Care Home: Cherry Tree Cottage

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What the care home does well .The service has good accessible information presented in a manner designed to help people who have a learning disability understand it better. This information both includes the guide to the service as well as information about how to complain. People are supported by staff who go through a robust recruitment process and get lots of training and support before they work with people.All staff then continue to receive training around the skills and knowledge they need to care for people using the service. Staff show good understanding for people and respect for their choices. What has improved since the last inspection? There have been improvements in the way medication is stored and it is now kept at a safe temperature.Staff receive on going training and support to be able to do their job.There is now an acting manager who is solely responsible for the management and development of the quality of care within Cherry Tree What the care home could do better: Care plans are not always kept up to date and risk assessments do not always reflect the activities the people who use the service are involved in.Management of the home is disorganised which means it is not always clear when something has been done this potentially places people who use the service at risk. The manager does not always tell us what is happening in the service so we do not have a clear picture how the service is being run on a day to day basis. Key inspection report Care homes for adults (18-65 years) Name: Address: Cherry Tree Cottage 6 Kinoulton Lane Kinoulton Nottinghamshire NG12 3EQ 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: Susan Lewis Date: 2 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: Cherry Tree Cottage 6 Kinoulton Lane Kinoulton Nottinghamshire NG12 3EQ 01159819080 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) : Mr John William Nunn care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: No one falling within the category LD to be admitted into Cherry Tree Cottage when there are 5 persons of this category already accommodated The maximum number of persons to be accommodated within Cherry Tree Cottage is 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Cherry Tree Cottage is a care home providing long-term personal care and accommodation for up to five younger adults who have a learning disability. There is car parking available. . The home is located in a rural area on the outskirts of a small village. The home is intended for those who prefer to live in the countryside. All of the homes bedrooms are single, and none have en-suite facilities. Care Homes for Adults (18-65 years) Page 5 of 37 Four bedrooms are located on the first floor and one on the ground floor. The home has an enclosed garden with further land beyond where horses are kept. Fees for the service range from 1300-2000 pounds per week depending on dependency needs. Additional charges are also made for additional individual time with staff 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 focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people using the service and their views on it. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Care Homes for Adults (18-65 years) Page 8 of 37 This inspection involved one inspector and an expert by experience, this is someone who may be a user of services and it was unannounced and took place over 7 hours. The main method of inspection used was called case tracking which involved selecting two residents and looking at the quality of the care they receive. We looked at the information held about these people, along with the services ability to meet their needs and expectations Care Homes for Adults (18-65 years) Page 9 of 37 We also spent time talking with the manager and staff to find out more about the support they give people and their training and knowledge about this. We used information provided by the service and other sources since our last inspection. We also looked at other documents and records held by the service to learn more about the care they provide. The quality rating for this service is 1 star this means that people who use the service experience adequate quality outcomes Care Homes for Adults (18-65 years) Page 10 of 37 What the care home does well. The service has good accessible information presented in a manner designed to help people who have a learning disability understand it better. This information both includes the guide to the service as well as information about how to complain. People are supported by staff who go through a robust recruitment process and get lots of training and support before they work with people. Care Homes for Adults (18-65 years) Page 11 of 37 All staff then continue to receive training around the skills and knowledge they need to care for people using the service. Staff show good understanding for people and respect for their choices. What has got better from the last inspection There have been improvements in the way medication is stored and it is now kept at a safe temperature. Staff receive on going training and support to be able to do their job. Care Homes for Adults (18-65 years) Page 12 of 37 There is now an acting manager who is solely responsible for the management and development of the quality of care within Cherry Tree What the care home could do better Care plans are not always kept up to date and risk assessments do not always reflect the activities the people who use the service are involved in. Care Homes for Adults (18-65 years) Page 13 of 37 Management of the home is disorganised which means it is not always clear when something has been done this potentially places people who use the service at risk. The manager does not always tell us what is happening in the service so we do not have a clear picture how the service is being run on a day to day basis. 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 Care Homes for Adults (18-65 years) Page 14 of 37 Susan Lewis CQC Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000616161 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. People who use the service are provided with accessible information and their needs and expectations are established. Evidence: We looked at information the service has to provide to people interested in living at Cherry Tree Cottage. We saw that there is a guide with lots of useful information such as how people can visit the home to find out if it is the right place, and the services they provide people with. It is written in a way designed to help people with a learning disability understand it, with plain English and symbols. We heard that no one new has moved in since our last inspection and that there are people currently interested in the service but they are still deciding if this is the place for them. The manager told us that people are encouraged to look around the home first and spend time either having a meal with them or staying overnight before making any decision. We saw that there is lots of information about people who use the service. The manager showed us they gather lots of information about peoples needs and expectations and Care Homes for Adults (18-65 years) Page 17 of 37 Evidence: involve others important to the person such as family and social workers. We spoke to staff who showed us that they understand about different peoples likes and dislikes, one telling us that I find care plans really useful, they give lots of information about people and how I need to support them. