Care Home: Blunt Street (9)

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What the care home does well The care home finds out what people need and write this down. Staff read these reports so that they can help people to keep healthy and as active as possible. People were helped to have interesting lives. Staff gave them individual attention and they were treated with respect. The care home`s policies and procedures kept people safe. Policies are rules about how to do things. Procedures tell people how to follow the rules. People were living in a comfortable and safe environment. Staff have training so they understand how to meet people`s needs. The care home was well managed. People were safe and their rights were recognised. What has improved since the last inspection? The care home had been redecorated in many areas Better records were being kept More staff had received training There were more permanent staff What the care home could do better: No requirements or recommendations have been made at this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Blunt Street (9) Stanley Common Ilkeston Derbyshire DE7 6FZ     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: Anthony Barker     Date: 1 6 1 2 2 0 0 9 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 28 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) 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Blunt Street (9) Stanley Common Ilkeston Derbyshire DE7 6FZ (0115)9323508 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.unitedresponse.org.uk United Response care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Four (4) persons (of either sex) in the category adults with learning disabilities / adults with physical disabilities. Date of last inspection Brief description of the care home 9 Blunt Street is a detached house in a small village development. The people living here are provided with adequate accommodation and single rooms. There is a reasonably-sized rear garden. The Service offers personal and social care to people with a severe learning disability with associated conditions that include autism, sensory and physical disability and challenging behaviour. Activities are planned to meet individual needs. 2 3 1 2 2 0 0 8 4 4 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspector visited at short notice. The last key inspection at this care home was on 23rd December 2008. We had asked the Acting Manager to complete a questionnaire about the care home, before this inspection. We had asked other people to tell us what they think about the care home. Eight people sent us their views. We looked at what staff had written about one persons life. We also looked around the care home. The people who live in the care home were not able to talk to us as they had high levels of dependency. But we saw how staff treated people and we spoke to the Acting Manager and staff. Care Homes for Adults (18-65 years) Page 5 of 28 The weekly fees at the time of this Inspection were from 1272 pounds to 2105 pounds. Care Homes for Adults (18-65 years) Page 6 of 28 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 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 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs of people are fully known and recorded before they are admitted to the Service so ensuring that staff can identify and plan to meet their diverse needs. They are given the opportunity to spend time in the Service before admission. Evidence: The Individual Charters, belonging to each person living at the Service, included the actual current fees for the service provided to them. This met a recommendation from the last inspection. These Charters were kept in peoples own bedrooms and also included the easy read summary from the last inspection report. Two people had been admitted to the Service since the last inspection. These two people had been transferred from another local United Response service that the Acting Manager of 9 Blunt Street had also managed and which had closed. For this reason, full pre-admission assessments of these peoples needs had not been carried out. We examined very comprehensive and detailed reports from an occupational therapist Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: and an Independent Mental Capacity Advocate (IMCA) which showed that a lot of thought had gone into the planning of this move. This was commendable. The two people concerned had spent time visiting the Service and interacting with the existing group of people before admission. Two of the staff from the closed care home had transferred with them and this had aided their settling in. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the Service had good quality person centred plans of care which demonstrated that their health, personal and social care needs were being met and they were enabled to make decisions about their lives. Evidence: The care plan of one person, who had lived at the Service for some years, was examined. We call this focussing on the experiences of one person, case tracking. This person was receiving personal one-to-one attention from staff on the day of this inspection. There an excellent set of care plan records that were well recorded, holistic, very person centred and included a well worded set of future goals. A system of three-monthly review records was examined which included monthly summaries. Person Centred Shift Plans provided staff with opportunity to make a daily record of their interactions with the people they support. These gave a different view each day of the staff role. Formal person centred care planning meetings were being held annually to provide a full multi-professional review of peoples needs. The Acting Manager made reference, in her pre-inspection self-assessment, to a number of Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: improvements in the care planning process. The quality of this