Care Home: Clifton Lawns

What the care home does well Clifton Lawns Specialist Care Home provides people using the service with a comfortable, homely environment to live in. The staff team try hard to meet the needs of the people using the service and treat them with respect. People using the service are given the support they need to make decisions about their own lives. Complex individual person centered care plans are being developed. The management team is committed to making sure the individual care plans as far as possible reflect the residents changing needs. What has improved since the last inspection? Following the service registration the management team has continued with the schedule of planned improvements at the home. Bedrooms, kitchen and communal areas have been completely refurbished to meet the needs of people using the service. The building improvements will increase residents opportunity for privacy and autonomy and more freedom to receive guests as they wish. What the care home could do better: Care plans of people using the service should sets out in detail the action that will be taken by staff to meet assessed needs so that people know their assessed and changing needs are reflected in their personal plan. There should be good information within the persons individual plan and the homes risk assessment and risk management strategies for staff to support people using the service to take risks as part of an independent lifestyle. The registered manager should obtain two written references for all employees working at the home before they are appointed to ensure the protection of the people using the service. Staff should have regular recorded supervision meetings at least six times a year with their senior manager in addition to regular contact on day to day practice so that people using the service benefit from a well supported service. Written policies and procedures must be in place and comply with current legislation and recognised professional standards and must be appropriate to the care home setting so that the health, safety and welfare of people using the service and staff is promoted and protected. Staff and people using the service must have access to all relevant policies, procedures and codes of practice so that the rights and best interests of the people using the service and staff are safeguarded by these policies and procedures.The manager should put in place regular opportunities for the staff team to meet so that staff can voice their opinions and receive a team brief. This means that all workers are clear about their roles and responsibilities and agreed tasks are actioned within the set timescales. Key inspection report Care homes for adults (18-65 years) Name: Address: Clifton Lawns Clifton Lawns 227 Blackburn Road Darwen Lancs BB3 1HL     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: Christine Mulcahy     Date: 2 3 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Clifton Lawns Clifton Lawns 227 Blackburn Road Darwen Lancs BB3 1HL Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Oakleaf Care Ltd Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home with nursing - code N To service users of the following gender: Male Whose primary care needs on admission to the home are within the following categories: Mental Disorder - code MD The maximum number of service users who can be accommodated is; 18. Date of last inspection Brief description of the care home Clifton Lawns is registered with the Care Quality Commission to provide 24 hour care and accommodation to eighteen men aged between 16 and 25 years who have severe and enduring mental health problems and require ongoing continuing care. The home is situated on the Blackburn Road in Darwen Lancashire and is on the main bus route to Blackburn and Bolton. Darwen town centre can be reached by bus quite easily within 5 minutes and there is a late store, newsagents and church located within Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 18 Brief description of the care home the busy Blackburn Road area all within walking distance from the home. Short stay parking only is permitted at the front of the home and there is a car park with ample parking spaces at the rear of the building on Clifton Street. This is also the preferred entry access point to the home. The management and staff at Clifton Lawns are qualified and experienced professionals. They are committed to providing a safe and homely environment for people using the service and they aim to empower and promote their independence. Fees and charges are determined through a robust needs assessment and can be discussed with the registered manager. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Clifton Lawns Specialist Care Home received a key (main ) inspection on 22nd and 23/02/2010. Before the inspection took place the manager was asked to complete a document called an Annual Quality Assurance Assessment (AQAA). This document provides information on the services strengths and weaknesses and any future plans to develop the service. Surveys were also made available to people living at the home and staff to find out their views. Other information since the service was registered was also reviewed. As part of the key visit we used a system called case tracking. This is a method that allows us to follow or track a particular situation so we can be sure it was dealt with appropriately. There have been no complaints received by the Commission since the service was registered with us in November. Care Homes for Adults (18-65 years) Page 6 of 31 What the care home does well: What has improved since the last inspection? What they could do better: Care plans of people using the service should sets out in detail the action that will be taken by staff to meet assessed needs so that people know their assessed and changing needs are reflected in their personal plan. There should be good information within the persons individual plan and the homes risk assessment and risk management strategies for staff to support people using the service to take risks as part of an independent lifestyle. The registered manager should obtain two written references for all employees working at the home before they are appointed to ensure the protection of the people using the service. Staff should have regular recorded supervision meetings at least six times a year with their senior manager in addition to regular contact on day to day practice so that people using the service benefit from a well supported service. Written policies and procedures must be in place and comply with current legislation and recognised professional standards and must be appropriate to the care home setting so that the health, safety and welfare of people using the service and staff is promoted and protected. Staff and people using the service must have access to all relevant policies, procedures and codes of practice so that the rights and best interests of the people using the service and staff are safeguarded by these policies and procedures. Care Homes for Adults (18-65 years) Page 7 of 31 The manager should put in place regular opportunities for the staff team to meet so that staff can voice their opinions and receive a team brief. This means that all workers are clear about their roles and responsibilities and agreed tasks are actioned within the set timescales. