Care Home: Grove (The)

What the care home does well The inspector believes that this is a very well run home, providing excellent levels of care and support to service users. Service users spoken to expressed satisfaction with the home, with one commenting "It is a good place here." The manager and staff team present as competent and knowledgeable around mental health issues, and to have a good understanding of the collective and individual needs of service users. The home presents as having a warm and friendly atmosphere, which encourages service users to live fulfilling and independent lifestyles. Service users have complex needs, and the home strives to meet these needs in a person centered manner. Care plans are of a very high standard, as are risk assessments. What has improved since the last inspection? The inspector was pleased to note that their have been improvements to the home since the previous inspection, and the total number of requirements set has fallen from four to one. Staff are now appropriately qualified, and have undertaken training around adult protection issues. COSHH products were found to be stored securely. What the care home could do better: Only one requirement has been made in this report, that the home carries out CRB or POVA FIRST checks for all staff before they commence working in the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Grove (The) 72 Grove Road Walthamstow London E17 9BN     The quality rating for this care home is:   three star excellent 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: Robert Cole     Date: 2 8 0 1 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. the things that people have said are important to them: They reflect 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.csci.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: Grove (The) 72 Grove Road Walthamstow London E17 9BN 02085203510 Telephone number: Fax number: Email address: Provider web address: aidanspence@hotmail.com Name of registered provider(s): Type of registration: Number of places registered: Ms Lisa Goldwater,Mr Aiden Spence care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person 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 to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home The Grove is a care home registered to provide accommodation and support to five adults with mental health needs. The home is located in the Walthamstow area of the London Borough of Waltham Forest. The home is in a residential area, close to shops and other local amenities, and to transport networks. The home is in keeping with other properties in the vicinity. The home is jointly owned by two proprietors who are both qualified psychiatric nurses. One of the proprietors is the registered manager of the home. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on the 28/01/09 and was unannounced. The inspector had the opportunity of speaking with service users, staff and the homes manager was present for much of the inspection. The inspection also included observations of staff as they carried out their duties, and a tour of the premises, along with an examination of records and other documents. Prior to this inspection the CSCI issued surveys to service users to gain their feedback on the running of the home. Three of these were completed and returned to the CSCI. The home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI, prior to the site visit. All of this has contributed to the overall inspection process, and to judgments made within this report. Care Homes for Adults (18-65 years) Page 5 of 29 Care Homes for Adults (18-65 years) Page 6 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 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 8 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. It is the judgment of the inspector that service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation and the opportunity of visiting the home before moving in. Evidence: The home has a Statement of Purpose in place. This states Our focus is towards a service where staff members are expected to treat and care for individuals as adults. This shall be achieved by delivering the highest quality of care which meets or exceeds the expectations of both individual and there sponsors. The Statement also includes a residents charter of rights, these rights include The right to be treated with dignity and individuality. and The right to have their cultural, religious, sexual, emotional and other needs met. The home also has a Service User Guide or Residents Handbook in place. This is of a Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: good standard, and all service users are given their own copy. It includes details of the facilities and services provided and of the aims and objectives of the home. Documents have been produced in plain English. The AQAA supplied by the home stated that key documentation may be produced in other formats such as video or audio tape to help make them more accessible to any future service users, thus helping to meet needs around equality and diversity issues. The AQAA supplied by the home states that all new residents undergo a comprehensive assessment process prior to admission, carried out by two in house Registered Mental Nurses. It also states that information may be gathered from other sources, including contact with social workers and community mental health nurses. There has been one new admission to the home since the previous inspection, and a comprehensive pre admission assessment had indeed been carried out by the homes manager. This included a detailed psychiatric history of the service users, and there needs around mental health, as well as other needs for example around relationships and social and leisure needs. The inspector spoke with this service user, who was able to confirm that they had had the opportunity of visiting the home before moving in. Care Homes for Adults (18-65 years) Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the view of the inspector that service users are supported to manage their own lives as much as possible, and that they have the opportunity of been involved in the day to day running of the home. Care planning and risk assessments are of an excellent standard. Evidence: Individual care plans are in place for all service users, and these are of an excellent standard. Care plans are drawn up with the involvement of the service user, their keyworker and