Care Home: 98 to 100 Gloucester Avenue

Similar services:

• Clover House
• Parkside
• Park Lodge
• Mere Hall View
• St Bonaventures
• Hudson Road
• Whitewalls
• Home Farm

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 98 to 100 Gloucester Avenue Hyndburn Respite Facility 98/100 Gloucester Avenue Accrington Lancashire BB5 4BG     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: Pat White     Date: 1 2 0 2 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.csci.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: 98 to 100 Gloucester Avenue 98/100 Gloucester Avenue Hyndburn Respite Facility Accrington Lancashire BB5 4BG 01254395060 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rebecca.Toman@ssd.lancscc.gov.uk Lancashire County Council Name of registered manager (if applicable) Mrs Rebecca Toman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 folowing categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Gloucester Avenue provides personal and social care for up to 5 adults with a learning disability and additional support needs aged over 18 years. This facility offers respite/short term care only. The establishment belongs to Lancashire County Council. The home is two semidetached houses, located approximately one mile from the centre of Accrington. There was written information about the home to inform people of the services and Care Homes for Adults (18-65 years) Page 4 of 30 care home 5 Over 65 0 5 Brief description of the care home facilities and the staff qualifications and training. The home offers single bedrooms, and has a large lounge/dining room. Two of the bedrooms and one bathroom are on the ground floor for service users with mobility difficulties. The home is maintained to a good standard throughout. The care staff team aim to offer a homely environment. Service users are either private or Local Authority funded. There was some information available to potential service users advising them about the home and information about the type of service they could expect. 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: A main inspection which included a visit to the home, was undertaken on 12th February 2009. This included checking important areas of life in the home and checking what had been done about the things that needed improving from the previous inspection in 2007. For the inspection we talked to 4 people staying there, talked to a relative, looked round, looked at service users care records and other documents, and talked to staff and the person in charge at the time. Also some written information about the home was given to us before the visit which told us about the facilities in Gloucester Ave, the staff and the premises. Questionnaires were also sent to some people using the service, and their families, and to some staff, to find out peoples views about the Care Homes for Adults (18-65 years) Page 6 of 30 service. At the time of writing the report we had received completed questionnaires from 2 service, users whose relatives had completed them on their behalf, and 4 members of staff. Some of the views of these people, and the people who were spoken with, are included in the report. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 8 of 30 The written information about some of the service users and the care and support they needed could be further improved. Some information was not detailed enough to provided useful instructions to staff on all important matters such as the assistance required in washing and shaving and feeding. The written information about the dangers to people in their every day life (risk assessments) was not as good as it could be and there was not enough guidance to staff to help them protect people. How a decision was made about restricting one residents freedom to move around in all parts of the house was not clear. This needs to be improved so that staff can show who has made these kind of decisions and why, and that when made on peoples behalf they are made in their best interests. The written instructions telling staff how to manage and give out medicines could be improved to make sure that people get the right medication whilst staying in the home. The records kept in the home for new staff could be better. They need to show that all the right procedures have been followed to try and make sure that people are suitable for working in the home, and also that they have received enough training when they first start work to look after people 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 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 admissions procedures were thorough and made sure that peoples needs were understood before they came to stay, and also that people were as prepared as possible for the break from their families. Evidence: Through talking to staff and a relative, and looking at records it was evident that before people agreed to have short term care (respite care) at Gloucester Ave for the first time, they were gradually introduced to the service to see if the home was suitable for them, and to see whether or not their needs could be met there. There was a thorough procedure for this introduction, starting with a referral from peoples social workers who undertook a comprehensive assessment of the prospective service users needs. The manager of the home met with service users and their main carer and family to undertake a further assessment, and to gradually introduce people to the home. Service users initially came for meals and gradually built up the time spent in the home resulting in overnight stays and finally stays of a few weeks if necessary. The mother of one of the residents spoken with at the visit to the home confirmed that Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: this had been the process for her son and that through this both she and him were happy that he would settle at Gloucester Ave. For people who stay regularly at the home their needs, and any changes, were updated through reviews and contact with the families before the booked period of respite. Since the previous inspection the contract and terms and conditions that were seen had been updated and now included accurate information about the fees. The person spoken with and two relatives who completed questionnaires indicated that they and the service users were happy with the service, and that it met both the carers need for a break and the service users needs for more independence. 