Care Home: Catherine House

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What the care home does well The home provides a service where people told us they were happy.There is clear information available for people who are thinking of coming to the home.People are supported to keep in touch with family and friends.The care plans for people at the home were mostly detailed and about the individual.The home is a nice environment with enough space.There are a small group of staff who know everybody very well. What has improved since the last inspection? This is the first key inspection since the home opened. What the care home could do better: People need care plans to include all care given to make sure that the care people get is fully recorded. We recommend that the care plan also be reviewed every month to look at if peoples needs have changed.Some staff need more training in some areas to ensure people are safe. These areas include giving medicines.The whistle blowing policy which tells people how to raise a concern needs to have the right contact details on it so that people are able to make a concern known. Wardrobes need to be risk assessed and action taken to make sure people are safe. The home must check that all staff are safe before they start work at the home.The home must make a staff record of staff working each day on each shift so that we know when people are working.The home needs to make sure each staff member has meetings with a supervisor at least six times each year to make sure staff are working well. The home needs to ask people using the home and who have access to the home what they think about the service provided so that the home can develop to meet peoples needs. Key inspection report Care homes for adults (18-65 years) Name: Address: Catherine House 131 Hamilton Road Taunton Somerset TA1 2EP 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: Gail Richardson Date: 1 8 0 1 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 37 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 © (2010) 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 37 Information about the care home Name of care home: Address: Catherine House 131 Hamilton Road Taunton Somerset TA1 2EP 01823286839 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Miss Alison Elizabeth Thorne care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide th following category of service: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability - (Code LD) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Catherine House is a semi detached house. There is some parking at the front and a garden enclosed at the back. The house is on the East side of Taunton. It is within walking distance of the town or there is public transport. The home is 1.5 miles from the town center where there are shops, pubs and a cinema. Catherine House provides care for up to five people with learning disability. Care Homes for Adults (18-65 years) Page 5 of 37 People have their own bedrooms There are two floors and there are bathrooms and toilets on both floors. The home has ramps indoors and outside, but there is one step indoors which may be a problem for someone using a wheelchair. The home has a car suitable to take people out. The fees at the time of the inspection are between £500.00 and £1329.00 per week. Care Homes for Adults (18-65 years) Page 6 of 37 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 7 of 37 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by one inspector who visited the home without telling anyone she was coming. Throughout this report the term we will be used as the report is written on behalf of the Care Quality Commission We were there from 09:30 am until 4:30pm. There were 2 people currently residing at the home. We spoke with one person living there. Care Homes for Adults (18-65 years) Page 8 of 37 We talked to all the staff on duty, the manager and owner of the home. We sent out surveys and looked at what people told us. We looked at the care records of two people who lived in the home. We looked at other records that told us how the home is run. An Annual Quality Assurance assessment (AQAA) was completed by the provider. This is a form the provider sends to the Care Quality Commission telling us how the home is meeting the needs of the people that live there Care Homes for Adults (18-65 years) Page 9 of 37 What the care home does well The home provides a service where people told us they were happy. There is clear information available for people who are thinking of coming to the home. People are supported to keep in touch with family and friends. Care Homes for Adults (18-65 years) Page 10 of 37 The care plans for people at the home were mostly detailed and about the individual. The home is a nice environment with enough space. There are a small group of staff who know everybody very well. What has got better from the last inspection This is the first key inspection since the home opened. Care Homes for Adults (18-65 years) Page 11 of 37 What the care home could do better People need care plans to include all care given to make sure that the care people get is fully recorded. We recommend that the care plan also be reviewed every month to look at if peoples needs have changed. Some staff need more training in some areas to ensure people are safe. These areas include giving medicines. Care Homes for Adults (18-65 years) Page 12 of 37 The whistle blowing policy which tells people how to raise a concern needs to have the right contact details on it so that people are able to make a concern known. Wardrobes need to be risk assessed and action taken to make sure people are safe. The home must check that all staff are safe before they start work at the home. The home must make a staff record of staff working each day on each shift so that we know when people are working. Care Homes for Adults (18-65 years) Page 13 of 37 The home needs to make sure each staff member has meetings with a supervisor at least six times each year to make sure staff are working well. The home needs to ask people using the home and who have access to the home what they think about the service provided so that the home can develop to meet peoples needs. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 14 of 37 If you want to speak to the inspector please contact Gail Richardson Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 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 15 of 37 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 16 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A Statement of Purpose and Service User Guide is available to provide details for any prospective person using the service. All prospective people have an assessment prior to admission to ensure that the home can meet their needs. Each person has a contract which details the terms and conditions of residency. Evidence: The home provides a Statement of Purpose for all prospective people using the service. Two new people have been admitted to the home since opening and three respite visit have been undertaken. All people who are considering admission to the home have their needs assessed by the provider and manager to ensure that the home can meet their needs. A prospective person was seen to be visiting the service with a planned overnight stay the following week to test run the service. One person living at the home told us that they came for respite and liked it so they stayed. A visiting health professional told us that the pre admission information and support provided by the service was excellent. All documentation supplied is all available in Total Care Homes for Adults (18-65 years) Page 17 of 37 Evidence: Communication symbols. Each person has a contract which outlines and details the terms and conditions of residency, this includes current fee scales. Care Homes for Adults (18-65 years) Page 18 of 37 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 using the service are consulted, when possible, about their needs and supported by staff in making decisions and developing independent life skills. Appropriate risk taking is promoted, and risk assessments are regularly reviewed and updated. All records are stored securely; people using the service have access to their care records should they want to. Evidence: Each person using the service has a detailed plan of care. The care plans identify areas of strengths, the person’s goals and what prescribed care and support needs are needed by staff. The care plans include future aspirations and how those would be managed. Areas of identified need, risk and aspiration are varied and relate specifically to each person. They include social interactions, work objectives, appropriate behavior, contact with relatives and friends, nutrition and living in a communal setting. People are supported to take risks as part of an independent lifestyle. People are given training about their personal safety so that people’s choices and preferences are not limited and skills can be Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: developed. Each person has where appropriate a one to one meeting with their key worker. At this time aims and aspirations are discussed and agreement made of a plan to set realistic goals with timescales is agreed with the person using the service. People using the service told us that they use this time to talk about any issues they may have. The registered person is recommended to undertake a monthly overview of each care plan and record this review as a means to audit care provided. People using the service confirmed that they were involved in decisions about their care. Each person has a daily diary which records activities, moods and support provided. Care plans also demonstrated that the services of specialists have been sought when needed. Nobody at the home has a work or college placement at this time and it is a plan for the future that this would be explored. One person told that they were included in decisions about the home and monthly house meetings were recorded which showed how all staff and people using the service have an input in to the changes at the home. People are supported to undertake cooking, cleaning and domestic chores. They told us that they did this and that they enjoyed it. One person told us We all look after our own rooms, keep them clean and tidy. People told us that they thought This is an excellent service and They look after me, give me freedom and listen to me. Notices around the home inform people about how to make a complaint, and access to independent advocacy services. These are all available in STC and photo format. The care records are stored securely but people are able to access their records when they wanted to. Care Homes for Adults (18-65 years) Page 20 of 37 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 are supported to take part in age, peer and culturally appropriate activities, and people use the local community. Appropriate personal family relationships are promoted and are supported as needed. Residents are treated with dignity and respect and their rights supported. A healthy diet is promoted. Evidence: One person talked to us about activities they undertake and what they enjoyed. They said they enjoyed walking, using the internet, watching TV, talking with family and friends and spending a quiet life at the home. Each care plan has an activity plan for each week, this includes exercise, this is flexible and people can change the plan for social activities as needed. People using the service are supported with contact with families and friends and some people go home for periods of time. People are supported to they level they request with Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: any spiritual needs they may express. People told us they could get up and go to bed when they wanted They also told us that they could watch TV in their rooms or in the communal lounge. There is some flexibility around meals and mealtimes to fit in with people’s choices and preferences. Breakfast consists of cereals and toast etc. which are chosen by people using the service. Lunch is a lighter meal with the main meal being in the evening, however this can vary. People assist with meal preparation and planning the menu. The home encourages a healthy diet and peoples weight is monitored if needed. People at the home are able to choose where they eat their meals and staff sit with people in the dining room to promote dining as a social experience and provide the support needed. Staff and people using the service were noted to all treat each other well with staff being respectful of peoples privacy and dignity and people treating staff in a respectful and friendly way. Staff demonstrated a good understanding of each person and there was clearly a comfortable relationship between staff and people using the service. Care Homes for Adults (18-65 years) Page 22 of 37 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. Each person receives personal support as they require and that has been agreed with them where possible. Areas of physical and emotional need are assessed and a care plan is in place to ensure staff and people using the service can meet those needs. Clear systems are in place to ensure that medication is safely managed and administered. Evidence: Each care plan provides clear information and guidelines about any personal care routines needed. There is currently little personal care provided at the home but support is given as needed. There is a choice of male or female staff to assist people, one person explained that the help they receive supports their independence. One person has hourly checks during the day; this was not reflected in the persons care plan and is recommended to be included to ensure staff are aware of the care to be provided. People were seen to be well dressed and we are told that people would be supported to do their own laundry where possible. People using the service access local GPs and district nurse teams and specialist support. Staff are experienced in working with people with behavior that can be challenging and have appropriate care plans in place and have received appropriate support through Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: training. Three staff have training in the management of medicines by the