Care Home: 4 Piggy Lane

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What the care home does well There is a relaxed and friendly atmosphere. The people who live in the Service say (and indicate by their relaxed manner) that support workers are kind and attentive. People say that they have good meals. People receive the support and assistance they need. Support workers know what they are doing and they have a detailed knowledge of what each person needs and wants. Medication is given safely and people are helped to promote their good health. Sensible steps are taken to reduce the chance of accidents. What has improved since the last inspection? Support workers have attended a number of relevant training courses. Additional funding has been obtained to enable things such as new wheeled armchairs to be bought. What the care home could do better: Some people might want to go out more. More staff on duty may make it possible for people to be out and about in the local community more. There are some limited gaps in the recruitment system. This means that we cannot be sure that all of the necesary security checks have been completed. The quality assurance system does not really involve members of staff. Also, it can do more to tell people what improvements have been suggested and what is going to be done about them. The fire safety training system needs to be more organised. This is so that all members of staff get frequent training in fire safety things. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 4 Piggy Lane 4 Piggy Lane Bicester Oxfordshire OX26 6HT     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: Mark Hemmings     Date: 0 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 4 Piggy Lane 4 Piggy Lane Bicester Oxfordshire OX26 6HT 01869249533 Telephone number: Fax number: Email address: Provider web address: pearl.whiteley@oldt.nhs.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Pearl Whiteley Type of registration: Number of places registered: Oxfordshire Learning Disability NHS Trust care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 5 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 - LDPhysical disability - PD Date of last inspection Brief description of the care home 4 Piggy Lane (the Service) can give accommodation and personal care to five people who have a learning disability. Most of the people also have a physical disability and all have special communication needs. This means that they do not have easy use of spoken and written words. The premises are single storey and are part of a terrace. They were purpose built in the 1980s. All of the other bedrooms are singles. Each bedroom has a wash hand basin. The Service is close to the centre of Bicester, where Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 5 5 Brief description of the care home there are shops and public transport links. The Service also has its own transport. The Registered Provider is the local National Health Service Trust. People who might want to move in can find out things about the Service. There is a Service Users? Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. Details about the cost of living in 4 Piggy Lane can be got from the Trust. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was a Key Inspection. We arrived at the Service at about 9 oclock and were there for about five hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). We are a bit disappointed in that the Assessment isnt that detailed. In future, we will expect it to give us a really clear idea of how things are going in the Service, what has been done during the course of the year and what is planned for the Care Homes for Adults (18-65 years) Page 6 of 28 next year. We considered any information that we have received about the Service since the last inspection. We spoke with two of the people who live there and we spent time with everyone else. We spoke with the Registered Manager, the deputy manager and with two of the support workers. We looked at some key records and documents and we had a look around the accommodation. 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. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: The Manager says that she completes an assessment of each prospective persons needs for assistance. This is done before a decision is made about whether or not the Service can meet the persons needs. She says that an important part of the process is talking with the person. This is done so that she can find out what support they need and how they want this to be given. As appropriate, members of the persons family and care managers (social workers) are involved. Whenever possible, the person is encouraged to visit the Service beforehand. This is so that they can see what it is like in practice. The Manager emphasises that she and the support workers want to do everything possible to help make the move into the Service a positive experience for the person concerned. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Someone is in the process of moving in at the moment. The Manager has got hold of quite alot of useful information from their care manager about things that will be important to the person. On the day of our visit, the person was due to call to the Service to have a look around and to get to know people. We asked support workers about their part in all of this. They say that the Manager has told them about the persons needs and wishes. They also say that she has listened to what they have had to say about what might be most helpful if the person does decide to move in. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7 and 9. There are individual written plans of care. There is a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. There is a written individual plan of care for each person. These are important documents. This is because they form one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be delivered. The plans are a source of information for staff. This then helps them to provide support in the right way. We looked in some detail at two of these plans. They contain information about a number of relevant things. For example, there is information about how to help the people say what they want and about how to support them in managing parts of how they go about things. There is stuff about how Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: to help them with practical things such as getting dressed and using the bathroom. We spoke with two of the support workers about what is in these plans. They have a good knowledge of the needs and wishes of the people concerned. The plans use quite alot of pictures to make them interesting and easier to use. There isnt too much boring text. We think that this is a good idea because it helps people to take an active part in planning their day to day lives. All of the people who live in the Service are helped to manage their financial affairs by the local authority. This involves it keeping a track of money coming in for them and then paying their bills. The Registered Provider does not get involved in any of this side of things. This is a good idea because it helps to avoid any conflict of interests. However, the staff do hold small amounts of money for each person. They do this so that it doesnt get lost and so that people always have enough to buy the everyday things that they want. Staff keep a record of the various transactions involved to make sure that everything is above board. We checked some bits of these records to make sure that the system is working okay. For example, we looked to see if there are receipts for things said to have been bought for people and there are. We also checked that the cash balance held for one person matches what the records say should be there. It does. Sensible consideration is given to the personal safety of the people concerned. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. The information is presented in a management style. This means that some of the people might find it to be dull and difficult to understand. We think that more can be done to make it interesting and user friendly. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14, 15, 16 and 17. People who use the Service experience good quality outcomes. This judgement has been made using available evidence including a visit to the Service. People can do interesting things. They are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: People are free to do things that interest them. Some of these things involve helping out a little bit and in their own way around the house. People do a number of other Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: things. For example, some of them go out to a local social club. Someone is visited by an aromatherapist and all of them go into town with a member of staff to do some shopping. The Assessment says that people will be encouraged to try new and different activities. We think that at the moment this might be a bit difficult to achieve in practice. This is because there are not always enough staff on duty to go out with people as often as they might want to. We have asked the Manager to look into this matter in more detail. She is going to speak with each person and with staff to see what more activities should be arranged and how this might be done. She is going to do this by 1 January 2009. People say that the pace of daily life in the Service is relaxed and unhurried. When we were there one person went out to a club. The others came into the lounge where they relaxed in the company of staff. They had drinks and did things such as artwork. The Service has a pet guinea pig. This was brought into the lounge and two of the people obviously enjoyed watching its antics. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service at any reasonable time. Everyone has contact with someone outside the Service who is just for them. In most cases this is a care manager or an advocate. In this instance, an advocate is someone who is not related to the person but who takes a particular interest in them. They can speak up for them if this is needed. People say that they receive good quality meals and that they have enough to eat. We were there at lunch time and it was a relaxed affair. People dined in comfort and at their own place. There is no sense of anything being rushed or too organised. People can choose what they want to eat. We looked at the record of what dishes people had for a few days before our visit. They were normal things such as shepherds pie and vegetables. Over the course of the days there was a reasonable variety. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are assisted in ways that are right for them. For example, some people need more personal space than do others. Or they have different interests. Support workers are courteous in their manner and they respect each persons individuality. For example, one person is quite excited about Christmas. One of the support workers has helped them do a present list and they have helped them to illustrate it with festive themes. People are confident that they can rely upon support workers to be there when they are needed and to be approachable. We observed support workers giving people the time they need to express themselves. They then respond in a helpful manner to their requests. People are helped to stay healthy. Support workers note when someone is not well and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: they make sure that medical assistance is obtained. Since our last visit to the Service, people have been supported to see their family doctors and other medical personnel. People are encouraged to promote their good health. For example, one person is being helped to loose a bit of weight while another is being helped to put some on. At the moment, staff manage medcicines for each person. This is done because the peole who live in the Service would find it too fiddly to do it for themselves. When the medicines are delivered to the Service, they are checked to make sure that they are correct. They are then stored securely and in an organised manner. The support workers who dispense medicines know what they are doing. A record is kept each time someone takes a medicine and we had a look at two of these. They are being completed in the right way. In more detail, we looked at two medicines in particular. This was done to check that the record of their use matches the stock that is left in the store. Everything is okay. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 22 and 23. There is a complaints procedure. The wellbeing of people is safeguarded. Evidence: There is a written complaints procedure. This uses alot of pictures and so it is likely to be easy for people to use. The Manager says that she has not received any complaints or even any grumbles since we were last in the Service. She says that if any are voiced in the future, they will be sorted out as quickly as possible so that anything that needs to be put right will be so. People say that they feel safe living in 4 Piggy Lane. The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, if someone is being bullied or having their freedom limited without good cause. We spoke with two support workers about this matter. They are aware of what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and well supported. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24, 25, 27, 29 and 30. People live in a comfortable setting that promotes their independence. The kitchen is clean and well equipped. There is a separate laundry. Evidence: The accommodation is decorated and furnished to a normal homely standard. Some of the people use wheelchairs. Normal wheelchairs can make places feel a bit hospitallike. We are pleased to see that the Manager has been able to get the funds needed to buy people quite plush wheelchairs. They are very comfortable and they look more or less like ordinary armchairs. The Assessment says that there is a bit of problem with storage because wheelchairs are quite bulky things. We understand that the Manager is thinking about creating another store room to sort this out. People say their home is kept warm enough in winter. The radiators are fitted with guards. This has been done to reduce the risk of someone being burnt if they fall against one. Support workers say that there is a good supply of hot water. This is temperature controlled to help reduce the risk of someone being scalded. We tested a few of the hot taps. The water isnt too hot. Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. we understand that the Oxford Fire and Rescue Service says that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. The assessment says that things are okay. The local Department of Environmental Health called to the Service last year to check out things in the kitchen. It says that the food handling arrangements in the Service are satisfactory. We looked at the kitchen too. It is neat and clean and looks like anyones kitchen. There is a system to make sure that the refrigerators are cold enough to store foods safely. Sensible steps are taken to promote hygiene. For example, staff know about the importance of washing hands particularly if theyve been doing other things such as being in the laundry. As we have said earlier, some of the people who live in the Service are older people. We asked about how they manage to get about in general. We also wanted to know in particular about the help they need when in the bathroom and in their bedroom. Most of the bedrooms have a special hoist fixed to the ceiling. These help people get into and out of bed in safety and comfort. There is also a hoist in the bathroom so that using the bath doesnt have to be a struggle. The laundry is equipped with a large washing machine and dryer. There is also a smaller washing machine. This is there so that people can have their clothes washed separately from bed linen that might need a hot wash. We think that this is another example of how the Service shows respect for the people who live there. The laundry arrangements work well. Each person has an adequate wardrobe of clean and presentable clothes from which to choose. There are new regulations that have been introduced to ensure that used water does not leak back into the main pipe-work. The Registered Provider is going to check with the local water supply company to make sure that it meets whats needed. This will be done by 1 January 2009. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 33, 34 and 35. There are enough staff on duty to make sure that people get the support they need. Security checks are completed on staff. Support workers know what they are doing. Evidence: There are three support workers on duty from early in the morning until the evening time. There is a waking staff presence in the Service at night. We looked at the roster to see if the various shifts are being filled reliably. We found that they are. At the moment, there are a number of vacancies. This means that agency staff are having to be used to fill some of the shifts. This can be a problem because agency staff are people who work in a whole number of services. Therefore, they cannot know the people who live in piggy Lane as well as the normal support workers do. We are pleased to note that the Manager hopes to fill the vacant posts in the near future. Earlier, in this Report we have said that more staff may be needed if people are to be out and about in the local community as much as they might want to be. The Manager will need to consider this carefully after she has looked at what extra things each person might want to do. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: The Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, seeking references and obtaining a police check. This is done to ensure that they are suitable and trustworthy people. We looked at the personnel file of one support worker who has been appointed recently. The file is neat and organised. The main security checks have been completed. However, there are gaps in the employment history. This means that we cannot be sure that all of the necessary references have been obtained. The Manager is going to check out the employment histories for all of the support workers by 1 March 2009. This is to make sure that nothing has been missed. New support workers receive introductory training before they work without direct supervision. After their introduction to the Service, support workers have extra training in a number of important subjects. For example, in first aid, food hygiene, supporting people who express themselves through difficult behaviour, the safeguarding of vulnerable adults and helping people who have difficulty getting about. They also begin working towards a nationally recognised qualification that deals with the sort of support they provide. At the moment, all support workers are doing extra training in how to help people who now and then need to use a particular medicine. When we spoke with support workers, we asked them about points of detail to do with their work. We wanted to see what their knowledge is. They have a sound understanding of important things such how people prefer to express themselves. We saw them using their expertise to good effect. They also know about how some people need special reassurance when they are anxious. Again, we saw them helping people to manage okay if they become distressed. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39, 40, 41 and 42. The Service is reliably managed. People are asked what they think about how things are going, but this could be more developed. Peoples health and safety is promoted. Evidence: The Registered Manager knows whats going on in the Service. When we ask her questions she gives us answers without having to fiddle about looking at bits of paper. She has both of the formal qualifications that we expect. These are important. This is because they are intended to help managers ensure that people receive high quality residential care services. Various things are done to help staff work as a team.There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there are staff meetings. We looked at the records of the most recent meeting. A number of things that make a difference to peoples quality of life were discussed. For example, they reviewed what each person likes to have with their late evening milky Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: drink. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. For example, they know who needs the most support when they go out and they organise themselves accordingly. People are asked about how well they think things are going in their home. These include informal everyday discussions. Also, there are regular house-meetings. All of the people who live in the Service are invited to attend these meetings. They can raise anything they like. We looked at the records of the last meeting that was held in September this year. People discussed a number of down to earth things such as how to plant out the garden for next year. However, there isnt much more than this done and staff arent being asked to say what they think. There is no system to tell people about all of the improvements that may have been suggested. Also, there is no reliable way to let people know what the Registered Provider intends to do in response to any of the suggestions made. We think that all of this could be done better. After all, its the people who live in the Service and the staff who are the experts on the place. The Manager says that she is going to get this sorted out. This is so that there will be a clear way of finding out what people have to say and there will be a more organised system for telling people what improvements are going to be made. She is going to do this in time for us to be told about it when the Registered Provider sends us its next Assessment in 2009. Regular checks are done to make sure that the Services fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells. Quarterly more detailed checks are completed by a contractor. There are unannounced fire drills. Each member of staff attends an annual fire lecture. The next one is due quite soon. After this has been held, the Manager is going to introduce a new system that will make sure that people who miss the training event can still have the tuition they need. This will mean that everyone will have been checked to make sure that they know about fire safety things by 1 February 2009. This is very important because the actions taken by staff largely determine the level of fire safety protection available in the Service. The gas-fired appliances used in the Service have been certified as being in a safeworthy condition. About once in every five years a contractor should be checking the electrical wiring. This is done to make sure that its condition is okay. There is some uncertainty about when this check was last done and about what was the outcome. The Manager is going to look into this and she is going to make sure that anything that Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: is outstanding is sorted by 1 June 2009. The Manager says that there have not been any significant accidents in the Service since we were last there. The Manager says that she keeps an eye on the place to make sure that there are no obvious hazards that might cause someone to have an accident. So for example, she checks things that might cause someone to trip over or which might make it difficult to move a wheelchair about. At the moment, these checks are being done informally and they are not being recorded. we think it would be useful to make this exercise a little more organised. Experience shows that this is a good way of helping to make sure that things dont get missed. In the meantime, We didnt notice any particular hazards. Things like bleach are stored out of harms way when not being used, the floors are level and there are no obvious things to catch yourself on. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. 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