process is commendable. The Acting Managers self-assessment stated, We support people using the decision making matrix. We saw a copy of one persons matrix and found it provides helpful person centred guidance on how to enable people to make decisions. The Acting Managers self-assessment also stated, One person we support takes a lead role when they want to make a drink, using objects of reference. We discovered that this referred to the case tracked person taking more personal initiative as a result of increased self confidence. The senior support worker we spoke with gave examples of the case tracked person making decisions and choices. These included the person choosing clothes to wear in the morning and when out buying clothes. This member of staff also provided us with examples of good practice when encouraging the case tracked person to wear clothes appropriate to the weather. Two of the four preinspection surveys, completed by key workers on behalf of people living at the Service, made reference to good practice regarding providing people with opportunities to make choices and decisions in everyday life. Comments included, The home involves me with choices in everything I do and, The home promotes my independence. Up to date and person centred risk assessments were in place to address the risks that the people living at the Service were exposed to. These were very comprehensive and holistic and referred to benefits from taking the risk and recorded the ways in which risks can be minimised as well as how people can still enjoy life. The senior support worker we spoke with showed a good understanding of the concept, and use, of, responsible risk taking in order to increase peoples independence. She gave us examples to support this understanding. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service provided activities and services that were age-appropriate and valued by the people who live here, and promoted their independence. Evidence: On the day of this inspection one person was attending a Local Authority Day Services provision. The two people who recently transferred for another United Response care home were visiting two people known to them at another care home and undertaking a baking activity together. The case tracked person went out shopping, mid morning, with a staff member and stayed out for lunch. This, and other evidence, pointed to people living at this Service having a reasonably full and satisfying life. The Communication Board in the entrance hall included each persons Activity Plan. These were outlined in words and symbols. There were also photographs of people involved in activities, both outside and domestic. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: The Acting Manager said that Activity Plans are reviewed at formal person centred reviews and spoke of videos taken of people involved in activities. The senior support worker we spoke with gave examples of the case tracked person being involved in activities that they valued and found fulfilling. She said, for example, how the person enjoys washing pots and making a drink. We directly observed this person rinsing out a mug in the sink. Information supplied by the Acting Manager before the inspection included, Two of the people we support have excelled in college, two other people have recently attended college for the first time. The Acting Manager also described how the case tracked person had, for a while, delivered local Thompson Directories, with staff support. The Acting Manager described, in her pre-inspection Self Assessment, a good degree of involvement that people have in the local community. This includes leisure activities such as swimming, walking, horse riding and bowling. She told us that people living at the Service are supported to go to the bank and have their own cheque book. The Acting Manager also told us about a successful Inclusion Day when members of the public were invited to meet with people living in local United Response care homes and have a fun day. A separate house was hired for the occasion. In her pre-inspection Self Assessment, the Acting Manager told us that people living at the Service had, maintained and developed new friendships when attending colleges and taking part in voluntary work. She said that the case tracked person had struck up a mutual friendship with a person living in another care home. She also gave us an example of one person attending a pottery class with a friend who lives in a local United Response care home. Two of the people living at the Service have contact with relatives, we were told, and the other two have supportive visits from people known to them in their past. A record of contact between the person we case tracked and a close relative was seen in the October 2009 Monthly Summary Sheet. It was clear from discussion with the senior support worker that daily routines were flexible and based on individuals choices. She told us of the case tracked person putting away used clothes in the laundry bin, using the washing machine and other activities to promote their independence. The Acting Manager told us, in her pre-inspection Self Assessment, that, People we support are involved in writing menus and are supported to complete a day-by-day list of their involvement in food preparation. We noted that the varied and nutritious four week rolling menu had an associated sheet, with words and symbols, showing what individual people can do to partake in food preparation. For example, Get mince out of the fridge, Help stir sauce into mince. We considered this good practice. The case tracked person had a specialist menu to reflect their particular health condition. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Examples of a photo-based menu were seen - giving a pictorial representation of the actual food eaten. This helps people to choose the meals they eat and to be meaningfully involved in preparing them. Each person had their own kitchen cupboard for some food stocks/utensils with individual photographs of the people on these cupboards. Overall, food stocks were at a satisfactory level. The extent to which peoples catering needs have been addressed at a person centred level is commendable. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service was providing people with personal support in the way they preferred and required and was meeting their physical, emotional and health needs. Evidence: The senior support worker we spoke with gave examples that show that the dignity and privacy needs of people living at the Service are being met. For instance, staff prompt people to close bedroom and bathroom doors and ensure that a towel covers the person when moving between these two rooms. There was evidence of equipment in place that maximised peoples independence. For instance, new grab rails hade been fitted in the hallway for one recently admitted person and a stair rail for the other. From observation and discussion with the Acting Manager it was clear that peoples communication needs had been assessed and, wherever possible, were being met. The hallway notice board included photographs of staff on duty during the day of this inspection and a photograph of the inspector. This helped people to know who was, and would be, in the house. Peoples need for advocates, when necessary, was recognised and Southern Derbyshire Advocacy Alliance had been involved in one persons formal person centred Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: review meeting. The likes and dislikes of each person living at the Service were recorded on file as an implicit part of the person centred approach. There was, overall, evidence of an imaginative approach being made to provide person centred support to people living at the Service. There was evidence of an improvement, since the last inspection, in the monitoring and recording of peoples health needs and health appointments. There was also evidence of a good level of involvement by external health professionals. For example, we examined documents that reflected involvement by an occupational therapist, and the Derbyshire Association for the Blind, prior to the recent transfer of two people into the Service. Also, a psychologist had been involved with the person we case tracked offering helpful advice. One other person has an alarm in their bed to alert sleep-in night staff if an epilepsy seizure is occurring. The Medication Administration Record (MAR) sheet, of the case tracked person, was examined. This was satisfactory and an improvement from the situation found at the last inspection. Each person living at the Service had a Medication Profile attached to their MAR sheet, along with their photograph. A record of staff signatures/initials was in place to ensure that signatures can be cross-referenced against staff names. A clear person centred prn protocol was in place for the administration of the case tracked persons paracetamol. This ensured that the person receives medication appropriate to their needs. We also noted that each person had a Medication Support Plan that described, How to support me to take my medicine. No controlled drugs were prescribed. Medicines were securely stored. Staff had received recent training in the safe use of medicines. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good procedures for handling complaints and abuse were in place ensuring that people were fully protected. Evidence: We examined the Services complaints procedure which was up to date and well put together with words and symbols. A copy was displayed on the notice board and each person living at the Service had a copy in their bedroom. The Acting Manager stated in her pre-inspection Self Assessment that a new Accident Investigation Form will elicit Whats not Working and so highlight a potential complaint from a person living at the Service. She told us that there had been one complaint received by the Service within the past 12 months. This was from a neighbour and there had been a satisfactory outcome. A form on which to record formal complaints was available on United Responses intranet. Safeguarding Adults Procedures and a Whistle Blowing Policy were in place to ensure that people living at the Service are kept safe from being abused. The senior support worker spoken with showed an awareness of these procedures and the Services whistle blowing policy. Staff training records showed that all staff had received training in Safeguarding Adults (Adult Protection) within the past two years. This training ensures staff understanding of adult abuse and its risk management. Since the last inspection there had been one concern expressed to the Service, and to us, by Social Services. This concerned one person living at the Service who had bruises noted Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: by Day Services staff. The matter did not remain a safeguarding concern for long and the Acting Manager spoke of improved communication with the Day Services through a daily diary. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were living in a comfortable and safe environment that was clean and hygienic. Evidence: The Acting Manager told us, in her pre-inspection Self Assessment, that, The kitchen has been refitted and decorated and the dining room and laundry have been decorated. She also told us that, The Service has been partly decorated with involvement of people we support. We saw evidence of the above and of more domestic lighting in place. Each bedroom had been redecorated and new carpets fitted. Two of the bedrooms examined were attractively decorated and well personalised, reflecting the interests of the people accommodated there. The Acting Manager spoke of plans to decorate the two bathrooms and the hallway. During a tour, the premises were found to be clean and hygienic, though there was an unpleasant odour in one bedroom. The Acting Manager said that the person using this room has occasional accidents. The bedroom had good quality domestic vinyl flooring and a special mattress was being used. We recommended to the Acting Manager that this situation be carefully monitored and, before the end of the inspection, she had written a plan of action and a monthly record - to be placed in the Communication Book. The Acting Manager told us, in her pre-inspection Self Assessment that just two staff had completed Infection Control Training. These were the two staff who had Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: transferred from the closed United Response care home. However, she later showed us evidence of this training being planned for January 2010. The senior support worker we spoke with said that red soluble bags, used to wash infected materials in the washing machine, had been recently introduced and this had reduced risks from cross infection. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service had well-trained and well-recruited staff which ensured that people living here were safe and their needs were met. Evidence: Five of the eight permanent care staff had achieved a National Vocational Qualification (NVQ) to level 2. This met the requirement to maintain a staff group with at least 50 qualified staff. The Acting Manager told us that a further member of staff will soon be starting this training - the other two are new staff, she pointed out. The staffing rotas were examined and discussed with the Acting Manager. There was evidence that staffing levels were sufficient. A requirement made at the last inspection, to reduce the use of agency staff, had been met, the Acting Manager said. This was because three staff vacancies had been recently filled and she saw, from now on, agency staff used only when staff are sick, on holiday or on training. Some staff had commented in their pre-inspection surveys that there should be more staff. The Acting Manager pointed out that one new appointment had been made since these surveys were completed. The senior support worker we spoke with felt that staffing levels had improved within the last month and were now adequate. The file of the most recently appointed member of staff was examined. Matters relating to her recruitment were satisfactory and included a Criminal Records Bureau (CRB) Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: disclosure and two written references. The Acting Manager provided us with a copy of the staff training matrix and clarified some details from it. It showed that, within the past three years, the staff group had been provided with training in First Aid and Basic Food Hygiene. Most staff had received Moving & Handling training within the past two years and two staff, who had not, were booked on a training course in February 2010. All staff had received Fire Safety training by the Acting Manager, a qualified fire trainer, within the last 12 months. The senior support worker we spoke with said that, in addition to mandatory training, she had, within the past 12 months, received training on topics that included Intensive Interaction, Epilepsy, Mental Capacity Act and Deprivation of Liberty Safeguards. The Acting Manager told us that staff receive regular supervision sessions with her. The senior support worker we spoke with confirmed she had had three supervision sessions within the last six months. This was an improvement from the last inspection. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Service was well managed so that people living here were protected and their best interests were promoted by the systems in place. Evidence: The Acting Manager told us, in her pre-inspection Self Assessment, that she had, over nine years experience in health and social care and nine years service with United Response. She had achieved the Registered Managers Award and had satisfactorily completed the NVQ in Care at Level 4. She had managed this Service for only a few months and, from evidence at this inspection, she showed a focussed and imaginative approach. The senior support worker we spoke with told us that, (The Acting Manager) is a supportive manager. The Acting Manager was planning to start the process of applying to us to become Registered Manager of this Service, in January 2010. Monthly independent audit visits to the Service on behalf of the Registered Provider, as required by Regulation 26, were taking place and being recorded. The Services current 24 point Business Plan was well set out and included target dates for Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: monitoring purposes. Most items had been achieved. Staff were being periodically sent Whats working, whats not working quality assurance questionnaires, in order to assess their opinions on the quality of service provided. The Acting Manager said that she was planning to send Quality Questionnaires to the relatives of people living at the Service, and to external professionals, to elicit their views on the Service. The surveys we sent out, prior to this inspection, completed by staff, relatives and by key workers on behalf of the people living at the Service, were generally positive. One relative commented that the Service was good at, care and dressing (my relative) in a clean and appropriate manner...care for their need in health and well being. The Acting Manager indicated to us, in her pre-inspection Self Assessment, that equipment at the Service was being maintained and good Health and Safety practices followed. We saw the electrical wiring certificate that was not available at the last inspection. Food hygiene practices were satisfactory and cleaning materials were being securely stored. We examined quarterly audit reports that included Heath & Safety. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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