Care Home: Glebe House Care Home

What the care home does well Glebe House provides a comfortable, clean and homely environment, where people are supported by a consistent and committed group of staff. People gave positive comments about their care and felt their needs were being met. Eleven people are using the rehabilitation unit and they told us of their plans to move on to supported living accommodation. They told us staff help them to be as independent as possible and they have regular meetings where they are given choices and are able to be involved in decisions that effect their day to day lives. They also have opportunities to discuss any areas of concern with either their key workers or a resident who acts as their representative and attends regular meetings called `your voice`. Staff spoken to had a good knowledge of the needs of people they cared for and felt they were generally given the training to ensure they have the necessary skills to provide the appropriate care. What has improved since the last inspection? Action has been taken to address one requirement given during the previous inspection regarding care plans. A lot of work has been carried out to improve care planning documentation. Care plans have been re-written and those looked at showed that they had been written by the individual person and were person centred. They clearly recorded treatment and rehabilitation and the action staff must take to ensure their needs are met. They also record future goals and aspirations and the steps they need to take to achieve these. Within the last twelve months the number of beds used for rehabilitation has increased to eleven and plans are in place to use the whole of the first floor for this purpose. A rehabilitation co-ordinator has been appointed and the unit runs separately from the main home on the ground floor. The service works alongside other healthcare professionals and within the last year five people have been helped to stop smoking by seeking the advice and support from relevant agencies. Within the last twelve months a full re-decoration programme has taken place and the home was clean and tidy, communal areas were bright and nicely decorated and there were no unpleasant odours in the home. People who showed us their rooms told us they were able to choose the paint, furnishings and carpet. What the care home could do better: Staff should receive training regarding the Mental Capacity Act and refresher training in mental illnesses. They should also receive training relating to specific conditions such as diabetes and epilepsy to make sure people have the knowledge and skills to care for people living at the home. Clear guidance should be available regarding family members working together, this is to make sure people are clear about their roles and responsibilities and staff shouldreceive regular supervision to carry out their roles. The activity co-ordinator should develop a programme of activities for people living in the rehabilitation unit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glebe House Care Home 7 South Dale Caistor Market Rasen Lincolnshire LN7 6LS     The quality rating for this care home is:   two star good service 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: Elisabeth Pinder     Date: 0 6 0 5 2 0 0 9 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. 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. 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Glebe House Care Home 7 South Dale Caistor Market Rasen Lincolnshire LN7 6LS 01472852282 01472852284 glebe.house@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Health & Care Services (UK) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 24 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 24 Conditions of Registration: The registered person may provide the following category of service only: Care Home only - PC to service users of the following gender: Both whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Maximum Numbers: The maximum number of service users that can be accommodated at Glebe House Care Home is: 24 Date of last inspection Brief description of the care home Glebe House is operated by Health & Care Services UK and is located in the village of Caistor, where there are a variety of local facilities such as shops, churches and community facilities. The home offers accommodation to 24 residents with mental health difficulties. The building is set in its own grounds, with car parking to the rear of the property. The home is a two-storey building with a lift providing access to the 1st Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home floor. All of the rooms are single bedrooms, some with en-suite facilities and there are two lounges and a separate dining room. On the first floor there is a rehabilitation unit. The home has a mini-bus for people to use and there is also easy access to public transport. The current weekly fee range is £335.18 - £ 1389.92. There are no additional costs. Care Homes for Adults (18-65 years) Page 5 of 29 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 was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service. From 1 April 2009 the duties of The Commission for Social Care Inspection (CSCI) will be taken over by the Care Quality Commission (CQC), the new independent regulator of all health and social care in England. Throughout this report the terms we and us refer to the Quality Care Commission (CQC). The visit lasted just under six hours and took into account previous information held by us including the previous inspection report, dated 08/05/2007, their service history and records of any incidents that we had been notified of since our last visit. Before we made our visit the previous manager had returned the Annual Quality Assurance Assessment (AQAA). This gave us Care Homes for Adults (18-65 years) Page 6 of 29 information about their own assessment of how well they were meeting standards and their plans to improve aspects of the service. