Care Home: Burghley Road (16)

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What the care home does well This is the first inspection since Community Housing Association (CHA) took over as the registered provider at Burghley Road. This change in management took place in January 2010 and at the time there were 13 residents living in the home. CHA have faced an enormous challenge in taking over the provision of this service, whilst offering a continuity of care to the people living there. Whilst there is still a great deal to do, CHA are already bringing about many improvements for the people living in the home. The most significant improvement is in the communication between the staff and the people using the service. The staff are taking the time to listen to the residents and understand what they want to say. They are also treating people with respect and trying to help them think about their addiction. The staff team is still quite small but they are working very well together and are providing a consistent approach. Whilst the support given to the people who use the service can be very challenging they are providing mutual support. Everyone is working very hard to improve the service received by the residents. The food in the home has improved enormously and the residents now are eating a healthy and nutritious diet, which they are enjoying very much. CHA are also implementing all their systems and policies, including assessments, care plans and risk assessments for all the residents so there is a focus on what each person is being supported to achieve. What has improved since the last inspection? This section is not applicable as this is the first key inspection for this provider. What the care home could do better: Whilst CHA have made significant progress in improving the service, there is still a great deal to do. The first priority is for the home to have a clear vision in terms of what outcomes they would like to support the residents to achieve in terms of their alcohol dependency. This needs to be conveyed to the residents so they know what is expected of them if they are going to continue living in the service. Many of the residents have a very poor appearance in terms of their personal grooming and their clothing. Whilst it is recognized that improvements in this area will be hard, and will need very close working relationships between the staff and residents, it is something that definitely needs to progress. At the current time, there is still more work to be done in supporting each person to develop interests and activities that are meaningful to them. This again may entail a great deal of individual support to enable people to access a range of community based facilities. In addition, whilst progress has been made in helping residents to receive the correct financial benefits, there now needs to be clarity in terms of what each person will need to pay for, especially in terms of alcohol, cigarettes and toiletries. Where possible, people living in the home should be supported to buy their own toiletries and clothes. They should also be encouraged to use the local hairdressers. The level of support needed by the residents also means that the staffing levels in the home, need to be reviewed to ensure there are adequate staff available to ensure they can make progress in their lives. A few other areas were also identified, that relate mainly to systems in the home. These included the need to improve the recording of medication taken as and when required, the need to update some recruitment checks and to ensure all incidents are notified to the appropriate bodies including the Commission. This is to ensure that the residents safety is maintained and appropriately monitored. Key inspection report Care homes for adults (18-65 years) Name: Address: Burghley Road (16) 16 Burghley Road London London NW5 1UE     The quality rating for this care home is:   one star adequate 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: Pursotamraj Hirekar     Date: 1 9 0 5 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 31 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 31 Information about the care home Name of care home: Address: Burghley Road (16) 16 Burghley Road London London NW5 1UE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Neil Robertson Type of registration: Number of places registered: care home 24 Community Housing Association Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence Additional conditions: The maximum number of service users who may be accommodated is: 24 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: Past or present alcohol dependence - Code A Date of last inspection Brief description of the care home Community Housing Association is a registered company and is a subsidiary of One Housing Group. Community Housing Association is the provider for 16 Burghley Rd. Community Housing Association run various services for people with mental health and / or substance misuse needs (that may include alcohol) and has experience of supporting people with complex needs. Michelle Crouch is the Responsible Individual. Mr Neil Robertson is the registered manager of this service. Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 3 21 Brief description of the care home The service is a 24 place care home for adults who have or have had alcohol dependency. It was purpose built in the 1990s for its current use. The home has 24 furnished single rooms or bed sits. The rooms are grouped into four clusters. There are communal toilet and bathing facilities on a ratio of about 1 facility to four service users. The building has a number of communal living areas and kitchenettes where snacks and drinks can be prepared. Currently, the home is indergoing a major refurbishment work. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is the report of the unannounced inspection carried out on 19/05/2010 over 6 1/2 hours by Jane Ray Compliance Manager, Roger James Compliance Inspector and PursotamRaj Hirekar. The registered manager, deputy manager and staff were present at various points in time through out the inspection at the home. The method of inspection included study of care plans, risk assessments, staff recruitment records, conversation with residents who use the services, conversation with senior staff, care support workers and a feedback session with the registered manager and deputy manager. The quality rating for this service is 1 star. This means the people who use this service experience adequate outcomes. 