Care Home: Arbor Way

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What the care home does well Everyone has a copy of their care plan. The care plans include plenty of helpful information to enable staff to meet people`s needs properly and in the manner they like. The home has an activities co-ordinator to help people to plan what they want to do each day. People are supported to make use of college courses, church activities, shops, hairdressers and other community resources. The people at the home make everyday choices about what they want to do and what they want to eat. They are involved in shopping for groceries and take part in cooking their chosen meals. The staff at the home hold a good understanding of people`s needs were seen to speak to people in a friendly, caring manner. Staff support people to attend health appointments with consultants and other professionals, such as dietitians, dentists, speech therapists and opticians so that their health needs are monitored and met. A Health professional comments "When I visit I find the staff friendly and hospitable. The manager is very experienced and professional. The gentleman I visit is very happy living in the home and despite his increasing health needs is determined to stay living at the home". There have been no complaints at the home since the last inspection. Staff are trained to recognise and report suspicions of abuse so that people are protected from harm. The home is clean comfortable and equipment has been provided to help people to remain in the home and stay safe, e.g. stair lift, specialist bath and grab rails. Staff are properly vetted before they start work at the home and provided with the training they need to equip them for their work. Most are training for National Vocational Qualifications at level 3, which is a positive achievement for the home. Suitable arrangements are in place for checking that equipment in the home remains safe to use. The fire alarms are tested and maintained by a contractor to make sure they are in safe working order, in the event of a fire. What has improved since the last inspection? Care plans and risk assessments are in place containing good levels of information to help staff to support people in a safe manner. The hard wiring in the home has recently been checked by a contractor to confirm that it is safe and the gas appliances have also been checked since the last inspection. What the care home could do better: The organisation`s Safeguarding Adults Against Abuse policy is not in keeping with the multi agency procedures and needs to be revised so that all suspicions of abuse (even "minor incident") may be reported for investigation by Social Services.The Statement of Purpose and service user guide needs to be reviewed to include any extra charges that are not included in the fees, such as paying for taxis. The manager said that she would review people`s care files and consider the need for any multidisciplinary decisions to be made i.e. where staff are expected to act in people`s best interests due to concerns that people may not be able to personally consent, e.g. to sedation for dental care. The manager has agreed to send surveys to relatives and professionals to seek their views so that they may contribute to the development of the service. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Arbor Way 78a Arbor Way Chelmsley Wood Solihull West Midlands B37 7LD     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: Kevin Ward     Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Arbor Way 78a Arbor Way Chelmsley Wood Solihull West Midlands B37 7LD 01217881937 01217881945 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Amanda Claydon Type of registration: Number of places registered: Royal Mencap Society care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 5 Physical disability (PD) 5 Date of last inspection Brief description of the care home 78a Arbor Way is a 5-bedded detached property located in a quiet side road in Chelmsley Wood. The Home is registered to provide long-term placements for adults with a learning disability and physical disability. The residents receive accommodation; full board, twenty-four hour care and supervision as required. Bromford Carinthian Housing Association who are accountable for major works and the external maintenance of the building owns the property. The Home and staff are managed by Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 5 5 Brief description of the care home MENCAP. The provider also takes responsibility for general internal decoration, carpets, furniture and so on. The Home, which blends in with its surroundings, is easily accessible by bus and close to local amenities such as shops, library and Doctors surgeries. Services are organised on a group living basis. Communal space includes a sitting room, dining room, conservatory and good-sized garden. Whilst all four of the bedrooms on the first floor are fitted with wash-hand basins, bathing and toilet facilities are shared, the only bedroom with an en-suite is located on the ground floor. There is a stair lift providing access to the 1st floor. The current fees range between 950 pounds and 1375 pounds per week depending on individuals needs. 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: The quality rating for this service is 2 star. This means that people who use the service experience good outcomes. This was a key unannounced inspection, which addresses all essential aspects of operating a care home. This type of inspection seeks to establish evidence showing continued safety and positive outcomes for the people living at the home. The inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file by us, such as notifications of accidents, allegations and incidents. Care Homes for Adults (18-65 years) Page 6 of 29 Questionnaires were returned by two people living at the home and a health professional, giving their views on the service. The inspection included seeing everyone living at the home. Due to the communication needs of the people living at the home it was not possible to get a clear impression of their views of the service. The inspection also included case tracking the needs of three people that live at the home. This involves looking at their care plans and records and checking how their needs are met in practice. Discussions took place with the staff on duty, as well as the manager. A number of records, such as care plans, complaints records, and fire safety records were also sampled