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service, two members of staff, the deputy manager and a practice nurse. Before our visit questionnaires had been sent to four people using the service and to four staff, those returned to us will be mentioned throughout this report. What the care home does well: What has improved since the last inspection? What they could do better: Staff should receive training regarding the Mental Capacity Act and refresher training in mental illnesses. They should also receive training relating to specific conditions such as diabetes and epilepsy to make sure people have the knowledge and skills to care for people living at the home. Clear guidance should be available regarding family members working together, this is to make sure people are clear about their roles and responsibilities and staff should Care Homes for Adults (18-65 years) Page 8 of 29 receive regular supervision to carry out their roles. The activity co-ordinator should develop a programme of activities for people living in the rehabilitation unit. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 29 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 into this service have access to a range of information to help them make a decision about moving into the home and they are involved in an assessment of their needs prior to being admitted. Evidence: Information about the service is written in the Statement of Purpose and Service User Guide, both documents tell people how they can access our reports and a general discussion was held with the deputy manager regarding the duties of CSCI being taken over by the Care Quality Commission, which is the new independent regulator of health and adult social care in England. The deputy manager agreed to discuss this with the company to ensure all relevant documents reflect this change. A review of all information available prior to the visit and the content of peoples care records, showed that people are not admitted before an assessment of their needs has been completed. One person told us he had visited the home and had been able to ask questions about the service before making a final decision about moving in. A member Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: of staff told us that either the manager or deputy manager visits people to discuss their individual needs and aspirations and admissions are often over a number of weeks to allow the person time to visit the home and stay for a short period to ensure they feel it is the right place for them. Records of two people who had been admitted within the last twelve months were looked at and these confirmed that a full needs assessment had been carried out and information had been gathered from people involved in the persons care. Two surveys were received from people living at the home prior to our visit, one confirmed that they had been asked if they wanted to move into the home, the other had not, however, people spoken to during our visit all said it was a joint decision between themselves and their care manager that they moved here. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully involved in their care planning including any assessment of risk and they are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Evidence: We continued to case track a further two people and looked at their care plans and risk assessments. Since the previous inspection a lot of work has been carried out to improve care planning documentation. Care plans have been re-written and those looked at showed that they had been written by the individual person and were person centred. They clearly recorded treatment and rehabilitation and the action staff must take to ensure their needs are being met. They also record future goals and aspirations and the steps they need to take to achieve these. An advance directive has been written telling staff what action they must take if the persons mental health deteriorates, however, discussions were held with two members of staff and they had limited knowledge about the Mental Capacity Act or specific mental illnesses. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Training records looked at showed that staff had received training in mental health in 2007. Each person has a key worker and regular reviews are undertaken with them to discuss changing needs and goals and people sign each review to show their involvement. Three people spoken to told us they were able to make decisions about their lives and are supported by staff when needed, they told us they are able to discuss risks and hazards with staff and agree a way forward to ensure their safety. They told us they have mobile telephones with emergency contact numbers stored and feel they can contact the home for advice should they need to. Care records clearly stated the arrangements for managing peoples finances and the support needed where necessary. Surveys received from two people living at the home told us they are sometimes able to make decisions about what they want to do each day and during the visit we heard staff discussing activities including rehabilitation with people and supporting their choice of activity. Care Homes for Adults (18-65 years) Page 14 of 29 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. This service provides a range of activities and leisure interests, both with the home and community based on individual preferences. Peoples rights are respected and meals are well managed in the main home and the rehabilitation unit. Evidence: Information received in the AQAA told us that staff support any lifestyle areas identified as needing support and people have access to local community facilities including work placements. This was evident during our visit, one person returning from a work placement needed advice and support from staff and this was given in a sensitive, professional manner. Currently people go out to the Pelican Trust which is a workshop based in Lincoln, Learn Direct which is an education centre and a day centre in Grimsby where they are doing courses on communication skills, health and Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: safety and first-aid. The service employs an activity co-ordinator