Care Home: Golden Gorse

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What the care home does well Golden Gorse provides a comfortably homely environment for the people who live there. There is a happy relaxed atmosphere and visitors are welcome. People living at the home have opportunities to take part in a wide range of activities, some supported by staff at the home and others at the local day services centre. People asked were very happy with the activities and it was apparent that staff match activities with personal interests and hobbies. People are encouraged to learn and develop independent living skills by taking part in general household tasks such as shopping and cooking. The home monitor the health care needs of people to ensure that they receive support from appropriate professionals outside the home. Care plans give clear information about the current needs of people and medical appointments, with outcomes, are recorded. There was evidence that the home has been pro-active in seeking advice to meet changing needs. Staff spoken with during the inspection were very enthusiastic about their jobs and demonstrated a good knowledge of each individual living at the home. People living at the home appeared very comfortable and relaxed with the staff who supported them. Recruitment records seen show that there is a robust recruitment procedure that minimises the risks of abuse to people. What has improved since the last inspection? x What the care home could do better: The registered manager has recently left the home and the home is being managed by senior care staff. The home is understaffed and senior staff are working excessive hours to cover care shifts and fulfil management duties. Duty rotas seen showed that two senior staff had worked well in excess of 100 hours each in the fortnight prior to the inspection. The registered provider needs to address the staff shortages as a matter of urgency. The increasing needs and dependency of the people who live at the home means that staffing levels of 2 staff during the day and 1 at night need to be reviewed. Staff spoken to felt that the home would now benefit from increased staffing at peak times. The previous manager continues to be a financial appointee for some people living at the home. As far as practicable staff should not act as an appointee and the provider should look at alternative suitable appointees. This would ensure consistency and make sure that people can freely access their money even when staff members move on from the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Golden Gorse 4 Alexandra Road Somerset TA245DP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Poole     Date: 2 6 1 1 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 29 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 29 Information about the care home Name of care home: Address: Golden Gorse 4 Alexandra Road Somerset TA245DP 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Parminder Degun Name of registered manager (if applicable) Mrs Karen Anne Wilson Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is 8. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Physical Disability (Code PD) The two bedrooms that are below 10 sq. m. can only be occupied by residents who are fully mobile. Date of last inspection Brief description of the care home Golde Gorse is registered with the Care Quality Commission to provide care to up to 8 people who have a learning disability and may also have a physical disability. Nursing care is not provided. The home is set on one level making all areas accessible to people with all levels of mobility, including wheelchair users. It is set in a residential area of Minehead close to Care Homes for Adults (18-65 years) Page 4 of 29 8 8 Over 65 0 0 Brief description of the care home the town centre and sea front. The registered provider is Mrs Parminder Degun, there is currently no registered manager. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. The home has been established for some years but a new provider took over in February 2009 and therefore the home was re-registered. This is the first inspection since the registration. The inspection was carried out by one inspector over one afternoon. We, the Commission were able to speak with people living and working at the home, tour the Care Homes for Adults (18-65 years) Page 6 of 29 building, observe care practices and view records. At the time of the inspection there were 8 people living at the home. Current fees range from £571.00 to £848.00 per week. The following is a summary of the inspection and should be read in conjunction with the whole report. Care Homes for Adults (18-65 years) Page 7 of 29 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 29 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. There is a settled group of people living at the home and no new admissions have been made since the registration. There is adequate information about the home in appropriate formats. Evidence: The home has a statement of purpose and a service user guide. The service user guide is available in a pictorial format making it accessible to people at the home. No new people have moved in since the current owners took over the registration earlier this year. Therefore this section could not be fully assessed on this occasion. Care Homes for Adults (18-65 years) Page 11 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. Care plans give clear up to date information about the needs and preferred routines of people. People living at the home are encouraged to make decisions about their day to day lives. Evidence: Everyone living at the home has a care plan that clearly sets out the support that they require. 2 care plans were seen and both were very personal to the individual. Care plans contained details of peoples likes and preferred routines as well as their physical needs. There was evidence that care plans were being up dated regularly to reflect changing needs and abilities. The home are in the process of changing the care plan format. One care plan seen was in the new format. It gave clear information about all aspects of daily life and had pictorial headings to make to more meaningful to the people living at the home. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Senior staff stated that it is anticipated that all care plans will be in the new format at the beginning of the new year. For one person their changing needs meant that they were no longer able to access the community unaccompanied. There was a plan in place that outlined the new restrictions, and what support needed to be in place to ensure that they continued to access the community and see friends with staff support. There was evidence that outside professionals had been consulted about the restrictions in place and the new care plan had been drawn up in line with Best Interests guidelines. Care plans seen also contained risk assessments to ensure that people were able to take part in activities with minimum risk to themselves and others. Throughout the visit it was clear that people are encouraged to make choices about their day to day lives. People said they were able to decide what time they got up, when they went to bed and how they spent their free time. People said that they made choices about the food in the home, activities and decoration in the home, especially their personal rooms. There are monthly meetings for the people living at the home where they are able to share information and be involved in decisions about the home. Care Homes for Adults (18-65 years) Page 13 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. People have opportunities to take part in a wide range of leisure activities in line with their interests and hobbies. Daily routines are flexible and people make choices about their day to day lives. Evidence: Routines in the home are flexible in line with peoples wishes and regular activities. There was evidence that people are supported to shop for their own clothes and personal items. People living at the home said that they assist with some household chores and are supported to learn new skills. To maintain and develop practical living skills people are encouraged to assist with food shopping and preparation. During the inspection it was noted that one person was involved in cooking the main meal of the day. Other people Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: said that they laid tables and helped to clear away. The majority of people attend day service provision during the week where they take part in a variety of activities. Everyone has a time table in their room outlining what activities they take part in and when. Day activities include gardening, cooking, music and drama. People living at the home also belong to various local clubs, one person attends a local church and some people are members of an advocacy group. People said that the staff help them to keep in touch with friends and family. Everyone asked said that family members were always made welcome. People living at the home are able to invite friends for meals on a weekly basis. The home is ideally located to enable people to access facilities in the town centre. People said that they go shopping and to the library. There are two vehicles to enable people to access amenities further away and have trips out. One person said that they had been to London to see a show and there was an overnight stay in Bristol planned for the coming weekend. Staff were able to demonstrate that they arrange trips that are appropriate to individuals interests and it was noted that people made suggestions about trips at the residents meetings. The main meal of the day is in the evening when everyone is at home, there is a lighter meal for anyone at the house during the day and people make packed lunches when they are out for the day. Menus are drawn up on a weekly basis and everyone is able to choose one meal a week. People living at the home assist with food shopping and are therefore able to make choices about the food coming into the home. The home has a large kitchen/diner and meal times are a social occasion. People living at the home said that meals were always nice and staff stated that there is an ample food budget to ensure that they are able buy good quality products including fresh fruit and vegetables. Throughout the visit it was observed that there was a warm and friendly atmosphere with constant interaction between people living and working there. Care Homes for Adults (18-65 years) Page 15 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. Personal health is monitored and the home is pro-active in seeking advice from healthcare professionals. Evidence: All care plans give guidance about the amount of support people require with personal care. 5 of the 8 bedrooms have en suite facilities and the other three people share a bathroom but have wash hand basins in their rooms. This enables people to carry out personal care in private. All bedrooms have keys so that people can lock them if they wish to. At the present time all day staff working at the home are female meaning that people do not have a choice about the gender of the person who assists them with personal care. People spoken with during the inspection said that staff supported them to shop for their own clothes and that they went to a local hairdresser. The home has responded well to the changing healthcare needs of people living at the home. Care plans are up dated to show changes in need and care required. Healthcare Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: is monitored and people have access to healthcare professionals according to their individual needs. Staff assist people to attend appointments outside the home. All appointments and the outcomes of any consultations are recorded in peoples personal files. Records seen show that people have access to professionals such as GPs, dentists, opticians, psychologists and psychiatrists. Everyone living at the home has a healthcare file that is separate from their main care plan. Files seen contained lots of historic information and may benefit from being sorted to ensure that all up to date information is easily accessible. Personal weights are monitored and we saw evidence that advice is sought where there are any significant changes. Currently no one living at the home orders or administers their own medication. Medication is administered by senior staff but all staff working at the home have received training in the safe administration of medication. The home uses a monitored dosage system and secure storage is available. Medication Administration Records were seen, these were well maintained and correctly signed when administered or refused. For one person, who has epilepsy, a protocol for the use of rescue medication has been drawn up with appropriate professionals and staff have received training in its administration. Care Homes for Adults (18-65 years) Page 17 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. The home has a complaints procedure which is accessible to all. People living at the home are comfortable to speak to a member of staff if they are unhappy. Evidence: The home has a complaints policy and everyone living at the home has a pictorial copy of this in their room. Everyone asked said that they would be comfortable to talk to a member of staff if they were unhappy. A complaints and compliments log is maintained and this shows that no complaints have been received since the current provider took over the home. Staff spoken with during the inspection were aware of the whistle blowing policy. Due to the size of the home and the stable staff team, staff spoken with felt that any changes in behaviour that may be indicative of a problem would be quickly noticed and appropriately responded to. The home does not use physical intervention. Two senior members of staff have recently received training in positive intervention looking at non physical intervention that can be used if someone is displaying behaviour that may place themselves or others at risk. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Some staff have received training in the protection of vulnerable adults. Everyone living at the home has regular access to family or professionals outside the home and some people belong to a local advocacy group. The home assists people with personal finance and the manager (who has recently left the home) acts as a financial appointee for 4 people. Records are maintained all of personal monies and records seen during the inspection correlated with monies held. Care Homes for Adults (18-65 years) Page 19 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. Golden Gorse provides a comfortable, homely environment for the people who live there. People living at the home are involved in choosing colours and decor. Evidence: Golden Gorse is located in a residential area in the town of Minehead. It is close to the town centre and sea front. It is one storey building making all areas accessible to people with all levels of mobility. The home is fitted with a fire detection and emergency lighting system. All bedrooms are for single occupancy and there is a communal lounge and kitchen/diner. Outside there is a courtyard garden. All areas of the home are comfortably furnished and domestic in style. A sample of bedrooms was seen and all had been personalised to reflect the tastes and interests of their occupants. People said that they had chosen the colours and decor for their personal rooms. There is a small laundry room, with washing machine and tumble drier, which is Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: appropriate to the needs of the people currently living at the home. All areas seen on the day of the inspection were clean and fresh. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Because the home does not have sufficient staff, some staff are working excessively long hours. Staff are dedicated and enthusiastic about their jobs. Evidence: The home supplied duty rotas which show that there are currently only 7 care staff employed. 2 working on nights and 5 on days. A maintenance person is employed one day a week but no other ancillary workers are employed. There are always two staff on duty during the day meaning that some staff are working excessively long hours. Duty rotas show that in a two week period one senior carer worked 139 hours and another worked 141 hours. As the registered manager has recently left the home this means that senior staff are also taking on management responsibilities. Although staff are dedicated and well motivated these excessive hours can not be sustained and additional staff must be employed as a matter of urgency. With the changing needs and increased dependency of people living at the home staffing levels need to be reviewed to ensure that they are sufficient to meet needs and provide a good quality of life. Staff on duty at the time of the inspection felt that the home would now benefit from increased staffing at peak periods of the day. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: The recruitment files of two members of staff employed since the current owners took over were viewed. These showed that there is a robust recruitment procedure that minimises the risks of abuse to people who live at the home. All staff had been checked against the Protection Of Vulnerable Adults (POVA) register and two written references had been obtained before they began work. There was evidence of a basic induction programme for new staff. Staff stated that they were receiving good training in statutory health and safety and in other subjects relevant to the needs of people at the home. Each person has an individual training file but there is no training matrix which gives an overview of the training undertaken or required by everyone. Care Homes for Adults (18-65 years) Page 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently without a registered manager and senior staff, with support from the provider, are managing the home. The building is well maintained and equipment is regularly serviced to ensure the health and safety of people living and working at the home. Evidence: The registered manager has recently left but came into the home for part of the inspection. The home are actively trying to recruit a new manager. At the present time the home is being managed by the senior care staff with support from the provider. As mentioned in the previous section, senior staff are currently working excessive hours to cover care shifts and fulfil management duties. As mentioned in section 5, the previous manager continues to be a financial appointee for 4 people. This is not appropriate and the provider needs to look at consistent appointeeships which enable people un-restricted access to their personal money even when a member of staff moves on. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: The home has some quality assurance systems in place to monitor the quality of care and to ensure that any changes made are in line with the wishes of the people living at the home. There are annual satisfaction surveys for people living at the home and other interested stakeholders such as relatives and visiting professionals. The last survey was carried out in July this year but results of this were not available and no analysis of findings or action plan was at the home. Assurances were given that feedback was positive and the completed surveys were currently with the provider for analysis. The home also holds monthly meetings for people living and working there. Minutes of these meetings showed that a wide variety of subjects are discussed and people have opportunities to share ideas. All accidents and incidents in the home are recorded. Records seen were clear and there was evidence that professional advice was sought where appropriate. The building is fitted with a fire detection system that is regularly tested in house and serviced by outside contractors. There are regular fire drills at the home and any difficulties encountered are recorded and amendments made to the procedure as appropriate. The Annual Quality Assurance Assessment (AQAA), completed by the previous manager in July, stated that all equipment in the home is regularly serviced to ensure its safety. Certificates of registration and insurance are in place. Care Homes for Adults (18-65 years) Page 25 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 26 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 1 23 20 (3) The registered person 31/12/2009 shall ensure so far as practicable that people working at the home do not act as a financial appointee or agent for anyone living at the home. To ensure that any financial appointee remains consistent and risks of abuse are minimised. 2 33 18 (1) [a] The registered person must ensure that adequate numbers of staff are employed. To ensure that staff do not work excessively long hours and that people living at the home receive appropriate care and support. 31/12/2009 3 37 8 (1) The registered provider must appoint someone to manage the home. To ensure that there is 29/01/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 adequate leadership and direction and that the home is sufficeintly staffed at all times. 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 23 All staff should receive training in the protection of vulnerable adults and be familiar with the local Safeguarding Vulnerable Adults policy and procedure. The registered person should review staffing levels to ensure that they are sufficient to meet the changing needs of the people at the home. The home should have a training matrix to give an overview of the staff training undertaken and outstanding. 2 33 3 35 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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