Care Home: Cottingham Road

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What the care home does well The home is clean and has a homely atmosphere. The people and their families are encouraged to visit the home to find out if the home is able to meet the needs of the person. Comments received from a family survey say that their relative `is well looked after I have no worry`. The people go on holidays and outings with staff The menu in the home is varied and the people are involved in choosing the meals. The bedrooms seen were individualised to the people`s needs. The people were getting on well with staff. The care planning is good with lots of information to tell staff how to look after the people. Staff like working with the people. They go on training to help them look after the needs of the people better. They get support from the manager. What has improved since the last inspection? Person centred care plans are put in an easy to understand format. Minutes from the people`s meetings are recorded in a pictorial format. The people`s bedrooms and the lounge was decorated. The manager was recently registered with the Quality Care Commission. What the care home could do better: The home needs to make sure that the accommodation meets the needs of all the people. Ensure that there are enough staff on duty when people want to go out and during the times when they need a lot of help from staff. Provide a vehicle that meets the needs of all the people in the home. To ensure that the home tells us of things that happen in the home about the people that they need to tell us under the home`s regulations. Key inspection report Care homes for adults (18-65 years) Name: Address: Cottingham Road 399 Cottingham Road Corby Northants NN18 0TW     The quality rating for this care home is:   two star good 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: Ansuya Chudasama     Date: 1 7 0 8 2 0 0 9 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 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Cottingham Road 399 Cottingham Road Corby Northants NN18 0TW 01536401888 01536406388 AnneG@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Mrs Emma Jean Edwards Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Cottingham Road Care Home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 4 Physical disability (PD) 4 The maximum number of persons to be accommodated at Cottingham Road care Home is 4. Date of last inspection Brief description of the care home Cottingham Road is a care home providing personal care and accommodation for four younger adults with learning and physical disabilities. The Premises are owned by the health authority and are managed by New Era a housing association. Each resident has a tenancy agreement with New Era. The national charity Royal Mencap Society provides the care service. Cottingham Road is a bungalow, which is located on the outskirts of the town of Corby. There is a large mature garden area to the side and Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 4 4 Brief description of the care home rear of the building, which is accessible to residents?. All of the bedrooms are single, there are no en-suite facilities however there are washbasins in each bedroom. The communal areas, have limited space, and there is insufficient space in the lounge for all of the service users to sit together, given that additional equipment, such as wheelchairs and adapted seating is required. There is one communal bathroom Information about current fees was provided in the pre-inspection questionnaire received on 10 July 2006. The fee per resident per week is currently £352.39. In addition to the fees, local authorities provide a grant to Mencap for provision of the services in the county. Residents pay an additional £62.35 per week from their benefits. The fees include personal care, staff support, accommodation, meals, laundry and a contribution towards a holiday. A list of additional costs and who is responsible for payment is available from Cottingham Road. Items to be paid by the resident include activities, meals and drinks while out, hairdressing and travel for pleasure. Care Homes for Adults (18-65 years) Page 5 of 30 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: two star good 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: This inspection was carried out in accordance with the Care Quality Commission (CQC) policy and methodologies which require review of key standards for the provision of a care home for older people that takes account of the peoples views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. We looked at the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We used information from surveys that were sent by CQC to the home to give to families, the people, staff and some professional people. We also looked at the information from the last key inspection and the records of any other visits that we have made to the home in the last 12 months. Information we Care Homes for Adults (18-65 years) Page 6 of 30 have about how the home has managed any complaints and things that have happened in the home, which are reported under notifications and are a legal requirement are also looked at. The report refers to we this is because the report is written on behalf of the Quality Care Commission. We last inspected this service on the 30th of August 07. This key inspection was carried out on the 17th of August 09. The manager of the home and staff helped out with the inspection process. During this inspection we tracked the care of two people who use this service. This involved reading their care records and talking to staff about their care needs. The people in the home were not able to verbally inform us of how their care needs were being met. We observed the peoples interaction and body language when interacting with staff and with other people. Documentation relating to staff recruitment, training and supervision, medication administration, complaints and health and safety were also examined. We had the opportunity to talk to some of the staff who were on duty. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: 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. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 of 30 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 10 of 30 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 coming to live at the home are properly assessed to ensure that their needs will be met Evidence: The home has not had any new admissions and there have been no vacancies at the home for many years. We were told that the assessment procedures would be followed if a new person was being admitted to the home. The home had a Statement of Purpose and Service User Guide in pictorial format and this gave detailed information about the services provided by the home. This also included information about the admission procedures. The homes AQAA says what we could do better is to provide the statement of purpose to be in video/audio version. We were told that the people living in the home had visited the home before they moved into the place. The peoples social workers and families had been involved in the admission process. However the home needs to Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: reassess the needs of one person with challenging behaviours to find out if the home can still manage their needs and this also takes into account the needs of the other people in the home. The files looked at showed that each person had a contract with the home. Care Homes for Adults (18-65 years) Page 12 of 30 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. All the people have care planning documents to ensure staff have the information needed to meet the peoples needs. Evidence: We looked at two peoples care planning in detail and discussed their care needs with staff on duty. The staff showed that they had very good understanding of the care needs of all the people. The staff reviewed care plans every three months. The plans were also being reviewed with the people and their family, and professionals involved with the persons care on a six monthly basis. We were told that the staff had attended the person centred planning (PCP) training. The plans were completed in a person centred way and were very detailed and very good. The people had risk assessments and these were linked with the support plans and helped the people to take risks as part of an independent lifestyle. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: We observed that the people were able to make decisions about what they did with support from staff. This included what food they had and, activities and social events that they attended. The peoples information was kept secure in the office and there are procedures about maintaining the peoples confidentiality. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people are supported to develop their independent living skills Evidence: Two people attend day care 4 days per week and the other two individuals attend 3 days per week. Each person has a day back where they have quality time with a member of staff and do what ever they enjoy doing as an activity. For example we are told that they go to town; go out for the day or just chill out. The home has talking books for each person and this was called what matters to me. This was good because it gave information about the person and their needs. We were told that last year only one person from the home went on holiday with staff support. It was said that this was due to funding restraints and not having enough staff to take the people on holiday. This year one person went on holiday in August Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: and one person was booked to go away but nothing had been booked for the other two people in the home. One of the comments read from a relative survey said I would like to see extra staff some evenings so residents can be taken out more often. We were also told that there were not enough activities for the people. We were told that a residents meeting takes place once a month and one was held in August 09 and the minutes were being typed up. We were told that the staff discuss food, activities and holidays using pictures. The AQAA says our plan for the next 12 months is to produce the service user meetings to be put onto audio. All the people in the home need help or encouragement to eat their meals. We observed staff feeding two people in the home at lunch time. This was done by talking to the people and giving them the time to eat their meal without rushing. We were told that the meals are chosen on a monthly basis. Discussion about choosing meals on a weekly basis was discussed and this was said to be positive. Staff spoken to knew what the people enjoyed eating and it was said that they liked takeaway food which, they had once a month. Family comments read in the survey said that staff informs them what is happening about their family member and it was said that the staff are very supportive. The home has a car that they share with another sister home. However this vehicle does not meet the needs of all the people. Taxis are used to meet the peoples needs. Evidence showed that using taxis was very expensive. We were told that it was costing the people £250 for four people per week to attend day care services and £90. 60 pence is a contribution from Northampton County Council. One comment received from a family member said that their family member should have their own or shared suitable transport through their mobility allowance and not rely on taxis. We were also told because of the peoples money being used on taxis, they were therefore not left with a lot of money to do other activities. This was discussed with the manager and they were looking into this withthe funding authorities. Care Homes for Adults (18-65 years) Page 16 of 30 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 peoples health care needs are being met by the home. Evidence: The care plans seen had information about how a persons care needs were being met by the home. We observed people being given personal care and the door being shut to maintain the persons dignity and privacy. The staff were also observed talking to the people in a dignified manner. There was evidence in the care plans to showed that people are offered support for their physical, emotional,and health needs. There were records of district nurse, general practitioner, and hospital appointments, and people have access to the opticians, dentists, and other health care professionals. All the women have well women checks annually to ensure they are kept healthy. The home had Health Action Plans, which gives information about the persons health needs in detail. One person in the home was not feeling well and the home had called the GP to visit the person. Staff told us that they respond to health issues quickly and monitor the peoples needs well. We observed one person being encouraged by staff to move around using the rollater wheel chair to maintain their mobility and help heal a bed sore. This was good. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We were told that all the staff who gave out medication had received the accredited training in administering medication. This was confirmed by talking to staff. There were medication profiles for each person and information about the medication the people took. The medication records looked at showed that these were being stored, administered and recorded properly. Medication was also monitored on the monthly visits by the organisation. Two staff were observed giving out medication and this was done by staff talking to the person. The home has a controlled drugs cupboard but have no controlled drugs in the home. Care Homes for Adults (18-65 years) Page 18 of 30 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. The peoples views are listened to and acted upon by the home to ensure their needs are met Evidence: The home has a complaints policy, and a complaints procedure is displayed in the home. We were told that a copy is given to families and also explained to the people when they come to live at the home. Some concerns raised in the surveys sent to us regarding communication with day care services was discussed with the manager. Evidence showed that this was sorted by the manager and improvements had been made The people in the home were not able to verbally inform staff if they were unhappy. However the staff spoken to had very good understanding of the body language, sounds and behaviours of the people to know if any one was not happy or unwell. The continuity of staffing to the home also helped develop this understanding. All the staff had completed the safe guarding of vulnerable adults training and we are told that this is discussed in team meetings. The recruitment procedures were being completed properly by the home. The peoples finances were inspected and the balance checked was correct. The manager and area manager monitored the peoples finances. This was managed well. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: The accident and incident file looked at showed that some incidents needed reporting to the safe guarding team of Social Services and CQC. This was where one person had physically hurt other people in the home. There was evidence to show that the home had put things in action to help minimise this behaviour. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and has a homely atmosphere but the physical enviroment does not always meet the specialist needs of the people who use the service. Evidence: A tour of the home showed that one bedroom had a hoist and a special bed. The person was having new furniture being delivered in their room. The room had a wheelchair and a comfortable chair to sit on. One room we looked at did not have lots of space in the room. This room had a bed, commode, wheel chair, relater wheel chair, comfortable chair and room furniture. We were told that this room did not meet the square footage required per individual. The peoples rooms were pleasantly decorated. We were told that individual bedrooms and lounge area had recently been decorated.None of the peoples rooms had en suite facilities. The home had one communal toilet with bathroom with a ceiling hoist. We were told that with all the other equipment in the room and staff trying to shower a person was at times difficult. This was due to not having enough space. We were told when a person is using the bathroom, other people have to wait until they have finished. However it was said that this can cause problems. An example of this is when one person in the home enjoys spending time relaxing in the bath. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: There was one small toilet on its own. We were told that when one person used this toilet, they had to hold on to the sink to stand up and a box was used to rest the persons feet. We observed that when some one was using the bathroom and the toilet, and a staff member or another person wanted to use the toilet, they had to wait. The peoples bedroom doors are fire doors but we observed that these were being wedged open. We were told that the people in the room wanted their door kept open because they wanted to hear and see what was happening in the home. This was observed. We were told that fire guards were going to be put on the peoples doors. No date was given for when this was to happen. The table in the dining room was long and one end stuck out near the side of the lounge area. It also had a bit of a sharp edge to the sides and if some one was to fall near here, they would hurt themselves. One person in the home was seen sitting at the end of the table and there fore limiting the access to the lounge and creating a health hazard. The lounge was pleasant but it was not big enough to accommodate all the people, the equipment the people use, and staff working on shift. The room had a small settee and two chairs. The kitchen was combined with the dining table. We were told that staff had to be in the room when food was being cooked. This was because one person in the home wanders around and touches things in the kitchen and therefore is not safe to be left in the kitchen/dining area on their own. At the last inspection it was said that the adequacy of the premises in relation to meeting residents needs and lifestyles should be kept under regular review in conjunction with placing authorities. Plans for building are in progress to make the home bigger with another bathroom and larger living accommodation. This requirement was first made in 2003 by CSCI now CQC. We read a letter sent to the principal planning officer regarding having a conservatory in March 2008 and a letter with quotes of cost to having a conservatory dated on the 6/5/08. The AQAA says no decision made with regards to the building being extended. Care Homes for Adults (18-65 years) Page 22 of 30 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. The