Care Home: 6 Harrow View

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What the care home does well We were told by the three residents that they like living at 6 harrow view, one resident was able to communicate this information verbally the other two residents communicated to us using sign language. We spent time looking at the statement of purpose and service user guide, the information in the statement of purpose and service user guide is good, informing prospective clients and stakeholders of the service they can provide to people living in the home. We spent time looking at the care plan information for one resident, the information was relevant and up to date. The care plan worked in conjunction with the assessment and all risk assessments were linked directly with the care plan with actions in place for any identified risk. We met with staff, all of whom were positive about working at the home stating training and development was good and that they had a lot of support from the registered manager and senior staff. What has improved since the last inspection? We spent time looking at the medication procedure, all relevant information was recorded on the medication administration records. The medication records and medication is audited twice daily when the staff hand overs take place to make sure that all medication has been correctly administered and the MAR sheet is correct. The Harrow safeguarding procedure was available at the home in a DVD, we discussed with the registered manager that the safeguarding procedure should be printed off and put in a safeguarding folder for staff to have easy access to. The rug in the dining room has been replaced with a new rug. We looked at the daily records for all three residents, all included what activities each person had done on a daily basis. There was also activity records completed by a therapist that visits the home on a daily basis. What the care home could do better: We looked at the safeguarding information and the registered manager must have a safeguarding folder with the homes safeguarding procedure, the local authority procedure and the relevant notification forms. The office carpet is in a bad state of repair covered in lots of stains. The office is also used as a sleep over room for staff, and as such should be made comfortable. We looked at the recruitment records of two staff, the registered manager must make sure that all references have been validated. We looked at four references and none of them had any record of any individual validating them. We saw a lot of copies of original documents in both files, the registered manager must make sure that any copies have a signature of the person that copied the document and a date of when this was done. One of the staff files did not include a staff photograph, we were told by the registered manager that she would make sure that this was done imminently. We looked at the safe working practices at the home, the registered manager must make sure that all hot water outlets are checked regularly to make sure the hot water temperature is set at the safe temperature to protect residents and staff. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 6 Harrow View 6 Harrow View Harrow Middlesex HA1 1RG     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: Jackie Derbyshire     Date: 2 9 0 7 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 30 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 30 Information about the care home Name of care home: Address: 6 Harrow View 6 Harrow View Harrow Middlesex HA1 1RG 02087230660 Telephone number: Fax number: Email address: Provider web address: junipertiger@aol.com Name of registered provider(s): Type of registration: Number of places registered: Clover Residents care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home only - Code 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 - Code LD Date of last inspection Brief description of the care home 6 Harrow view is a semi-detached house providing accommodation for up to three people who have learning disabilities. It is part of a local care-providing organisation whose services include both care homes and domiciliary care for people with learning disabilities. At the time of the inspection, there was three male residents living in the home. The home is situated on a busy road in Harrow, near the main Harrow shopping centre. The Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 3 Brief description of the care home accommodation comprises of three bedrooms, all of which are located on the first and second floors. The second floor bedroom has an en-suite bath and toilet, whilst there is a separate bathroom and toilet on the first floor. The ground floor accommodation comprises of a lounge, dining room, shower room, and kitchen. There is a well-kept garden, and a converted building that is used as an art-workshop, at the rear of the property. The weekly fee is £1973, this fee may change depending on the care package. The registered manager explained that fees depend on the needs of each person, and are negotiated with the funding authority. Charges and exceptions are recorded about in the Service User Guide, which is available on request from management. Care Homes for Adults (18-65 years) Page 5 of 30 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 the people who use this service experience good quality outcomes. Throughout this report the word we will be used as meaning the Care Quality Commission CQC. 6 Harrow View unannounced Inspection took place on 29th July 2009, we spent 5 hours at this site inspection. We spent time with the three people living at the home, the registered manager, senior care staff, care staff and looking at documentation and checking records. The CQC received one survey from a resident, one survey from a relative and two staff surveys. Comments from these surveys will be included throughout this report. Five requirements were set at the last inspection in October 2007 all have been fully met. We will refer to the AQAA Annual Quality Assurance Assessment that has been completed and returned to the CQC. Six new requirements was set from this Inspection. A lot of hard work has taken place to Care Homes for Adults (18-65 years) Page 6 of 30 improve the service by all staff. What the care home does well: What has improved since the last inspection? What they could do better: We looked at the safeguarding information and the registered manager must have a safeguarding folder with the homes safeguarding procedure, the local authority procedure and the relevant notification forms. The office carpet is in a bad state of repair covered in lots of stains. The office is also used as a sleep over room for staff, and as such should be made comfortable. We looked at the recruitment records of two staff, the registered manager must make sure that all references have been validated. We looked at four references and none of them had any record of any individual validating them. We saw a lot of copies of original documents in both files, the registered manager must make sure that any copies have a signature of the person that copied the document and a date of when Care Homes for Adults (18-65 years) Page 8 of 30 this was done. One of the staff files did not include a staff photograph, we were told by the registered manager that she would make sure that this was done imminently. We looked at the safe working practices at the home, the registered manager must make sure that all hot water outlets are checked regularly to make sure the hot water temperature is set at the safe temperature to protect residents and staff. 