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 needs of the service users were documented in the care plan but this could be improved to give more useful information to staff. Service users were encouraged to make choices in their lives whilst staying in the home and to maintain their independence. Evidence: Each service user staying at Gloucester Ave, for however short a time, had a care plan which provided written information about their needs and how staff should meet these needs. The 3 plans looked at showed that some parts of these plans were detailed and person centred. This means that they described how people would like to be supported from their own point of view and included details of peoples preferences and likes and disklikes. There were sections on all aspects of personal, social and health care and as stated above some sections were completed fully and provided useful guidance to staff. However some parts of the ones looked at were not as detailed as they should be and did not provide enough information. For example one Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: did not provide information about the assistance required with feeding and bathing. Another did not have any information about what assistance was required with shaving and washing and dressing. A third care plan stated that full assitance was needed in a number of personal care matters with no explanation of what this meant. Though there was no indication that people were not receiving the correct support, detailed written instructions are useful to help make sure that the right support is provided in the preferred way. Written details are especially useful in circumstances when the staff and residents change as is the case at Gloucester Ave. There was evidence that people had sufficient choices in their lives whilst staying at Gloucester Ave. As stated above some of the care plans were person centred and stated what people liked to do and how. Talking to staff, looking at records and information provided to the commission by the service showed that people had choices in their daily routine, meals, channels on TV and whether or not to continue attending the day centre whilst staying in the home. Staff worked closely with the relatives to establish peoples likes and dislikes and what they would like to do whilst staying in the home. One resident will only stay in the home when there are no people of the opposite sex, either residents and staff, and this is accommodated as much as possible. Some people choose when they want to stay at the home and some choose the same period as their friends. Some service users chose to manage their own spending money whilst at Gloucester Ave and staff support them in this. Service users and families are encouraged to participate in the running of the home, as much as is possible for a short term care facility. Peoples opinions are sought about the development of the service and people have been involved in the future plans for the development and refurbishment of the home (see Envirinment). Computer games have been bought according to service users request and open meetings have been held to explain and consult about the proposed changes to the respite service. Staff understand the need to encourage service users to maintain and if possible increase their independence. For example staff said that residents could have a key to their bedroom door if they could manage one, and that some people could help in the kitchen if deemed safe. However this was not always underpinned by useful written risk assessments. There were no risk assessments underpinning the use of bedroom door keys and for one resident who had been visiting the home for several months and had two overnight stays, there were no written risk assessments. This meant that staff had no written guidance to direct them as to what the risks were and how this should be managed. Care Homes for Adults (18-65 years) Page 14 of 30 Care Homes for Adults (18-65 years) Page 15 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. Service users were encouraged to take part in appropriate activities and to maintain their independence. However it was not clearly demonstrated how all decisions about peoples rights were made. Relationships with family and friends were encouraged and supported and the food served was in accordance with peoples needs and preferences. Evidence: Through talking to staff, service users and looking at records it was clear that service users were encouraged to continue with their interests and activities whilst staying at Gloucester Ave. Some continued to attend their day centres with transport to and from Gloucester Ave. Service users interests and activities were recorded in service users personal records and showed that people were taken shopping, enjoyed watching TV and listening to music, and were encouraged to use local facilities such as the cinema and going to restaurants. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Service users relaxed in the home by watching TV, listening to music and playing computer games, and sometimes were taken out at the weekend to restaurants and the cinema. The commission was told in the information supplied by the home prior to the site visit that the refurbishments will include installing internet access for service users so that they can bring their lap top computers. Staff in the home made sure that close links were maintained with families. Families were involved in the planning of the service and informed of any concerns during peoples stay in the home. They were also involved in reviews in between periods of respite care. The relative spoken with and those completing the questionnaires felt that they worked in partnership with the staff in the home. One said that staff were very helpful and responsive. Service users were encouraged to maintain and develop friendships and sometimes groups of people chose to stay in the home when their friends were there. As stated above there was information on the care plans about peoples preferred routines and likes and dislikes and these records and talking to staff demonstrated that in general peoples independence was promoted. People could have keys to their bedroom door (see above) and most service users had free access around the home. However one resident had a risk asessment that stated she was not allowed in the kitchen as it was not safe for her to do so. There was no record of who had been involved in making this decision, and how, about a matter which could be seen as restricting this persons choice. There was also no written information about whether or not alternative arrangements were made for involvement in kitchen activities. The plans for the refurbishment of the home indicated that some of the developments would further encourage peoples independence. The food was cooked served by the care staff, and appeared to suit peoples tastes and preferences. Records were kept on service users personal files of what meals were served to individuals each day. This showed variety and meals appropriate for peoples cultural needs. Halal meat and vegetarian meals were served to people if required. Meals were planned on a daily basis so that the tastes of the current residents could be catered for. The