homes recruitment procedures are robust to protect the people from any potential harm but staffing levels needed reviewing to ensure there are adequate staff on duty to meet the peoples needs Evidence: The staff recruitment files were looked at in detail. Evidence showed that the relevant checks and references were being obtained when recruiting staff at the home. The files needed to be better organised so the information is easy to find. The staff spoken to state that they had completed the induction training and said this was good. It was also said that they had done training on first aid, manual handling, food hygiene, medication, safe guarding procedures, fire safety and epilepsy. The staff spoken to told us that they were doing NVQ level 2 training in care. It was also said that they enjoyed working at the home and with the people. The AQAA says that the home has 13 permanent staff and 8 staff have NVQ level 2 or above. On the day of the inspection, we observed that one member of staff was busy helping a person with personal care and we observed another person sitting in their room and they looked distressed because they had been sick and this was all over their clothes. The other staff on duty informed us that they too were busy helping out with personal Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: care. This meant that the person had to wait until a staff became available. We were informed that the manager usually starts works at 7-30 to 2-30pm but due to unforeseen circumstances, they arrived at 9-45am and had to leave early. We observed that there were not always three people on duty every mornings. The AQAA says due to the high complex needs of the individuals we support we ensure that there is always a minimum of 2 staff on duty when all service users are in service. We were told that there were not enough staff on duty at peak times. The staff did the cooking, cleaning, washing, give out medication, do the care plans, reviews, risk assessments, admin work, and provide care for the people. It was said that the staff did not have a lot of time to spend with the people. However we observed that staffing on the day was not adequate. Evidence also showed that certain people needed more attention and monitoring and therefore the other people did not receive the same interaction from staff. We were also told that shifts have also been covered by 2 relief staff and did not have a permanent staff. The rota showed that this happened on a waking night shift when a relief member of staff worked this shift first time by themselves. Comments received from family also said that there were not enought staff on duty to take people out in the evenings. Staff told us that they get to know the people well and want the best for them. The home was retaining a core of their staff and this provides continuity to the people. We are told that team meetings take place regularly and they discuss the peoples needs and other issues about the home. Staff say that they are getting supervision. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of the people to meet their needs. Evidence: The manager is currently undertaking training towards NVQ level 4 in care and management. The manager was recently registered by CQC as the manager of the home. Prior to this she was the deputy manager of the home since 2005 and worked as an acting manager at Cottingham Road since February 2009. The manager told us that they are committed and interact well with the people and staff. This was observed. The staff tell us that the manager is supportive One comment from a professional states that I believe the manager does her best within the resources available. It was also said that the manager had the right skills and experience to support peoples needs. We were also told that some of the staff do above their call of duty and have a good rapport with the clients. The accident and incident records show that these were being recorded appropriately. However the CQC and SOVA were not being informed of incidents that needed Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: reporting under regulation 37 notifications and under safe guarding procedures. (See complaints and concerns section) The organisation carries out regulation 26 monitoring visits of the home to find out how the peoples needs are being met. This was good and information was well written with action points for people concerned to undertake. The home undertakes family questionnaire surveys and one was undertaken recently. The comments read were very positive but there were some areas that needed looking at. The manager was dealing with this. The fire doors were not being kept closed all the time. (See environment section) Monthly emergency lighting and weekly fire alarm testing was being done. There were general risk assessments of the home. Fire drills were undertaken once a month and staff carry out safe working practice training to ensure the people are kept safe. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 24 23 The premises must meet the 20/10/2009 needs of all the people and any associated hazards are eliminated. Provide CQC an action plan with time scales to state how this is to be achieved by 20/10/09. To provide a comfortable and safe place where all the peoples needs can be met. 2 33 18 Review the staffing rota to ensure that there are adequate numbers of staff on duty at peak times. This is so the peoples needs are met. 20/10/2009 3 42 13 The fire doors must be kept close at all times. This is to ensure that the people are kept safe. 20/10/2009 4 42 12 The home must report 20/10/2009 incidents that are reportable under regulation 37 Care Homes for Adults (18-65 years) Page 28 of 30 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 Notifications and and Safeguarding Of Vulnerable Adults procedures to CQC and Social Services safe guarding team. This is to ensure that the people are safe guarded and kept safe. 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 2 3 14 14 14 Provide all the people a holiday or days days as stated as part of their placement contract. Provide the people more activities in the evenings out doors. Provide a vehicle for the home that meet the needs of the people Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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