Care Home: Deja Vu.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Deja Vu 14 - 16 Liphook Road Lindford Hampshire GU35 0PX two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Bowman Date: 2 2 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.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: Deja Vu 14 - 16 Liphook Road Lindford Hampshire GU35 0PX 01420 477863 01252 612539 dejavu@robina.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robinia Care Ltd Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 0 care home 7 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) The maximum number of service users to be accommodated is 7. Date of last inspection 2 2 0 8 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Deja vu is a care home for seven younger adults with learning disabilities. The home is situated in a residential area of Lindford, Hampshire, within easy reach of the local shops. All residents are accommodated in single bedrooms. One bedroom has en-suite facilities and the remainder are provided with hand basins. The home has a large, enclosed rear garden and patio area. The home is owned and operated by Robinia Care Limited, an organisation that has been a care provider since 1995. Current fees are from #965 to #1,442 per week with additional charges for hairdresser, newspapers chiropody, toiletries and annual holidays over #500. 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: 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home We collected information about the service since the previous site visit, which was completed on 20th September 2006, and recorded it in the inspection record under the Commissions Inspecting for Better Lives (ILB) process. We assessed this information and the information sent to us in the Annual Quality Assurance Assessment (AQAA) completed by the service, giving up-to-date factual evidence about the running of the home, informing us of what they think they are doing well, how they have improved the service and their plans for further improvement. Surveys were completed by eight staff members, giving their views on the care and support given to the service users, and on the running of the home. Quotations from these documents have been included in the report. The service users communication needs involved signing, the use of objects of reference and symbols, therefore observations of their interactions, reponses and demeanour were made, as their views could not be directly sought. The homes own collated results of quality assurance questionaires, completed by the service users with support from the staff, were viewed to ascertain their level of involvement in the running of the home. Service users and staff records, maintainance certificates and complaints Care Homes for Adults (18-65 years) Page 7 of 31 and compliments records were sampled and the Statement of Purpose, the Service User Guide and policies and procedures were viewed. Thanks are offered to all those who completed surveys and gave their time on the day of the site visit, for their contribution to this report. An unannounced site visit was carried out on 22nd August 2008 to assess the outcomes of the key inspection standards for younger adults (aged 18-65years) with respect to the service users living at the home Two senior members of staff, who had taken responsibility for the running of the home since the resignation of the registered manager in April, provided support for the inspection process. A partial tour of the premises was undertaken and some of the service users bedrooms and communal areas were viewed. What the care home does well The home promotes a person-cented approach to care planning, which is well documented to show how decisions have been made. Records confirmed service users full involvement in the process and care plans were in a format accessible to them to enable their understanding. The activities of daily life were riskCare Homes for Adults (18-65 years) Page 8 of 31 assessed and records were kept on how the service users confidence was built with respect to accessing the community and developing independence. The use of public transport was encouaged, and the organisation also provided a dedicated minibus and a shared car for the service users convenience. The home blended well with adjacent properties on a residential street and was close to community facilites, which the service users were supported to access. What has got better from the last inspection No requirements or recommendations were included in the previous inspection report. The AQAA recorded a number of changes which had been undertaken to improve the service with respect to outcomes for the service users, including new furniture and carpets for the communal areas, which the service users had been involved in choosing. Service users are now involved in the interview process for prospective new staff and more one to one time with the staff has led to the opportunity to attend more activities in the community and for more regular trips out. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home could do better 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 Christine Bowman The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 01622724950 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. Care Homes for Adults (18-65 years) Page 10 of 31 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries.southeast@csci.gsi.gov.uk or by telephoning our order line - Care Homes for Adults (18-65 years) Page 11 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 12 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 . Prospective service users have the information they need to make an informed choice about where to live and their individual aspirations and needs are assessed to enable a personalised plan of care to be drawn up. Evidence: The information about the home covered all the important areas a prospective service user would need to know about to make a decision about deciding to live at the home. It was available in symbolic format to promote understanding and also available on tape. There had been no new admissions since the previous site visit. Assessment documentation sampled, confirmed that a thorough assessment of the service users needs had been carried out. Information collected covered all areas of need including a medical overview, personal hygiene, eating ansd drinking, communication, mobility, social contacts, activities, religion and cultural beliefs, support needs to promote access to the community and likes and dislikes. Records confirmed that the manager had carried out a very detailed assessment of the Activities of Daily Living in conjunction with the service user with respect to their needs and preferences, which included their needs with respect to equality and diversity to ensure an individual approach to their care. Care Homes for Adults (18-65 years) Page 13 of 31 The AQAA recorded that prospective service users were offerred visits to the home including meals, day visits and overnight stays to help them to decide if they would like to live there. A special staff member is allocated to the service user at this point to offer continuity and consistency and to answer any questions. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Person-centred planning promotes the involvement of the service users in decisionmaking about their lives with appropriate support and independence is promoted through building confidence and balancing the risks involved. Evidence: Service Users files sampled were person-centred, included their goals and aspirations and described how they had been involved in making decisions about their lives. Personal information had been gathered to ensure the Service users equality and diversity needs had been taken into consideration in the compiling of their care plans. This information included their religious, cultural and sexuality needs. Clear information was available to the staff to enable them to commuicate with the service users and included guidance on how the service users handle their finances. Care plans were detailed in recording the needs, preferences, aspirations and goals of the service users. They were written in a person-centred way, in a format accessible by the service users and records were kept on how the service users had been involved in the compiling of them. The eight staff, who completed surveys, confirmed Care Homes for Adults (18-65 years) Page 15 of 31 that they were always given up-to-date information about the needs of the people they support in the care plan. Care plans covered all the activities of daily life and recorded how the service users confidence was built in accessing the community and developing independence. Service users, whose plans were sampled, had been risk assessed with respect to the activities of daily living. The AQAA recorded that, all new outings are also risk assessed before commencement and that health action plans were in place for all service users, which had been written with input from the individual, their family and their General Practitioner, outlining how to attend to the needs of the individual when medical attention is required. Care Homes for Adults (18-65 years) Page 16 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 . Service users are supported to engage in a range of activities that take account of their needs and preferences. They are supported to maintain personal relationships and be part of the local community. Service users rights are recognised and they are offered a healthy diet which reflects their individual taste and dietary needs. Evidence: On the day of the site visit, day centre facilities were closed due to the summer break. One service user was taken to Weymouth in the homes minibus to meet their family for a seaside holiday and two other service users and supporting staff accompanied them for the trip. The AQAA recorded that the home ensures regular contact with relatives and friends of each person living at Deja Vu and that they are also welcome to visit the home. Two service users went out shopping later in the day to the local shops. In addition to supplying transport, the home also ensures that the service users are supported to use public transport and have obtained bus and train passes. The service users, whose records were sampled, had activity schedules showing their regular community access and activities organised at the home for them to participate Care Homes for Adults (18-65 years) Page 17 of 31 in. Records confirmed that service users enjoyed drama classes, outings, rambles, cooking, current affairs, swimming and relaxing in the sensory room. Activities were arranged at a variety of venues. The AQAA recorded that there was flexibility in the staff rota to enable service users to be supported to engage in evening activities of their choice. A pictorial menu was displayed in the kitchen and a staff member explained how the service users made their choices with the use of pictorial aids. The staff training matrix confirmed that the staff had accessed food hygiene training. The AQAA also recorded that a senior member of staff had been booked to attend a course on healthy eating and would then be handing this information on to the staff team. Care Homes for Adults (18-65 years) Page 18 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 . Service users personal and healthcare needs are met according to their preferences and wishes and safe procedures are in place to promote their access to medication. Evidence: Service users person-centred plans sampled, indicated their preferences with respect to any personal care provided and included their support needs and their ability to make their own choices. Clear instructions informed the staff of how any asistance should be given. Service users had been allocated key workers to offer consistency and continuity and to work with them on their plans to achieve their goals and aspirations. Professional advice had been sought with respect to behaviour plans, and there was evidence of referrals for specialist support for a service user whose behaviour had changed recently. The staff responded sensitively to ephisodes of difficult behaviour, keeping the atmosphere calm and pleasant, and following agreed protocols. Seven of the nine staff, who completed surveys, thought they always had the right support, experience and knowledge to meet the different needs of the people who use the service with respect to equality and diversity issues, and two that they usually did. Records were kept of appointments with healthcare professionals and each service user had a Health Action Plan, showing how they were supported to live a healthy lifestyle. The AQAA recorded that each service user had an annual review with their Care Homes for Adults (18-65 years) Page 19 of 31 General Practitioner (GP) and could choose to visit a different GP, should they wish to do so. The medication administration records of two service users were sampled. Risk assessments carried out with respect to self-medication indicated that neither were capable of safely taking responsibility for their own medication. Information was clearly recorded on the medication administration sheets, a sample of staff signatures was kept to identify the staff member responsible, and records were kept of medication received and returned to the pharmacy. Controlled