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive needs assessments were carried out for the people who were planning to use the service so that staff could help them to meet their needs and aspirations. Evidence: Written information about the home, its objectives and philosophy was available to the people who use the service. These documents showed what people who use the service can expect and clearly detailed the specialist services provided, quality of the accommodation, staff experience and how to make a complaint. Copies of these documents are made available to the people who use the service, their relatives and representatives. People who were new to the service received a full and thorough needs assessment before moving into the home. The needs assessment focused on residents achieving their full potential with the support of specialist services and the use of community resources. Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: Case tracking of the three people currently living at the home confirmed that an individual needs assessment had been completed before moving into the home. Individual written contracts including the terms and conditions of their stay at the home had been provide to each resident and residents had signed to agree these conditions. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some of the care needs of the people using the service were not clearly identified in the care plans so care workers had unclear instructions about how to fully meet peoples needs. Policies and practices ensured residents were involved in decisions about their lives and wellbeing. Evidence: To help us look at the service from the point of view of the people living at the home we track peoples care to see whether the service meets their individual needs. We looked at the care plans of the three people currently using the service and found these records required more detail for the workers to fully meet the residents identified needs. The care plans we looked at were set out to include as much information as possible about the person using the service. Initial and emergency details like date of birth, next of kin address, GP name address, and an up to date photograph of the residents were attached to individual care plans. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: Written information in all three care plans was comprehensive and showed us that resident had received a thorough needs assessment and the staff were fully committed in supporting the resident to lead a purposeful and fulfilling life as independently as possible. Current diagnosis, detentions under the Mental Health Act 1983, social work and hospital information, employment, physical history and current physical health, medication, allergies, risk history and forensic history all made up a comprehensive individual profile of the person using the service. Two of the care plans we looked at did not say how often the care plan would be reviewed. This means that because it could not be shown when the plan needed updating it could not fully reflect the residents changing needs and agreed changes. Also because of this it was unclear whether the identified care plan goals had been actioned. A risk assessment stated that the person using the service should use alternative coping strategies and distraction techniques when risks were evident but did not state the details of the strategies to be used. Therefore it could not be shown what the individualised procedures were for this person to prevent the risk of harm to himself or others. We looked at another care plan and found that written information contained in the plan did not correspond with the information written in the initial needs assessment. This means that it staff would not know what to do to meet the residents initial care needs identified in the assessment. One of the care plans did not include a falls risk assessment even though the care plan stated that the resident had hearing and balance problems. There were no instructions telling staff what to do if the person fell and needed assistance. We looked at a good example of a Care Programme Approach (CPA) 72 hour care plan that identified the persons needs, set objectives and goals and described what nursing interventions to use. Unfortunately the plan did not include a review date. Care Homes for Adults (18-65 years) Page 13 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Leisure and recreational opportunities available to people using the services met their personal interests and preferences. Visiting from relatives and friends was flexible. Meals and snacks ensured variety and nutrition. Evidence: The philosophy and ethos of Clifton Lawns strongly promotes the rights of the people who live there to an ordinary and meaningful life. The manager said that wherever possible residents could make choices about all aspects of their lives like waking and going to bed times and handling their own finances and medication. There is a strong commitment to enabling residents to integrate into community life Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: and use facilities like work experience, sports opportunities, volunteering and college courses to develop their skills and reach their full potential. Discussion with the manager and observations of the support received confirmed that as far as possible the independence of people using the service was maintained. We noted a variety of accessible activities like board games, pool table, newspapers and magazines. These were available to people and care plans addressed areas of opportunities. One care plan described the level of independence of one of the residents and how the staff would support him to continue using the services independence kitchen to prepare and cook his own meals. Menus and meal times is varied to suit the people who live at Clifton Lawns. Meals recorded on the recently reviewed menu sheet were well balanced and nutritional with choices that catered for the cultural and dietary requirements of the people using the service. Residents religious and cultural needs had been assessed and identified on moving into the home as part of the initial admission process. Where these needs had changed the manager told us that staff would always be sensitive to this and support the residents in their decisions. The manager told us they were always looking for new opportunities for residents to be involved in so they could maintain their independence and continue to make informed choices about areas of their lives and their daily living. Care Homes for Adults (18-65 years) Page 15 of 31 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. The health care needs of the people using the service were set out in a plan of care. Residents were protected by the homes medicine policies and procedure and care practices showed that residents privacy and dignity was respected. Evidence: Examination of personal health records that belonged to the 3 people using the service showed there was sufficient mental health care information for staff to meet the identified needs. Evidence of regular contact with GPs, and other health professionals were clearly recorded and kept in the residents care plan. Discussion with the person in charge confirmed that the specialised health care and support delivered to people using the service was consistent, sensitive, and met the identified needs of the people using the service. An effective medicines policy supported by written procedures and practices was available for staff to follow. Examination of the medicines cabinet and MAR sheets showed that medication in the home was stored and managed appropriately. Residents individual medication was stored in separate locked cabinets in the homes clinic. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Medicine records were fully completed and signed by appropriate staff. There is a very good record of compliance with the receipt, administration, and safekeeping of medicines in the home and 100 of the staff team have received accredited training in safe handling of medication. Care Homes for Adults (18-65 years) Page 17 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems were in place to make sure that complaints made by residents and relatives were acted on and recorded. Staff training and the homes safeguarding policies and procedures ensure residents are protected from abuse and have their rights protected. Evidence: The manager said that the culture within the home was for residents to express their views and concerns in a safe and understanding environment. There is an effective, clearly written, easy to understand complaints procedure and a copy is given to all residents on admission to the home. The document has been recently reviewed and explains the complaints process and deadlines in details. The registered manager said that residents know and trust the staff well enough to feel confident that wherever possible concerns will be dealt with before becoming major problems. No complaints have been made to the CQC about the service since registration. There is s robust policy and procedure for safeguarding adults and gives clear guidance to those using them. All staff are trained in safeguarding adults and were fully aware of where to find the policy and how it should be used. Care Homes for Adults (18-65 years) Page 18 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good standard of decoration and furnishings in the home which ensured the environment was comfortable and homely. The home was clean, pleasant and hygienic Evidence: We looked around the home and some of the occupied bedrooms and shared space to be well furnished with good quality furniture. People using the service were encouraged to personalised their bedroom with their belongings. The current environment is fully able to meet the changing needs of people using the service and is designed to provide spaces where residents can enjoy maximum freedom in a residential setting. Roons seen included a prayer room, rehabilitation kitchen to support those preparing for independent living, shared toilets and bathrooms andquiet rooms. The home is well lit, very clean and tidy and smelled fresh. Records to show the home met the relevant fire, Health and Safety, electrical and water system standards and regulations were in place and confirmed the home was compliant in each area. A further tour of the building showed us there was a substantial amount of building work taking place in another part of the home following the homes planned maintenance programme. The work did not interfere with the day to day running of Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: the home and the manager ensured access to the areas of building work were properly secured. Care Homes for Adults (18-65 years) Page 20 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. At Clifton Lawns staff are trained, skilled and in sufficient numbers to support the people who live at the home. The homes recruitment policy and procedure should be properly followed to protect people using the service. Evidence: The staff rota showed there were sufficient staff on duty to meet the needs of the people using the service. Particular attention was given to busy times of the day and specific needs of the residents like medical appointments. The manager said a staff training matrix would be made available once staff training needs had been identified. This is a new service and staff training would be identified on an individual basis and seen as ongoing. The manager said there was an expectation for all employees to undertake further essential training including refresher training. The training would always focused on delivering improved outcomes for the people using the service. Within the workforce there is a total of 9 employees. 5 employees are trained Registered Mental Nurses (RMN), who have the expertise, skills and competencies to meet the needs of the people using the service. There are 4 support workers who Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: have brought with them experience and skills in working with people who have enduring mental health problems. There is also a full time maintenance worker who is responsible for the maintenance and upkeep of the building. The manager said that he plans to employ a full time cook and housekeeper when the number of residents increase. There is a good recruitment procedure that clearly defines the process to be followed and ensures the protection of people using the service. We looked at 2 staff files and this showed us that one of the employees had started working at the home after only one written reference was taken up by the manager. Other essential pre employment checks were had been done to ensure the protection of the people using the service. The manager was reminded that to fully ensure the protection and wellbeing of people using the service two written references should be obtained before appointing the person to the job. The staff files also showed us there was no evidence that staff received regular support and supervision required to carry out their jobs. The manager was reminded to put in place arrangements for managers to brief staff and have regular recorded supervision meetings at least six times a year in addition to regular contact on day to day practice including the philosophy and ethos of the service. We spoke to staff who despite the lack of formal supervision were able to show their specialised training and skills used to support, engage and encourage the resident to be fully involved in their lives at the home. A key worker system actively provides one to one support and communication. Staff were observed working effectively with people using the service demonstrating a variety of skills required to meet the residents needs. Care Homes for Adults (18-65 years) Page 22 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Up to date health and safety policies and procedures would ensure welfare of people using the service is promoted and protected. The management and administration of the home is based on openness and respect. People using the service benefit from a well run home. Evidence: The registered manager has the required qualifications and experience and is competent to run the home. He has a clear understanding of the key principles and focus of the service. He is aware of current developments and can plan the service accordingly. We examined records of residents finances and transactions were verified by staff and residents signatures and receipts were kept as proof of purchase. All records relating to people using the service and the care home were stored securely to maintain confidentiality. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: Many of the homes policies and procedures including health and safety were reviewed recently to ensure safe working practices. However many essential policies and procedures were unavailable and should be put in place to ensure the safety and welfare of people using the service and staff is protected and promoted. Records and documents showed that appliance equipment and home safety checks including fire safety were done regularly and staff sign to show they know how to follow these. Good practices, monitoring and record keeping ensure a low number of preventable accidents and the manager complies with statutory reporting requirements and other relevant legislation. There is a service quality assurance system in place however it is too early to make an evaluation of the service at this stage. The manager plans for future internal audits to be carried out that will determine residents and their relatives satisfaction of the service and the results of these will be included in the homes information brochure. There is a good strong working relationship between the registered manager and the staff team. There needs to be better understanding of the risk assessment process in all aspects risk management for people using the service. Written records to show that the manager and staff team meet regularly for staff to voice their opinions and receive a team brief should be available so that each are clear about their roles and responsibilities and agreed tasks are actioned within the set timescales. The home has the necessary insurance cover in place to fulfill any loss or legal liabilities. Care Homes for Adults (18-65 years) Page 24 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must keep the service users plan under review and notify the person of the revision or changes to the plan Where practicable the plan must be reviewed with the person using the service at the request of the person or at least every six months and updated to reflect changing needs. 24/03/2010 2 6 15 The registered person shall after consultation with the service user prepare a written plan which shall specify how the persons needs in respect of their health and welfare are to be met. Please ensure that the plan sets out in detail the action that will be taken by staff to meet the assessed needs so that people using the service 24/03/2010 Care Homes for Adults (18-65 years) Page 26 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action know their assessed and changing needs are reflected in their personal plan. The plan should describe the services and facilities that will be used to meet the current and changing needs, aspirations and goals. 3 9 13 The registered person must ensure that any activities in which the person using the service participates are so far as reasonably practical free from avoidable risks. Unnecessary risks to the health and safety of people using the service are so far as possible eliminated Staff should enable people using the service to take risks, ensuring they have good information on which to base the decisions, within the context of the persons individual plan and of the homes risk assessment and risk management strategies. 4 34 19 The registered person shall 23/04/2010 not employ a person to work at the care home unless the registered person had obtained two written references in respect of the person. The registered person must 25/03/2010 Care Homes for Adults (18-65 years) Page 27 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action obtain two written references for all employees working at the home before they are appointed to ensure the protection of the people using the service. 5 35 18 The registered person must ensure that people employed at the care home receive training appropriate to the work they are to perform. Also suitable assistance including time off for the purpose of obtaining further qualifications appropriate to their work. The registered manager must ensure there is a staff training and development that meets the sector skills council training targets and ensures staff fulfill the aims of the home and meet the changing needs of people using the service. 6 36 18 The registered person shall have regards as to the size of the care home, the statement of purpose and the number and needs of the people using the service ensure that people working in the care home are appropriately supervised. Staff should have regular 23/04/2010 23/04/2010 Care Homes for Adults (18-65 years) Page 28 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action recorded supervision meetings at least six times a year with their senior manager in addition to regular contact on day to day practice. 7 38 12 The registered manager must maintain good professional and personal relationships with people using the service and staff. The manager should put in place regular opportunities for the staff team meet so that staff can voice their opinions and receive a team brief. This means that all workers are clear about their roles and responsibilities and agreed tasks are actioned within the set timescales. 8 40 17 The registered person must 23/04/2010 ensure that records required by regulation for the protection of people using the service and for the effective efficient running of the business are maintained up to date and accurate The homes written policies and procedures must comply with current legislation and recognised professional standards and are appropriate to the care 23/04/2010 Care Homes for Adults (18-65 years) Page 29 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action home setting. Staff and people using the service must have access to all relevant policies, procedures and codes of practice. 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 13 The registered manager should consider specialist opportunities and support for residents personal development, independence and education training or paid work for integration into the community. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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). 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