Care Home: Broken Banks (2)

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What the care home does well Service users were regularly assessed to determine whether their needs were being met. The care plans showed how service users would be supported and included information about the things they enjoyed and preferred; this would ensure they received the care they needed and wanted. A key worker provided most of the support at Broken Banks and service users were aware of how to contact the core house for out of hours support. The key worker had the appropriate skills and qualifications to assist service users with their daily routines. Service users knew how to make a complaint and were confident they would be listened to. Safeguarding procedures were clear and would help staff to respond to any signs of abuse or neglect. Recruitment practices were safe and this ensured service users were protected from being cared for by unsuitable people. What has improved since the last inspection? Risk assessments had been done to determine whether service users were at risk and needed window restrictors. What the care home could do better: The information about the services available at Broken Banks needed to be reviewedto ensure service users had up to date information. The correct fee information needed to be recorded on the service user contract to ensure they were aware of what their care was costing. Service users need to be involved in developing and reviewing their individual care plans; this would ensure they were fully involved in decisions about their care. The individual care plans should be reviewed and updated with the service user at least every six months to ensure the care was current. Service users should be provided with extra support to ensure housekeeping tasks were completed and the home was clean and odour free. Service users dietary needs should be monitored to ensure they receive a nutritious, healthy and balanced diet. A lot of work was needed to ensure the home was a pleasant, safe, clean and well maintained place for service users to live in. There needs to be a record of maintenance and renewals that would show planned and ongoing improvements. A copy of the revised policies and procedures needs to be available at Broken banks; this would ensure staff and service users have access to current safe guidance. Some aspects of the management of medicines needs to be improved including development of procedures and accurate record keeping; the key worker would benefit from medication awareness update training. The key worker would also benefit from update training to help him to recognise and respond appropriately to abuse and neglect and to protect service users from harm. The increase in responsibilities of the key worker had impacted on service users daily lives; this should be reviewed to ensure services users received the support they needed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Broken Banks (2) 2 Broken Banks Colne Lancashire BB8 0JY     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: Marie Matthews     Date: 0 8 1 2 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 31 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 31 Information about the care home Name of care home: Address: Broken Banks (2) 2 Broken Banks Colne Lancashire BB8 0JY 01204594550 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Thomas Hanna Type of registration: Number of places registered: Pendle Residential Care Limited care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home 2, Broken Banks (accommodating 3 younger adults) is part of Calder View Dispersed Homes Scheme. This is a semi-independent living scheme for younger adults who have mental health problems, with a staffed core house nearby at Calder View in Colne. This dispersed house has staff support as needed by the service users. Broken Banks has a designated keyworker who visits every day and service users can telephone for staff assistance whenever they need; 24 hour emergency support is provided by Calder View (core house). Broken Banks is located in a quiet residential area, near to Colne town centre shops and other amenities. The house has long-distance views over the Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 3 Brief description of the care home surrounding countryside, on-street parking and pleasant private garden. Upstairs are 3 single bedrooms and a house bathroom. A further small bedroom is available as compensatory space for the smallest single bedroom. Downstairs is a WC cloakroom, kitchen, dining room and lounge. Information about the services offered by the home is provided in the form of a service user guide and is available, with a summary of the most recent inspection report, to existing and prospective service users and their relatives. On the day of the inspection the weekly fees ranged from £361.50 to £382.00. Items not included in the fee include all personal items. Care Homes for Adults (18-65 years) Page 5 of 31 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 last key inspection on this service was completed on 18th December 2006 followed by an annual service review on 18th December 2007. This key inspection, including a visit to the home, took place on 8th December 2008. The inspection process involved looking at records, a tour of the home, discussions with the registered manager, key worker and two service users who lived in the home. The home sent us their annual quality assurance assessment (AQAA) before the inspection visit; this gave us a picture of what had improved over the past twelve months and where further improvements were needed. Care Homes for Adults (18-65 years) Page 6 of 31 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 set out on page 4. Care Homes for Adults (18-65 years) Page 7 of 31 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 8 of 31 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 9 of 31 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. A thorough assessment process ensured service users needs would be met. Evidence: The files of two service users were examined; all three service users had lived at Broken Banks for some years. Each service user had been given useful information in the form of a statement of purpose and service user guide and a copy of the last inspection report was available; this would inform service users about what to expect whilst living at Broken Banks. The service user guide had not yet been revised to reflect the changes of ownership; the key worker advised this was being done by head office for all of the homes. The information was not yet available in other formats. The needs of each service user had been considered prior to admission and as part of an ongoing process; this would ensure they were getting the care they needed. The service user, other professionals and friends and family had been involved in helping to devise a plan of care that reflected all the care that was needed. Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: From looking at training records it was clear the key worker had the necessary skills and experience to meet service users needs. Each service user had been given a copy of the up to date terms and conditions or contract; this would ensure service users were aware of their rights and obligations whilst living at the home. It was noted that service users had signed the contracts but the amount of the current fee charged had been left blank; this should be completed to ensure service users were aware of the cost of their care. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of service users were met and were reflected in their individual plan of care although service users should be involved in the development and review of their care. Service users were encouraged to maintain their independence and to make decisions about their daily lives. Evidence: Individual care plans were discussed with the key worker and one service user. The key worker was responsible for maintaining care plans. The care plans showed what care and support service users needed to ensure all aspects of their needs were met. However there was no evidence that service users had been involved in decisions about care and one service user said he didnt know what was in his care plan. The plans had been reviewed each year and the manager was advised this should be done at least every six months to ensure the care was current. It was clear from records and discussion with two service users that they were Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: supported to make decisions and live independently within a risk assessment framework. The care plans included a number of assessments of risks to ensure service users were safe and protected from harm. One service user said he had, in the past, been helped to manage his money; there were clear records to show his finances had been protected. Service users were given the opportunity to participate in the running of the home although regular meetings had not taken place recently; one service user said the meetings had been useful as any concerns could be discussed. Service users were not involved in the selection of new staff although they had been given the opportunity to participate in the annual user survey and to complete surveys for the key inspection but had chosen not to. There was evidence that service users had read some of the policies and procedures; this would help to keep them safe. Information about confidentiality was included in their individual plan to inform them that any information held about them would be stored securely. Care Homes for Adults (18-65 years) Page 13 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Independence and choice were encouraged and service users were able to develop and maintain contacts with family and friends. Further support and monitoring was needed to ensure service users nutritional needs were met. Evidence: Two care files were looked at and the key worker and two service users were spoken to about leisure activities. Service users were responsible for their own leisure activities and it was clear that staff support had decreased since the last key inspection. However one service user said he attended the local church and another enjoyed supporting the local football team and was accompanied by the key worker. Some service users had been on an annual holiday with staff and other service users from Calder View; the key worker said they had enjoyed it and would be involved in planning next years holiday. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: Service users were encouraged and supported to maintain contact with family and friends who were welcome to visit the home. One service user said the neighbours were friendly and they enjoyed living in the house. Service users had agreed to share housekeeping tasks and were responsible for cleaning and tidying their own rooms; it was clear during a tour of the home that more supervision and support was needed in this area as some areas of the home were unclean. One service user said that jobs didnt always get done and the key worker confirmed that sometimes extra encouragement and support was needed. Service users privacy and choices were respected and they had keys to their bedrooms and to the front door and could come and go as they pleased; one service users lock had been damaged and was still awaiting replacement. It was clear that service users were responsible for providing their own meals; one service user chose to have all his meals at Calder View and another would go there for lunch. One service user went to the local shops for all his meals. The kitchen fridge, freezer and cupboards were empty; there were facilities in the kitchen for individuals to lock their own food away although these cupboards were not used. It was difficult to determine whether service users were having a healthy nutritious diet as there were no nutritional assessments or records to support any monitoring; this was discussed with the registered manager who was considering introducing more support to help service users with the planning and preparation of healthy nutritious meals. Care Homes for Adults (18-65 years) Page 15 of 31 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. Service users health care needs were met. Medicines were generally managed safely although staff need to be provided with up to date guidance to help them to safely manage service users medicines. Evidence: Service users were responsible for making decisions about their personal routines; two service users said they could do what they wanted. The same staff key worker visited the home twice a day which provided consistent support for service users; out of hours the service users would contact the core house at Calder View. Records showed that service users health was monitored by regular contact with mental health professionals, GPs and social workers and by daily interaction with the key worker. One service user said he would visit his doctor if he was worried about his health and the key worker said he would provide support and advice as needed. Records showed service users had accessed healthcare facilities in the community to help maintain and improve their health and well being. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The medication policies and procedures had not been updated and were therefore different from those at the core house; this meant that staff at Broken Banks were not provided with safe and current guidance which could put service users at risk. Medication procedures needed to include guidance to help staff manage medicines for periods spent away from the home and to support them with the secondary dispensing procedure that was in place at Broken Banks. Medicines were stored safely and records were clear and generally accurate although directions on one service users medication record did not match the details on the prescription which could put service users at risk of not receiving the correct medication. Service users managed their own medicines with support from the key worker who had recieved appropriate training in safe management of medicines in 2004. Care Homes for Adults (18-65 years) Page 17 of 31 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. Service users had access to a clear complaints procedure and were sure their concerns would be listened to. Service users were protected by clear procedures although