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: Whilst CHA have made significant progress in improving the service, there is still a great deal to do. The first priority is for the home to have a clear vision in terms of what outcomes they would like to support the residents to achieve in terms of their alcohol dependency. This needs to be conveyed to the residents so they know what is expected of them if they are going to continue living in the service. Many of the residents have a very poor appearance in terms of their personal grooming and their clothing. Whilst it is recognized that improvements in this area will be hard, and will need very close working relationships between the staff and residents, it is something that definitely needs to progress. At the current time, there is still more work to be done in supporting each person to develop interests and activities that are meaningful to them. This again may entail a great deal of individual support to enable people to access a range of community based facilities. In addition, whilst progress has been made in helping residents to receive the correct financial benefits, there now needs to be clarity in terms of what each person will need to pay for, especially in terms of alcohol, cigarettes and toiletries. Where possible, Care Homes for Adults (18-65 years) Page 7 of 31 people living in the home should be supported to buy their own toiletries and clothes. They should also be encouraged to use the local hairdressers. The level of support needed by the residents also means that the staffing levels in the home, need to be reviewed to ensure there are adequate staff available to ensure they can make progress in their lives. A few other areas were also identified, that relate mainly to systems in the home. These included the need to improve the recording of medication taken as and when required, the need to update some recruitment checks and to ensure all incidents are notified to the appropriate bodies including the Commission. This is to ensure that the residents safety is maintained and appropriately monitored. 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 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 health care 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents thinking of moving to the service are supported to find out enough about the home so they can decide if they want to move in. Further clarity is needed on what people living in the home are expected to pay for themselves and what is provided in the home, to enable people to manage their finances. Evidence: We are not reducing the amount of alcohol people are drinking, but we are helping them to manage how they are using it better. (Quote from the manager during the site visit) We have one person who is making overnight visits to see if they want to move into the home. (Quote from a member of staff during the site visit) This is a good house, you get your food and you are looked after. (Quote from a resident during the site visit) Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: From talking to the management team in the home it was evident that they were still working toward a clear understanding of how they could best support the people living in the home with their ongoing alcohol dependency. They explained that they have visited another service that provides a service to a similar group of people. Having a vision for the service is essential as it impacts on all the other work taking place in the home. The residents also need to know what support they are being offered to relation to their alcohol dependency and what expectations are placed on them if they wish to live in the service. This needs to be reflected in the homes statement of purpose and all other key documents. We looked at the assessments for two people who have moved into the home, since One Housing started managing the service. Both these people had comprehensive assessments provided by social services. These were combined with a needs assessment completed by the home with the input of the resident. This information had then enabled a care plan to be prepared for each person. From talking to staff we understood that people thinking of moving to the home can visit, where possible as part of the process of deciding if the service is right for them. They are also given a range of written information about the home and the organization to help them with this decision. We looked at the contracts given to people once they move into the home. Whilst they have been signed by the manager and resident, the section on costs is not complete and there is still not clarity on what will be paid for by the home and what the resident will need to pay for themselves. This needs to be clarified so that people can be supported to understand and manage their personal finances. 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. People living in the home are supported by the staff to express their choices and these are reflected in their individual care plans. Evidence: I meet every fortnight with a member of staff and we discuss what I want to happen. I went through my care plan with them. We had a residents meeting about three weeks ago to talk about what people want to do. (Quote from a resident during the site visit) We spoke in detail to four residents who all said they spoke regularly to the staff, although some found it harder to remember their names than others. In addition we also spoke to staff about how they support the residents. It is evident that there is a great deal of work happening to develop the communication with the residents and to encourage them to express choices. This is also helped by residents meetings which are taking place. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: The staff we spoke to said that they have still not established a key-working system and at the moment all the staff are working with the residents and the two support officers are taking the lead in developing the care plans. Once the numbers of residents in the home increase a key worker system will be needed to ensure each resident gets the correct support. We looked at the needs assessment, care plans and risk assessments for four of the residents. Implementing this system has been an enormous piece of work for CHA and their progress is excellent. The care plans are easy to follow and the goals realistic and achievable. Progress towards meeting the goals is recorded on an ongoing basis. Risks have been identified and guidance is in place to enable staff to reduce and manage these risks. This includes guidance where needed on how to support people when they are aggressive or have other challenging behaviors. 