Care Home: 7 Wellington Street

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What the care home does well There is safe and thorough recruitment of staff, this means the service provides safeguards for people who live at the home. The home has a stable staff team. Staff spoken with were enthusiastic about their work, enjoy supporting people, are happy with the training opportunities available to them and feel well supported. Plans of care are very well written offering information on daily routines, choices, likes, dislikes and preferences. This shows the service looks at every individual independently to ensure their needs are met. Good plans of care give the staff the information and confidence needed, and demonstrates they are aware of individuals needs and are able to meet them. There is a wide range of activities on offer within the home and in the community. People are encouraged to take part in the daily routines of the home where possible. What has improved since the last inspection? The last key inspection was undertaken in April 2007, there have been no visits to 7, Wellington Street since then. The requirements made at the last inspection have been met and improvements in the following areas were noted. The service has improved the way they record and inform staff on managing risk. This means everyone is protected and people are not left in a vulnerable situation. Behavioural plans of care are in place which means staff can support people in a consistent and considered way. Health care monitoring is well recorded and which now includes weight charts, this means people are fully supported with their health requirements. The home has introduced menu planners with symbols and photographs of all dishes. We have reviewed our practice when making requirements, to improve national consistency. Requirements are made when it is considered that people who use service are being put at risk to their health, safety or welfare. One requirement was made on this inspection; consideration of recommendations made will continue to support the ongoing development and maintenance of the home. What the care home could do better: Medication practices and systems need to be managed better. This is to ensure that people using the service receive their medication to promote their health, and that risk of harm through error is minimised. The home needs to consider how each person would be evacuated in the event of a fire and to seek advice. This means people are kept safe.The home must make sure that they have detailed information on bed guards and protectors, this is to ensure people are as safe as possible. Key inspection report Care homes for adults (18-65 years) Name: Address: 7 Wellington Street 7 Wellington Street West Bromwich West Midlands B71 1DR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Rachel Davis     Date: 1 7 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: 7 Wellington Street 7 Wellington Street West Bromwich West Midlands B71 1DR 01215323556 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Pioneer Care Limited Name of registered manager (if applicable) Ms Sandra Horsley Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1 service user who may also have a physical disability Date of last inspection Brief description of the care home 7, Wellington Street is a semi-detached property which is rented from the Local Authority and is located in West Bromwich. The centre of town is within a two mile radius,there are local shops nearbyand public transport is good. The home is fully occupied and registered to provide care for three people with learning disabilities one of whom may also have a physical disability. The accommodation includes a dining area, lounge, kitchen, downstairs walk in shower and toilet, three bedrooms on the first floor, a bathroom and toilet, and sleeping in room. There is a Wessex style lift leading from the lounge area directly into one of the bedrooms. There is a ramp leading to the front door and back garden. There is off side parking on the road in front of the property. The garden to the rear is has a patio and large lawned area which is secluded. provision. Information regarding the fee levels is not available in the Service Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home User Guide and therefore people need to contact the service directly to access this information. 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: One inspector visited the home for six hours on 17th March 2010. This visit was a key inspection and we advised the registered manager on 15th March 2010 that we were coming. We use the National Minimum Standards for Care Homes for Adults as the basis for the inspection. The last key inspection was held on 11th April 2007, there have been no further visits to the home. Before this visit took place we sent out an Annual Quality Assurance Assessment (AQAA), this is a self assessment document that all services must complete. The AQAA gives us important information about the way the home is meeting National Minimum Standards in care and the improvements planned to create better outcomes for the people who live there. We look at any notifications they have sent to us about events that affect the well being of the people who live there. There were questionnaires sent to people who use Care Homes for Adults (18-65 years) Page 6 of 29 the service and staff members. Four were returned from staff. We case tracked one person who lives in the home. Case tracking includes meeting people and talking about the care they receive or watching staff supporting them, looking at their care records and medicines and the way that they are helped to make choices and decisions. This assists us to understand the experiences of people who live in the home. Time was spent talking to the staff team on duty during our visit and observing the way they interact with the people they care for. We could not speak with the people who live there about their experiences of living in the home as one person can only communicate with the staff and the other two people were out. We looked around the building to make sure the home is clean, warm and comfortable. We looked at the bedrooms, the lounge area, the dining room, and bathing facilities. We inspected the storage system and medication procedures and we looked at records of staff training and recruitment, health and safety records and the food people are offered. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Medication practices and systems need to be managed better. This is to ensure that people using the service receive their medication to promote their health, and that risk of harm through error is minimised. The home needs to consider how each person would be evacuated in the event of a fire and to seek advice. This means people are kept safe. Care Homes for Adults (18-65 years) Page 8 of 29 The home must make sure that they have detailed information on bed guards and protectors, this is to ensure people are as safe as possible. 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 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. People have the necessary information and have been suitably assessed prior to moving into 7 Wellington Street. Evidence: The AQAA tells us : We provide a holistic approach so that all potential new service users can be assured that their needs will be met. The service has a Statement Of Purpose and Service User Guide, these set out the aims and objectives of the home, and include information about the service. The documents are made available in a format appropriate to the people who use the service, individual capacity and language. The Service User Guide needs to include the fees payable , this means prospective people have information on the costs involved. Reference to the Care Quality Commission (CQC) including the address needs updating. Presently documentation refers to the Commission for Social Care Inspection (CSCI) which changed to CQC in April 2009. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: There have been no new referrals since the last key inspection held in April 2007. There are three people living at 7, Wellington Street, they have all lived there for a significant length of time. The needs assessments have been looked at on previous inspections and were again during this inspection. Records demonstrate they are in keeping with the practices at the time of the assessment. 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. Plans of care have been reviewed and offer all the required information to fully support the people who live at the home. Additional information within risk assessments would further support the staff in ensuring people remain safe. Evidence: The AQAA tells us : All service users have a needs led assessment which states their individual needs, ability, what they require in help, assistance and support. Plans of care are very good and contain clear information; we found that they are clear, informative and reviewed. They include life histories so staff are able to tailor the way in which care is delivered to meet their specific need. The plans evidence a person centred approach, this means they look at people in a very individualised way and offer evidence of peoples involvement and development of the plans. Overall plans of care are well documented and there are clear day to day records to confirm how people wish to live. It was pleasing to note the home operates a key Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: worker system which enables staff to work with people closely on a one to one basis. We spoke with staff who told us they really liked working at the home and felt well supported. We noted that behavioral management plans are in place, this means there are clear instructions for staff to follow and ensures consistent and appropriate care management is provided to the people who use the service. We are satisfied that other professional support is requested when necessary e.g. from the district nurse or dentist as records verified this. We can also confirm plans of care are reviewed as required. One visiting professional had recorded It was a pleasure to undertake a review and would like to pass on her thanks to the staff team for the good and positive work that has been accomplished. Risk assessments are in place but in some instances should offer clearer information, the manager needs to ensure what is required is carried through. For example one risk assessment stated that bed guards needed to be checked every week. We could not evidence this was happening. It was not clear on how they should be checked or whether staff were competent to do so. This could potentially leave people at risk. We have also asked the service to make enquiries to see whether bed guard covers are required , this advise needs be sought from the appropriate professional. This is to ensure people who use the service are adequately protected. 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. Support is given to promote peoples rights and independence. People are able to enjoy a full and stimulating lifestyle; routines are flexible meaning people make choices in all areas of their life. Evidence: The AQAA tells us : We listen effectively and support our service users to participate in activities, giving encouragement. We looked at the plans of care for two people using the service; we also talked to staff about how they support people using the service. Plans show there are opportunities to maintain and develop social skills and take part in appropriate activities, for example going to day care, shopping, visiting family, eating out and regular outings. Whilst we were here one person went to the local supermarket with the support of a staff member. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Everyone at the home attends church when they wish to. The service arranges suitable transport for everyone and a holiday is provided by the home every year. Surveys tell us : Service users are always asked if they would like to partake in social activities. Everyone living at 7, Wellington Street participates in the homes food shopping and their personal shopping. They access community facilities for activities and health appointments. Where this is not appropriate professionals visit the home. People receive varied meals and have chosen to plan their menus on a daily basis. Staff confirmed issues such as meals were discussed regularly at house meetings. People prepare meals with support, and a range of foods are available in stock to facilitate choice. There is a good selection and ample quantity of fresh fruit and people are free to help themselves. Healthy options are available and weight and diet are regularly monitored. 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. The health and personal care needs of people living at the home are met. Medication is securely stored but improvements are needed in recording systems and staff practices. Evidence: We looked at the health care provided to one person living at the home. We can see that they have had a range of routine health screening with for example the dentist, doctor and optician to ensure any changes in health can be identified and acted on early. The manager has worked in partnership with Social Services to start to make decisions for those lacking capacity who do not consent to health screening and treatment. Weight charts are now being completed for the people who use the service. This is an improvement since the last inspection and staff can clearly refer to these to ensure weight is appropriately maintained. We were able to see two people on the day of inspection. They were well dressed, clean and presented as being calm and comfortable. We talked to staff who said they Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: had no concerns about peoples current health. We observed medication administration at lunchtime and saw that medication was signed off for one person as given before this occurred. This practice must cease, medication should only be signed off after support has been provided by the staff. Medication administration records need to reflect an accurate account. We also noted that records of medications in the home did not tally with the medication administration records, this means there is not a clear audit account. Staff have signed to say that the total of medications is as stated, and clearly it was not. The operations manager confirmed there was no returns book kept in the home, this will be introduced with immediate effect. This system will offer clarity to staff on what medications have or need to be returned to the pharmacist. We also saw that one person had been prescribed a steroid cream, which had been collected by the staff but then not applied , there was no record of its existance. This means the person using the service had not received necessary treatment. We consider this leaves people at risk and efficient, effective and auditable systems need to be implemented without delay. This is to fully protect the people who use the service. The home must make sure they have a safe way of giving people their medicine and staff must ensure they fill in the records properly. This is so that everyone can check that the proper drugs have been given at the proper time, to safeguard peoples health. 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. There are clear procedures in place, helping to give the assurance that people using the service are protected and safeguarded from harm or abuse. Evidence: We can verify the home has a complaints procedure, which is made available to people and their relatives when they move in. The operations manager verified the service acts on all complaints and concerns identified. The complaints book identified no complaints since the last inspection. Through discussion it was evident a concern had been raised and was being dealt with, but it was not recorded in the complaints log. We recommend all comments are evident to support the service with identifying how changes are made to improve the services for the people who live there. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse to vulnerable people and provides a framework of consistency to protect those individuals who are at risk. During our inspection we check to ensure vulnerable people are suitably protected. The home has policies and procedures for safeguarding people in the home and staff have received training for recognising signs of abuse and reporting possible abuse. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: The manager is ensuring the staff are aware of The Mental Capacity Act Deprivation of Liberty Safeguards. All staff must be aware of their responsibilities and ensure there are no other less restrictive ways of keeping people safe and well if liberty is compromised. Decisions must always be in the persons best interests and assessments and questions must be satisfactorily answered. We are satisfied the home is aware of its responsibilities. We looked at how peoples money is protected and are satisfied that effective systems are in place. 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. People live in a comfortable, homely and safe environment. Evidence: 7 Wellington Street is warm, clean and homely; the home has a variety of aids and adaptations which are suitable for the people who live there. We have asked the home in an earlier outcome group to ensure the bedrails used are safe and covers are provided if necessary. All rooms are single occupancy, we saw that bedrooms have been personalised and were individualised to the people who use the service. No one holds a key to their bedroom. Cleaning products and other solutions are locked away reducing hazards to the people who live there. We found infection control procedures are in place, such as liquid soap, gloves, aprons and paper towel dispensers. We have asked the home to ensure they are satisfied that they meet with the Hygiene Code. Care Homes for Adults (18-65 years) Page 21 