Care Home: Ca Na Gardens

Similar services:

• Hillside
• Applegarth
• 122 Scorer Street
• Jubilee Villa Care Home
• Thornham Grove
• Beech Lodge
• 8 Thorndale Road (Homefield College)
• Hunter`s Lodge

What the care home does well There is a written assessment about each person who lives in the home, which gives information about them and about their care needs. Staff continue to try to make sure the home is the right place for people who live there.There are written care plans for each person, which tell about the kinds of support people need. Social workers and other healthcare professionals are involved with making sure people continue to get the right kind of care and support. People who live in the home are involved in different activities. Some go to day centres. Some people have one to one support to do things.Families are welcome in the home. People are offered cultural choices in meals and some activities.People who live in the home have generally good support in their personal care. They have access to GPs and other health professionals for check-ups. Staff look after medication well.Staff pay good attention to making sure people who live in the home have rights.Most parts of the home are kept tidy and clean and in good condition.People have their own things in their bedrooms.Staff support people with care and sensitivity. There is a rota showing which staff are on duty, and who is in charge. Some people have one to one support from staff.There are different policies in the home to tell staff how to do their work safely and well. Staff have training in different subjects to help them learn. What has improved since the last inspection? Staff have had training in different subjects, including safe handling of medication, and how to supportpeople who communicate their needs through their behaviour.Staff are meeting the care needs of people who live in the home in a better way. They are following up on things that other professionals have told them, like social workers and psychologists. This has helped people with things like communication.Staff have been trying hard to make sure that each person has different activities to be involved in and that they can go out each day. Staff are trying to involve people more in daily jobs in the home so that they can learn more daily living skills. Staff have been keeping us more informed about incidents affecting people who live in the home.Some repairs have been made in the home.There is a new training pack for staff who come to work in the home.There are some new staff working in the home. The provider has made sure they have collected all the information they need to make sure new staff are safe to care for people in the home. What the care home could do better: There have been some real improvements in the home and staff work hard to support people and meet their needs. But we found some issues which give us concern.We found some fire safety risks. Checks had been done by staff, but where there were problems, action had not been taken. These issues are of concern relating to the safety of people who live in the home.One of the directors of the company that owns the home has been working on shift, even though they are not a qualified or experienced member of staff and have not been recruited to work as a carer. Staff have followed decisions this person has made, which has resulted in some potential risks to people. This is not a safe situation for people who live in the home.There is still not a registered manager who is working in the home on a daily basis. Some of the concerns that have arisen are because there is not good ongoing management. This means that people who live in the home have not been living in a properly managed place. (Since our visit, the provider has worked to change this). Key inspection report Care homes for adults (18-65 years) Name: Address: Ca Na Gardens 174 Scraptoft Lane Leicester LE5 1HX 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: Chris Wroe Date: 0 8 0 6 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 33 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 33 Information about the care home Name of care home: Address: Ca Na Gardens 174 Scraptoft Lane Leicester LE5 1HX 01162413337 01162202772 Biggsy_31@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hamra Associates Limited Name of registered manager (if applicable) Mr Ray McLaughlan Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: No additional conditions of registration apply. Date of last inspection 2 5 1 1 2 0 0 9 A bit about the care home Cana Gardens is a care home providing personal care and accommodation for up to eight people with a learning disability. Care Homes for Adults (18-65 years) Page 4 of 33 The home, which is located on the outskirts of Leicester city centre, offers six single bedrooms and one shared bedroom. Communal facilities include a lounge and a separate lounge/dining area. Both of these rooms have patio doors, which lead onto a large garden to the rear of the home. There are a variety of local amenities close by including a large supermarket, small local shops, health centres, temples, churches and takeaways. There is a bus route nearby, and travel to and from the city centre takes about 20 minutes. Current charges are between £344 and £352 per person per week. Care Homes for Adults (18-65 years) Page 5 of 33 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 healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 17th May and 8th June 2010. The provider (owner of the home), Ray McLaughlan, and staff in the home helped us with our inspection. Our visit to the home lasted a total of nine hours. Ray is also the legal registered manager of the home, but a part-time manager is employed to run the home. The main way we do our inspections is doing something we call case tracking. This means looking at the care given to people in different ways. The ways this was done are: talking to the people who live in the home - talking to staff and the manager - watching how people are given support - looking at written records. We watched how staff got on with people who live in the home and how they supported them. We watched to find out how comfortable people were in their home. We spoke to two members of staff during our visit to the home, who told us about working in the home and gave us their views. We checked all the standards that Care Homes for Adults (18-65 years) Page 7 of 33 the Care Quality Commission has decided are keystandards during this inspection. The information in this report is just about what we checked in this inspection. We have kept details about individual people out of the report, to make sure these things are kept confidential. What the care home does well There is a written assessment about each person who lives in the home, which gives information