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 30 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 30 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. The home provides a statement of purpose that is specific to the individual home and the resident group they care for. It clearly seats out the objectives and philosophy of the service supported by a service user guide. When requested the documents can be produced in different formats to meet the capacity of the resident. Evidence: Comments from people living at the home. I like living here, the staff are really nice and support me. One client signed to say they were happy living at the home. We spent time looking at the statement of purpose and service user guide, both records were up to date and relevant, informing prospective residents and the people living at the home what the service can provide. we were told by the registered manger that the documents can be available in different formats if requested. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: We spent time looking at a residents file the individual had very complex care needs. The initial care needs assessment was informative and the home provided a care plan and support package to meet their needs. There were a lot of revive wed assessments in place that show the home is constantly reviewing the care needs of the people living at 6 Harrow View. We discussed input from family members and were told by the registered manager that the families of the three residents living at the home have a lot of input into their relatives care. We spent time with the three clients who told us they are happy living at the home. We looked at one residents file that included a contract with the terms and conditions of 6 Harrow view. The contract was in agreement with the registered manager and the family of the resident. The placing local authority had agreed to the care package and review records were seen in the residents file from meetings that had taken place about the care provided at the home. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service know and record the preferred communication style of the individual, and will use proven methods that enable the person to lead a full life that promotes independence and choice. Theses include communication aides such photographs and pictures and symbols. Evidence: Comments from people living at the home and their relatives. The staff support me to be as independent as possible All aspects of care are done really well. Personal hygiene and cleanliness is excellent. We spent time looking at one residents care plan, the care needs of the individual are complex. The care plan was very informative showing all social and health care needs Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: and how the home was meeting the needs. We spent time talking to all three residents and the staff on duty, the staff were very knowledgeable about the residents needs and were seen to be working closely with the residents supporting them and talking to them not telling them what to do. We saw a lot of care plan reviews that show the home reviews all of the residents care needs on a regular basis. We spent time with one resident in their bedroom who told us that he is supported very well and staff will encourage him to do self care tasks for himself. The resident told the staff when he had, had a bath that morning. We looked at daily records that show the choices the residents make on a daily basis. We spent time talking to the registered manager and staff who told us that the three residents have different care needs from support to full assistance, however each resident is supported to make decisions daily including what to wear, what to eat, where to go for activitys. We looked at the finance records of all three residents, one residents finances are monitored by their family. The financial transaction records for all three residents were correctly completed with receipts in place for all transactions. The correct balance was counted in each residents wallet. We looked at the risk assessment records of one individual, the risk assessments were very thorough and included an action plan of all identified risk areas. The risk assessments worked in conjunction with the assessment and care plan information. We saw a lot of risk assessment review records, we were told by the registered manager they are completed annually or when a risk is identified. We looked at the training records of all staff that show that staff have attended risk assessment training. Care Homes for Adults (18-65 years) Page 14 of 30 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. Residents are involved in meaningful day time activities of their own choice and according to their individual interests, diverse needs and capabilities. Where appropriate education and occupational opportunities are encouraged, supported and promoted. Evidence: Comments from people using the service. I like doing activitys with the staff, we have a good time I am going to college again next September, I am going to do the same course in computers as my friend. We looked at one residents file that included the individuals chosen religion. We Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: discussed spiritual needs with the registered manager and we were told that none of the residents attend any religious services. We spent time looking at all three residents activity programmes. All three residents have a full programme of activities including community centres, going to local shops, eating out, going for trips on trains and in cars, going to college, meeting family and friends. We spent time talking to a resident who told us that he enjoyed going out with staff, on the day of the inspection all three residents were taken out into the local community for lunch, and one resident was going clothes shopping. There was a therapist working with one resident who visits the home on a daily basis to provide activitys and also massage therapy. We were told that the