who is responsible for overseeing the activities within the home. These are decided with individual people and a programme is then written taking into account their preferences. Activities currently being undertaken include, a weekly health walk, arts and crafts, board games, DVDs and interactive DVDs such as quizzes and beautician care. This member of staff is also deployed in the rehabilitation unit, however, her role in the unit does not differ from that of the rehabilitation co-ordinator whereby she assists with the daily rehabilitation tasks and a discussion was held with her regarding looking at specific activities for these people. Eleven people are currently using the rehabilitation unit and those spoken to confirmed they are involved in planning menus, shopping, preparation and cooking of meals and laundry tasks. They told us about their goals and most people said they aimed to eventually move to supported living accommodation. Monthly meetings are held with people where they discuss topics such as holidays and day trips. The service has a system called your voice this is where people living at the home can go to a designated person (also living at the home) and raise any issues of concern. Issues will be documented and the representative will attend monthly staff meetings and area meetings and raise issues of their behalf. A discussion was held with the cook who showed us information received from people about what they would like on the menus. She told us she was in the process of writing new menus for the summer and would be taking into account individual choices. She was aware of likes and dislikes and dietary requirements and people told us they were generally satisfied with the food provided. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples physical and emotional health needs are met and staff respect peoples preferences when providing personal care. Medication is given by staff who are trained and safe procedures are followed. Evidence: Individual health action plans are written and records are kept for weight, diabetes, epilepsy, opticians, dentists and chiropody. Records of visits to GPs (general practitioner), psychiatrists and other healthcare professional are also recorded. People have an annual health check and during our visit we spoke to a visiting practice nurse who told us most people visit her at the surgery and she has no issues with the service at the moment. She feels staff are supportive to people living here and staff always refer health matters appropriately to her. The service has liaison with a stop smoking agency and within the last twelve months five people have been helped to stop smoking. Two staff members spoken to had limited knowledge about specific illness such as diabetes and epilepsy and this was discussed with the practise nurse who said she would liaise with the necessary people and try and arrange some training for staff. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Individual risk assessments are written regarding peoples ability to manage their own medicines and the action staff must take to support the person. We observed one person receiving medication after lunch and this was done using safe procedures. Medication records were completed satisfactory and medicines were stored safely. The service has regular monitoring visits from the local pharmacy, the last visit being on 10/03/09, their report read no homely remedies protocol, each resident buys and keeps their own and these are kept in a secure location. The deputy manager confirmed that she undertakes monthly medication audits and all staff completed training in November 2008. Future plans include staff undertaking an advance course in medication, which will include the mental health module. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the procedures in place for handling complaints and allegations of abuse. Staff have received training in these subjects to help them protect the people they support. Evidence: Information taken from the AQAA tells us that a robust company complaints and abuse policy is in place and records are kept. People living at the home have been given a simplified version and this was available on display in the home. Posters were also displayed for whistle blowing and independent advocacy. Two surveys were received from people living at the home, one identified that they knew what to do should they wish to make a complaint and who to speak with if they felt unhappy, one told us they did not know. During our visit people told us they would raise any concerns with their key worker or the designated representative of your voice. Monthly visits are made by a representative of the company who gives people the opportunity to raise any issues of concern with her. Reports looked at verified this and records showed that no complaints had been raised within the last twelve months. The deputy manager told us that the service has a good relationship with the Lincolnshire Safeguarding Adults team and feels they are able to contact them for advice when needed. One referral had been made to the safeguarding team and this Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: had been dealt with and appropriate risk assessments put in place to protect the person involved. Care Homes for Adults (18-65 years) Page 20 of 29 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. People live in a well-maintained, clean, comfortable and safe environment. Evidence: Information taken from the AQAA told us that within the last twelve months a full redecoration programme has taken place and this was evident during our visit. The home was clean and tidy, communal areas were bright and nicely decorated and there were no unpleasant odours in the home. People who showed us their rooms told us they were able to choose the paint, furnishings and carpet. A full time maintenance person works in the home and issues requiring attention are immediately dealt with where possible. Surveys received from 2 people living at the home both identified that they felt the home was always clean and fresh. People using the rehabilitation