Care Home: Greenfield Close Residential Home

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What the care home does well Staff would visit anyone who wanted to come and live at the home to make sure they would be happy there. The expert by experience said, `Service users we spoke to all had keyworkers. The keyworkers are all helpful and polite and friendly towards service users.` Residents are able to make choices about what they do. Staff make sure residents can do things for themselves without getting hurt. One person catches a bus to work on her own. Residents are able to go to a local day centre and one person told us "I go to the day centre three times a week" People are able to do things out of the home. The expert by experience said `Most of the service users were out on activity when we were there` and `One of my favourite things about the home were the animals that the service user could feed (horses and chickens) but also the huge garden which had a wishing well and the woodland area`. Residents have a choice of meal and sometimes eat out at a local pub.Residents can have their family and friends come to visit them. Residents are able to do things at their own pace. People receive the healthcare they need. One person said the chiropodist cuts his nails. The expert by experience said,`I liked that the service users cooked their own meals (with support) and tidied the home if they wanted to, as I think this would make them feel more like it was their house.` What has improved since the last inspection? There are always two staff in the mini bus when taking residents out. Medication can be properly looked after. Residents can say if they are not happy about something. Only people who have been checked to make sure they are the right sort of people to help others work in the home. What the care home could do better: Make sure residents have clothing that fits them properly. Always write down when a resident has some medication. Staff should make plans for people to make sure they are safe from any abuse. When something is broken it needs to be mended quickly. Staff must do all they can to stop any infection being passed between people. Key inspection report Care homes for adults (18-65 years) Name: Address: Greenfield Close Residential Home Greenfield Close Coddington Newark Nottinghamshire NG24 2QR 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: Stephen Benson Date: 0 6 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 32 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 © (2010) 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 32 Information about the care home Name of care home: Address: Greenfield Close Residential Home Greenfield Close Coddington Newark Nottinghamshire NG24 2QR 01636677981 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): stuart@clearwatercare.co.uk udayan@clearwatercare.co.uk Greenfield Close Residential Home Limited Name of registered manager (if applicable) Miss Marilyn Shirley Brookes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 17 0 care home 17 learning disability Additional conditions: The maximum number of service users who can be accommodated is 17. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disabilities - Code LD. Date of last inspection 0 2 1 2 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Greenfields is a care home where up to 17 men and women who have a learning disability can live and be helped. It is owned by Clearwater Care. Greenfields is in a village called Coddington, which is near Newark in Nottinghamshire. It is close to the A1 and a main bus route. There is a post office and shop, a pub, a restaurant and a church in Coddington. The home is made up of a house and two bungalows which have their own lounge, dining room, kitchen, toilets, bathroom and shower room. There is not a lift in the house. There is plenty of garden and cars can be parked at the front of the home. Anyone can ask to see the latest inspection report, statement of purpose and service user guide. The fees range from £407.50 to £861.67 depending on dependency needs. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about... to each service user and these were returned. The main method of inspection used is called case tracking which involves looking at the quality of the care received by the service users living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the service users needs who they support. An expert by Care Homes for Adults (18-65 years) Page 7 of 32 experience assisted in the inspection and spoke with service users and staff and had a tour of the building. What the care home does well Staff would visit anyone who wanted to come and live at the home to make sure they would be happy there. The expert by experience said, Service users we spoke to all had keyworkers. The keyworkers are all helpful and polite and friendly towards service users. Residents are able to make choices about what they do. Staff make sure residents can do things for themselves without getting hurt. One person catches a bus to work on her own. Residents are able to go to a local day centre and one person told us I go to the day centre three times a week People are able to do things out of the home. The expert by experience said Most of the service users were out on activity when we were there and One of my favourite things about the home were the animals that the service user could feed (horses and chickens) but also the huge garden which had a wishing well and the woodland area. Residents have a choice of meal and sometimes eat out at a local pub. Care Homes for Adults (18-65 years) Page 8 of 32 Residents can have their family and friends come to visit them. Residents are able to do things at their own pace. People receive the healthcare they need. One person said the chiropodist cuts his nails. The expert by experience said,I liked that the service users cooked their own meals (with support) and tidied the home if they wanted to, as I think this would make them feel more like it was their house. What has got better from the last inspection There are always two staff in the mini bus when taking residents out. Medication can be properly looked after. Residents can say if they are not happy about something. Only people who have been checked to make sure they are the right sort of people to help others work