the homes manager. However, it was positively noted on the day of inspection that all care staff are encouraged to contribute to the on-going care planning process through discussions at regular staff meetings. The inspector sat in for part of a routine staff meeting on the day of inspection, and witnessed detailed discussions around how the home could meet the needs of service users, for example one service user has recently been presenting some challenging behaviours, including aggressive behaviour towards staff. The staff team was able to discuss these issues, Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: and develop strategies to support this individual in a consistent manner. Another service user has a complex relationship with a parent, and again the staff team had a detailed discussion about the best way the service user could be supported to maintain a relationship with their parent. The inspector considered these discussions to be proactive and creative in their approach to managing difficult and complex issues, and it was clear that the best interests of the service user remained at the centre of all discussions. Care plans are clear and easy to follow, and subject to regular review. They contain detailed information about how the home is able to meet the needs of service users, for example one states X enjoys short walks, buying fruit, going to shops that sell music and painting. X also likes longer walks to Hollow Ponds or Lloyds Park. As indicated here, plans cover needs around social and leisure needs, and also needs around self care, daily living skills and mental health issues. Risk assessments for individual service users are incorporated in to the care plans, and as with the rest of the care plans are of a very high standard. Assessments clearly set out what the potential risks are, for example around self harm, arson and violent and aggressive behaviour, and include strategies to manage and reduce those risks. Staff spoken to demonstrated a good understanding of both care plans and risk assessments. Service users are supported to take risks as part of their daily lives, for example been able to access the community. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. The AQAA supplied by the home states Limitations on freedoms, choices or use of facilities are always decided with the persons best interests in mind and imposed only when critical to the service users well being. An example of this is the covert administration of medication to one service user who had been refusing to take medication. This person was assessed and found not to have capacity to make a decision over their medication, which is critical to their continued health. The decision was taken as part of a multi disciplinary meeting which included health care professionals and is subject to regular review. As stated though, most of the time service users are able to make choices for themselves over their daily lives. For example, service users were observed to get up at a time of their choosing, and to be able to help themselves to drinks and snacks. Service users are able to choose what clothes to wear, and to buy their own clothes. One service user informed the inspector that they had been out the day before and bought themselves some new clothes. Two service users are able to come and go from the home as they please without staff support. For the two who need staff support to access the community, this is readily available. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: There was evidence that service users have the opportunity of been involved in the day to day running of the home. Monthly residents meetings are held, the agenda is set jointly by staff and service users, and minutes are kept. Recent meetings have included discussions around holidays and activities. Service users are involved in the staff recruitment process, and are involved in choosing any new decor or furniture within the home. It was noted that some confidential information relating to service users was on display on the office notice board. This was brought to the attention of the homes manager, who removed it during the course of the inspection. Staff and service users have access to their own records. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that service users are supported to live valued and fulfilling lives. Service users have routine access to the community, and food was of a good standard. Evidence: The AQAA supplied by the home states We actively encourage service users to achieve their goals, follow their interests, pursue leisure activities and be integrated in to community life itself, in a way and at a pace that the given resident deems appropriate. No service users are currently involved in any employment. One service user attends a mental health day centre, where they are involved in an arts program. This centre also provides an opportunity to develop and maintain friendships. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Service users are supported to participate in a wide range of social and leisure activities, both in house and in the community. In house service users have access to television, DVDs, music, puzzles and board games and a wide selection of books. The home has recently obtained a piano, while one service user has their own guitar, and another has an accordion. The home has various pets, including a dog, cat, tropical fish and turtles. Service users are involved in their upkeep, for example feeding the fish and walking the dog. One of the homes proprietors runs an in house art class, and examples of art produced by service users was on display within the home. In the community, service users choose their own individual activities, for example on the day of inspection one service user went swimming, while another went out taking photographs. This service user informed the inspector that they had recently bought a new camera, and that they were taking pictures of places that represented significant milestones in their life. Other activities include visits to the cinema, pubs and bike riding. Service users are offered two holidays a year away from the home, and are planning a holiday to Southend in the near future. The AQAA indicates that activities are developed and encouraged to help residents to develop and maintain social, emotional, communication and independent living skills where appropriate. In addition to social and leisure activities, service