel Grove 4 Bruddel Grove The Lawns Swindon Wiltshire SN3 1PW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alyson Fairweather     Date: 3 0 0 3 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 29 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 29 Information about the care home Name of care home: Address: 4 Bruddel Grove 4 Bruddel Grove The Lawns Swindon Wiltshire SN3 1PW 01793642378 Telephone number: Fax number: Email address: Provider web address: thelma.wilson@rethink.org www.rethink.org Name of registered provider(s): Type of registration: Number of places registered: Rethink care home 5 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 who can be accommodated is 5 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the folowing category: Mental Disorder, excluding learning disability of dementia (Code MD) Date of last inspection Brief description of the care home 4 Bruddel Grove provides accommodation and personal care for up to five people affected by severe mental illness. The home is run by Rethink a national charity that provides a range of care and support services around the country. Bromford and Carinthia Housing Association owns the property. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home 4 Bruddel Grove is located in the Lawns area of Swindon, which is close to Old Town where there are a range of shops and public amenities. It is a detached property at the end of a short cul-de-sac. Two service users have their bedrooms on the ground floor and there are three bedrooms on the first floor. The communal space consists of an open plan loungedining room and another smaller room that is used as an area to smoke in. There is garden at the back, with a parking area at the front. Service users receive support from a home manager, a team leader and a permanent staff team. Relief and agency staff were also being used at the time of this inspection. The fee level is 922.38 pounds per person per week. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We recently asked the home to complete an Annual Quality Assurance Assessment (known as the AQAA). This was their own assessment of how well they were performing and it gave us information about their future plans. We also sent out surveys to the residents and staff so that we could get their views about the home. Four service users and three staff members replied. We reviewed the information that we had received about the home since the last inspection in 2007. We made an unannounced visit at the end of March 2009, and met with most of the residents and staff as well as the manager and team leader. We looked around the home and saw a number of records, including care plans, risk assessments, health and safety procedures, staff files and medication records. The judgements contained in this report have been made from evidence gathered Care Homes for Adults (18-65 years) Page 6 of 29 during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? What they could do better: We found evidence that staff had been offered a great deal of training. However, it was Care Homes for Adults (18-65 years) Page 8 of 29 noted that not all staff had infection control training, although there had been some discussion about how this would be done. The manager has been asked to make sure that all staff have this training. We have also recommended that all staff have training in diabetes care. We also found that there had been a couple of incidents in which residents had been involved. Each home has a duty to inform us of anything which affects the welfare of residents, and this had not been done. We have therefore asked that the manager ensures that we are notified in future. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 29 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 29 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. Prospective clients and families are given information leaflets so that they can choose whether or not they wish to use the service. Residents have their individual needs assessed before they arrive, so that staff know how best to support them. Evidence: The home has a comprehensive Statement of Purpose and Service User Guide which give an overview of the service which will be provided. This is given to every potential resident, and also gives details of the organisations complaints procedure. Of the four residents who wrote to us, all felt that they had had enough information on the service prior to admission. One person said: I viewed the home before becoming a resident, then had a month or six weeks to decide. Another said: I really wanted to come her. All residents are referred to Bruddel Grove by staff of other mental health services, for example the Community Mental Health Team (CMHT). This referral includes a detailed application form, risk assessments where present and details of the current multidisciplinary care plan. The homes manager or team leader then conducts a Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: referral interview, at which stage residents are able to say what they feel their needs and goals are, and to assess whether the home might be able to help with these. Potential residents make several visits to the home, and can spend time getting to know staff and other residents. This allows further assessment of their needs to take place. All four people who wrote to us said that they had been asked if they wanted to move in to Bruddel Grove. One person said: I had a look round and I was pleased with what I saw. Another person said: I was invited to a few overnight stays before I moved in. All four people said that they were given enough information to help them make up their mind. One person told us: My relative looked Bruddel Grove up on the internet; another said: I received a print out of the home. Care Homes for Adults (18-65 years) Page 12 of 29 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. Care plans reflect the needs and personal goals of residents. People are encouraged to make choices and decisions about their own lives, and are supported to take risks as part of an independent lifestyle. Evidence: Each service user had a Care and Recovery plan, which covered different aspects of their needs, including general mental health, physical health, day to day living and health and safety. Issues were identified under each of these headings, together with statements about the residents objectives and the action that had been agreed to support these.The plans reflected the residents views, for example by highlighting when they felt they did or did not need a lot of input in a particular area. We asked staff if they were given up to date information about the needs of the people they support, e.g. in the care plan. All of them said they were, and one said: All our care plans are to a high standard. Another staff member told us: We are always given up to date information because we have a hand over before every shift Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: so if there are any changes we are told as soon as possible at the beginning of a shift. We saw this to be the case during our visit, as the staff from the morning shift passed on information to the in-coming afternoon shift. Residents are supported to make decisions about their own lives with guidance from the staff. They are encouraged to manage their own finances wherever possible, although some have official financial appointees, and some have family involvement. Where restrictions are in place, for example to limit self harm or harm to others, this is clearly recorded and guidelines are drawn up for staff to follow. Several residents told us that they could do their own thing. One person told us: Every day is different and I take each day as it comes. Another said: I make my own choices. One person told us that sometimes Medication can alter decisions. Rethink have information in the home which outlines their values and beliefs - dignity and respect, recovery, diversity and equality, support for all, choice, valuing staff and volunteers. Bruddel Grove states that it is committed to working towards cultural competency and wishes to deliver effective services to anyone who may need them, regardless of their ethnicity, sexuality, disability, age, gender or religion. Risk assessments were on file for all service users, and these are reviewed regularly. They included things like personal care and risk of someone harming themselves. Risk assessments completed at CPA meetings are also on file. Staff place great emphasis on encouraging residents to be as independent as possible, while trying to minimise any risk to their safety. Some residents smoke in their bedrooms, and staff were said to discuss this frequently with residents, pointing out the potential risks. A risk assessment had been introduced for these residents, and is reviewed with them on a regular basis. Care Homes for Adults (18-65 years) Page 14 of 29 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. Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. People can exercise independence in the home and have opportunities for personal development. They benefit from the support they receive, which helps to maintain relationships and develop individual skills. Their rights and responsibilities are recognised within the daily routines. Residents like the meals and receive good attention from staff with nutrition and menu planning. Evidence: Each service user had a daily routine, which they had discussed as part of their Care and recovery plan. Most people look after their own room, and some undertake some other household chores. None of the residents had a regular nine to five type occupation. Activities were often arranged on the day to take account of peoples motivation and short term needs. People were all engaged in different activities at the time of our visit, with two people going out for lunch together. Some people like to go Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: to the pub and like to be accompanied by staff.Others like clothes shopping, and another has started doing dressmaking. Some people are interested in cooking and baking, and like to discuss recipes with staff. One person has done some voluntary work, but doesnt like to join in group activities, another likes swimming and has been gathering information about local mental health services. One person is saving up to buy a bike. Information about residents family backgrounds was included in their care plans. The plans described the type of contact they had with relatives. One person said that members of their family visited each week. Other peoples relatives visited occasionally. Staff members, in their role of key workers, were supporting service users with their relationships. Most residents look after their own money, although some have help from family members or appointees. Some people go to the post office, pay their own rent, and have bank and building society accounts. One person keeps some money in the office for safe keeping, but manages it by themselves. Some are able to cook, shop, do housework, laundry, keep room clean. capable on phone and can make own appointments. All residents made their own drinks and snacks during the day in the homes kitchen, and most make own breakfasts. The main meals were cooked for residents, except when people chose to prepare their own as part of a self care programme. Care Homes for Adults (18-65 years) Page 16 of 29 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. Residents personal support needs are recorded in care plans so that they can receive this support in the way they wish, and their physical and emotional health needs are met. People are supported to self medicate where possible, and are protected by the homes medication policies and procedures. Evidence: All residents are registered with a GP whilst living at Bruddel Grove, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. Although Bruddel Grove caters for people with mental health needs, one or two residents have had physical problems which have necessitated having personal care support from staff, who have supported all the district nurse, GP and hospital appointments needed. One person was seen to have regular podiatry appointments, and another has regular appointments with the Community Psychiatric Nurse (CPN). All residents have regular appointments with the local psychiatrist. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: All residents have a crisis self management plan which outlines agreed procedure when facing a crisis situation.Staff have health information for smokers on file. The home has good medication policies and procedures in place. Residents medications are reviewed annually with their psychiatrist or the General Practitioner (GP). The Medication Administration Record (MAR) was checked and found to have been completed accurately, with all staff signatures in place. Medication storage was found to be good, with all drugs kept in a locked cabinet. All staff have completed medication training, and have received a Certificate in Managing and Safe Handling of Medicines. Staff count the stock of medication at least once daily, so can spot any errors immediately. The home also had an audit done by Boots the chemist recently, and they were very pleased to tell staff that they found nothing wrong with the systems in use. One person likes to have their medication in their room at night so they can take it when they wake up very early in the morning. This medication is put in a dossette box each night, and two staff sign to say this has been done. The resident makes sure that the medication is safe, and keeps the bedroom door locked. Staff then check in the morning that the medication has been taken. They have also put a risk assessment in place for this procedure. Care Homes for Adults (18-65 years) Page 18 of 29 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. Residents feel their views are listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm, although reporting mechanisms could be tighter. Evidence: The home has a complaints procedure in place, and this is given to residents and their families along with the service user guide. All four residents who wrote to us said that they knew who to talk to if they werent happy and all said they knew how to make a complaint. One said: My keworker, as I trust her, and another: Any member of staff, but mainly the manager Within the home, residents had the opportunity to raise concerns and were encouraged to air their views, for example in house meetings and during the monthly key worker sessions. A suggestions box had been put in the front hall as a means of obtaining feedback from service users and their visitors. No formal complaints have been made either to the home or to us; indeed the staff had received several compliments on their care of residents, both from family members and visiting professionals. The home has copies of the Swindon and Wiltshire No Secrets document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members have received training in Safeguarding Adults. During discussions with the manager, we saw that there had been two incidents Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: involving residents which we had not been told about. We clarified what type of incident needed to be brought to our attention, and have asked the manager to make sure that this is done in future. Care Homes for Adults (18-65 years) Page 20 of 29 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. Residents live in homely surroundings and have accommodation that reflects their lifestyles. It is clean and hygienic, although not all staff have had infection control training. Evidence: Bruddel Grove is located in the Lawns area of Swindon, which is close to Old Town where there are a range of shops and public amenities. It is a detached property at the end of a short cul-de-sac. Two residents have their bedrooms on the ground floor and there are three bedrooms on the first floor. The communal space consists of an open plan lounge-dining room and another smaller room that is used as an area to smoke in. There is garden at the back, with a parking area at the front. Since our last visit, several large trees had been felled, giving the garden more space and light. All furniture was in good condition and some redecoration had been done. Smart new flooring had been laid in the communal areas and paintwork had been refreshed in several rooms. One resident who showed us round his room was able to point out several personal items he had, including a flat screen television, a stereo, a big leather chair and lots of pictures. The accommodation seen was clean and tidy. Staff said that as part of their key Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: worker role they supported service users with the cleaning of their own rooms. There was a small laundry area that was separate from the kitchen. Some residents use the laundry by themselves, but others have some help from staff. All the resident we spoke to said that the home was always fresh and clean. One person said: Its lovely, and another said: Staff work very hard to keep Bruddel Grove clean and tidy and a nice place to live. However, when we checked staff files we noted that some people had done infection control training, but not all. It is recommended that all staff have this training, and we were told during our visit that one member of staff will take responsibility for making sure it is done. Care Homes for Adults (18-65 years) Page 22 of 29 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. Residents individual and joint needs are met by appropriately trained and qualified staff. They are supported and protected by the homes recruitment policy and practices. Residents benefit from well supported and supervised staff. Evidence: There has been a stable staff group for some time, all of whom are well known to residents. There are still vacancies, but shifts have been covered by bank staff. The manager reported that there has been little use of agency staff for some time. All current staff either have or are undertaking their NVQ or equivalent. When we asked residents if the staff treated them well, everyone said that they were always treated well. One person said: All the staff are good and they do a lot for me in respect of leading a calm and fun life. Another person said: Staff are lovely. Bruddel Groves employment checks include Criminal Records Bureau (CRB) and checks against the Protection of Vulnerable Adults (POVA) register, two written references and a medical declaration. All potential staff complete an application form, and this is kept by the home. Staff recruitment was supported by Rethinks human resources department and followed the organisations policies and procedures.All the files we looked at contained appropriate information. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: New staff go through an induction training period, where they are supervised by a senior member of staff. We asked staff if their induction covered everything they needed to know to do the job when they started. One person said: did my induction some time ago when I joined the organisation, but over the years on-going training has been excellent. Another said: My induction helped me a lot and I felt relaxed when completing my first two weeks. The induction covered everything I needed to know. Training records showed that staff have had specific training in basic mental health, Aspergers syndrome, difficult, disturbing and dangerous behaviours, food hygiene, Safeguarding Adults, safe handling of medication, professional boundaries, basic emergency aid and fire safety, equality and diversity, basic health and safety and food hygiene. It is planned to hold more training in understanding personality disorders. When we asked staff if they are given training which is relevant to their role, one person said: The training is very up to date and helps a lot to understand all areas of my role. We saw that some staff have had training in managing diabetes in the past, but that not all of them had done this. We also saw that one resident with diabetes had a record in the support and recovery plan that said they were able to look after their diabetes well themselves. The support and recovery plan said that all staff should be fully aware of diabetes. It is therefore recommended that all staff undertake this training. Formal, one to one supervision sessions with staff are held monthly, and these are carried out by the manager and the team leader. Staff also have an annual appraisal, and new staff have a probationary review after three months. One person told us: I have monthly supervision but my manager is very good and I can go to her with any problems or concerns. When we asked staff if they feel they have the right support, experience and knowledge to meet the different needs of residents, all staff felt they did. One person said: I have good support in all these areas and over the years training needs have been met. Care Homes for Adults (18-65 years) Page 24 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home. Their views underpin the monitoring and review of care practice, and people feel that their views are listened to. The homes policies and procedures are good, and the arrangements for carrying out health and safety checks mean that residents live in a safe environment. Evidence: The manager, Thelma Wilson, has many years experience of working with people recovering with mental health problems. She has achieved an NVQ Level 5 in Management and in Advanced Management of Care. Recently, she has undergone training in Level 2 food hygiene, employee relations, conflict management, recovery management, Deprivation of Liberty Safeguards, the Mental Health Act and the Mental Capacity Act. The day to day management tasks are shared between the homes manager and the team leader. One staff member in particular felt supported by the manager. They said: Bruddel Grove has been open since 1994. Our manager has always put the residents wishes first. She is always there for them should they need her. The office door is always Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: open, and all the residents pop in throughout the day. I know that it is a job, but working at Bruddel Grove is very rewarding and I love it. Organisationally, Rethink oversees the running of the home with monthly visits and through their quality assurance system, which involves carrying out of an audit to look at the homes performance in relation to some key principles and outcomes. The home had been awarded Green (safe) status following the most recent audit. There were other means by which residents gave feedback, for example through house meetings and key worker sessions, as well as on more informal occasions. This feedback appeared to be informative, and in the survey done in 2008, one resident wrote: Its all right here. Rethink also states in its mission statement that If something goes wrong, well put it right. The home will be run for the residents - that is its primary purpose. Staff had attended fire marshal training and courses in first aid and health and safety during the last year. Ms Wilson had provided information in the pre-inspection questionnaire about the arrangements being made for health and safety. We examined some records and found them all up to date and accurate. Risk assessments had been undertaken concerning some environmental hazards and others which involved individual service users. The homes fire risk assessment was current and fire drills were held quarterly. Some safety checks were carried out and recorded daily, weekly, monthly, quarterly or annually. Bruddel Grove had recently been inspected by the Fire Authority, and received a glowing report. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 23 37 The registered person must be sure to inform CQC of any incident which affects the wellbeing of any resident. So that all incidents, and how they are managed, might be monitored. 05/06/2009 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 improving their service. No Refer to Standard Good Practice Recommendations 1 2 30 35 All staff should have infection control training. All staff should have diabetes training. Care Homes for Adults (18-65 years) Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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