in the home. Care Homes for Adults (18-65 years) Page 9 of 32 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 Stephen Benson CPC1 Capital Park Fulbourn Care Homes for Adults (18-65 years) Page 10 of 32 Cambridge Cambridgeshire CB21 5XE 01223771300 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 11 of 32 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 32 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. Anyone new coming to live at the home would be supported to move in gradually. Evidence: We were told in the assessment they completed that, Prospective service users are fully assessed by a person competent to do so before admission and Family and relative views are taken into account and on admission an individual support care plan is drawn up with the service user. There have not been any new admissions to the home since the last inspection, however staff were able to describe the assessment process that would be followed which include carrying out a pre admission assessment and preparing care plans. The person would then have some introductory visits so they can get to know everyone. Care Homes for Adults (18-65 years) Page 13 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents cannot rely on their care plans being kept up to date and providing guidance on how their needs should be met. Residents make some decisions about what they can do and independence is promoted. Evidence: We were told in the assessment they completed that, We have developed support care plans to be person centred and each individual service user has been at the centre of this planning and given their views and expressed their wishes aims and goals. A sample of three care plans were seen and these provided information about peoples needs and how the should met. Information about daily routines was laid out in an easy read format. The deputy manager said there have been major changes made to the care plans to make them more person centred and show personal opinions and choices. One resident was identified as displaying challenging behaviour, however the care plan Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: had not been reviewed for three months, despite the fact there had been recent episodes of physical aggression. Staff said they thought all care plans needed reviewing and they had not been checked to see if they have been. Staff said there had been review meetings and other contact with the Community Learning Difficulty Team (CLDT) but these had not been recorded. At the last inspection a requirement was set that Care plans must be fully completed, regularly reviewed and take into account the Mental Capacity Act (MCA). The home was required to submit an improvement plan following the inspection and said Staff developing individual care plans to make them person centred and take into account MCA. Staff have MCA training 10 01 09. There was no reference to the Mental Capacity Act in the care plans seen. Staff said that residents are able to make choices on a daily basis with guidance where necessary over such things as what they wear that is appropriate for the weather. The expert by experience wrote in her report, Service users can choose when to go to bed and when to get up. They can go to their rooms at any point during the day to have some time alone and relax. Some service users choose the colour of their bedrooms. There is a choice of bath or shower. Support is given if it is needed. Service users can choose if they have visitors in. Service users can choose what they wear. One resident did not go to the day centre as he had a disrupted nights sleep. In our survey forms two people said they always make decisions about what they do each day and two people said they sometimes do. One person commented talk to me more and explain things in a more simple fashion and involve me more in decisions about myself in the section what could the home do better? An entry was seen in the comments book stating, Happy that he is making his own choices of what he would like to do with support with staff from Greenfields. One person who was eating his lunch in the kitchen told us, I prefer to eat my meals in the kitchen. There were risk assessments seen in care files, and one resident was seen setting of to catch a bus to go to her work placement and seen returning by bus in the afternoon. Staff said another resident goes to the local post office and collects the milk. Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: Care Homes for Adults (18-65 years) Page 16 of 32 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. Residents are able to follow a lifestyle that suits their interests and abilities. Evidence: We were told in the assessment they completed that, We integrate into the local community and are involved in local groups. Some service users have gone into voluntary work. The majority of residents attend a local day centre and two have employment placements. Those residents who do not have any form of placement are able to join in activities organised by the home both in and out of the building. A group of residents went out to a local pub for lunch and some told staff on their return they had eaten sausage and chips and fish and chips. One resident told us, I am going to work at a coffee bar and another said, I go to the day centre three days a week. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Staff said they are able to go out into the local community regularly, and residents enjoy shopping, bowling and having a meal out. One person said, I love going to the pound shop, they have some lovely things. Staff said they also organise planned trips and recently went to Skegness for the evening. The expert by experience wrote in her report, Most of the service users were out on activity when we were there. Some were out shopping with staff, some at a day centre and the rest were on a bowling trip. The staff told us there were different activities on different days but it was the service users choice if they wanted to go. There was a conservatory in the home which was mainly used for in house activities, such as arts and crafts, games a nd there was even a full sized pool table. It was mentioned that a few service users had their own jobs outside the home. One female service user also liked to do housework around the home, which she did on a