users have routine access to the local community and community facilities, such as banks, shops, markets, cafes and parks. One service user visits a church every week, helping to meet their needs around equality and diversity issues. In the past the home has had access to an allotment, which service users have very much valued. The manager informed the inspector that the local authority had agreed to provide an allotment again to the home in the near future. Service users are able to maintain contact with family and friends. For example one service user has a girlfriend who lives in Scotland who they are able to visit. Visitors are welcome at the home at any reasonable time, and with one risk assessed exception service users are able to see visitors in private if they so wish. Service users are able to maintain contract by telephone, and are able to have their own phone if they so wish. Service users are given their own mail to open. Records are kept of menus, these indicated that service users are offered a varied, balanced and nutritious diet. The AQAA states that although mealtimes are flexible, the home aims for residents and staff to share the dining table to enhance the family atmosphere of the home. The kitchen was clean and tidy and food was stored appropriately. Service users are able to help themselves to drinks and snacks, and fresh fruit was available on the day of inspection. The home issues regular Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: questionnaires to service users to gain their feedback on what meals they prefer. Service users are involved with the daily routines in the home, such as laundry, washing up and keeping bedrooms tidy. 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. It is the inspectors judgment that the home is able to meet the personal and health care needs of service users. Medications are administered and recorded as appropriate, and service users have access to relevant health care professionals. Evidence: All service users are able to manage their own personal care. Staff will however encourage service users to attend to personal care and dress appropriately. All service users are registered with a GP and dentist. Records are maintained of medical appointments, including details of any follow up action necessary. These records indicate that service users have access to health care professionals as appropriate, including psychiatrists and CPNs. The home seeks to support service users to live healthy lifestyles, for example through the use of exercise such as swimming and bike riding, and by providing a healthy diet, the AQAA states that the home is planning on incorporating more fresh produce in to meals. The home has a comprehensive medication policy in place, and all staff undertake Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: training before they are able to administer any medications. Records are stored in a locked cabinet inside the office. No service users currently self medicate, although the AQAA indicates that where it has been assessed as safe, the home would actively encourage service users to manage their own medication. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. Medication Administration Record charts were maintained, those examined by the inspector were accurate and up to date. 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. It is the inspectors judgment that the home has taken reasonable steps to help ensure service users are safeguarded from the risk of abuse. Staff have undertaken training in adult protection issues, and the home has an appropriate complaints procedure in place. Evidence: The home has a complaints procedure, which includes timescales for responding to any complaints received. Surveys completed by service users indicated that they have a good understanding of whom they could complain to if they so wished. The home maintains a complaints log, although the manager informed the inspector that no complaints have been received in the past year. The home has an adult protection procedure in place, and also a copy of the local authorities adult protection procedures. The inspector was pleased to note that since the previous inspection all staff have now undertaken training in adult protection issues. Staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection issues. The home holds money on behalf of service users in a locked cabinet inside the office. Records and receipts are maintained of financial transactions involving service users monies, those checked by the inspector were accurate and up to date. Care Homes for Adults (18-65 years) Page 19 of 29 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. It is the inspectors judgment that the home is suitable to meet its stated purpose with regard to the physical environment. The home was well maintained, and service users have access to adequate private and communal space. Evidence: The home is situated in the Walthamstow area of the London Borough of Waltham Forest. The home is in a quiet residential area, close to shops, transport links and other local amenities. The home is in keeping with other homes in the area, and was well maintained both internally and externally. The homes communal areas consist of a lounge, a dining area and a kitchen, and a rear garden. This is paved, but has a fish pool and various pot plants. Service users are free to move around communal areas. Furniture and fittings were well maintained and domestic in character, and the home is decorated to a good standard. All service users have their own bedrooms, these are ensuite with a toilet, shower and hand basin. Service users have been able to personalize their bedrooms to their own tastes, for example with their own possessions such as televisions. Bedding, curtains and carpets were well maintained and domestic in character. Bedrooms contained Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: adequate natural light and ventilation, and meet National Minimum Standards on size requirements. Bedrooms contained adequate furniture, including table, chair, chest of draws and a wardrobe. In addition to the ensuite facilities, the home has a communal bathroom/toilet and another toilet on its own. Bathroom and toilet facilities were clean, tidy and free from offensive odours. They had working locks fitted. The home has taken steps to help prevent the spread of infection. Laundry facilities were appropriate in scale for the home, and hand washing facilities were situated around the home. COSHH products are stored securely, and staff have access to protective clothing such as latex gloves. 