about them and about their care needs. Staff continue to try to make sure the home is the right place for people who live there. There are written care plans for each person, which tell about the kinds of support people need. Social workers and other healthcare professionals are involved with making sure people continue to get the right kind of care and support. People who live in the home are involved in different activities. Some go to day centres. Some people have one to one support to do things. Care Homes for Adults (18-65 years) Page 8 of 33 Families are welcome in the home. People are offered cultural choices in meals and some activities. People who live in the home have generally good support in their personal care. They have access to GPs and other health professionals for check-ups. Staff look after medication well. Staff pay good attention to making sure people who live in the home have rights. Most parts of the home are kept tidy and clean and in good condition. Care Homes for Adults (18-65 years) Page 9 of 33 People have their own things in their bedrooms. Staff support people with care and sensitivity. There is a rota showing which staff are on duty, and who is in charge. Some people have one to one support from staff. There are different policies in the home to tell staff how to do their work safely and well. Staff have training in different subjects to help them learn. What has got better from the last inspection Staff have had training in different subjects, including safe handling of medication, and how to support Care Homes for Adults (18-65 years) Page 10 of 33 people who communicate their needs through their behaviour. Staff are meeting the care needs of people who live in the home in a better way. They are following up on things that other professionals have told them, like social workers and psychologists. This has helped people with things like communication. Staff have been trying hard to make sure that each person has different activities to be involved in and that they can go out each day. Staff are trying to involve people more in daily jobs in the home so that they can learn more daily living skills. Staff have been keeping us more informed about incidents affecting people who live in the home. Some repairs have been made in the home. Care Homes for Adults (18-65 years) Page 11 of 33 There is a new training pack for staff who come to work in the home. There are some new staff working in the home. The provider has made sure they have collected all the information they need to make sure new staff are safe to care for people in the home. What the care home could do better There have been some real improvements in the home and staff work hard to support people and meet their needs. But we found some issues which give us concern. Care Homes for Adults (18-65 years) Page 12 of 33 We found some fire safety risks. Checks had been done by staff, but where there were problems, action had not been taken. These issues are of concern relating to the safety of people who live in the home. One of the directors of the company that owns the home has been working on shift, even though they are not a qualified or experienced member of staff and have not been recruited to work as a carer. Staff have followed decisions this person has made, which has resulted in some potential risks to people. This is not a safe situation for people who live in the home. There is still not a registered manager who is working in the home on a daily basis. Some of the concerns that have arisen are because there is not good ongoing management. This means that people who live in the home have not been living in a properly managed place. (Since our visit, the provider has worked to change this). Care Homes for Adults (18-65 years) Page 13 of 33 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Chris Wroe CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 14 of 33 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 15 of 33 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. The assessment process in the home is generally good, so that people benefit from being in the right place for their needs. Evidence: No one new has moved into the home since we last inspected. For each person who lives in the home, there is a written assessment - this gives information about what kind of support and care each person needs. These have good detail about each person. There are also written personal profiles, which give information about each persons ways of communicating. The staff continue to make sure that the home is the right place for people who live there, and that they can meet their needs. The service user guide has been written in plain English, with pictures to aid understanding. Care Homes for Adults (18-65 years) Page 16 of 33 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 live in this home benefit mainly from good attention to their care needs. Evidence: Each person has a care plan, which gives information about their care needs and how they are supported. The care plans talk about the different activities people do and what support they need for these. There are also some risk assessments for each person, which tell about how they can be supported to do the things they want to do but still be kept safe. Social workers and other care professionals are involved in peoples ongoing care, and review meetings are held to make sure people are getting the care they need. Staff have improved the way that they involve professionals and follow their advice. There has been some improvement in the way that staff communicate with people, but this needs to be built on further. The manager has booked to go on a communications training course. Staff are developing person centred plans for each person. There is more being done in the home to help people to develop their daily living skills Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: some people help with washing up, making sandwiches or cleaning bedrooms. More time is given to helping people to do things. One member of staff told us that they used to take people out to do food shopping, but now this is done by one of the directors. Involving people in shopping and meal planning would be a good way to help them to learn skills and to be able to have choices. The home still needs to give more attention to helping people learn skills so they can be more involved in looking after their own needs. Care Homes for Adults (18-65 years) Page 18 of 33 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. People who live in this home benefit from a generally improving lifestyle. Evidence: We saw that people do different things that they enjoy and different activities. We saw from written records that there has been an improvement, and that people are having the chance to do more things - including those people that need more support. We found that people do different things like going to discos, going shopping, going to the pub, going for walks. Some people go to day centres. The home has a large garden, which people can enjoy in warm weather. People who live in the home spend time with their families. Relatives are welcomed in the home. It is good that staff are trying to help people to do more, especially for those who need more support and are more isolated. However, there are still some times when there are not enough staff to support people who need more than one person to support them to do the things they enjoy. Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: Members of staff showed good understanding of peoples needs and likes and dislikes. People who live in the home are supported to go to church if they want to, or to other religious places of worship. Different things are provided to support cultural needs and wishes, such as Asian television channels, and Asian food. Meals are prepared by care staff. There is variety in meals provided, and people have some choices. Staff cater for different cultural diet choices, and health needs. Staff showed us they understood different dietary needs and how to ensure people had a safe and healthy diet. Care Homes for Adults (18-65 years) Page 20 of 33 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from god attention to the health and personal care needs. Evidence: Staff give personal care to people who live in the home, supporting them according to their needs. People have access to a local GP, and they are supported to have ongoing health checks, such as eye care, and dental care. We found that staff follow up concerns about peoples health and wellbeing, and have improved the way that they keep other professionals involved with peoples care. We looked at a sample of medication and saw that recording has been done correctly and this tied in with medicine stocks. We saw from looking at written records that any problems with giving out medication are dealt with. The home has introduced safeguards to make sure medication is given out properly. There are regular checks of stocks. Staff have completed distance-learning training about giving out medication safely. Care Homes for Adults (18-65 years) Page 21 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst there has been improvement in reporting, people who live in this home may be put at risk by lack of ongoing rigorous attention to safeguarding by the management of the home. Evidence: There is information in the home about how to make a complaint. Staff told us about how they protect people in the home from harm. Staff have had some training about safeguarding people from harm, and they understand about protecting people. The home is better at reporting incidents to us and to social services. While there has been improvement in the way in which staff have been trained and how they look after people, we still found issues that gave us some cause for concern about peoples wellbeing. One of the directors has been working in the home as a member of staff to cover staff shortages - but they have not been recruited or checked as a member of staff, and there is no evidence that they have had the training or experience required to do the job. Because of their position as a director, some members of staff follow their direction about the care of people, when they are not qualified as a senior carer to give direction relating to peoples care. Because of potential risks from this, we advised Social Services, and asked the provider to make immediate changes to ensure only qualified and competent staff work at the home. On our follow-up visit to the home to finish the inspection, we found that the director was no longer on the staff rota, and members of Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: staff told us they had not been working in the home. It is good that the home took prompt action about this. The provider has now told us that the director may work in future at the home as a member of staff, because they are now ensuring proper checks and training is in place. There has also been work done to ensure that staff are all aware of who is in charge, so that they understand the managers and senior carers are responsible for telling them how to meet the care needs of people who live in the home. People are supported by staff to look after their money. The Social Services department is the appointee for people who live in the home, safeguarding their money. One person has their own bank account and is supported by staff to look after their own money. One member of staff said it might be good if some other people in the home could have their own bank accounts so they can learn skills about managing their money, and going to the bank. This may be something the provider could look at with the Social Services department. Care Homes for Adults (18-65 years) Page 23 of 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home could benefit from greater attention to their living environment, to support their wellbeing. Evidence: We looked around some parts of the home. We found that while some parts of the home were fresh and clean, there was one bedroom which continues to have an offensive smell - although it was improved from the last time we inspected. One member of staff told us that there were plans to solve this problem by providing an ensuite bathroom for the person whose room it was. The lounge and other parts of the home were mainly bright and welcoming. There have been some improvements made since we last visited - the banister that was loose had been repaired. The kitchen floor lino covering is still worn in places, and has not yet been attended to. The provider told us about plans to get this work done. There is a large garden for people in the home to use and sit out in. People who smoke go outside in the garden. Fire safety tests and other checks are done in the home to make sure people are safe. We found that while staff had carried out tests of safety equipment, where issues were noted, these had not been followed up. Fire doors were reported as faulty, as was Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: emergency lighting. There was no evidence that these had been put right. When we looked at the fire doors for the office and the kitchen, we found that they did not close properly, and so were not providing a safety measure in the event of a fire. Fire doors were also propped open in the home, and there was not a risk assessment in place to tell about this, and about how staff would ensure the safety of people who live in the home. The fire safety plan of the layout and room allocation of the home was not up to date. These issues could put people who live in the home at risk of harm. We wrote to the provider after our first visit, to