Care Home: 8 Yealand Drive

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 8 Yealand Drive 8 Yealand Drive Ulverston Cumbria LA12 9JB 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: Ray Mowat Date: 1 2 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 28 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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: 8 Yealand Drive 8 Yealand Drive Ulverston Cumbria LA12 9JB 01229582764 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): sue.millington@oakleatrust.co.uk The Oaklea Trust Name of registered manager (if applicable) Mrs Susan Millington Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 5 care home 5 learning disability Additional conditions: The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD (Learning Disabilities) up to 5 service users in the category of LD (E) (Learning Disabilities over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 28 Brief Description Yealand Drive is situated on a residential housing estate on the outskirts of the town of Ulverston in Cumbria. It is on a bus route and is within walking distance of local amenities and approximately two miles from the town centre. The home is owned by Fairoak housing association but managed and staffed by the Oaklea Trust, a not for profit charitable organisation, specialising in providing services to people with learning disabilities. The home is registered to provide residential care for up to five people with learning disabilities. The front garden has been made into off road parking for two vehicles. There is ramped access to the front door and the downstairs of the home and rear garden are fully accessible. The ground floor consists of a large lounge, an open plan dining room and kitchen. There is also a laundry/utility room a bathroom with accessible bath and toilet and a single bedroom. Upstairs there are five bedrooms, one being a staff sleep-in room the other four being residents bedrooms, there is also a bathroom with a traditional bath, overhead shower and a toilet. There is a good size rear garden that is accessible from the patio by a paved path. The home has access to a people carrier style vehicle. The home provides suitable information to residents in the statement of purpose and service user guide, with some information provided in alternative formats such as symbols and audio versions. The range of fees is from £527.50 to £712.27 with additional charges for personal sundry expenses. 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 Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. During the visit we (The Commission for Social Care Inspection, CSCI) met with people living in the home and talked to the staff on duty. We also met with some care staff individually and asked them about their role and responsibilities. The manager completed a self assessment questionnaire called an Annual Quality Assurance Assessment (AQAA) and sent it to us before the inspection visit. This provided us with information about how the home is run and the managers views on what the home does well, where they have improved and plans for the future. There is also information about the people who live in the home and the staff working there. Surveys were sent out as part of this inspection to people living in the home, staff and other professionals with their views being used to formulate the judgements in this report. We also examined records relating to the running of the home that are required by legislation, which included care plan files that guide staff in supporting people to achieve their goals and lead independent lives. We examined records relating to the maintenance and safety of the home, however staff records were not available due to the managers absence. What the care home does well: Care Homes for Adults (18-65 years) Page 7 of 28 The homes statement of purpose and service user guide have been kept under review making sure the information is up to date and accurate. These are made available to people in different formats such as audio tape and DVD making them easier for people to understand. All the people in the home have been issued with a contract of terms and conditions called a customer agreement. This explains the rules about living in the home, peoples rights and the cost of the service. A person centred care plan has been developed with each person living in the home using photographs and pictures to make it more meaningful to the individual. They contain valuable information about how the person prefers to live their life and what is important to them, which helps and guides staff in providing a personalised service and helping people to achieve their goals. How people communicate is an important part of the care plan and gives staff a better understanding about the person and how they will make their needs known. Everyone in the home has been offered an annual holiday or a number of day trips if they prefer, which they obviously enjoy and value. Peoples preferences in relation to activities and leisure pursuits are also recorded. There is a competent and well trained staff team in place who have worked in the home for a number of years ensuring a good continuity of care for the people living there. Staff said we get regular supervision and support from the manager and senior staff. Regular meetings are held with people living in the home and with staff to make sure peoples views and opinions are recorded and responded to. Feedback in the surveys sent to staff as part of this inspection were positive as reflected in the following comments regular training and refresher courses are available, We enable people to reach their level of independence and respect their preferred choices. We put the needs and wishes of the customer at the centre of all we do. The home is well maintained and decorated and furnished to a good standard. All areas of the home are clean and hygienic. What has got better from the last inspection: The range of activities offered to people has increased both in the home environment and in the local community. Medication records were all up to date and accurate making sure peoples medication is managed safely. The home was well maintained making it safe and comfortable for the people living there. Risk assessments have been kept under review making sure they are up to date and relevant. Care Homes for Adults (18-65 years) Page 8 of 28 What the care home could do better Sponges should be removed from the communal bathrooms to make sure people only use their own toiletries and avoid the risk of cross infection. Daily activity sheets are completed on a daily basis at the end of the shift, these should be monitored on a regular basis to make sure all the people living in the home are given the opportunity to take part in appropriate activities including people with limited or no verbal communication skills. All staff absences should be covered so that there are enough staff available to support peoples individual needs. The emergency lighting system should be checked to ensure it is working properly. The fire safety record/log book should be looked at to make sure all weekly checks are being carried out in line with fire officer recommendations. 