Care Home: Carrdale Care Home

What the care home does well The needs of the people who live at the home are assessed before and after they move in. This means that their care needs can be planned and properly met. All of the people had care plans which inform staff about how to meet their needs. Information about the home is available to help people decide if it is the right home for them. Health care needs are well met by using a multi agency approach. This helps the people who live at the home to stay healthy. The home has medication systems for the staff to follow to make sure that the people who live at the home are not put at risk. The people have opportunities to take part in a variety of leisure pursuits and interests which provides them with a stimulating environment and helps them to develop new skills and increase their confidence. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each person`s preferences. They treat the people who live at the home as individuals and support them to live the life they choose as much as possible so they know they are valued. There are procedures in place at the home that make sure that the people who live there are protected and kept safe from abuse. The staff are supervised and trained so they know how to provide the people with good care. The manager is experienced. They are approachable and clearly present in the home to give direction and support to staff and make sure that the service is centered on the people whom live at the home. What has improved since the last inspection? This is a new service. What the care home could do better: If liquid soap and disposable towels were available in communal bathrooms this would reduce the risk of cross infection consequently protect the health of the people and staff at the home. If the settee was replaced this would remove the unpleasant odour from the living room and hall. This would would make the home more pleasant for the people who live there and show that they are valued. If the homes medication procedures were followed all of the time this would make sure that people receive medication when they should. This means that their health will be safeguarded. If all of the care plans had sufficient detail and all parts of the plan were completed, staff would know that the information in them was up to date and correct. This would mean that they would be sure they were providing the people at the home with the support and care they need. If staff recruitment records showed that all of the staff have been properly vetted this would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. If the staff at the home all had up to date training in adult protection procedures and were informed of the whistle blowing procedure this would make them more skilled at safeguarding the people at the home. Staff fire instruction will make sure that staff are clear about what they must do in the case of a fire to keep the people at the home as safe as possible. If monitoring visits were carried out at the required intervals this would show that the organisation are monitoring the welfare of the people at the home regularly therefore helping to keep them safe and making sure they are provided with good care. Key inspection report Care homes for adults (18-65 years) Name: Address: Carrdale Care Home Carrdale Care Home St Aidans Terrace New Herrington Houghton Le Spring Durham DH4 4LZ     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: Hilary Stewart     Date: 2 0 0 1 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Carrdale Care Home Carrdale Care Home St Aidans Terrace New Herrington Houghton Le Spring Durham DH4 4LZ Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) CHOICES House Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. The maximum number of service users who can be accommodated is: 6 2. 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: Learning Disability - Code LD, maximum number of places 6 Date of last inspection Brief description of the care home 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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 peterchart Poor Adequate Good Excellent How we did our inspection: How the inspection was carried out. Before the visit. We looked at: Information we have received since the home was registered. How the service dealt with any complaints and concerns. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and the staff. The Visit: An unannounced visit was made on 20th January 2009. During the visit we, Care Homes for Adults (18-65 years) Page 5 of 27 talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. We told the manager what we found: At the time of the visit the home had a new manager who been in post since November 2009. They said they were very keen to improve the service and evidence showed that some improvements had already been made and others were in the process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The manager did not know the charges for the home. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If liquid soap and disposable towels were available in communal bathrooms this would reduce the risk of cross infection consequently protect the health of the people and staff at the home. If the settee was replaced this would remove the unpleasant odour from the living room and hall. This would would make the home more pleasant for the people who live there and show that they are valued. If the homes medication procedures were followed all of the time this would make sure that people receive medication when they should. This means that their health will be Care Homes for Adults (18-65 years) Page 7 of 27 safeguarded. If all of the care plans had sufficient detail and all parts of the plan were completed, staff would know that the information in them was up to date and correct. This would mean that they would be sure they were providing the people at the home with the support and care they need. If staff recruitment records showed that all of the staff have been properly vetted this would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. If the staff at the home all had up to date training in adult protection procedures and were informed of the whistle blowing procedure this would make them more skilled at safeguarding the people at the home. Staff fire instruction will make sure that staff are clear about what they must do in the case of a fire to keep the people at the home as safe as possible. If monitoring visits were carried out at the required intervals this would show that the organisation are monitoring the welfare of the people at the home regularly therefore helping to keep them safe and making sure they are provided with good care. 