unit are expected to assist in some domestic tasks to help develop their skills to increase their independence and during the visit people were observed hoovering and cooking. The grounds and gardens were well kept and care planning for one person included working in the garden to develop his interest and skills in gardening. The service has received a four star award from their Environmental Health Officer and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: we were told that there were no outstanding requirements or recommendations from them. Care Homes for Adults (18-65 years) Page 22 of 29 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. There is enough staff on duty to meet the needs of the people currently living at the home. People are protected by robust recruitment procedures and staff have access to training and support to ensure they are knowledgeable and equipped to meet peoples needs. Evidence: Information provided in the AQAA told us that a consistent, experienced staff team is employed, many of whom have worked in the home for a number of years. The service does not use agency staff but has a number of people working on an as and when needed basis. Duty rotas for the last two weeks were looked at and these showed there were generally four staff on duty between the hours of 07:15 - 21:15 and two staff throughout the night. However, on one occasion this dropped to three staff. The deputy managers hours are in addition to these. The majority of staff surveys returned indicated staff feel there are usually enough of them on duty to meet individual needs and people spoken to during our visit told us staff are always around and theres always someone to talk to. However, surveys received from two people living at the home told us they always and sometimes felt they are well treated by staff and one specific comment read the staff have no patience. This was discussed during our visit and no one raised any concerns. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Four staff surveys were returned and told us that relevant checks had been carried out prior to their employment and they felt their induction training covered everything they needed to know to do the job. They also indicated that they are given training relevant to their roles. The records of two staff recently employed were looked at and these showed that essential checks such as written references and C.R.B. (Criminal Records Bureau) checks had been carried out. Training records were looked at and showed that there is a continuing programme of mandatory training and eighteen staff have achieved a nationally recognised vocational award, level II. Care Homes for Adults (18-65 years) Page 24 of 29 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. This service is being well managed with procedures in place to ensure the health and safety of people is promoted and adequate systems to monitor the quality of care provided. Evidence: The home is currently being managed by the deputy manager as the registered manager was recently dismissed from post. She is supported by an area manager who visits at least once a month and is contactable at all times. Staff told us they feel supported and can raise issues of concern with the deputy and felt these would be dealt with, However, staff told us they had not had regular supervision and records showed the last dates for one person as February 2008, the other person November 2008. No issues were raised in staff surveys, however, one person felt the service could improve by reducing the long days by two hours. This was brought to the attention of the deputy manager who said she had not been informed of this concern but would address it through the homes quality assurance monitoring. Another person raised a concern about the number of family members working together and this was Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: also discussed with the deputy manager who agreed to speak with higher management and look at company guidance. Regular staff meetings are held, the last being in April 2009 and the minutes of these were in the process of being typed. Discussion and records showed that there are systems in place to monitor the quality of the service being provided. This includes seeking the views of people living at the home and their relatives/representatives. A discussion was held with the deputy manager regarding sending questionnaires to staff, GPs, district nurses and any other people who use the service and she agreed to speak with the area manager about this. The area manager had visited the home at least once a month to monitor and evaluate how the home is running and reports were available of her findings. Information provided in the AQAA told us that there are a range of policies and procedures in place and dates each policy had been reviewed. We were also told of equipment maintenance and service dates. Environmental and fire risk assessments were up to date and records showed staff had completed health and safety training and infection control training. Care Homes for Adults (18-65 years) Page 26 of 29 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 29 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 It is recommended that care plans include reference to the Mental Capacity Act and the effects it has upon peoples lives. The activity co-ordinator should develop a programme of activities for people living in the rehabilitation unit. It is recommended that staff receive training relating to specific conditions such as diabetes and epilepsy to make sure people have the knowledge and skills to care for people living at the home. It is recommended that staff receive refresher training regarding specific mental illnesses. It is recommended that staff receive regular supervision to carry out their roles. Clear guidance should be available regarding family members working together, this is to make sure people are clear about their roles and responsibilities. 2 3 14 35 4 5 6 35 36 40 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. 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