resident has gone from having 10 minuet sessions to hour long sessions now and they enjoy the time with the therapist. We discussed visitors coming to the home with the registered manager and was told that all family members visit the home on a regular basis. Two of the residents go home every other weekend to see their families. We saw daily records that showed when family members visited the home. We looked at the care plan of one resident that had daily routine information in place, staff were seen interacting with the residents, supporting them and not telling them what to do. We spent time talking to one resident about the food provided, we were told that the individual really likes the food and will choose what they want. We spent time looking at the weekly menu and talking to staff, we were told the menu is chosen for nutrition and also around cultural diets. All three residents are from different cultural backgrounds, staff told us that different meals are cooked. On the day of this inspection all three residents were going out for lunch. Care Homes for Adults (18-65 years) Page 16 of 30 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. Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and is flexible, consistent, reliable, and person centred. Staff respect privacy and dignity, and are sensitive to changing needs.Residents have access to healthcare and remedial services. Evidence: Comment made by people that use the service and a relative. All of the staff support me really well. Give good support to all of the residents. We spent time in the home and watched staff interacting with residents supporting and assisting them with their personal care. All personal care took place in the residents bedroom or in the homes bathroom. All three residents require different levels of support from prompting and encouraging to full care. All residents have a key worker that is responsible for recoding any care need changes and also liaising with other healthcare professionals. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We looked at one residents file that had a full healthcare plan in place. All annual check health checks had taken place including visiting the optician, hearing tests, visiting their GP. We were told by the registered manager that the resident will not go to the dentist and will not allow a dentist into the home. All staff are aware to keep a check on the residents oral hygiene programme. We saw information regarding input from multi- professional specialists including psychology, psychiatry and other therapists. We spent time looking at the medication records kept at the home, we looked at all three residents medication records. The MAR sheets were correctly recorded with daily audit records were medication is counted and the information given at the staff handover. We checked the medication that was in the home, all medication was stored correctly and all of the correct amount of medication was accounted for. We were told by the registered manager that she checks the medication on a regular basis. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. It is available on request in a number of different formats including pictorial to help anyone living at or involved with the service to complain or make suggestions for improvement. Evidence: Comments form people that use the service. I am happy living here, if I had a problem I would speak to manager or a member of staff. We spent time looking at the complaints policy and procedure. The complaints procedure is available in different formats, we saw a copy of the complaints procedure on the notice board in the kitchen that was in pictorial format for two of the residents and in bold print for the other resident. The complaints procedure was also include in the statement of purpose and service user guide, with time scales included to show that the complaint would be investigated appropriately. There have been no complaints in 6 harrow View in the last 12 months. We spent time looking at the homes safeguarding policy and procedure. We discussed safeguarding procedures with the registered manager and staff, all were knowledgeable about the procedure that should be followed if a safeguarding incident Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: occurred. In discussion with the registered manager we discussed having a safeguarding folder with the homes procedure and the local authority safeguarding procedure for staff to refer to if a safeguarding incident occurred. We looked at the training information for all staff and all staff have attended safeguarding training. There have been no safeguarding incidents at 6 Harrow View in the last 12 months. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is very pleasant and a well maintained environment. Evidence: Comments from people that use the service. I really like living here, my room is really nice. One resident signed to tell us they like their bedroom and that is was comfortable. We spent time having a full tour of 6 Harrow view. The communal areas of the home are comfortable with good fixtures and fittings. The kitchen was very well decorated, we were told by a resident that the kitchen had recently been decorated. We were escorted by all three residents to look at their bedrooms, all three residents were happy with their bedrooms. The furniture in two residents bedrooms was adapted as they had behavioral issues and the bedrooms had to be made safe. We were told by the registered manager that the information was in the care plan and risk assessments. One resident was very happy showing us their bedroom, we were told that he had just tidied his room so that it was very tidy. We were told by the Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: registered manager that the house is getting new windows and then all windows will have new curtains or blinds. The staff office that is also the sleep over room needs a new carpet as it is badly stained. We went into the garden that is at the back of the house, there is also a therapy/activity room at the back of the garden that residents will have therapy sessions and play. There was a lot of art on then walls that the residents had done. On the day of this inspection the home was clean and very tidy. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are consistently enough staff available to meet the needs of the people using the service. The staffing structure is based around delivering outcomes for residents and is not lead by staff requirements. Evidence: Comments from people that use the service and their relatives. I really like all of the staff they support me when I need it. Staff always act and listen to what parents say. One resident signed to say they like the staff. We spent time looking at the AQAA that was returned to the CQC that had all of the staff qualifications. There are currently 10 staff working at the home, 8 have a NVQ level 2 qualification with 3 also having a NVQ level 3. We spent time talking to staff who were positive about the qualifications. We spent time looking at the staff rota for the month of July and August 2009. There are constantly sufficient staff on duty to meet the care needs of all three residents. We Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: spent time talking to the registered manager who told us that the current staffing levels are in place to meet all care plan contracts as all three residents have one-one care. Staff were positive about the staff team, comments were that they work closely to make sure all of the residents are well looked after. We spent time looking at the staff training programme for all staff, all staff are up to date with mandatory training. Two new staff are at present going through the induction programme. We spent time talking to staff who were all very positive about the training they had completed. We spent time looking at the recruitment information fro 2 staff one being recently employed the other working at the home for 5 years. The references in both files did not show that they had been validated. The registered manager stated that they were however there was no information pertaining to checks on any of the four references looked at. The new staff employee did not have a photograph in the file, the registered manager stated that she would make sure this was done imminently. We saw a lot of copies of original documents in each file, we asked the registered manager if the originals had been looked at, we were told that all originals are required as part of the recruitment procedure. The registered manager agreed that all copies will in future have a signature of the individual who saw the original and a date entered for when it was seen. All other recruitment information was in place including a CRB Enhanced disclosure for all staff. We spent time looking at supervision records for two staff, the supervision records show that supervision meetings take place on a regular basis. We spent time talking to the registered manager and staff, all stated that supervision was provided regularly to all staff. We were told by staff that there was an open door policy at 6 Harrow View and the registered manager was very supportive. Care Homes for Adults (18-65 years) Page 24 of 30 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 manager has a clear understanding of the key principles and focus of the service, based on organisational values and priorities, they work to continuously improve the service. The manager promotes equal opportunities, has good people skills and understands the of person centred care and effective outcomes for people who use the service. Evidence: Comments from the people that use the service and staff. The manager is very good to me, she has helped me a lot. There is an open door policy and the manager supports me when I need assistance. I have worked here for over 5 years I think this is a good home to work in the manager is very supportive. We spent a lot of time with the registered manager who was very knowledgeable Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: about all procedures in the home. Residents and staff were all extremely positive about the registered manager. The Registered manager has a level 4 NVQ in Management.We discussed training with the registered manager who told us that she attends relevant training to keep herself up to date. The registered manager is also a key trainer for Clover. The registered manager was seen to be very inclusive at 6 harrow View assisting residents when required and working with the staff as a team member. We looked at quality assurance information at the home that showed annual questionnaires are given to residents, their relatives and any other stakeholder involved with the home. We did see a lot of positive comments on questionnaires regarding the care provided. We discussed the outcome of the findings and was told by the registered manager that any issues are dealt with straight away with an action plan put in place. We did not see a summary of the homes quality assurance annual review on the day of this site visit. We spent time looking at the health and safety records at the home including fire alarm checks, evacuation records, gas, electric and PAT testing. We also spent time looking at the storage of food and the daily temperature records of the fridge and freezers. We were told that the Environmental Health had just completed a unannounced inspection with no recommendations made, the registered manager told us that they had 4 stars at the last visit and hoped for the same outcome this time. The registered manager did send a AQAA document to the CQC that had all information on safe working practices at the home including information that all staff are up to date with moving and handling, food hygiene, fire safety and health and safety. The registered manager must implement a procedure for checking the safe hot water outlets in the home to make sure they are all set at a safe temperature and the residents and staff are protected. Care Homes for Adults (18-65 years) Page 26 of 30 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 30 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 13 The registered manager to put in place a safeguarding folder with all relevant information in place. For staff to access and follow correct procedure if a safeguarding incident occurs 29/08/2009 2 24 23 The registered manager to replace the carpet in the staff office-sleep over room. To provide a comfortable environment for staff to work and sleep in. 29/09/2009 3 34 19 The registered manager must make sure that all references have been validated. To make sure the references are valid to protect the people using the service. 29/09/2009 Care Homes for Adults (18-65 years) Page 28 of 30 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 4 34 19 The registered manager 29/09/2009 must make sure that all staff personnel files have a recent photograph of the staff member. To ensure the identity of the employee and protect the people using the service. 5 34 19 The registered manager 29/09/2009 must make sure that the copies of original documents have a signature and date of who saw the original and when. the original was To make sure all copies are taken from original documents. 6 42 23 The registered manager must make sure that hot water outlets in the home are checked regularly. To make sure the hot water is set at a safe temperature to protect residents and staff. 29/09/2009 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 Care Homes for Adults (18-65 years) Page 29 of 30 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. 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