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 27 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 27 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. People have their needs assessed by their care manager before they move into the home. The manager looks at the assessment to see if the home can meet the persons needs. They then carry their own assessment out prior to the person moving in so they can use this information for the care plan. People can visit the home before they make a decision. Evidence: The manager said that the people who live at the home have had their needs assessed before and after they move in. A person can only move into the home if they are certain that their needs can be met there. An assessment of need is carried out by the persons care manager and the homes manager. The person and their family are involved in the process. If a person decides to move into the home they can visit before they move in permanently, so they can be gradually introduced to the other people who live there. Care Homes for Adults (18-65 years) Page 10 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has their own care plan to make sure that they receive the care they need, in a way that respects their privacy and at the same time promotes their independence and right to make their own decisions. This means that they know they are valued as individuals. Some care plans lacked enough detail to fully inform staff about how to meet the persons needs. Evidence: The manager said that the people who live at the home are consulted as much as possible about their care plans. Records showed that each person has a care plan. Any significant events are recorded in each persons individual daily recording sheets. Each persons care plan contained information for staff about areas such as the persons physical health, personal care needs and social skills. Not all care plans have enough detail to fully show how the needs of the people are met. For example one plan had a section titled summary of my support,care needs but this had not been completed. The persons personal profile had been started but Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: not completed. In another person support plan their seizure management plan had not been dated so staff could not be sure whether this was up to date and accurate. Their moving and handling support plan had not been updated or reviewed since 4/2/08. The manager said that this should have been taking place every six months. They also said they are in the process of updating all of the care plans and changing the format so it was more detailed. They intend to get all of the care plans up to date and accurate in the near future. Also all of the people at the home will have new personal centered plans in the place in the next twelve months. The staff could describe how they work consistently with the people. Staff said that the people who live at the home are given choices as much as possible.They take part in planning the activities. There is a monthly meeting at the home where people are supported to talk about issues and events at the home, activities they would like to take part in and where they would like to go on holiday. The manager said that people have been to the theatre, day trips, meals out, holidays and parties. The home has some general risk assessments about the home itself and also individual ones to support the people to have a more independent lifestyle. Records showed that risk assessments had been carried out on daily living and activities for each person. Most had been reviewed but some showed the last review date to be 2008. The manager said that they intend to update them regularly in the future. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service experience healthy stimulating activities, supported by staff who value them, while maintaining links with their families and friends. This means they can have new experiences and interests and do not become isolated. Evidence: The manager and staff said that they arrange a variety of outings for the people who live at the home. Records showed that some people had been involved in activities such as going out shopping,to pubs, restaurants, community centres, the library and church. The manager said that they support the residents to plan a holiday every year. One person said I want to go to Blackpool and another person said I would like to work in a charity shop. The manager said that the staff team were supporting the people to work toward these goals. One person had written in the diary themselves that they wanted to go shopping that Friday. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: On the day of the visit three people had gone to day centres, one person had been to the hairdressers another had a health appointment in the afternoon. Staff and the manager said that relatives and visitors are welcome and encouraged to visit at any reasonable time throughout the day and evening. Records showed that people who live at the home had received visits from friends and other people involved with their care. One person said I ring my mam. The manager said that the residents have been asked for their opinions about the food provided as much as possible and the menus are based on their likes and dislikes. Special diets can be catered for. One member of staff said they can eat what they want and another said we get plenty of money for food. Fresh fruit and vegetables were in the home on the day of the inspection visit and there were stocks of food in the cupboards. Hot drinks and snacks are always available throughout the day and evening although some people need support from staff for their safety. The manager said that this has been risk assessed, if people can not independently use the kitchen, the reasons for them needing support are written in their care plan. People were seen to be having meals, snacks and drinks during the day. Care Homes for Adults (18-65 years) Page 14 of 27 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. All of the people who live at the home have individual care plans through which staff monitor and promote the health of the people at the home to maintain their well being. This helps the people stay healthy. Furthermore the manager and staff respect the privacy and dignity of the people who live at the home. This is so the people know that they are valued as individuals. Some of the medication procedures were not being followed all of the time. Evidence: The care plans identify the personal support that each person needs with everyday tasks. However as already stated the level of support that staff offer is not always clearly detailed in the individual care plans and some care plans were not up to date. People who live at the home are supported to attend health care practices in the local community and visits to dentist and opticians. They were recorded in their care plans. Specialist support is available from psychologist, psychiatric services when required. Records are in use to monitor the administration of prescribed medicines. The administration sheets that are in use are known as a monitored dosage system. Staff Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: that are authorised to administer medicines are listed in the file. Some of the instructions recorded on the sheet had been hand written but were not signed by two people to say that it it was correct. There were a few gaps in recording of when medication had been administered. This manager said that the medication had been administered but staff had forgotten to sign the records. This was discussed with the manager who took immediate steps to rectify this. The home did not have a medicine cabinet but kept it locked in a cupboard. The manager said that the people who live at the home do not manage their own medication and this has been risk assessed. Care Homes for Adults (18-65 years) Page 16 of 27 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. A satisfactory complaints procedure is in place. This means that complaints should be dealt with effectively so people know that their comments are taken seriously. Satisfactory protection procedures are in place to protect the people at the home from risk of harm. Evidence: Policies and procedures are in place that demonstrates how the home responds to complaints. The manager said that the home has had two complaints since it was registered. Staff actively encourage the people who live at the home and their families to tell them their opinions of the service as much as possible. The manager said that people are supported to complete annual questionnaires to seek their opinions of the service. One person, when asked what they would do if they were concerned about something said I would tell the staff another person said I would tell the (the managers name). The service currently has policies and procedures on safeguarding adults to inform staff what to do if they think a person at the home could be suffering from abuse.The manager said that all staff have received training and are aware of the signs and symptoms and the need to report suspicions of danger, harm or abuse immediately. There is a copy of th Local Authorities Safeguarding Adults procedures in the office.The manager could describe what actions they would take to safeguard the people who live at the home from potential abuse. When asked if they felt safe at the Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: home people spoken to on the day of the visit said that they did. They do not use physical intervention at the home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and clean home, although some repairs and improvement are necessary. Evidence: The home is comfortable, warm and clean. There are enough bathrooms and showers for the people who live at the home. Liquid soap and disposable towels were not available in the communal bathrooms and toilets which increases the risk of cross infection. The kitchen had been refurbished and looked clean and neat. Each person has their own bedroom and they looked comfortable and clean. They were all personalised and made very individual. The lounge had a noticeable unpleasant odour. This apparently was coming from the settee and staff and the people at the home were aware of this. The manager said that a new settee had been ordered and should be arriving in the next two of weeks. The laundry is organised and clean. Care Homes for Adults (18-65 years) Page 19 of 27 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. Sufficient numbers of staff are in post to meet the diverse needs of the people who live at the home and they have opportunities for training so they know how to give them good care and meet their needs. Some staff had not received all of their mandatory training. Furthermore the home has a recruitment procedures in place, which help to make sure only suitable people work at the home. Some records did not show that all checks had been carried out. Evidence: Staff said that they receive training, which helps them with their work. The manager said that all staff will receive the training and support they need. The company has a training manager and they have developed a training matrix which will help to make sure all staff will receive the training they need. Staff said that they have had training but not with this company yet, as they only took over a few months ago. Most had received mandatory training such as