local pharmacist. One staff has had distance learning in this area and is recommended to have training by an appropriate body. Medication is appropriately stored and managed. The homes AQAA told us We encourage people in our care to take a level of responsibility for their medication. There are lockable cabinets in client’s rooms. We provide a secure medication cabinet for clients that are unable to manage their medication. One person is currently managing their own medication. There are appropriate risk assessments, monitoring and recording systems in place in easy read format to ensure any risks are managed safely. Care Homes for Adults (18-65 years) Page 24 of 37 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. People using the service and staff confirmed that should they raise any concerns they would be confident that they would be acted upon appropriately by the management of the home. Policies, procedures and staff training are in place to protect residents form abuse. Evidence: There is a complaints policy and procedure on a notice board in the dining room, this is available in symbol form and contains the timescales people can expect for response. The home has a whistle blowing procedure which is recommended to include contact details for an external body so that should people wish to raise a concern they are able. The homes AQAA told us If a person in our care should feel unhappy about any part of our service, they are encouraged to talk to their key worker or the manager, and it is hoped that the situation would be rectified. If the client was still unhappy about the situation they would be given full support to make a full complaint. No complaints have been recorded at the home since opening and CQC have not received any complaints about this service. Following discussion with people using the service they said that if were unhappy they would speak with staff at the home . One service user told us that any problems can be raised anytime and also in the one to one meeting with their key worker. The person said Any problems, staff are lovely, would talk to them, they encourage me to go out and I feel safe here. Staff training in the Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: safeguarding of vulnerable adults has been taken by two staff and further training is booked for staff for February. Policies are in place to support staff in identifying types of abuse and action to take should an allegation be made. Individuals needing assistance to manage their personal finances have appropriate records of staff involvement. Financial records were seen and appeared in order. One person decided to keep their own money and was supported to do this. Care Homes for Adults (18-65 years) Page 26 of 37 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. Catherine House provides a homely, comfortable and safe environment. It is decorated and maintained to a high standard. The home appears to meet the needs of people using the service and maintains a good standard of hygiene. Evidence: The home is safe, comfortable and a pleasant place to live. It is suitable for its current usage and all areas both indoor and outdoor are well maintained. People at the home told us that they have access to all areas of the home at any time but may require supervision when in the kitchen. All areas are accessible and the one step noted indoors is highlighted to promote accident prevention. Both bedrooms in use are decorated to reflect the choices and preference of the individual. The home does not have a call bell system and so to get staff attention in the night people using the service would have to shout for assistance. People have access to a door key but not everybody chooses this option. People are able to lock their doors from the inside for privacy; however staff have emergency access should they need it. The home has a large board in the hallway which identifies when people are in or out of the home and space for any messages. This is in place for people using the service and staff. People have access to a telephone should they need it and can be used in agreement with the manager. People share the communal bathing Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: facilities but due to low occupancy the two people residing at the home currently have a bathroom each. There is a ground floor toilet and shower and the laundry is situated in the rear garden accessible from the back of the house. Office space is also separate to the house and accessible through the garden. The garden is a paved and decked area which is easily accessible and attractively laid out with seating areas. People have shared communal space consisting of a pleasantly decorated lounge and dining room which also has a small seated area. All furnishings and fittings appear to be well maintained and of a good quality. Staff and people using the service maintain the home to a good hygiene standard. All chemicals are risk assessed and data sheets kept for reference. All substances hazardous to health are stored securely. There is no smoking in the house and the designated smoking area is in an area outside the house. Care Homes for Adults (18-65 years) Page 28 of 37 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a consistent staff team who know the people using the service well. Rota’s must be introduced to enable clear audits of staff working on each shift. The recruitment procedures are not robust and may place people at risk and must be addressed immediately. Supervision of all staff must be implemented to support good practice within the home. Staff training is ongoing and must be undertaken by all staff in all mandatory areas within a reasonable timescale. Evidence: Staff and people using the service confirmed that the current staff team is stable and agency staff are not used. On the day of inspection one staff member was on duty each morning and two each afternoon. One sleeping staff is on duty overnight. People using the service told us that they like the staff at the home and that they felt safe and supported. Each person has their own key worker with whom they meet if able to and who updates their care plan with them. Observation of staff demonstrated that they have a clear understanding of peoples needs and are committed to the role they Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: have undertaken. Each staff member has a detailed job description available in their recruitment files but no staff contracts of terms and conditions were available. Each person who works at the home undertakes an induction program which is line with the Skills for Care Common Induction Standards. The general manager told us that staff training is ongoing and that further training is planned to ensure that all staff have training in the mandatory areas. Two out of the four staff employed have achieved a National Vocational Qualifications (NVQ) in care. Recruitment files were examined for all staff at the home both voluntary and permanent. These records were not adequate to ensure that people were not placed at risk. No start dates were available to enable us to see if people started work prior to checks being