for information as part of this inspection. An annual quality assurance assessment was completed and returned by the provider in time for this inspection, providing the manager’s views of the home’s performance during the last year. What the care home does well: What has improved since the last inspection? What they could do better: The organisations Safeguarding Adults Against Abuse policy is not in keeping with the multi agency procedures and needs to be revised so that all suspicions of abuse (even minor incident) may be reported for investigation by Social Services. Care Homes for Adults (18-65 years) Page 8 of 29 The Statement of Purpose and service user guide needs to be reviewed to include any extra charges that are not included in the fees, such as paying for taxis. The manager said that she would review peoples care files and consider the need for any multidisciplinary decisions to be made i.e. where staff are expected to act in peoples best interests due to concerns that people may not be able to personally consent, e.g. to sedation for dental care. The manager has agreed to send surveys to relatives and professionals to seek their views so that they may contribute to the development of the service. 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 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. Suitable arrangements are in place for assessing peoples needs and supporting them to move to the home. There is scope for increasing information about extra charges, such as taxis, in the service user guide. Evidence: There have been no new admissions to the home since the last inspection. The home has an admission procedure, which includes assessing peoples needs before they move in. The manager confirmed that this would include pre admission visits and providing people with information to help them to make a decision to move in. The home has a statement of purpose and service user guide, containing helpful information about the home. The service user guide has been illustrated with pictures to make it easier for people to understand. The Statement of Purpose contains information about the current range of fees and extra fuel charges (40p per mile) for the use of the homes vehicle. The people at the home are also charged for taxis but this is not recorded in the statement of purpose or service user guide. The manager Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: said that she would update these documents accordingly. 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. Indiviudals needs are well planned for and reviewed so that staff have the information they need to support people in a proper manner. Evidence: Two peoples care plans were checked and documents from other care plans were also sampled to check that peoples needs are planned for and reviewed. The care plans contain very good levels of information about peoples needs and how they should be met. The information is well detailed so that staff are provided with the guidance they need to support people properly. The care plans include detailed information about peoples personal routines and they in which they prefer their care to be provided. This is particularly important, as no one living at the home is easily able to communicate their immediate choices verbally to staff. Everyone at the home has a copy of their own care plan, which contains a good number of photographs to help make the information easier for people to understand. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The care plans have recently been dated, as evidence they have been reviewed. A good range of risk assessments are in place for people explaining how their care needs are to be met safely. Well detailed risk assessments are in place for a person with significant physical care and health needs,explaining the manner in which he should be supported to safely make transfers and use the stair lift. Comments by staff demonstrated a satisfactory awareness of the risk management guidelines and confirmed that they had discussed and reviewed safe moving and handling practices recently for the person concerned. People are being encouraged to make everyday choices and decisions. In the morning people were seen to choose their breakfast and make drinks with support from staff. Staff explained that people are consulted about menu choices each week. Meals pictures are used to help people to choose their preferred meals and their choices are then recorded on the menu alongside their names. Notes of house meetings show that these they take place on a regular basis and are used to plan everyday activities and make decisions about the decor and furniture for the home and other matters that concern the people living there. 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. The people at the home are supported to take part in a meaningful lifestyle in keeping with their preferences. Evidence: None of the people at the home attend traditional day services, instead they are supported to go out places by staff at the home. On the day of the site visit one person went to buy tickets to the clothes show and another went to pay their rent and do some shopping. Another person went to a luncheon club and another went to pottery classes. One person stayed at home to receive a massage. The activities plans and records show that support is given for people to go on a satisfactory range of activities, including college courses, cinema and shows. One of the people living at the home had been to see the Sound of Music on the previous Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: week end with a member of staff. Several people also make use of activities arranged at the local church. A whiteboard on the wall in the dining room is used to remind people about their plans for the day. It includes pictures of people carrying out activities they enjoy and includes pictures of staff that will support them. The manager explained that efforts are made for people to stay in touch with their families with letters, telephone calls and visits,where appropriate. Evidence of this was also seen in peoples contact records. One person has recently been reunited with their family with support from staff at the home. The plans and records show that people are encouraged to take part in everyday living activities, such as shopping for clothes, cleaning their bedrooms and making drinks. Staff explained that the people at the home also shop to choose the groceries for their preferred menu option and take part in preparing the meal. Where people need support with eating, guidance is in place in their care plans. 