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plan is not used as a working document and does not consistently reflect the care being delivered. Risk assessments are completed but these are basic and mainly focus on keeping residents safe. Evidence: We looked at what plans are in place to show staff how people need and expect to be supported. We found there is lots of information about each person, with individualised information about each persons care. We saw information about peoples routines, health needs and behaviours and the way staff are to support them with it. However information about the persons review was not always recorded in the care plan and plans did not always reflect the changes in care a person received. Staff spoken with said that they found plans useful and helped them know what they needed to do. People who lived at the service said that staff helped them as they needed and wanted support. Although care plans identify risks people may be at in their day to day life these are often Care Homes for Adults (18-65 years) Page 19 of 37 Evidence: general and dont always identify where someone is carrying out an individual activity. This may lead to the person being at risk if carrying out that activity. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in a limited range of activities but are supported to live an individual lifestyle. Evidence: We looked at the activities people are involved in. We spoke with people who use the service and they said that they spent the day as they wanted and went out to a club every week. We saw staff spending time with them playing cards or arranging to take them out shopping. The staff told us that there was a youth club on Wednesdays that people were able to go to. A relative said I would like my relative to go to youth club on a Wednesday and Eventually I would like my relative to have support from Cherry Tree to go into some kind of college or employment or even voluntary work. Records showed that people went to the club regularly. We asked Can you have friends in the home? A person replied Yes with the managers permission. This was discussed with staff who said that people were able to have friends but obviously they had to take other peole who lived in the home into consideration. Care Homes for Adults (18-65 years) Page 21 of 37 Evidence: Comments received from staff said that the service could provide more activites such as college courses. We also received a comment from a visiting professional There is a substantial funding package in place to enable service users to access community activites. The home does not always carry this action out as the staff often do not drive. The location is not easily accessible for non drivers and so often they are understaffed. We found that people using the service are supported to maintain relationships with people important to them. Families told us that Staff do there best to keep me updated with eventualities and offer good support and advice. Care records showed that staff supported people to return home when they wanted to and make phone calls with their relatives. A person living at the home told us I visit my dad on Friday and Saturday then go to my mums on Sunday. We looked at the meals people eat. We saw that there is no set menu but that food is planned on a daily basis. The manager told us that people were more involved in menu planning than before. People had access to a wide variety of foods and staff told us that they tried to encourage people to eat healthy diets. 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. People are supported with their personal and healthcare needs. Evidence: We looked into the way peoples health and personal care needs are supported by the service. A family member told us that They have excellent staff, caring and kind and They meet the needs of my relative. The atmosphere in the home was calm and we observed staff working with people in a respectful and friendly way. Staff are able to describe the particular needs of individuals and told us weve had support and training about each person. We found records are kept showing people are fully supported with their health needs, with detail of appointments with health professionals outside the service. We saw that meetings had been held around specific areas of support individuals needed. However, records were not up to date or stored in the care plan and so did not always give clear record of all the support provided by the service. We looked at the way people are supported with their medication. We found that the manager is in the process of changing pharmacists due to the limited service they have been receiving. This has meant that there is extra medication kept in the home than Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: there should be. We looked at the records and found there were no unexplained gaps and that all the medication balanced with the medication recorded as given to people who live at the home. However handwritten entries on the record sheets were not countersigned to reduce the risk of errors being made. The temperature for the room where the medication is stored is now monitored to ensure it does not go above the recommended limit. People we spoke with were asked if they could choose to bath or shower? They replied Yes.I do not need help but I tell a member of staff for safety reasons. We also asked if they received care from both male and female staff ? They replied Yes I dont mind either. What do you do to stay healthy and well? They replied Go to the gym. Records showed that people had access to all healthcare appointment such as dentist and optician, referrals were also made to Speech and language therapists as well as psychologists. as well as this we saw records that showed peoples sexual health was monitored. 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 benefit from a robust complaints policy and systems to keep them safe. Evidence: We looked at how people are able to make complaints about the service. The manager showed us that they have a complaints policy which they use to respond to any complaints received. Full records are kept of these. Since our last inspection the service has received four complaints from the information provided by the manager only one was upheld but only 75 of the complaints made were responded to in a timely manner. We have not received any complaints about the service. We saw that people who use the service are provided with information about how to complain and a form designed to be easier to use with plain large text and symbols to help peoples understanding. Relatives told us that they knew how to complain and that the manager listens to them. We looked at what systems are in place to keep people safe from the risk of abuse. We saw that the service has a copy of the local authority policy around this. Staff described to us how they might recognise signs of abuse and we found that staff are aware of how to recognise signs of abuse. They are aware of the need to report concerns, telling us if youve seen something inappropriate you go to the person in charge. One concern we raised with the manager was the number of restraints reported in the pre inspection information. There was a total of 175 since the last inspection and as there Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: are currently only two people living in the home this appeared high. The manager explained the circumstances and that they were currently working with social services to resolve the issues that created this situation. The manager was asked if a Deprivation of Liberty assessment had been carried out. The manager said no and would make a referral to start the process. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although people live in a homely and clean environment there are still areas that cause potential risk. Evidence: We looked at the environment where people live. The home is set in a very rural setting and is only accessible by car being some distance from the closest large town. The property is beginning to look tired and some identified bedrooms had black mold in the corners caused by condensation. The manager said that this was due to the poorly fitting double glazing and was being looked into. The communal areas were clean and tidy with the furniture in the lounge dining area modern and comfortable. We looked at two bedrooms and these were spacious and where a person was currently living in it, personalised. The water temperatures were checked as they were very hot at the last inspection, these were all at the safe, correct temperature and the manager told us that they had now fitted a thermostat to ensure the water remained at a safe temperature. The downstairs shower room, which is used by one person was very cold and there appeared to be no heating in this room. Care Homes for Adults (18-65 years) Page 27 of 37 Evidence: Outside the home there is a large garden and the crazy paving area was rough and uneven this could potentially cause someone with a walking problem difficulties. We found the buildings to be otherwise clean, with facilities in place to maintain control over the risk of infections. We found suitable hand washing facilities and saw that the kitchen is kept clean with appropriate steps taken to maintain food hygiene. The laundry had been tidied up from the last inspection ensuring people were able to use it safely to do their laundry. However we were told that people do their ironing in this room and as space is limited there is potential if another person comes into the area to be burnt by the iron. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can expect to be supported by safely recruited and trained staff. Evidence: We looked at the staffing. We saw that there is a rota and that there are appropriate numbers of staff to support people. Although a visiting professional told us that The location is not easily accessible for non drivers and so they are often understaffed. We looked at the documents held about staff. We saw that the service undertakes checks for each new member of staff, obtaining references and checking peoples background and employment history including any criminal record. We found that each new member of staff is given initial training and information. But we did not see any paperwork that supported this. The manager told us a lot of the information gets sent to the other home he is currently managing. He told us that this will change once the acting manager is registered with us. Staff confirmed that they were fully trained and supported to learn how to support people. Staff told us we are closely supervised when first working on our own. Information about training was not available as it was stored at the sister home however we saw certificates in staff files to show that they undertake a variety of training to help Care Homes for Adults (18-65 years) Page 29 of 37 Evidence: them do their job. The manager also told us in pre inspection information that all staff undertake training that includes all mandatory health and safety training. Staff told us they were encouraged to do training to help them develop their understanding of their role. 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. Although the home is run in a person centred way, management is disorganised and this potentially could lead to people being at risk Evidence: We looked at the management of the service. There is currently a registered manager and an acting manager. The acting manager is in the process of applying to be registered with us as a fit person to manage a care home. The current registered manager also manages another service within the group. Visiting professionals told us that they saw this as a step forward, improving leadership on site at last, which is welcome. As a result of the management a great deal of the paperwork needed as evidence for the inspection visit was either held at the other service or had not been filed properly and so was disorganised making it difficult to find. We spoke with staff and they told us that they thought management was supportive and ran the home in a person centred way. We saw there are systems in place to monitor the quality of the service. The manager Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: had started to use The Quality Tree as a Quality Assurance system to look at ways of improving the service for people who use it. Staff spoken with were aware of the system and they said they had spoken about it in team meetings and were working their way through it. We saw that there are systems in place around the health and safety of individuals. However they were not always followed and the fire safety checks in particular were not being carried out at regular intervals. Staff spoken with said they understood the need for safety checks and felt that safety was important in the service. We looked at the accident and incident records and saw that some of these incidents should have been reported to us and had not been. This was discussed with the manager. 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 1 39 24 A system for measuring how 31/08/2009 well the home is providing a service to people living there must be developed. This is so that peoples are taken into consideration and an annual development plan is made to show how the service is improving. 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 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 6 15 Peoples plans msut be kept under regular review 31/03/2010 This is to ensure that as peoples needs change they are recorded and addressed. 2 9 13 Risk assessments should be carried out on activities people are involved in. 31/03/2010 This is to ensure that people have full, active but safe lives whilst living at the service. 3 23 13 Where people who use the service are having their freedom restricted an assessment should carried out and a referral to the Deprivation of Liberty assessor should be made. 10/03/2010 This is to ensure that people 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 are not restrained unnecessarily 4 24 23 Heating must be provided in the identified shower room. 30/04/2010 This is to ensure that the facilites are suitable for the needs of the people who use the service. 5 42 23 Safety checks (including fire safety)must be recorded. 10/03/2010 This is so that people living at the home know equipment to help them and keep them safe is working properly. 6 42 37 10/03/2010 All incidents that affect the well being of a person who users the service must be reported to the Commission. This is to show how the safety and well being of people who use the service is being managed and protected. 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 12 Ensure that peole who use the service have access to a wide variety of activities including more structured 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 activities. 2 20 Where Medication Administration sheets are handwritten staff should sign and countersign to ensure the entries are correct. All complaints could be investigated within the 28 day time frame. The uneven paving at the back of the house could be levelled to make it safer. The manager organises the paperwork for the running of the home in a more structured way so as to be able to manage the home more efficiently 3 4 5 22 24 37 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). 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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