Care Home: Aston House

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What the care home does well People are helped to have choice and decide what they want to do. Staff include them in planning the care and support they need and make sure what they write down about this is correct and up to date. The food is good; it is freshly cooked in the home and there is plenty of choice. People enjoy the food and are pleased they have a choice of what they can eat each day. People`s families are kept in touch with how their relative is. People are encouraged to see their families often. People are helped to do things they enjoy and to get out and about. Lots of activities are arranged so that there is usually something for people to do. People are encouraged and supported to gain paid employment if they are able to and to have opportunities for learning and training. The house is comfortable and clean. People living in the home like the staff, and the staff care them and treat them well. People at Aston House say they are happy with their care. The owner, manager and staff work hard to make Aston House a good place for people to live. What has improved since the last inspection? The things that staff write about the help people need give a better picture of what they should do to make sure people get the right care. More choice of food is provided and the cook knows more about the people with special food requirements. Records about how people`s money is dealt with are better. The staff write down better information about how each person`s safety is looked after. What the care home could do better: The owner, manager and staff team are working hard to improve and develop the service they give to people who live in the home Aston House. A lot of progress has been made in the last two years. We have made some recommendations and suggestions in this report and in view of the constructive approach of the owner and manager during the inspection are confident that these will be acted on. The areas we have highlighted are for the written information about recruitment to be improved and for the audits of medication to provide more detail about the checks carried out. Key inspection report Care homes for adults (18-65 years) Name: Address: Aston House Hampton Park Road Hereford Herefordshire HR1 1TJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Denise Reynolds     Date: 0 9 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Aston House Hampton Park Road Hereford Herefordshire HR1 1TJ 01432267996 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: astonhousecare@aol.com Mr Mark Zylinski care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 16 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: Mental Disorder, excluding learning disability or dementia (MD) 16 Date of last inspection Brief description of the care home Aston House is a large detached house set back from the road in a residential area of Hereford. The house has 10 single bedrooms, 3 double bedrooms, shared lounge, dining room, smoking room, meeting room and bathroom facilities. It has a good-sized garden. The home is registered to offer services for up to 16 adults who have experienced some mental health problems. For some people it is their ongoing home, for others it may be less permanent, on the way to more independent living, but for all the aim is to provide a normal, homely and supportive environment. Mr Mark Zylinski, the registered provider, has owned the home since 1988. He is a qualified psychologist Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 16 Brief description of the care home and visits the home regularly. The service user guide contains information about the fees for the home. 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: One inspector spent two half days at Aston House for this inspection. We spent time observing day to day life, speaking to people who live there, the owner, manager and some staff. We also looked at a range of essential records needed to support the care of people and the overall safety and management of the service. The focus of our inspection was to look at the outcomes for people who live at Aston House and to find out what they think about their care. To help us with this we looked in detail at how some of them are supported by staff. Some weeks earlier the owner and manager had sent us their Annual Quality Assurance Assessment (AQAA). This is a self assessment tool which services use to describe what they do well, what they need to do better and what their plans are for improvement in the coming year. At this time we also sent surveys to some people using the service, some relatives,staff and some professionals. Care Homes for Adults (18-65 years) Page 6 of 30 We used all of this information to help us build a picture of the quality of the service people at Aston House are receiving. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 30 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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. No-one new has moved into the home for about two years but the manager has good ideas for finding out what help and support someone new would need and making sure it is the right place for them to live. Evidence: The manager described to us the careful process she would follow when anyone new is thinking about moving in. This includes finding out about the care and support the person would need to check that Aston House staff would be able to provide the correct care. Time would be spent helping the new person and people already living there to get to know each other before a final decision is made. This should help to make sure that people have the best chance of getting on with each other. The written information about the home has been updated since the last inspection. The service user guide provides clear and easy to read information describing the sort of service people at the home receive. The contact phone number and address for the Care Quality Commission need to be updated as these have changed. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: We spoke with the last person to move into the home. They said they had been given lots of support from staff and other people living at the home to settle in. They told us that Aston House has been a good choice for them and that living there has been very positive for them. 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. People living at Aston House are involved in planning their own care, are supported and encouraged to live the life they choose and to make decisions for themselves. Evidence: Each person living at the home has a comprehensive care plan which looks at what their needs are and how these can be met to give people control over their lives and support to make choices and decisions. The care plans for each person differ according to what their needs are and the ones we looked at showed that people are viewed as individuals with differing needs. Each person has a keyworker and we saw records that showed that the key workers play an important part in supporting people. People we spoke to were positive about the overall support and help they get. The care plans and risk assessments we looked at matched the care needs described in assessments and we saw that reviews are used to check if things need to be changed. We also noted that care plans are updated promptly when needed; for example, new information following a dental appointment was added to the care plan immediately. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Information we had from a professional supported the view that care plans are used well to support the care given Assess client individual need and match care plan appropriately. Seeks urgent assessment and review of care plan if clients needs extend beyond areas of their competency. Staff also felt that are supported to make decisions, for example one wrote in their survey Aston House supports people to live as independently as possible. Residents are encouraged to make their own decisions and choices. We saw that aspects of peoples care where there may be a risk for some reason were included in clear written risk assessments. These did not result in unnecessary restrictions in peoples lives. Some people need more help than others in dealing with finance and we saw that records are kept of spending. Some information was not available when we were at the home but Mark Zylinski sent this to us promptly after the inspection. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Aston House are supported by staff to lead active and varied lives. People who live in the home and the staff together create a community spirit within the home and links with families, friends and the wider community are encouraged. Evidence: During both days at the home we saw that people were relaxed and at ease with each other, with staff, and the owner. We also found people were confident and open when speaking to us about life in the home. During the day we saw people pleasing themselves about how they spent their time. Some went out, some spent time in their rooms or did their washing and others sat in the sitting room watching TV, reading the papers or chatting and putting the world to rights. Some people at the home go to courses at local colleges, for example one is taking a course in a foreign language. One person works part time on a farm. The manager Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: told us that she wants to look into more training opportunities for people, possibly using a distance learning training provider. Staff had recently done a Social Inclusion training session run by an independent consultant. The manager and owner arranged this to improve staff awareness of the importance of helping people be involved in community life. Staff told us they are speaking with people about where they would like to go and are trying to do more varied things. The manager told us that involvement in activities is built in to the staff role and they are expected to actively get involved in this. During the inspection we saw that most people went out for at least part of each day and that they were asked what they would like to do. Some people go out independently and on their own and people go out with staff in groups. We got more information about peoples lifestyles when we joined the staff handover and looked at the records of activities people have done. The manager has asked people to write down what they think about things they have done to help with planning future events. We looked at what people had written. This showed that people had enjoyed themselves, for example a recent day out in Abergavenny to go to the market and for lunch was described by one person as follows We all had a wonderful day. Plenty of time to relax in the fresh air and browse in the shops. A nice lunch and unrushed trip home. A night out bowling for seven people was also enjoyed A great night - enjoyed by all who attended. Very relaxing, everyone encouraged each other to do well. Must do it again. As well as group activities and outings people have chance to do things with staff one to one, for example, one person plays badminton with a member of staff regularly. There are also activities in the home including writing pieces for the homes newsletter and an art group which displays work in the home. People encouraged us to look at the art work and pointed out some they felt were particularly good. We found that there was a very positive atmosphere in the home and staff and that people showed respect and genuine concern for each other. People are encouraged to keep in touch with their families. Relatives who sent surveys to us added to the positive view of life at the home explaining ways that Aston House has helped their relatives. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People said they think the food is very good. One person told us that the old cook was good but that new cook is very good too. We were invited to join people for lunch on both days. These were relaxed and sociable occasions when everyone sat and ate together including staff and the owner. There are two choices of meal for lunch and dinner and the cook writes the options on a white board in the morning so people can indicate which they want. The food we saw served and had ourselves was tasty and fresh and included pastry and cake made fresh on the day. One of the dishes for each meal was a vegetarian option. One of the people who lives in the home made a lovely chocolate cake which everyone enjoyed. Over the two days we were at the home the menu choices were varied and nutritious with plenty available for people to have a second helping if they wanted. 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 living at Aston House are supported to have their health and personal care needs met. People are treated with respect and due regard for their right to privacy and independence. Evidence: Most people at the home are able to deal with their day to day personal care needs themselves but staff offer support and help when needed. For example one person had their hair cut washed and blow dried for them by one of the staff. They enjoyed this and were pleased with the results. The care records provided good evidence that peoples healthcare needs are known and dealt with well by staff. The records showed that people have regular appointments with dentists, opticians, their GPs and specialist health professionals. We saw evidence that guidance from health professionals is recorded promptly. When a person has health care needs that are outside the skill and experience of staff this is recognised and contact is made with relevant professionals for their help. Medication is generally dealt with carefully and safely and storage arrangements are Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: secure. Since our last inspection the owner has provided people who look after their own medication with lockable storage for their rooms; this means that medication is now stored more safely. Medication records were generally good and information is recorded to provide an audit trail to monitor the medication held in the home. We did an audit of some items of medication and found errors in the balances of two items. We were able to do this audit and find the error because of the good records being kept. It was evident that the error had occurred within the previous two days. We pointed the error out to staff and to the owner and they took prompt and appropriate action. This included a referral to the multi agency adult safeguarding process, an internal investigation and review of their medication policy and procedures and a check of other medication in the home. The manager told us that they are also planning further medication training for all staff. We have made a recommendation about making more detailed records of the medication audits the home does. 