tell about our concerns and ask for prompt action. When we completed our inspection on our second visit on 8th June, we found there were still problems with the fire doors. Care Homes for Adults (18-65 years) Page 25 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from improving staff recruitment and training processes. Evidence: There are at least two members of staff on duty in the home - including during the night. Staff in the home are responsible for caring for people who live in the home, and for doing cleaning and cooking. The staff rota shows who is working in the home, and who is responsible for each shift, and where one to one support is given to people - although sometimes there are changes to the rota so it is not always clear - and staff do not always seem to know who is in charge. We looked at records about the staff who work in the home. The provider has made sure that proper checks have been carried out, like checks with the Criminal Records Bureau. Two written references are now being collected for each person who comes to work in the home - which is an improvement since we last inspected. There are good clear recruitment records. There is also a new induction pack for staff to complete when they begin to work in the home. Staff have training in different topics to help them to do their work well. Recently they have had training about how to support people positively where their behaviour is challenging. Staff are supervised and supported in their work by the manager and deputy Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: manager. We saw that staff are committed to working well and supporting people well. Care Homes for Adults (18-65 years) Page 27 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of ongoing effective management of this home means that there continue to be issues affecting the safety and wellbeing of people who live there. Evidence: The provider is also the registered manager of the home. But the provider has not worked in the home on a day to day basis for a long time, and has been trying to find another manager who can become the registered manager. There is a new manager, who has been working in the home for over six months. The manager works part-time, as he also works in another care home. We found that there are some good things happening in the home, like improved supervision for staff, and better reporting to us. But there have still been issues which concern us about the management of this home. The deputy manager and the manager do not often meet, and communication is often through a book or on the telephone. This can create problems. There has been a lack of clear consistent management, which in turn gives rise to concerns like the issue regarding a non-qualified person working in the home (see section 4 of this report) and issues about health and safety (see section 6). We have been flexible in allowing time for the provider to find someone who will become Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: the registered manager. We met with the provider and manager to discuss this further, and they have employed another deputy manager and put in place a management structure, which is clearer. We will be looking at how this works in ensuring the home is well managed and people who live there well looked after. We asked the provider about how they check the quality of the service they are providing. This is becoming a much more important part of the management of a home. The provider told us that questionnaires are provided in the welcome pack for people who come to the home to fill in if they wish to. The manager has also started to do checks to make sure staff are carrying out their jobs properly - for example checks of medication, and checks of peoples diet. The manager and provider also use information from inspections and Social Services checks to guide them to improve the service. Staff do tests and checks to make sure equipment in the home is safe. There are policies which tell people how to work safely. In staff meetings, issues about health and safety are talked about. We did find that where checks had been carried out and staff had concerns about the safety of equipment and reported these, action had not always been carried out to correct faults (see section 6 of this report). Care Homes for Adults (18-65 years) Page 29 of 33 Are there any outstanding requirements from the last inspection? Yes  No  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 1 24 23 The provider must ensure that all fire safety precautions are taken to prevent the risk of fire, including holding proper information about who is living in the home. 31/12/2009 This is to ensure that people in the home are kept as safe as possible from the risk of fire. Care Homes for Adults (18-65 years) Page 30 of 33 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 Description 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 Description Timescale for action 1 23 18 The provider must ensure that people who live in the home are cared for at all times only by appropriately recruited, trained, experienced and qualified staff. 18/06/2010 This is to ensure that peoples wellbeing is safeguarded at all times. 2 24 13 The provider is required to take action to address fire risks identified by staff, and to ensure that people who live in the home are safe from the risk of fire. 30/06/2010 This is to protect the wellbeing of people who live in the home. 3 37 10 The provider must ensure that the home is properly managed on a day to day 30/09/2010 Care Homes for Adults (18-65 years) Page 31 of 33 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 Description Timescale for action basis to ensure continuity, effective management, and safety of people who live in the home. This is to ensure that the home is managed with sufficient care, competence and skill to ensure the wellbeing of people who live there. 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 7 We recommend that people who live in the home are supported to have more involvement in doing daily living tasks, like shopping, looking after their money, helping in the home, to build up their skills and understanding. We recommend that clarification is given to staff about the role and position of directors in the home, about the role and position of senior staff and management, and that it is made clear who is qualified, accountable and responsible to make decisions about the care of people who live in the home. It is recommended that the provider pays attention to getting refurbishment and maintenance work done in the home to improve the living environment for people who live there. 2 23 3 24 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or 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. © 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!