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 9 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 10 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 . Ongoing assessments are kept under review to ensure the home is suitable and can respond to peoples invidual needs. Evidence: The homes statement of purpose and service user guide are very informative and have been kept under regular review to make sure they are up to date and accurate. They are issued to people on admission to the home and made available to people enquiring about the service. They are made available in different formats including a DVD making information more accessible to people. The organisation also has an informative website.This ensures that people have all the relevant information they require to make an informed decision about moving into the home. There have been no new referrals to the home as there is a stable group of residents. All referrals are made by the social work team with detailed assessments completed prior to admission including any specialist assessments by health professionals involved. Based on these assessments detailed person centred care plans are developed to guide staff in providing a suitable service that responds to individual needs and preferences. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Staff receive suitable training giving them the skills and knowledge to support people to lead a fulfilling and independent lifestyle. Through the completion of person centred care plans staff develop a good understanding about each persons individual needs and personal preferences about how they like to live their lives. Care Homes for Adults (18-65 years) Page 12 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 . Person centred care plans help staff to support and guide people to lead an independent lifestyle. Evidence: Key workers are appointed for each peron living in the home. The key worker will take a lead role working closely with the manager and other professionals to make sure peoples individual needs and preferences are assessed, recorded and reviewed on a regular basis. Person centred care plans and My life, my choice books are used to record in detail peoples basic and specialist needs and how they like to live their lives. This included important relationships in peoples lives, likes and dislikes, what is important to them and their personal and healthcare needs. These are recorded using pictures and symbols to support the typed text making them easier for people to understand and contribute to them making them more meaningful. The care plans are very detailed and provide valuable information for staff particulalry relating to personal and healthcare needs and how people communicate their wishes. These are called communication passports that identify how people make their needs known and the meaning of common gestures, words or behaviours based on previous experience of Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: the person. Staff complete a daily events form for each person, which records all daily events and should record how peoples rights and choices have been respected. They included activties undertaken, food choices and a record of any achievements. Based on the records examined two people have a sedentry lifestyle spending a lot of their time in and around the home. It was not clear from the records if this was their choice or that alternatives were either not available or not offered. Although the person centred care plans are detailed and contain a lot of valuable information about how people like to live their lives, the systems for monitoring that people are achieving their goals and leading an independent lifestyle should be strengthened. When staff absences are not covered leaving just two staff on shift, such as on the day of this visit, this has a negative impact on peoples opportunities to participate in activities outside of the home. It is recommended the home review how choices are offered to people with limited or no verbal communication skills and how these are recorded, to enable the home to accurately assess how they are meeting peoples needs. Use of pictures and symbols to help people understand the choices available to them would also be beneficial. In addition to key workers consulting with people individually regular house meetings are held enabling people to be involved in all aspects of the running of the home. We examined the minutes of meetings, which reflected peoples involvement with discussions and decision making such as choosing new colour schemes for the decoration of the home or new furnishings. The organisation also has a customer forum which people can contribute to through their house meetings or by attending the forum personally. There is a good range of risk assessments in place to safeguard people living and working in the home. These include personal risk assessments for specific activities as well as general risk assessments for the environment. These are kept under review to make sure they are up to date and relevant. Based on discussions with staff they have a good understanding about their responsibilities in relation to maintaining confidentiality. All records were securely stored with staff only sharing information on a need to know basis. A good example of this was a member of staff who questioned my presence during a handover of personal health information. The home has a suitable policy in place, which is discussed with staff at induction and through ongoing training and supervision. Care Homes for Adults (18-65 years) Page 14 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 . People are supported by staff to pursue their interests and hobbies both in the home and in the local community. Opportunities can be restricted by occasional staff shortages. Evidence: One of the five service users attends the local day service five days each week monday to friday. This provides them with a good range