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. Peoples personal care and health care needs are addressed with sensitivity and respect. Suitable arrangements are in place for the safe management of medication at the home. Evidence: The staff at the home were seen to approach the people at the home in a friendly and kind manner and were sensitive to their non verbal cues for assistance. A member of staff was able to explain the cues that people use to communicate their needs and feelings e.g. one person was seen to knock on the table and the staff member explained that this was a greeting message and responded accordingly. Makaton (sign language symbols) were seen posted to the notice board. A member of staff explained that this is to encourage the use of makaton when communicating with people to develop their their ability to communicate their needs more effectively. The people at the home were supported to rise in an unhurried fashion with sensitive support from staff. Everyone at the home was well groomed and dressed in age appropriate good quality clothing. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Staff demonstrated a satisfactory awareness of peoples care needs and of the support to be provided them. Staff explained that close monitoring of food and fluid intake was maintained for a person of low weight and were aware of the hospital admission protocol to be followed in the event of refusal to eat and drink. The health records show that the advice of the dietician has been appropriately sought for the person concerned. Information sheets were seen on the file of a person with a deteriorating condition so that staff may be aware of how the condition may develop. Staff demonstrated a good understanding of the persons support needs. The staff spoken to said that they had recently reviewed the moving and handling practices used when helping the person concerned to transfer from the stair lift to the wheelchair so that a consistent, safe approach is followed. The persons file shows that a consultant is involved in monitoring the condition every three months and the manager said that she would urge a multidisciplinary care review in the event that there is any deterioration in the persons needs that affects the ability of staff to provide safe care practices. Entries in peoples health notes show that they are supported to attend regular check ups and treatment where necessary, such as dentists and opticians. Due the needs of the people at the home, no one currently holds their own medication. A staff member gave a good account of safe medication procedures and was seen giving out medication. Two staff were involved. One member of staff member provided a double check to make sure that the medication was correct before it was given out. Information was seen on file explaining the reasons for the medication being given and staff were seen to correctly sign the record as medication was given out. Further checks of the medication are also carried out during the day so that any errors may be picked up promptly should they occur. The manager confirmed that there have been no errors since the checking systems have been implemented. A list of individuals homely remedies have been agreed with the GP and they have signed their agreement to these medications being given. 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. Staff are trained to recognise and respond to suspicions of abuse to keep people safe from harm. The homes procedures could undermine proper investigations being carried out if not addressed. Evidence: There have been no complaints to us about the home since the last inspection and the manager explained that there have been no complaints directly to the home. A complaints procedure is available at the home and the manager confirmed that peoples relatives have previously been sent information explaining how to complain. Four staff spoken to confirmed they had received Safeguarding vulnerable adults against abuse training. This was also verified in staff training records. The staff spoken to were able to demonstrate a satisfactory understanding of different types of abuse that can occur and who to report their concerns to. A staff member explained that they had also been given telephone numbers of people they could call if they had any concerns about the running of the home. The homes Safeguarding procedure states that minor incidents should be investigated by the manager (section C19531 of the procedure). This is not in keeping with good Safeguarding practice as all incidents of abuse should be referred to Social Services for investigation under the Safeguarding procedures. The manager assured us that this is Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: the action she would follow in practice. There have been no abuse allegations at the home since the last inspection. Two peoples expenditure records were checked. The record show that staff sign to verify how money has been spent and keep receipts for auditing purposes. The manager also carries out regular checks of peoples money to verify the expenditure is appropriate. 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. Abor way provides a comfortable, clean and homely environment for people to live in. Evidence: Arbor way provides comfortable, homely, accommodation for the people that live there. The lounge is cosy and has comfortable furniture and a special chair is in place to meet the needs of a person with mobility issues. Overall the home is in good condition and clean. Peoples bedrooms are comfortably furnished and they have been supported to choose the decor colours. One bathroom has a specialist bath in place and there is also an easily accessible shower upstairs. Other equipment such as grab rails, raised toilet seats and a stair lift have been fitted to meet the needs of people at the home. The manager said that she would continue to closely monitor the capacity of the home to meet the changing needs of a person with poor mobility, currently in an upstairs bedroom, to ensure that the living placement remains safe and appropriate. Suitable arrangements are in place for managing continence laundry. The home has two washing machines with sluice facilities. Protective clothing, including plastic aprons Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: and gloves are available about the home for staff to use where appropriate. A suitable clinical