training should be provided to update staff knowledge and skills. Evidence: The complaints procedure was clear and made available to service users; one service user said he would talk to the key worker or staff at the core house if he had a problem. The key worker said complaints would be dealt with informally and resolved immediately; there were no formal complaints recorded since the last inspection. One service user said previous problems had been discussed as a group with the key worker and had been sorted out. The home had a safeguarding procedure that informed staff of the different forms of abuse and how to respond to any suspicions or reports of abuse or neglect; the procedure should include the contact information of local agencies that would need to be notified of any incidents. The key worker had not had any recent safeguarding training; training would help him to recognise and respond appropriately to any suspicions of abuse and neglect. There were procedures to support staff with dealing with verbal and physical aggression, managing challenging behaviour and the use of restraint. It was Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: recommended that the key worker received training to help him to respond appropriately to protect himself and others. Records showed that service users money had been looked after properly although there was no procedure to support staff with this. Care Homes for Adults (18-65 years) Page 19 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvement was needed to ensure service users were provided with a safe, clean and pleasant place to live in. Evidence: Broken Banks is situated on a quiet estate close to shops and local amenities. Service users spoken to were happy with the location. The home was comfortable and homely although there were a number of areas in need of attention that were highlighted during a tour of all areas. Areas requiring attention included the front door bell was not working, a carpet gripper was not secure and presented a trip hazard and wallpaper around the home was peeling away from the walls. Corridors and service users bedrooms were untidy and in need of cleaning, one bedroom had not yet had the door locks replaced following damage when keys were lost two months ago, bedding was shabby and had been burnt by cigarettes even for the service user who did not smoke, two of the beds were without base sheets, curtains in one bedroom were hanging off the rail and radiators were still not working and all rooms upstairs remained cold. The bathroom was tidy although the downstairs toilet did not have an overide locking device in place; this was needed to maintain peoples privacy. Communal areas were comfortable although in need of decoration. The dining area was the designated smoking area although it was clear from overfilled ashtrays that the two service users Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: who smoked did so in all areas of the home; it was noted that there were no heat detectors in the smoking area and the fire safety officer should be consulted for advice. At the time of the visit the home was not clean and the laundry baskets were overflowing with dirty laundry; the registered manager said a carer from the core house had been providing weekly support with cleaning. The kitchen was equipped with a washing machine but there were no facilities to dry anything; the registered manager said a washer dryer had been requested but they were awaiting a decision from head office. Service users were responsible for cleaning tasks and had a rota but one said the rota didnt work; it was clear more support and supervision was needed to ensure the home was clean and hygienic. The key worker was aware of some of the repairs identified although there were no records to evidence any requests for maintenance or previous repairs completed. The home did not have a formal planned maintenance and renewals programme that would support plans for future improvements. The acting regional manager was spoken to and advised that Broken Banks was due to be refurbished and redecorated in 2009, she said she would check on any outstanding repairs and also advised that all maintenance requests were sent to head office each month and any requests were prioritised. Care Homes for Adults (18-65 years) Page 21 of 31 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 were suitable and had the skills and competencies to support the service users. Evidence: The key worker system was used at Broken Banks; this ensured service users received support from the same member of staff each day. The key worker said other staff who were known to the service users would provide support when he was on leave. Service users knew that the key worker would visit two to three times each day and that they could contact the core house out of hours. The key worker was supported by the registered manager who was based at the core house. Concerns were raised as the key worker had been previously responsible for two services and this had recently increased to five services; it was clear from evidence gathered at the key inspection that this had impacted on the level of support he had been able to offer service users at Broken Banks. The acting regional manager stated that the situation was currently under review. The key workers records were looked at and showed that a safe recruitment procedure had been followed to ensure service users were not looked after by unsuitable people. The key worker had received appropriate training that would help him to meet service Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: users needs and to keep himself and others safe. However some of this was in need of updating including health and safety, safeguarding (see standard 23), moving and handling and medicine awareness to ensure his skills and knowledge were updated. The key worker had also achieved a recognised care and management award; this showed he was competent to support the service users in his care. Records showed he had received occassional one to one support from the registered manager although it was reported that some of these records were missing. Care Homes for Adults (18-65 years) Page 23 of 31 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 home was safe and managed by competent persons and peoples views and opinions were sought. Evidence: The registered manager who was responsible for Broken Banks was based at the core house and was responsible for a number of other small homes. He has appropriate qualifications in management and care that would support him in his role. The key worker said the registered manager visited Broken Banks each month although there were no formal records to support this. The registered manager said a recent service user survey had been completed although the service users at Broken Banks had chosen not to participate. The registered manager said a survey would be introduced that would also seek the views of friends, family, health and social professionals. The service had also achieved the Investors In People award; this was a recognised Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: quality award that monitored the management of the service and the