drugs were stored appropriately and a running total of drugs administered was recorded in a controlled drugs register. Drugs sampled agreed with totals recorded confirming the safe handling of medication. Care Homes for Adults (18-65 years) Page 20 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 . Service users are supported to express concerns and staff and relatives are informed of how to progress concerns so they may be acted upon to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. Evidence: The complaints policy had been improved and up-dated since the previous site visit. Service users had been provided with their own copy, which was in a suitable format containing symbols and simple language to promote their understanding. Service users had opportunities for one to one time with their key workers when any worries could be explored. Copies of the complaints policy were also posted on notice boards in the home and the AQAA recorded that relatives had been supplied with the new version. No formal complaints had been received since the previous site visit and the Commission for Social Care Inspection had received no complaints on behalf of this service over the previous two years. All the staff who completed surveys, confirmed they knew what to do if a service user, their reative, friend or advocate had a concern about the home. A copy of the local authority Safeguarding Adults policy and procedure was held at the home making sure that staff were aware of when referrals should be made and giving referral details. The staff training matrix showed that safeguarding adults training was kept up-to-date and 100 of the staff, who completed surveys confirmed that their employer had carried out checks such as Criminal Record Bureau and references before they started work for the protection of the service users. One safeguarding Care Homes for Adults (18-65 years) Page 21 of 31 referral had been made and responded to appropriately. The home held only small amounts of cash on behalf of the service users, transactions were recorded and receipts retained. Care Homes for Adults (18-65 years) Page 22 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 . Service users live in a home which meets their needs in a homely and comfortable way and which is clean and hygenic. Evidence: The home was located on a residential street and was in keeping with the surrounding homes. Local amenities, including public transport, a shop, pub and hairdresser were within close proximity of the home and the AQAA recorded that service users were encouraged to use these facilities and to feel part of the local community. The organisation provided a minibus for the people living at the home and a car was shared with a nearby service. The gate leading into the premises was secured and at the front of the house was a car park. Hanging baskets and potted plants gave the entrance to the home a welcoming ambiance. A tour of the premises was undertaken and the communal areas were viewed. The home had a large, modern and well-equipped kitchen with a dining area located at one end. One service user was observed making themselves a cup of tea independently and another helped themselves to buscuits from a tin. There were two lounges, one of which was large and furnished with comfortable sofa and easy chairs, and the other was small and regarded as the quiet room. The AQAA recorded that the lounge had been up-dated over the previous twelve months and that the new furnishings had been chosen by the service users. Both rooms had televisions for the service users entertainment and videos and DVDs, music centres and compact discs were also available. There were large french windows in the most spacious of the lounges, Care Homes for Adults (18-65 years) Page 23 of 31 making it a light and cheerful room. Displayed on the walls were pictures and framed photographs of the service users and the lighting was domestic. The garden beyond was mostly laid to lawn, but in one corner was a sensory garden, planted with herbs and containing a fountain and seating, for the enjoyment of the service users. Service users bedrooms viewed were suitably furnished and personalised. Care plans described how the service users had made choices about the style of their bedrooms and had chosen furniture from catalogues with support from their key workers. The laundry facilities were domestic and a staff member stated that some of the service users liked to be involved in their own laundry duties. Care plans viewed confirmed that some service users were supported to be independent in this and other areas of daily living skills. The home was clean and there were no unpleasant odours. The staff training matrix confirmed that infection control training had been regularly updated. The AQAA recorded that an environmental assessment of the whole home, outlining areas of improvement with timescales, was carried out annually to maintain a pleasant and comfortable environment for the service users. Care Homes for Adults (18-65 years) Page 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Minor shortfalls in fundamentally safe recruitment practices, good induction and regular mandatory and approprite specialist training prepare the staff for the supportive role and equip them to meet the service users needs. Evidence: The AQAA recorded that more than 50 of the current staff had either achieved a National Vocational Qualification at level 2 or above or were working towards one. Three of the nine staff, who completed surveys, thought there were always enough staff to meet the needs of the people who use the service, four thought there usually were and one that there sometimes were. The staff on duty on the day of the site visit were observed interacting respectfully and sensitively with the service users. However, a comment from a staff member, that some staff from abroad speak together around the service users in their own language, was discussed with the senior member of staff on duty. They confirmed that protocols were in place making it clear to the staff that this practise was not acceptable. They confirmed that the staff were all tested on recruitment with respect to their knowlege of, and skills at reading, writing and speaking the English language. A senior staff member stated that recruitment was carried out by the organisations human resources department, but that interviews take place at the home with the involvement of the service users. The AQAA recorded that service users prepare questions they would like to ask, with support from their key workers, and attend the Care Homes for Adults (18-65 years) Page 25 of 31 interviews of prospective new staff. The personnel files of two staff, recruited since the previous site visit, were sampled. Application forms had been completed, Criminal Record Bureau (CRB) checks and references had been returned prior to the offer of a post and equal opportunities monitoring documents had been included, indicating that the process was fair. A full employment history had not been required and the applicants had not been asked to explain gaps in employment for the protection of the service users. 