regular basis. There is a choice of different meal on the menu. Service users can choose if they want to go out and when they go out. There were notices seen inviting friends and relatives to forthcoming functions at the home including a cheese and wine evening. There were comments seen in care plans of residents having contact with their relatives and some had made entries in the comments book. The weekly routines revolve around residents commitments at the day centre and work placements. Those not going out are able to get up later and choose whether to join in any of the activities organised. One resident told us, I get up at 10 to 8 and I say what I am going to wear. There is a record kept of what meals residents have. These showed that they are able to make choices at each meal, although it was noted that one resident had the same meals practically every day (fried bread for breakfast, cheese sandwich for lunch and a fry up for tea). The resident told us that is what he wants. The deputy manager said they try to get him to eat other meals but he will only try something different on a Thursday. Care Homes for Adults (18-65 years) Page 18 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive the personal support and healthcare they require to promote their well being, but are being placed at risk by unsafe medication practices. Evidence: Staff were seen supporting people to get ready for the day, including providing personal care in private. Routines were flexible to take into account the preferences of each resident, so they washed and had their breakfast as they were ready to do so. A resident told us, They help me nicely. One resident was seen wearing pajamas that were too small for him and records showed he had little new clothing over the last year, although he did have new pajamas in February this year. We were told in the assessment they completed that, Healthcare needs are addressed and all service users attend regular appointments with outside professionals and these are communicated to individuals in a way they can understand. Staff said they had made a referral for one resident to see a psychologist over a year ago but had not yet got an appointment. Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: There were records of professional visits made in the care files showing routine health appointments are taking place, including eye tests, dentist and chiropody. One resident said, The chiropodist cuts my nails. An entry was made in the comments book saying a relative had, Thanked us for prompt attention attending accident and emergency today after a fall and informing Mum and Dad immediately. A district nurse was seen in the home to give one resident an insulin injection before breakfast. Staff were seen administering residents with their morning medication and they observed the resident to ensure this was taken. A new drugs cabinet to store any controlled drugs in has been purchased. One resident had been given a prescribed medication as needed (known as PRN) following some incidents of challenging behaviour. There was no guidance seen as to when this should be administered the reason for it being given was not recorded on two occasions and one occasion it was recorded in the daily notes as being given but not on the forms to record the administration of medicines. Care Homes for Adults (18-65 years) Page 20 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are listened to if they make a complaint but are not being protected from abuse. Evidence: We were told in the assessment they completed that they, Respond to complaints immediately they are received. One resident complained during breakfast that the crusts had been left on his toast. A member of staff wrote down the complaint and asked the resident to sign it. The complaints log showed two further complaints have been received in the last year, one concerning the phone lines not working and the other about activities. The latter is still under investigation. In our survey forms three residents said they knew how to make a complaint and one said they did not. One resident referred to a complaint he had made previously which had already been investigated. The expert by experience wrote in her report that when speaking to a resident, She said she likes it at the home and feels safe here with the staff. Another 2 reidents told the expert by experience they felt safe and one joked about the staff. A requirement was set at the last inspection that Staff must be aware of the procedures Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: to follow in the event of any form of abuse. In the improvement plan they were required to send us they stated, Staff to receive training on SOVA (Safeguarding of Vulnerable Adults) -applied for. Staff have been made aware of whistleblowing policy and action to take if abuse is suspected to protect people in their care. We were told in the assessment they completed that they,We act on safeguarding issues immediately and refer to safeguarding team for investigation. Regular checks to assess staffs understanding of safeguarding our service users. During the early morning one resident was seen to hit another resident on the arm several times. A member of staff was nearby and intervened. The resident who had been hit told us, It didnt hurt, she is always doing it, she does it to staff as well. The member of staff left shortly afterwards as she had completed her shift. On checking the notes for the resident there was no entry of this incident and staff on duty were not aware of it, however staff said the member of staff had phoned up shortly afterwards to inform them of it. The notes contained references to 23 further incidents where the resident had hit other residents since the beginning of August 2009. There was no record showing these had been reported as safeguarding referrals and staff said they had not done so. Care Homes for Adults (18-65 years) Page 22 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being placed at risk of harm as a result of practices in the home not being sufficiently robust. Evidence: Areas of the home seen during the visit were clean and tidy. The hood above the cooker in one of the units was broken and as a result was not secured. A resident told the administrator about this and said, Its health and safety in the kitchen. This had not been reported previously, but the handyman said it had not been broken the previous day and removed it as it could fall onto someone if they tried to use it. The expert by experience wrote in her report, The approach to the home is through a spacious front garden which was very tidy. A friendly member of staff showed me around the three homes. The building was a bungalow split into three different houses. Each house having its own kitchen, bathroom and lounge. All three bathrooms were brightly coloured and very clean. All three houses were recently decorated in bight beige neutral colours. There were paintings and pictures up on the walls. All three lounges were decorated slightly different with different furniture but all had a cosy homely feel. Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: The gardens were all looked after but all lacking in adequate seating and tables for the service users. The home also had chicken and a cockerel, which roamed freely in the service users garden. When speaking with service users they commented that they liked this and got to feed them. All the bedrooms were very individual and personal to the service users. We were later told that there is sufficient seating available, however this had been put away for the winter. In our survey forms people said the home is always clean and fresh and two said it usually is. One person told us, I can get around everywhere in my wheelchair. There is a red bag system in use for soiled laundry and protective clothing is provided. One resident said, I dont like them (staff) using gloves when they give me personal care. The deputy manager said staff did not wear gloves when assisting the resident, but there was not a risk assessment for this. Care Homes for Adults (18-65 years) Page 24 of 32 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. Residents have their needs met by staff who are provided with the training they require to do this. Residents are protected by recruitment practices in the home. Evidence: Staffing levels vary through the day depending upon the number of residents at home at the time. One member of staff had called in sick this morning and another member of staff had been contacted who came in to cover. Staff said there are sufficient staff on duty and spoke of having time to talk and do things with residents. Staff also said that the current rota is being reviewed and it is intended to have two staff awake at night in the near future. One person commented in our survey form that some staff have strong accents and sometimes staff think I am being awkward and cantankerous when really I have not understood what has been said to me. The files for some new staff were seen and these contained the required pre employment checks . It was stated on the assessment they completed that all staff who have started work in the home in the last 12 months had satisfactory pre employment checks carried out. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Staff training records showed that regular training is provided and there is a plan for future training. We were told there is a staff training programme and more than half the staff have got a professional qualification. Care Homes for Adults (18-65 years) Page 26 of 32 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. There are suitable management arrangements in the home. Evidence: A new manager was appointed in March 2009 and is currently going through our process to be considered for the position of registered manager. Staff said the manager had changed a lot of things and was getting things right. There was a file of survey forms that have been given out during the year. One relative commented, Staff are lovely and appear totally committed to their work. The residents are happy and contented, I enjoy my visits enormously. The assessment we ask the provider to complete and send back to us was returned on time. We were told in the assessment they completed that equipment is serviced or tested as recommended by the manufacturer or other regulatory body. Dates were provided showing this to be the case. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Staff said they had taken part in a fire drill and they did not have any concerns about health and safety within the home. Care Homes for Adults (18-65 years) Page 28 of 32 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 1 6 15 Care plans must be fully completed, regularly reviewed and take into account the Mental Capacity Act. 01/03/2009 This will enable to staff to know peoples needs and their capacity to make their own decisions and choices. 2 23 13 Staff must be aware of the procedures to follow in the event of any form of abuse. 01/03/2009 This will ensure staff know how to protect people. Care Homes for Adults (18-65 years) Page 29 of 32 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 1 17 16 Carry out a dietary assessment for the resident who does not have a varied diet. 02/11/2009 This will ensure the resident receives the most healthy diet possible. 2 18 12 Ensure residents have sufficient clothing that fits them. 19/10/2009 This will ensure residents look presentable at all times. 3 20 13 Ensure that accurate records 19/10/2009 are kept of any medication that is prescribed to be administered as needed (PRN). This will ensure that residents are closely monitored for any medication Care Homes for Adults (18-65 years) Page 30 of 32 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 they take. 4 24 12 Ensure any repairs and hazards are reported and made safe as they arise. 26/10/2009 This will ensure residents are not at risk of harm. 5 30 13 Carry out a risk assessment on the practice of providing personal care without the use of protective gloves. 26/10/2009 This will show what measures are required to prevent residents being placed at the risk of infection. 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 7 Provide residents with information in a manner they understand and supported to make decisions for themselves they are able. Ensure residents understand to the best of their ability what has been said to them. 2 32 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 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 © (2010) 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. 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