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. People living in the home are being supported to develop their independent living skills and are really enjoying the food that is provided. They do however need more support in order to enjoy a range of meaningful activities. Evidence: The food is very good and I eat everything. (Quote from a resident during the site visit) I just watch TV and I go out for a walk. (Quote from a resident during the site visit) No one encourages me to do anything. (Quote from a resident during the site visit) At the moment we are not doing activities, the support officers have been Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: concentrating on the care plans. (Quote from a member of staff during the site visit) We spoke to the staff about the support they are providing for the residents. They explained that they have needed a lot more help with their personal care than they previously expected and they have amended the staffing structure to reflect this change. They are also supporting them to do their own laundry and tidy their rooms. Where possible, residents are able to make themselves hot drinks. We could see from talking to staff and residents, that CHA is recognizing peoples culture and for example arranged a party for St Patricks Day. There is however little progress in supporting residents to pursue meaningful activities based on their individual interests. This is recognized as an area of work that needs to be taken forward. We saw lunch being served during the inspection and it looked tasty and nutritious. All the residents we spoke to said they enjoyed the food. Fresh food is used and fruit is available. People are also offered sandwiches and other snacks between meals. The cook working during the week is employed through an agency, but has developed a good rapport with the residents. She has only completed a one day food hygiene course and needs to undertake more thorough training. Care Homes for Adults (18-65 years) Page 15 of 31 Personal and health care 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 adequate 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 are receiving their medication safely. Further support is however needed to enable people to be well presented and to ensure they attend all their primary health care checks. Evidence: Ive been to the optician but not to the dentist for a while. (Quote from a resident during the site visit) I go to the office now for my medication. (Quote from a resident during the site visit) We met and spoke to a number of the people living in the home. We saw that many of them were very poorly presented, with long nails, unshaved faces and dirty and torn clothing. It is recognized that there are a lot of issues to address in order for this to improve, but the staff do have a responsibility to support the residents to be better presented. From talking to the residents and looking at their care plans, it was seen that they are Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: being supported to attend health care appointments. During the visit one of the support officers was observed arranging podiatry input for some of the people living in the home. It is however recognized that some people have still not had all their primary health care checks including the GP, dentist and optician, although these appointments are sometimes refused. It was also noted that one of the residents has insulin controlled diabetes, and whilst the district nurse administered the insulin the staff have not been trained in this. We looked at the medication arrangements in the home. The Boots blister pack system is used. We looked at the medication for four people and it was all appropriately stored, administered and recorded. The only exception was a couple of medications that were given as required, where the recording and administration systems were not correct. At the time of the inspection no control drugs were being taken, although the correct storage facilities and record book were available. 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. The home has recognized the various aspects of the reported incidents and appears to have taken measures that would help achieve better outcomes for the residents who use the services. Residents have access to an appropriate complaints procedure and feel able to raise any issues they are not happy with. Evidence: We looked at available records to evidence notifications being written and sent to us. The home had several incidents involving residents that include missing person, hospital admission and falls since its registration. When we looked at the records of the incidents that had been notified to the Commission, we found that some had not been sent. These incidents affected the safety of the residents, for which we could not follow-up on how the home has handled the matter. We looked at the records of these incidents and could see they had been handled appropriately. They had also been used to look at how the care of the individuals involved could be improved. The complaints policy and procedures are appropriate and promote the safety and well being of residents who use the services. The registered manager had stated that the home has not received any complaint since its registration. We have spoken with the some residents and none of these residents have reported of any complaints in the last 5 months. The residents have further told us that any minor incidents are Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: reported to the home and they are dealt with appropriately. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home has improved. The home is cleaner and major refurbishment work are taking place in a timely manner. Residents have been engaged in the refurbishment consultation process to elicit their choices and cooperation as well. Evidence: In a quest to drive up the environment standards and enhance security measures, the home has undertaken a major redecoration work. The redecoration work is proposed to ensure more homely environment and will provide 3 communal lounges for residents that are comfortable, decorated to a high standard and used appropriately. The home proposed that the 3 lounges will be earmarked for specific purposes such as social inclusion events, games room and therapeutic groups as well. The staff and managers office are being relocated to the ground floor in a much more visible and accessible location. This will include a vision panel overseeing the entrance foyer to enable observation of people entering and leaving the home. The rear small office will remain as a managers office. The work is proposed to be completed July 2010. A new oak flooring was laid in the foyer and dining room. During the redecoration work the home has made alternative arrangements for residents dining. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The home has reviewed security measures and continued to use a call system so residents can contact staff if needed. There is also CCTV system externally and in communal areas. The home has further proposed to introduce walkie talkies to ensure better emergency contact between staff working in the home. Residents were engaged in a consultation process during their regular meetings. The entire scheme should look and feel much brighter and more homely. We looked at the various records the home has maintained in relation to health and safety checks. These record included first aid box, gas safety record, checking all areas of the home are kept clean including bedrooms, fire drills plans and fire alarm systems as well. We looked in the laundry and everything was working well. We could also see the cleaner working hard and trying to keep communal areas clean. A management team is closely monitoring and overseeing the progress of the refurbishment work. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported by a team who work cohesively and are supervised. Staffing levels are not adequate to meet the complex support needs of the residents. Evidence: We looked at the staff rota. The home has registered manager, a deputy manager, two support officers, six care and support officers, two night staff, a full time cleaner and a full time cook. The 24 hours care delivery for residents by the staff is structured in four shifts - morning, day, late and night shift. Currently the home had 13 residents with varying degree of needs and some residents have complex needs as well. As shown earlier in the report some residents are needing additional support in some areas of their lives. Therefore it is necessary for the home to review the staffing structure to ensure there are enough staff to support residents with their personal care, going to health care appointments and participating in meaningful activities. The interaction of staff with the residents was good, showing there was a good rapport and a good understanding. On this inspection we looked at 8 staff records. The recruitment checks were incomplete in the staff files. This was brought to the attention of the registered manager, who then found the necessary details of the agency staff. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: some of the permanent staff have moved from another home managed by the same company to Burghley Road. Their recruitment checks and relevant records need to be made available at the home all the time. Some staff that were part of the TUPE arrangements from the previous provider need their recruitment checks such as the CRBs updated. Staff spoken with have stated that they had received mandatory training. The home has carried out staff training needs assessment and was in the process of arranging training in-house and through Camden Social Services. Staff confirmed they receive supervision and minutes of the meetings are kept on the individual staff files. The minutes of the meeting was available and showed how information is shared with staff. Concerns raised by staff are addressed in the best possible way, which benefits the residents. 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. Residents and staff benefit from a well managed home to promote independent living and quality of life through ongoing monitoring and development of the home. Evidence: The home has a registered manager. The home had an internal quality assurance system and procedure, to ensure that the quality of care provision and delivery is always of high standard. The homes quality assurance work is carried out through regular monitoring of ongoing activities, regular staff supervision, provider visits, and development and close monitoring of an operational plan. The home had also sought the views of residents who use this service through regular residents meetings and other key stakeholders including Camden Social Services. The registered manager confirmed that there are clear roles and responsibilities in relation to the management of the home. Staff were confident that either the deputy manager or the registered manager would be available if they needed someone to speak with. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: We looked at the personal monies for four residents. CHA has worked hard to help the residents claim their financial benefits and in most cases these have been resolved. For the residents who need support to manage their monies, the records show that they have spent very little money over the last three months and have had only limited opportunities to buy clothes or toiletries. The home has a programme of servicing and testing of equipment; gas and electrical testing and carries out regular fire tests and drills. 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 1 4 The registered person must 25/06/2010 ensure that the statement of purpose explains how people living in the home will be supported in terms of their alcohol dependency. This is so the residents and staff are clear about what the home is aiming to achieve and their role in this. 2 5 5 The registered person must ensure each resident has a completed contract stating clearly what the home will provide and what they are expected to pay for themselves. 25/06/2010 This is so each person knows their expenses especially for cigarettes, alcohol and toiletries and can manage their personal Care Homes for Adults (18-65 years) Page 27 of 31 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 finances. 3 12 16 The registered person must support the people living in the home to enjoy a range of meaningful activities based on their individual interests and making use of the resources in the local community. This is so that they can enjoy valued and fulfilling activities. 25/06/2010 4 17 13 The registered person must 30/07/2010 ensure that the cook working during the week has completed a sufficient food hygiene qualification. This is to ensure food is provided safely for the residents. The registered person must promote the welfare of the residents by ensuring that they are supported to maintain an appropriate standard of personal care. This is so that they are able to be well presented. 25/06/2010 5 18 12 6 19 12 The registered person must ensure the residents are supported to attend all their primary care health check 25/06/2010 Care Homes for Adults (18-65 years) Page 28 of 31 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 ups including an annual check at the GP, dental and optician check. This is so their health can be promoted and any health issues addressed as soon as possible. 7 23 37 The registered provider 25/06/2010 must give notice to the Commission without delay of the occurrence of any serious injury to a service user, any event in the care home which adversely affects the well being or safety of any service user. This is so that the Commission can monitor how these incidents are being addressed. 8 33 18 The registered provider 25/06/2010 must review the staffing structure to ensure there are enough staff to support residents with their personal care, going to health care appointments and participating in meaningful activities. This is to ensure residents care needs are being met. Care Homes for Adults (18-65 years) Page 29 of 31 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 9 34 19 The registered provider 25/06/2010 must ensure that all staff recruitment checks and relevant records are made available at the home all the time. This is to safeguard the residents by ensuring they are supported by staff staff with all the necessary checks. 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 6 The registered person should implement a key working system to ensure all residents get the same level of individual support. The registered person should arrange for the staff to receive training on diabetes so they are able to recognize if the resident concerned needs any particular assistance with their health care needs. The registered person should ensure medication that is taken as required is stored appropriately and recorded correctly on the medication administration records in order to avoid any confusion for the staff administering the medication. The registered person should support the residents to have access to their monies and the support to buy items that they need such as new clothes. 2 19 3 20 4 43 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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