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. It is the inspectors judgment that the home is staffed in sufficient numbers to meet the needs of service users, and that staff have a very good understanding of their roles and responsibilities. Evidence: The home provides 24-hour support, with the two proprietors providing an emergency on call back up system. There was a staffing rota on display, this accurately reflected the actual staffing situation on the day of inspection. During the course of the inspection, the home was able to provide a one to one staffing level to service users. Through observation and discussion there was evidence that staff have a very good understanding of their roles and responsibilities, and of the collective and individual needs of service users. Service users spoken to generally expressed satisfaction with the staff, and staff were seen to interact with service users in a respectful manner. Throughout the course of the inspection instances of positive interaction were witnessed, for example encouraging a service user to go swimming and supporting service users to get involved with the daily routines, such as sorting out the rubbish for recycling. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: As mentioned in this report staff have regular meetings, which provide the opportunity to discuss issues around service users, as well as any other issues. All staff are able to contribute to the agenda. Staff also receive regular supervision from the homes manager. The AQAA supplied by the home states that supervision offers Opportunities for staff to receive the feedback and support necessary for both the improvement of their current practice and the development of their professional objectives. Some of the staff team are working towards an NVQ in care, while others already have a relevant qualification. The manager provides training around mental health issues to staff, and other recent training has included first aid, food hygiene, adult protection and Breakaway. The AQAA supplied by the home indicates that the home has appropriate employment related policies in place, including on equal opportunities and recruitment and selection. The staff team in part reflects the cultural and age range of service users, thus helping to provide staff who can better relate to service users, and help to meet any needs around cultural equality and diversity issues. The inspector was pleased to note that service users have the opportunity of been involved in the recruitment and selection process for new staff. The inspector checked the staff employment files. These were found to contain proof of ID, along with employment references. However, for two staff employed at the home there was no CRB check or POVA FIRST check in place. The home was able to demonstrate that it had applied for CRB checks for these two staff, and that they were currently waiting for them. However, it is required that before staff can commence working in the home, the home must first obtain a CRB or POVA FIRST check to help ensure the suitability of the employee. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that this is a very well run and managed home. The manager has many years experience, and presents as having a strong commitment to the rights of service users. Health and safety is well managed, and appropriate quality assurance systems are in place. Evidence: The homes manager is a Registered Mental Nurse with over twenty five years experience, many of those in a managerial position. Staff and service users spoken to informed the inspector that they found the manager to be approachable and accessible, and staff were seen to interact with the manager in a relaxed manner on the day of inspection. One service user said I can always talk to the manager. The manager present has having an excellent understanding of the individual needs of service users, and a strong commitment to equalities and diversity, by ensuring that service users are indeed respected as individuals, and a commitment to supporting staff to maximize their potential. There was also evidence through surveys that the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: home has built up good relations with relevant health and social care professionals. The AQAA supplied by the home indicates that the home has all necessary policies and procedures in place as required by National Minimum Standards. Those checked by the inspector, including medication, adult protection and complaints were found to be of a satisfactory standard. Record keeping in the home was of a good standard, and staff and service users can access their records as appropriate. Staff supervision, staff and residents meetings and care plan reviews all contribute to the quality assurance process within the home. Surveys are also issued to service users and health and social care professionals to gain their feedback, completed surveys seen by the inspector contained generally very positive feedback, for example one CPN wrote The Grove provides a homely settled environment for X. Copies of previous inspection reports are available to view in the home. Fire extinguishers were situated around the home, and last serviced in June 2008. Fire exits were clear from obstruction on the day of inspection. Fire alarms are checked by staff on a weekly basis, and were last serviced in may 2008. The home tests fridge/freezer and hot water temperatures. The home has in date safety certificates for PAT testing, electrical installation and gas safety. The home has in date employers liability insurance cover in place. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes R 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 34 19 The registered person must 31/03/2007 ensure that all necessary employment checks are carried out on all staff, including CRB checks, in line with the Care Homes Regulations 2001. (Timescale 30/04/06 not met) 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 1 34 19 The registered person must 31/03/2009 ensure that all necessary employment checks are carried out on all staff, including CRB checks, in line with the care Homes Regulations 2001 To help ensure the suitability of employees. 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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