tea time meal was observed on the day of the site visit and was relaxed, with good interaction between staff and residents. Appropriate assistance was given to a resident who required feeding and one resident benefited from appropriate utensils to assist her. Care Homes for Adults (18-65 years) Page 17 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. People received appropriate personal care support and health care though some written guidance to staff could be improved. Medication was managed and administered safely though written guidance for staff could be improved. Evidence: Records and talking to staff showed that people received the various levels of personal support they needed and that staff understood their needs. Time was spent in the introductory period getting to know people and how to look after them, and relatives were inviolved in this process. There was also evidence that people received personal support in a culturally sensitive way. However as stated in a previous section the written information underpinning this could be more detailed and person centred so as to guide staff in the care of new residents. This would also benefit staff who are new to the home. Peoples health needs were recorded on the care plan and staff were aware of these. Though the home was not responsible for the organising of peoples health care the home ensured that people received the health care they needed whilst staying in the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: home. For example people would be taken to a hospital appointment if this fell within the period of their stay. People had access to their General Practitioner if need be. There were policies and procedures for the management and administration of medication and some good practices were in place. Looking at records and checking 2 peoples medication showed that good records were kept of medication coming in and out of the home, and accurate records were kept of the medication administered whilst people were staying in the home. It appeared that staff took every step to ensure that medication was administered according to how this was administere at home. Few residents stay in the home who administer their own medicines but some were supported to apply their own creams. This was underpinned by a useful risk assessment showing that this was safe, and how it should be monitored. However some matters were identified that needed reviewing and clarifying for the specific nature of the respite care service. Though the booking in of medication coming into the home and leaving the home was undertaken thoroughly, and some good procedures were in place, there were no written procedures specific to the service to underpin this. The records of one medicine counted when brought into the home showed that there were more tablets than there should have been and it was not clear why or where they had come from. However if someone other than the dispenser had put extra tablets into bottles there was a risk of a mistake being made and the wrong tablets being put in. Also there was insufficient written guidance about when to adminsiter when required medication, and about what dose to give for variable dose medication. For example there was no written guidance about when someones inhalers should be given. For another resident there was no written guidance about when one or two tablets of a medication should be given, only some information passed on verbally from the parent. There was no record of this conversation. Another resident was occasionally give non prescribed parcetamol, but there was no clear explanation about what this was for and no written guidance to staff as to when it was needed. Care Homes for Adults (18-65 years) Page 19 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. There were thorough systems in place to ensure that peoples concerns were taken seriously and to help protect people from harm and abuse. Evidence: The complaints procedure was available in the home, and there was a picture format available to assist some service users. According to the information supplied by the home prior to the site visit no complaints had been made to the home in the last 12 months. None had been made to the commission. The relative who was spoken with and those completing the questionnaire said that they knew what to do if they were not happy with anything but had no concerns so far. There were satisfactory policies and procedures to help protect people from abuse, including a whistleblowing procedure, and since the last inspection staff had undetaken relevant training in Safeguarding Adults. This should further help to protect people. There had been one allegation made by a service user against someone not connected with Gloucester Ave. A member of staff had invoked the Safeguarding procedures and the records kept showed that the correct action had been taken to try and protect the service user. 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 provided comfortable and safe accommodation in accordance with the aims and objectives of a short term respite service for this service use group. Through a comprehensive programme of refurbishment the facilities will be further improved. Evidence: At the time of the site visit Gloucester Ave was going through a period of change together with the other respite care unit for people with disabilities, and a comprehensive programme of refurbishment was planned for these two units. This involved amalgamating the two units during this period. At the time of the site visit the other unit was about to close and the service was to be transferred to Gloucester Ave. On completion of this refurbishment Gloucester Ave was to close for its own refurbishment and service users and staff will temporarily transfer to the new unit. The whole process was expected to be completed in about 12 months. This process was being managed to cause as little disruption as possible and people had been informed and consulted. The plans for refurbishment of Gloucester Ave involves a complete refit for the kitchen and includes adaptations for people in wheelchairs. Two downstairs bedrooms and a bathroom will be further adapted for people with multiple disabilities. The home will be Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: completely redecorated and furnished. Due to the imminent plans for developments only essential maintenance was being carried out to ensure the comfort and safety of the residents. At the time of the site visit the home was adequately decorated, pleasantly furnished and clean and fresh in all areas. The premises were safe, comfortable and homely and furnished in keeping with the residents age group. There was equipment to assist people with disabilities such as a tracking hoist system and an easibath. As stated above the facilities for people with disabilities was to be further improved under the planned refurbishment. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a well qualified and trained staff team that could meet the needs of the service user group. Staff recruitment procedures should help ensure that only suitable people worked in the home but the records kept to evidence this could be improved. Evidence: Records and talking to staff indicated that all the staff team had completed relevant National Vocational Qualifications at different levels, and an Induction training for new staff specific for people working with service users with learning disabilities. There was a mixture of male and female staff that enabled them to provide a gender specific service if need be. The staff spoken with and those four who completed appeared to have a good understanding of their role and how to look after people with disabilities. The home was staffed according to the needs of the residents though 2 staff who completed questionnaires felt that more staff should be on duty sometimes to increase the options for service users. A domestic was employed in the home several days a week to help ensure standards of cleanliness were maintained. Staff records were looked at to check the staff recruitment procedures. These showed that these procedures were in accordance with the Care Homes Regulations but that there were some gaps in the records. The Criminal Records Bureau (CRB) and Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Protection Of Vulnerable Adults checks and suitable written references were obtained prior to people commencing work. However for one member of staff whose records were viewed there were insufficient records kept about the CRB disclosure to demonstrate that there were no matters of concern. For another member of staff there was only one reference on the file. For both members of staff there were no records of induction training having been undertaken. Therefore it was unclear as to how these members of staff had been assessed as ready to undertake all duties. Records, conversations with people and the information provided by the home showed that training was being developed to assit people to carry out their role successfully. The staff member spoken with had completed a number of different training courses indicating that staff had access to the training that they needed to assist them in their work. These courses were mandatory, such as Safeguarding of adults, moving and handling, food hygiene and first aid. Other courses available were British Sign Language and Introduction to Autism. Staff who completed the questionnaires felt that they had relevant training that assisted them to feel competent at work. Staff spoken with and those who completed questionnaires felt that they were well supported by managers, and confirmed that regular formal one to one supervision occurred. Regular team meetings were held, and these support measures should assit communication and good team work. 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. An experienced and qualified manager ran the home in the interests of the service users. The health and safety of the staff and service users was promoted. Evidence: An experienced manager ran the home and and had almost completed all the qualifications necessary for post of registered manager. There was a team leader in post, who was also the deputy manager, and although there had been recent management changes the continuity of management and leadership appeared to have been maintained. The responsible individual had been making unannounced monitoring visits to the home to help ensure that the home took responsibity for maintaining the standards of care. Systems were in place to try to find out the views of service users and their relatives. Annual questionnaires were sent to people, and every time a person came to stay in the home they and their relative were contacted before admission to see what services they needed, and afterwards about what they thought of the stay. As stated above Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: people have been consulted about the proposed changes and have been able to give their views about the developments. Relatives who communicated with the commission felt that the service was developed according to their needs. The health and safety of the service users and staff was promoted. The information supplied to the commission by the home prior to the site visit showed that all the necessary maintenance and servicing of appliances and installations had been undertaken, and were current. Relevant health and safety training was undertaken reguarly, such as moving and handling, first aid, food hygiene and internal fire safety training. Looking at the fire procedures indicated that the equipment was adequately tested and maintained. However fire drills were only being held annually, and it was not clear whether or not this was frequent enough to ensure that all staff had the necessary knowledge and experinece to evacuate the home safely if need be. 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 9 14 Any risks must be assessed and risk management strategies recorded in the care plan so that staff have clear written guidance So that service users can be supported to take responsible risks as part of an independent lifestyle. 30/03/2009 2 20 13 All procedures and practices must be reviewed to ensure they are specifically suitable for a respite care service, including the clarification of responsibity in relation to relatives, and including booking in procedures and liaising with relatives. So that staff are clear what their responsibilities are and to ensure that residents receive the correct medication. 31/03/2009 Recommendations Care Homes for Adults (18-65 years) Page 28 of 30 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 6 The care plans should include sufficient details in all aspects of personal, health and social care to guide staff on what care and support is needed and in the way that suits individuals preferences. When peoples choices and independence are restricted it should be clearly documented how the decisions are made, why and by whom and show that it is in the persons best interest. There should be clear written guidance for staff about when to adminsiter when required medication, what dose to administer for variable dose medication and about non prescribed medication. All staff recruitment records according to the Care Homes Regulations should be availavble in the home, including all information relating to CRB disclosures, two written references and record of the Induction training completed. The fire service should be consulted about the frequency of fire drills to ensure that they are held frequently enough. 2 16 3 20 4 34 5 42 Care Homes for Adults (18-65 years) Page 29 of 30 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!