received. Two people had not completed an application form and a declaration under the Rehabilitation of Offenders Act. Therefore, no employment history was available and subsequently three people did not have two appropriate references in place. The references in place were addressed To whom it may concern and so their authenticity could not be verified. One person had a reference which was not dated and so it could not be ascertained if this was sought before the person started work at the home. It was confirmed that all of these staff work alone at the home supervising people who use the service. Three staff members did not have a current, clear photograph. The home has policies in place for recruitment of permanent and voluntary staff, both identified that 2 suitable references must be obtained before people start work at the home. Where people have worked in a care environment previously then the reason for them leaving that employ must be provided and recorded. There was one instance when this was not completed. An Immediate Requirement was left at the service which required staff to be appropriately supervised until the checks had been received. The home were given 7 days to complete these checks. The home does not currently have staff rotas in place and so it is not possible to identify which staff are on duty at any given time. The registered person must undertake a rota to ensure that a record is made of which staff are working at the service. Supervision records showed that only one of the four staff in place have received supervision. All staff are recommended to receive supervision up to six times a year. The topics to be covered are identified within the National Minimum Standards and are recommended to be included. This will promote and support good practice. Care Homes for Adults (18-65 years) Page 30 of 37 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 people using the service views are sought and play an important part in the development of daily life. Management of recruitment is poor and is required to be further developed to ensure the safety of people using the service. The health, safety and welfare of residents is promoted and protected. Evidence: The home is registered to Miss Alison Thorne who is the registered provider and delegates management responsibility to a manager who is not yet registered with the Care Quality Commission. The registered Provider and manager are on duty throughout the week and work at the home as part of the staff team. The management of the recruitment of staff needs further development by the registered provider and manager to ensure that people are not placed at risk. The views of both people who use the service and staff are listened to, and valued. These views are, were appropriate transferred to changes in the running of the home. The Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: registered person is recommended to develop this review to include relatives and visiting health professionals involved in the home. The home requested the opinions of people using the service in August 2009 as part of an annual audit of quality of care. There have been three accidents at the home since the last key inspection. These are well recorded. It was observed that some freestanding wardrobes were not secured to the wall and may pose a risk of tilt/tip injury. Wardrobes are recommended to have a risk assessment undertaken and appropriate action taken to ensure they are safe for each person using the service. Staff have access to policies and procedures which are regularly reviewed and updated to promote good practice. All records are stored securely in line with he Data Protection Act. Records demonstrated that appropriate checks are carried out on electrical equipment, and that household equipment is regularly serviced and well maintained. There are clear fire safety and COSHH records. The home undertakes weekly hot water checks to monitor the temperature that hot water is delivered. This is to ensure that there is no risk of injury to people using the service. Care Homes for Adults (18-65 years) Page 32 of 37 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 Care Homes for Adults (18-65 years) Page 33 of 37 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 1 34 19 The registered person is required to ensure that all staff employed have two appropriate references in place prior to starting work at the home. Any staff currently at the home must have the suitable checks in place within 7 days and be appropriately supervised until they are in place. 25/01/2010 This is required to ensure that people using the service are not placed at risk. 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 32 18 The registered person must ensure that staff training is provided for all staff, in all mandatory areas. 19/02/2010 This is required to ensure that staff have the appropriate skills and information to provide the care needed. Care Homes for Adults (18-65 years) Page 34 of 37 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 2 33 18 The registered person is required to provide a staff record of staff working each day on each shift. 01/02/2010 This will provide a clear audit of staff on duty for each shift. 3 34 19 The registered person must 29/01/2010 ensure that recruitment procedures are robust and completed prior to staff starting work at the home. This includes and application form, employment history and reasons for leaving that employment, start date and current photograph. No references should be received addressed To whom it May Concern and should be requested independently of the staff member. These checks must be in place to ensure the safety of people using the service. 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 is recommended to undertake a monthly overview of each care plan and record this review as a means to audit care provided. Page 35 of 37 Care Homes for Adults (18-65 years) 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 2 19 The registered person is recommended to ensure that all care provided in included within each persons individual care plan. Staff training is recommended for medication administration. This training is recommended to be by an appropriate person and that distance learning is not the only form of training in this area. The whistle blowing procedure is recommended to include contact details for an external body so that should people wish to raise a concern they are able. The registered person is recommended to ensure that all staff receive supervision up to six times each year. The topics to be included are recommended to be the areas included in the National Minimum Standards. The registered person is recommended to develop the quality audit review to include relatives and people involved in the home. Wardrobes are recommended to have a risk assessment undertaken and appropriate action taken to ensure they are safe for each person using the service. 3 20 4 23 5 36 6 39 7 42 Care Homes for Adults (18-65 years) Page 36 of 37 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. Copyright © (2010) Care Quality Commission (CQC). 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