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. Staff are well recruited meaning people are suitably vetted. There is regular, consistent, appropriate and relevant training being provided. This means people are supported by well trained, skilled and equipped staff. Evidence: During the time we spent at the home we spoke with staff and observed or heard them supporting people. We found there were very positive and engaging interactions between those people living at the home and the staff members. Staff tell us they feel valued and respect their manager. Duty rotas were not checked on this visit but we saw enough staff on duty to meet the needs of people who use the service and we can confirm the home has a consistent staff group. We looked at the files for two members of staff including the last person to be recruited. The new file contained an application form, two written references, health declaration, identification and an enhanced Criminal Record Bureau disclosure. This means staff have been suitably vetted prior to working with vulnerable adults. The date of birth should be removed from the homes application form to comply with age discrimination legislation. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: We were also able to evidence that staff had worked alongside established staff before working as part of the staff numbers. This is known as shadowing and enables staff to understand their role and ask experienced staff any questions. The files also contained evidence of training that has been completed, this included mandatory training and additional training to support the needs of the service. Recently appointed staff have received training in a number of key areas and staff we spoke to feel that this has helped them to gain confidence in their role. We received four returned questionnaires from staff, these are their views: I am extremely happy with the home. The home is very good at taking care of the needs and wants of the service users. The service users happiness is always at the forefront of any decisions taken. Respects service users. Good training is given. Care Homes for Adults (18-65 years) Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at 7 Wellington Road are benefiting from a well run home. The environment is safe with good health and safety procedures in place. This gives the assurance that people using the service are protected. Evidence: A new home manager is starting at the home on 29th March 2010. The registered manager Sandra Horsley covers a number of services and is based at head office which is close by. We saw and heard evidence to validate the present manager and registered manager promote equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. At the time of this inspection the services are being deregistered and re- registered with us as supported living services, there will be no changes to the staff team or where people live. All service maintenance records that we requested in the AQAA were up to date to show the environment is being safely maintained. We discussed individual fire risk assessments and advised the home to consult with the fire service to see if they were Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: satisfied with the control measures in place regarding individuals. We also advised the home to formally consider and record how each individual person would be evacuated in the event of a fire. The registered manager confirmed policies are effectively implemented and monitored. The service operates procedures that seek to ensure the quality of the service provided is good. We looked at the most recent quality assurance documentation which clearly demonstrates outcomes for people. However, the quality assurance is done collectively and therefore does not enable managers to look at specific issues. We recommend future quality assurance systems look at services within the company individually. Care Homes for Adults (18-65 years) Page 25 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 26 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 20 13 Regulation 13(2) 01/04/2010 Accurate, complete and up to date records must be kept of all medication received and administered. This is to ensure medication is accounted for, available and is given as prescribed. 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 1 The service user guide needs to contain information with regard to the costs for living at the home. This means people are clear about what they receive for their money. Recommendation March 2010 All records should be updated to reflect the change in name of the regulatory body from the Commission for Social Care Inspection (CSCI) to the Care Quality Commission (CQC). Recommendation March 2010 Risks pertaining to bed guards should contain a clear management plan. This means people are suitably safeguarded. Recommendation March 2010 Page 27 of 29 2 1 3 9 Care Homes for Adults (18-65 years) 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 4 9 The home needs to seek advise from other professionals with regards to the need for bed guard covers. Recommendation March 2010 Records should contain better evidence to confirm people undertake meaningful and varied activities. Recommendation March 2010 Complaints, comments and grumbles should be kept together to assist the manager in identifying any patterns or trends. Recommendation March 2010 The date of birth should be removed from the homes application form to comply with age discrimination legislation. Recommendation March 2010 The outcomes of quality assurance should be collated for each service rather than collectively. This means people have clearer and specific information about individual services. Recommendation March 2010 To consider how each person would be evacuated in the event of a fire and to seek advice about further minimising the risk of fire. Recommendation March 2010 5 13 6 22 7 34 8 39 9 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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