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. People living in the home feel able to raise concerns they may have. Staff get the training they need so they know how to recognise and respond to signs of possible abuse. Evidence: Information in the surveys from relatives showed that they know how they can make a complaint and that they have always felt satisfied with how the home deals with concerns. The staff surveys confirmed that staff know what they should do if someone approaches them to say there is something they are not happy with. We suggested that it would be good practice to follow up any complaints in writing at a later date to confirm that people remain happy with the outcome. People we spoke to at the home said they could tell staff if they had any concerns. The record of complaints showed some minor concerns had been reported. We saw a record of a complaint made since the last inspection. This showed that it had been dealt with well. The home has a written policy and procedure about adult safeguarding and the manager and deputy have attended training with Herefordshire Council about managing safeguarding concerns. Other staff have also done safeguarding training with the council or were booked to do a course in February. Staff we spoke to Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: understood the expectations of them as care workers if they become aware that someone is at possible risk of harm. Care Homes for Adults (18-65 years) Page 21 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. People living at Aston House have clean and homely surroundings. The house is safe and generally well maintained. Evidence: All of the rooms we saw during our inspection were clean and the house was warm. Most of the house is well-decorated and comfortably furnished. It would be good practice to upgrade the premises, when possible, to provide a more modern level of service for the people living in the home, for example by reducing shared bedrooms and providing ensuite facilities. Since the last inspection a rolling programme of decorating and maintenance work had continued. We observed that furniture and bedding in some bedrooms is showing signs of age and consideration should be given to updating furniture as part of the overall maintenance programme. Bedrooms in the home are fitted with suitable locks (except for one used as access to a fire exit). This means that people who choose to have a key to their room have the benefit of being able to control access to their rooms. Some fire exits lead through bedrooms, this reduces the privacy of the people living in those rooms. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The communal rooms are spacious and domestic in style. People are able to personalise their bedrooms and even in the shared rooms people have been able to mark out their own space by the way the furniture is arranged. The laundry area was clean and tidy and we were told that each person has a day to do their washing so that their clothes are washed separately to other peoples. This is good practice. Some people choose to go to a launderette to do their washing. There is a maintenance book which showed us that faults and problems are noticed, reported and acted on. Care Homes for Adults (18-65 years) Page 23 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. People living at Aston House get on with the staff and feel they are supported. Staff get a range of training to help them maintain and develop the skills they need to give people the best care. The way staff are recruited is generally safe and helps reduce the risk of someone unsuitable getting a job at the home. There are enough staff to give people the time and support they need. Evidence: There is a training programme which gives staff up to date training in various topics related to health and safety matters, mental health and care related subjects. More than half of the staff have completed or are taking part in NVQ qualifications and two of the senior staff have done mental health related courses with the Open University. Staff we spoke to confirmed that they have received training in various topics including first aid, food hygiene and moving and handling. Some staff told us they were booked on medication and risk assessment training in the near future. In their survey one of the staff wrote Aston House is very good at providing training to staff and staff are very caring of the residents and always try to put their needs first. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The staff surveys also confirmed that staff have effective induction and ongoing training. The staff we spoke to were enthusiastic about their work and want to help in the development of the service at Aston House. The people who live there told us the staff are good and that they like them. We saw that the relationships between staff and people at the home were positive and relaxed. When speaking about or to people at the home the staff were respectful and professional. We got the impression that there was a sense of equality between staff and people at the home and were pleased to see that the cook also got involved in getting to know people. Recruitment procedures at the home met legal requirements to carry out expected checks. Some aspects of the records about the employment process could be improved and we have made a recommendation about this. These improvements will provide a more robust audit trail of the recruitment process and the verbal discussions during interviews. Staffing levels give staff time to go out with people to health appointments and for social activities. Care Homes for Adults (18-65 years) Page 25 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. People living at Aston House are benefiting from the developments and improvements in the way the home is managed. There is a commitment from the owner, new registered manager and staff to make sure the service is run for the benefit of the people living there. Evidence: At the time we did our inspection a longstanding member of staff, Tracey Ditchfield, was about to be registered with us as manager of the home. Tracey has relevant training and has worked in mental health settings for a number of years. Staff and the owner described her as having the commitment and drive needed to support staff in continuing to make improvements in the service Aston House provides. Some quality assurance measures have been adopted and there is good communication with people who live in the home, families and professionals. Results of surveys need to be collated and reported on to people so they can see their views have been listened to and acted on. There are regular house meetings and people told us they welcome this chance to have their say about how things are done. They Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: commented on improvements since the last inspection such as more varied and home cooked food and the new telephone booth constructed to provide privacy for phone calls. The AQAA filled in by the new manager was brief but gave an honest and accurate picture of how things are done at Aston House. During our inspection we were able to verify information in the AQAA. We looked at some of the monthly reports the owner ,Mark Zylinski, had written. These showed that he has been checking things at the home and speaking to people who live there and staff to find out what they think. Other things people said about the service in surveys included Aston House is a very caring service. You would go a long way to find better. Everything is quite satisfactory; I have no suggestions. (re what they could do better). Aston House is a good care provider for people with various mental health problems. Management and staff can be trusted and work in partnership with CMHTs (community mental health teams). Care Homes for Adults (18-65 years) Page 27 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 28 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 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 20 The medication audits need to contain more information (eg whose medication was checked and the actual counts done); this will provide better evidence of the checks done. Information about discussions at interviews needs to be recorded. This will provide a record that issues such as gaps in employment history, reasons for leaving previous jobs, and specific information about individual circumstances have been been dicussed and taken into account when deciding whether to offer a job or not. When documents providing proof of identity have been checked, copies should be kept as part of each persons recruitment record. 2 34 3 34 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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