involvement and development of staff. Records showed that policies and procedures had been reviewed recently although Broken Banks did not have a copy of the updated guidance; all staff needed access to clear and safe guidance to help them to do their work properly. The home had responded to recommendations made at the last inspection and the registered manager had provided us with the annual quality assurance assessment (AQAA) although it could have included more information to support any improvements made since the last key inspection. There were no records of any visits by the responsible individual to monitor the day to day management of the home although a new member of staff had been appointed to complete this monitoring. All staff were given mandatory safety training that would help to keep them and others safe; as identified previously the key worker would benefit from moving and handling and health and safety training. Hazardous products were stored safely to ensure their were no risk of accidents. Records were sampled and showed that systems had been serviced and maintained to ensure the home was safe. As requested at the last key inspection risk assessments had been developed regarding the lack of window restrictors; currently the risk was deemed to be low risk and the registered manager was advised to keep these under review. Care Homes for Adults (18-65 years) Page 25 of 31 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 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 24 23 All areas of the home, 26/01/2009 including those noted during the inspection, must be kept in a good states of repair. This will ensure the home is a safe, well maintained and pleasant place for service users to live in. 2 24 23 The heating system must be repaired. This will ensure all areas of the home are warm and comfortable. 29/12/2008 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 Each service user should be issued with a revised copy of the service user guide; this would ensure they have up to date information about the home. The service users copy of the terms and conditions or contract should include the amount of fee payable; this would ensure they are aware of their payment obligations whilst living at Broken Banks. Page 27 of 31 2 5 Care Homes for Adults (18-65 years) 3 6 The individual plan should be reviewed and updated at least every six months and the service user should be involved in this process; this would ensure the plan is up to date and reflects current needs. Service users should be involved in the development of their individual plan; this would ensure they receive the care they want and need. Consideration should be given to re introducing regular group discussions; this would give service users an opportunity to raise and discuss any issues that are important to them as a group. Consideration should be given to providing service users with support to access a wider range of leisure activities. Service users should be given extra support and monitoring to ensure housekeeping tasks are being completed; this will ensure the home is a pleasant place to live in. The broken door locks should be replaced to ensure service users rights to privacy and dignity are respected. Service users nutritional needs should be assessed and monitored on a regualr basis; this will determine whether service users are receiving a healthy and nutritious diet. Consideration should be given to rpoviding service users with support with the planning and preparing of healthy nutritious meals. Procedures should be developed to help staff with the provision of medicines for periods spent away from the home and for managing the practice of secondary dispensing. The medication administration record should clearly record all medicines administered as prescribed to prevent the risk of error. Staff at Broken Banks should be provided with a copy of the revised medication policies and procedures; this will ensure they have guidance to manage service users medicines safely. The key worker should be provided with safeguarding training to update his skills and knowledge. The key worker should be provided with training to help him to respond appropriately to verbal or physical aggression; this would help to keep him and others safe. The contact information of local agencies that would be involved in any safeguarding referrals should be included as part of the safeguarding procedure; this will ensure staff 4 6 5 8 6 7 14 16 8 9 16 17 10 17 11 20 12 20 13 20 14 15 22 23 16 23 Care Homes for Adults (18-65 years) Page 28 of 31 have access to support and advice from appropriate agencies to help them to protect service users. 17 24 Records should be kept of any requests for repairs or maintenance with a record of dates of completion. This will ensure requests are responded to promptly. There should be a formal planned maintenance and renewal programme that includes timescales. This will support that improvements are ongoing. Service users should be provided with sufficient good quality bedding to ensure their comfort. All service users rooms should be fitted with appropriate locks. This will help service users to maintain their privacy. The ground floor toilet should be fitted with an appropriate lock. This will ensure service users rights to privacy. Advice from the fire safety officer regarding fitting an appropriate detection device in the designated smoking area. This will help to improve service users safety. Service users should be reminded of the risk of fire including the appropriate use of the designated smoking areas and this should be monitored by staff. This will reduce the risk of fire and harm to service users. The home would benefit from a periodic thorough clean to ensure it is a clean and odour free place to live. Service users should be given extra support as necessary to help them to maintain a clean and odour free home. Consideration should be given to providing service users with suitable equipment to dry their laundry. The company should review the number of services for which the key worker is currently responsible to ensure service users receive the support and supervision they need. The key worker should be provided with training to update his skills and knowledge to ensure he can meet service needs effectively and safely. Records to support regular one to one supervision should be replaced on file. There should be records to support any visits made to Broken Banks by the registered manager and the outcome of his visit. The responsible individual should visit the home each month and make a report of the visit to support that the service is being monitored. 18 24 19 20 21 22 26 26 27 28 23 28 24 25 26 27 30 30 30 33 28 35 29 30 36 38 31 39 Care Homes for Adults (18-65 years) Page 29 of 31 32 40 Broken Banks should be provided with a copy of the updated policies and procedures to ensure the staff have access to safe and current guidance. The key worker should be provided with moving and handling and infection control training to ensure their skills and knowledge are up to date. 33 42 Care Homes for Adults (18-65 years) Page 30 of 31 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. 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