of educational and vocational activities in addition to the hobbies and interests they pursue from home. We met with service users and they all appeared relaxed in their home environment and were moving feely around the home with staff offering unobtrusive support. Only one person was able to share their experiences with us who said they were happy living in the home and liked it because it is peaceful. People were offered everyday choices such as what time to get up, what to wear and what to eat and drink. Some people were enjoying a busy lifestyle and participating in a good range of activities both in the home environment Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: and in the local community. Others had a more sedentry lifestyle spending a lot more time in and around the home. Some relaxing activities have been developed by staff using multi sensory equipment and music to provide a relaxing atmosphere in peoples rooms. Every three weeks a music therapist visits the home and people also enjoy going out to a weekly social club to meet their friends. One of the people attends the day service part time, which suits their needs. We examined the daily activity sheets that are completed by staff at the end of the shift. It was not clear from these if people had chosen a quiet life at home or if there was a lack of opportunity for them. Certainly on the day of the inspection a staff absence had not been covered and there were only two staff on duty during the day and this restricted peoples opportunity to get out and about. Peoples individual hobbies and interests were well documented which is helpful for staff when planning activities. All the people enjoyed either a weeks holiday or a number of day trips during the summer months, which judging by the photographs they enjoyed. Staff support people to attend local events and concerts which also prove popular. The home has a people carrier style car that is used to transport people around the local community. Special occasions and birthdays are celebrated with house parties and people enjoy a Bar b q in the summer months giving them another opportunity to socialise with friends and family. Meals and menus are very flexible with staff having a good understanding about peoples different tastes, likes and dislikes. Staff support people with the menu planning, shopping and preparation of meals making sure appropriate choices and alternatives are provided and people have a varied and nutritional diet. Care Homes for Adults (18-65 years) Page 16 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 . Personal and healthcare needs are well documented and closely monitored by staff to make sure they receive appropriate support and have access to health services. Evidence: Each individual has a personal health action plan and health record that documents their personal and healthcare needs and all interventions and contact with health professionals. This ensures people are receiving appropriate support and guidance in relation to their healthcare. The home is involved with a number of agencies and health professionals who contribute to peoples care plans and specific strategies that guide staff in responding to sometimes challenging behaviours, ensuring a consistent and reliable service is maintained. We observed staff administering medication which was handled in line with good practice guidelines with all medication administered being signed for as it was taken. During administration a tablet was dropped on the floor and again this was handled appropriately with the tablet being bagged up and returned to the pharmacy and a replacement tablet administered. Medicine records were clear and were up to date and accurate supporting and guiding staff in the safe handling and administration of all medication including PRN (as and when required medicines). How and when PRN medication is administered is agreed and approved by the relevant health professional involved. All medication entering or leaving the home Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: is recorded enabling accurate stock records to be maintained. All the medication was securely stored in a wall mounted purpose built cabinet and is stored in either a monitored dosage system or the prescribing pharmacy container. Care Homes for Adults (18-65 years) Page 18 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 . The home listens and responds to peoples views and makes sure they are safeguarded at all times. Evidence: The home has a suitable complaints policy and procedure that is issued to people when they move into the home. It is provided in different formats making it more accessible to people and easier for them to understand it, including audio and DVD versions, which is good practice. There were no recorded complaints since the last inspection. There have been no adult protection referrals made since the last inspection visit. The home has appropriate procedures in place to guide staff practice and ensure people living in the home are safeguarded. Staff receive suitable training that ensures they are aware of their responsibilities in identifying, recording and reporting incidents or concerns. Based on discussions with staff they were confident that reported incidents would be taken seriously and acted upon. Care Homes for Adults (18-65 years) Page 19 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 . Yealand Drive provides a safe and comfortable home that is decorated, furnished and maintained to a good standard. Evidence: A programme of repairs and renewals is agreed each year as part of the annual business and development plan for the home. This ensures the home is well maintained, safe and comfortable. The decor and furnishings are of a good standard and suitable for the individual needs and lifestyles of the people living there. People are involved in choosing new colour schemes and furnishings. A good example of this was how staff picked up that a person who has autism was turning over their quilt when they went in their room. The quilt had quite a bold pattern, which was changed for a more neutral colour, which has been beneficial with the person now happy to spend time relaxing in their room. An accessible spa bath has been installed in the downstairs bathroom, however despite this, one person is not able to access this and Social Workers are reviewing there placement to ensure personal care needs can be appropriately met. People are involved in household chores including the cleaning of their rooms. Four bedrooms have been recently decorated and all roooms have had a new lockable cabinet provided. Further decoration is planned in addition to the front driveway being resurfaced. All areas of the home were clean and hygienic and suitable laundry facilities are in place. The home has suitable infection control policies and procedures in place to guide good practice with clinical waste facilities provided. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: However a number of bath sponges were left in the upstairs bathroom, with no way of identifying who they belonged to, and which is used by a number of different people. The home should ensure personal toiletries are stored seperately to avoid communal use and the risk of cross infection. Care Homes for Adults (18-65 years) Page 21 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 . The home has a consistent staff team who are well trained and competent in their role and are committed to supporting people to achieve their goals. Evidence: Due to the absence of the manager during this inspection visit some of the staff information was not available, therefore the following judgements are based on staff survey responses, discussions with staff during the visit and information taken from the AQAA. Over 50 of staff have achieved their National Vocational Qualifications at either level 2 or 3. All new staff complete a thorough induction programme including the Learning Disability Award Framework (LDAF) as well as spending time in the home shadowing experienced staff. During the induction period the manager meets regularly with the new staff to reflect on their skills, knowledge and training and development needs. We examined the staff rotas for the home for the last two months. This reflected a suitable number of staff being on duty for the majority of the shifts, however when staff absences are not covered such as on the day of the inspection and there are only two staff on duty, it is difficult to meet all the peoples individual needs. When staff absences are covered the home use either one of the regualr staff or one of the regular relief staff who are familiar with the people living there and their routines. This provides a good continuity of care for people. We examined the staff meeting minutes which showed that regular staff meetings are held, which keeps the staff team Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: up to date with changes and enables them to discuss relevant events. In addition staff said they met regularly with their manager for formal supervision every 4-6 weeks. They said this gave them an opportunity to talk about anything that concerned them and that it is our time to raise any issues or concerns. They also said training, development and practice issues are discussed. Several staff responses talked about good communication and how this helped them to respond to the changing needs of people communication is good between the team and it is a brilliant team to work with, whereas another person felt a better means of communication was required. Based on feedback from staff they were receiving suitable training to guide and support their practice in both core subjects such as manual handling, first aid and mistreatment and abuse as well as more specialist training specific to the people living there. Care Homes for Adults (18-65 years) Page 23 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 . The manager provides clear leadership ensuring the home is run in the best interests of the people living there. Evidence: The registered manager Sue Millington continues to provide clear leadership and support to the people living and working in the home. The staff we met commented on a well run home. They confirmed that Mrs Millington was always available and they could discuss any issues with her as they felt their comments were valued and taken on board. House meetings are held on a regular basis in addition to key workers meeting with people individually and the organisation organising customer forums for people living in the home. Residents meetings are also held on a regular basis, we examined the minutes from the recent meetings which reflected service users views and suggestions. The most recent included a discussion on the arrangements for Christmad lunch, which were agreed with people. Formal consultation takes place with a quality questionnaire used to gather peoples views. The most recent report resulting from this consultation was included in the service user guide, including peoples responses and actions agreed in response to them. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: We examined various records required by legislation including personal finances and a house file recording health and safety checks. These were up to date and in order, with all financial transactions signed by two staff and regular checks taking place and recorded. Managers have received budget training and work closely with the organisations finance department to agree an annual budget and Business plan and monitor all income and expenditure ensuring the home is viable and operating effectively. The fire officer recently visited the home to undertake an audit of systems and records in May 08. Recommendations from this visit have been put in place including a new risk assessment and recording system in line with fire safety regulations. It is recommended the home review weekly fire safety checks and how these are recorded as the record started on 7/5/08, yet there were only 10 signitures in place, which would suggest the last check was in August. We also looked at weight charts, legioella records, environmentla H&S checklist, fridge freezer checks water temperature checks, carbon monoxide record, fire log. All other health and safety checks were in order and up to date. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 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 Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 The home should review how choices are offered to people, with limited or no verbal communication and how these choices are recorded. The home should ensure personal toiletries are stored seperately to avoid communal use and the risk from cross infection. All planned staff absences should be covered to ensure there are sufficient numbers of staff on duty to meet peoples individual needs. The fire safety record should be reviewed to make sure checks are being completed in line with fire officer recommendations. Emergency lights were on during this visit, which should now be checked to ensure they are working properly. 2 30 3 33 4 42 5 42 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!