100 of the staff, who completed surveys, confirmed that their employer carried out checks such as CRB and references before they started work. The first two weeks of the induction of new staff was carried out at the provider organisations main office and covered mandatory training and an introduction to the organisations policies and procedures. The next two weeks were spent being introduced to the home, working as a supernumerary staff member and starting to complete a workbook leading to a Certificate for working with People with Learning Disabilities. The Skills to Care Common Induction Standards, which are an excellent introduction to the caring role, and promote the individual service users rights to be treated as an individual and have their equality and diversity needs respected, were completed over a six month period. The staff training matrix confirmed that health and safety, moving and handling, first aid, infection control, fire safety and safeguarding adults had been updated in a timely manner and future training dates had been recorded. Other training offered on a regular basis and included in the training matrix consisted of, communication, equality and diversity, the Mental Capcity Act and managing challenging behaviour. Staff training and development plans sampled, included certificates for the training recorded and also for the care of medication, epilepsy and footcare to enable them to support the service users needs. Other training booked for attendance in the training plans viewed included, positive leadership and well-being, person-centred planning and handling service users money. The nine staff, who completed surveys, all confirmed they were given training, which was relevant to their role, helped them to understand and meet the individual needs of the service users with respect to equality and diversity and keeps them up-to-date with new ways of working. Staff commented that the training and support was good, and that the organisation offered support for personal development. Two staff members thought that better staffing levels would improve the service. Care Homes for Adults (18-65 years) Page 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users opinions are central to influencing the development of the home and their health, safety and welfare is protected and promoted because the home engages in good preventative practises in this area Evidence: The registered manager for the service had resigned in April 2008 in order to manage another Robinia home. Since that time, the organisation had been actively seeking a replacement and this had been achieved recently. A new manager had been recruited and was due to take up post at the end of September. An application for the registration of the new manager had also been applied for. In the meantime, two senior staff members had managed the home and one is now due to take planned leave. The staff surveys completed indicated that some staff had not been happy to be left without a manager. Comments on what the service could do better included, dont leave the service without a manager at any time, stability of management and staffing levels and if all the staff work at their best together to maintain the minimum standards of care. The staff made positive comments about the support they receive from the organisation with respect to training and development and with respect to treating the service users as individuals. They comented that sevice users were Care Homes for Adults (18-65 years) Page 27 of 31 included in the running of the home, given opportunities to make choices and that they live in a person-centred way. The collated results of the service user surveys for 2007, confirmed that service users had been given support to complete this task. Areas highlighted were catering and food, individual requirements, personal care and support, daily living, premises and management. Service users views were recorded, including areas they felt could be improved upon. Actions required had been listed with timescales and a record was kept of completed actions. The Annual Quality Assurance Assessment (AQAA), which had been completed by the previous manager, contained excellent information confirming a comprehensive understanding of equality and diversity issues, showing how the service users views had been incorporated into how the service is run and identifying further planned changes for the improvement of the service. The AQAA also recorded that equipment had been tested or serviced as recommended by the manufacturer or other regulatory body. Certificates for portable electrical appliances and for the gas appliances were sampled, confirming that servicing had been carried out in a timely manner. The Control of Substances Hazardous to Health (COSHH) had been appropriately risk assessed to safeguard the service users. Policies, procedures and codes of practice in relation to Health and Safety had been reviewed in a timely manner to ensure the staff were kept up-to-date with current legislation and practise. The staff training matrix confirmed that training in moving and handling, food hygiene, first aid, fire training, health and safety and infection control had been updated on a regular basis and dates for planned training were included. Records were kept of accidents and other serious incidents and the home keeps the Commission for Social Care Inspection appropriately informed of such events. There was an ongoing programme of maintainance and repair, but the AQAA recorded that response times could be improved upon. The collated results of the service user surveys also recorded that, maintainance times could be improved. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 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 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 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 34 Staff recruitment should include a full employment history with gaps explained to protect the service users and to ensure prospective candidates are suitable to work with vulnerable adults. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.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. 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