first aid, food hygiene and safeguarding adults training. One member of staff said I havent had any training with this company yet but they have let me start my NVQ in February which I am pleased about. The manager said that some staff have not received safeguarding training but they would know what to do if they suspected abuse. Staff could describe what actions they should take to make an alert if they suspected someone was at risk. The manager Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: stated at a later date that all staff will receive their mandatory training by the end of March 2010. More than half of the staff have vocational qualifications. Staff had not received training specific to the people they care for. The manager said that they have had training in the Mental Capacity Act and issues around the Deprivation of Liberty however this has not been incorporated into the policies and procedures of the home as yet. There is a copy of the Mental Capacity Act available to staff in the office. Staff were aware of the Mental Capacity Act but were not clear how this would affect the people who live at the home. Sufficient staff were on duty at the time of the visit. Staff said and records showed that sufficient staff had been on duty in the home the previous week.The manager said that there are enough staff but not enough to cover sickness and holidays. Staff are flexible and work extra hours to cover the shifts. One member of staff said we can always work extra hours if we want. The manager said that all staff have been CRB Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. All staff go through a recruitment process and they cannot not start to work at the home until this is completed. They are interviewed and are only successful when they have two satisfactory references. Copies of staff records showed that checks had been carried out. Some records did not show that all gaps in an applicants work history had been explored during the recruitment process. Also if someone could not use their last or present employer as a referee the reasons why. Care Homes for Adults (18-65 years) Page 21 of 27 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 registered person is knowledable and experienced. They run the home in the best interests of the people who live there and there are procedures in place that make sure they are protected as much as possible. Evidence: The manager said that the people who live at the home and their families are asked their views about the running of the home as much as possible. They said that they will use this information to improve the service. The home will have a quality assurance system in place which will be implemented throughout this year. Some monitoring visits had taken place at the home but not every month. Safety checks have been carried out on the equipment in the home such as testing electrical equipment and the servicing the central heating boiler. Fire safety risk assessments had been completed. The fire logbook showed that fire drills take place but it was not clear if staff were receiving fire instruction. Staff said that they have fire drills. Records showed that training is provided for staff in fire Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: safety and first aid. The manager said that they have the knowledge and experience to run the home effectively. They are in the process of registering with the Commission. It was observed that there was a friendly atmosphere at the home and a pleasant rapport between the people who live at the home, the manager and staff. The staff said that they could approach the manager with any concerns. Staff said that they liked working at the home and it had improved since the new manager had started. The manager said that staff are now to receive individual supervision and they have regular staff meetings. Records showed that individual formal supervision has started to take place. The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that staff sign records when any of the residents money is used and the manager checks them regularly. Some of the records were checked and found to be correct. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 6 12 Every person at the home should have an up to date and accurate care plan. This is so staff have the information they need to provide each person at the home with good care and meet their needs. 31/03/2010 2 35 18 Staff must receive mandatory training at the required intervals and training appropriate to the work they are to perform. This will show that the orgaisation are sure that staff have the skills and knowledge necessary to provide the people with good care. 31/03/2010 3 39 26 Monitoring visits must take place every month and a copy of the report lodged at the home. 31/03/2010 Care Homes for Adults (18-65 years) Page 25 of 27 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 This means that the health and welfare is monitored every month by the registered provider. 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 9 All risk assessments should be reviewed regularly so the organisation can be sure that staff have up to date and accurate information so they can safeguard the people at the home from unnecessary risk. The homes medication procedures should be followed at all times and the manager should make sure that the medication cabinet meets the Royal Pharmaceutical Societies standards. The noticeable unpleasant odour should be dealt with and removed as soon as possible. This will make the environment much more pleasant for the people at the home and show that they are valued. If staff recruitment records showed that any gaps in applicants work history had been explored in every case this would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. The manager should check with the Local Fire Brigade to make sure they are carrying out fire instruction for staff the correct way and when they should. 2 20 3 30 4 34 5 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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