waste contract is in place for the safe disposal of relevant products. Four staff at the home confirmed they had received infection control training. Care Homes for Adults (18-65 years) Page 22 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 properly vetted and trained so that the people at the home receive the support they need from a suitably trained and and equipped staff team. Evidence: Staff at the home explained that there are always three staff on duty. At the weekend there are 2 staff on duty morning and evening and three during the middle of the day. This was verified by the manager and entries contained in recent staff rotas. The manager explained that vacant shifts are nearly always covered from within the staff team or by using the organisations bank staff who are known to people at the home, so as to provide consistency of care. This was verified in recent staff rotas. A management on call rota is in place for staff to seek managerial support out of office hours on occasions when the manager is not on duty. There is currently no designated person, such as Team Leaders, to cover the manager, when she is on holidays, though staff have access to the advice of the manager of another home close by that is also run by the organisation. The manager agreed to arrange for a review of the management structure to ensure accountability for the home when she is not available, with a view to introducing a shift leader system at the home. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Two staff recruitment files were checked. Both contained evidence to demonstrate that staff are properly vetted before they start work to ensure they are suitable to work there. This included evidence of identity, Criminal Record Bureau Checks and two references. Comments by four staff confirmed that they are provided with regular training updates in safe practice subjects, such as first aid, food hygiene, fire safety, moving and handling, medication, Safeguarding against abuse and infection control. This was verified in staff training records provided by the manager and a sample examination of staff training certificates. The manager reported that staff have received a recent briefing on the Mental Capacity Act and planned to go ahead with staff training on this subject. She also explained that she is planning autism training for staff to be provided by Autism West Midland. In the annual quality assurance questionnaire the manager reports that 80 of staff now hold National Vocational Qualifications (NVQS) at level 2 and that most are now training for NVQ level 3. This is a positive achievement for the home, as these qualifications equip staff to carry out their work in an effective manner. Care Homes for Adults (18-65 years) Page 24 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. Suitable management arrangements are in place for maintaining a safe environment for the people that live and work at the home. There is scope for surveying the views of relatives and professionals so that they can provide an independent perspective and contribute to the development of the home. Evidence: The Registered Manager holds the Registered Managers Award and the National Vocational Qualification, level 4 in Care. The manager also has a number of years management experience, working with people with learning difficulties and as such is suitably qualified and experienced to run the home. The manager explained that surveys had been completed by the people living at the home, with support from staff, to seek their view of the service. The manager acknowledged that this has limited value, as the people at the home have significant communication needs and are largely dependent on staff to interpret their responses to questions. The manager agreed to arrange for surveys to be sent to relatives and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: relevant professionals to seek an outsiders perspective of the home. A senior manager visits the home regularly each month and completes a report outlining the findings for the manager to follow up and address. Shift handover reports are carried out to pass information between shifts. This includes consideration being given to planned appointments as well as checking medication and monies in the home. Staff confirmed that they receive regular planned supervision from the manager to support them in their work and professionals development. This was verified in staff supervision records seen on file. The fire safety records were sampled. The log shows that fire alarms and lights are being tested and that fire drills are regularly carried out at the home. Certificates provide evidence to show that the fire alarm system is being properly maintained by a contractor. A new member of staff who transfered to the home from another service run by the organisation confirmed they had been taken through the fire drill as part of their induction. A landlord gas safety certificate provided evidence to show that gas appliances have been properly checked to ensure they are safe to use and the hard wiring has recently been checked (certificate seen). Similarly, electrical appliances have been recently checked by a contractor to ensure they remain safe to use. Hot water monitoring records show that the hot water temperatures in the home are being routinely checked to make sure that people are not placed at risk of being scalded. the records show that shower heads are being routinely de-scaled and flushed through to stop the threat of legionella developing in the home. Care Homes for Adults (18-65 years) Page 26 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 27 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 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 should be updated to include the circumstances under which people may be expected to pay for taxi fares, so that there is no confusion over what they should be charged for. The homes Safeguarding procedures should be amended to ensure that all incidents (even minor incidents ) are reported to Social Services for investigation as required under the multi agency Safeguarding procedures. Proceed with plans to review the staffing structure to provide accountability in the home when the manager is off duty or unavailable. Proceed with plans to survey the views of relatives and professionals so they can contribute to the development of the service. 2 23 3 31 4 37 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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