Care Home: Hambleton House

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What the care home does well On the day of inspection the home was notably clean, tidy and fresh throughout. The home`s cleaning programme is effective and we saw that staff work hard to maintain it. Most of the staff employed at Hambleton House have worked there for a long time. This has helped them to build up good relationships with the service users and provide them with some continuity. During the inspection the staff were warm, friendly and professional. They got on well with the service users, and shared jokes with them. All the service users we spoke to said they were happy with the care provided at Hambleton House. One told us, `Maureen and all the staff look after us and run baths for us every night.` We saw that routines vary for individual service users. This is good practice as it means the home isn`t being run on institutional lines. For example, during the evening some service users had baths, put on their night clothes, and then came down to watch television. Others were still up and dressed when the inspection ended and said they weren`t getting ready for bed until `much later`. All service users have their own programme of activities, depending on their needs and what they want to achieve. We talked to them about the sort of things they like to do. One service user has created a vegetable garden at the back of the home. He showed us what he`d been growing and said staff cook the vegetables for the service users to eat. Other service users told us about their attendance at day centres, voluntary and paid jobs, and college courses. What has improved since the last inspection? One of the communal bathrooms has been completely refurbished. A chair lift has been installed on the main staircase to make it easier for service users with limited mobility to get upstairs. As smoking is no longer allowed on the premises, a smoking shelter has been erected in the garden for the sole use of service users who choose to smoke. The games room has been redecorated and has had a new floor laid. The Manager has has attended courses on the Mental Capacity Act/Deprivation of Liberty Safeguards and Health Facilitation. What the care home could do better: Some of the information in the home`s Statement of Purpose/Service User Guide is no longer accurate and needs updating. Some care plans were not up to date and had not been regularly reviewed. Some risk assessments were vague and also in need to reviewing. Some service users are not satisfied with the food served, didn`t think they had enough choice, and said they would like the opportunity to prepare snacks. Comments included, `The food varies, it depends which staff are on`, `We get choices for meals but not for sandwiches`, and, `At present we can make tea or coffee but we can`t make snacks.` Service users` `accident and emergency grab sheets` were undated and unsigned so it was difficult to tell if the information was current or not. Other health care records were incomplete. The home`s safeguarding policy/procedure was not clear about social services` role in safeguarding investigations. The freezer in the annex has broken down and needs replacing/repairing. The microwave and toaster have been removed and service users and staff said they don`t know why and want them back. Some windows are in need of repair/replacement. A shower head holder in one of the bedroom en suites is broken and there is no hot water for the sink. Service users` requests made in the `Service User Satisfaction Questionnaire` do not appear to have been followed up. Areas which have scored `adequate` need addressing at management level and an action plan produced to show how this is to be done. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hambleton House 337 Scraptoft Lane Leicester Leicestershire LE5 2HU     The quality rating for this care home is:   one star adequate 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: Kim Cowley     Date: 0 9 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Hambleton House 337 Scraptoft Lane Leicester Leicestershire LE5 2HU 01162433806 Telephone number: Fax number: Email address: Provider web address: baz2104@hotmail.com Name of registered provider(s): Type of registration: Number of places registered: Baba Sawan Lodge Limited care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Hambleton House is registered to provide personal care and accommodation to both male and female service users in the following categories: Learning disability (LD) 15 Learning disability (LD(E)) 2 MD Mental disorder 18 - 65 years (MD) 3 The maximum number of service users to be accommodated in Hambleton House is 18 To be able to admit the named person of category LD(E) (over 65 years) named in variation application number V36850 dated 27th November 2006. To be able to admit the named person of category LD(E) named in the variation application number 53629 dated 22nd September 2003. To be able to admit the named person of category LD(E) named in the variation application number 57627 dated 15th October 2003. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 2 0 15 3 Brief description of the care home Hambleton House provides accomodation and care to eighteen younger adults who have either a learning disability or a mental disorder. It is situated on Scraptoft Lane in a residential area. It is close to a range of local amenities, including shops, pubs and sports facilities. There is regular bus service from Scraptoft Lane to Leicester City Centre. The home is on three floors. All communal areas and some bedrooms are situated on the ground floor, and the remaining bedrooms are on the first and second floors. At the back of the home is a terrrace and lawn. There is some car parking at the front. The fees are based on local authority rates. Further information about the home is available from the Registered Manager. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of we indicates the Care Quality Commission) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five hours, we checked the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three service users by meeting them, talking with the staff who support their care, checking records relating to their health and welfare, and viewing their personal accommodation as well as communal living areas. Care Homes for Adults (18-65 years) Page 6 of 31 Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to a further eight service users, the Manager, a senior carer and a carer. What the care home does well: What has improved since the last inspection? What they could do better: Some of the information in the homes Statement of Purpose/Service User Guide is no longer accurate and needs updating. Some care plans were not up to date and had not been regularly reviewed. Some risk assessments were vague and also in need to reviewing. Some service users are not satisfied with the food served, didnt think they had enough choice, and said they would like the opportunity to prepare snacks. Comments Care Homes for Adults (18-65 years) Page 8 of 31 included, The food varies, it depends which staff are on, We get choices for meals but not for sandwiches, and, At present we can make tea or coffee but we cant make snacks. Service users accident and emergency grab sheets were undated and unsigned so it was difficult to tell if the information was current or not. Other health care records were incomplete. The homes safeguarding policy/procedure was not clear about social services role in safeguarding investigations. The freezer in the annex has broken down and needs replacing/repairing. The microwave and toaster have been removed and service users and staff said they dont know why and want them back. Some windows are in need of repair/replacement. A shower head holder in one of the bedroom en suites is broken and there is no hot water for the sink. Service users requests made in the Service User Satisfaction Questionnaire do not appear to have been followed up. Areas which have scored adequate need addressing at management level and an action plan produced to show how this is to be done. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. People who want to come to the home have their needs assessed to ensure it is suitable for them. The homes Statement of Purpose/Service User Guide needs updating and improving. This judgement has been made using available evidence including a visit to this service. Standards 1 and 2 was inspected. Evidence: The home has a Statement of Purpose/Service User Guide which provides information about the home to potential service users and their representatives. Some of the information in this document is no longer accurate. For example, details of training undertaken by the Manager and staff is over two years old, and the homes regulatory body is now the Care Quality Commission (and not CSCI as stated on page 1). The Statement of Purpose must be improved to ensure it is accurate and up to date. The Service User Guide also needs improving. It should be written in a user-friendly Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: way to make it more accessible to the people it is intended for. Plain English and the use of pictures or photos would make it easier to understand. The home currently accommodates a varied group of service users, some have lived at the home for many years and others are relatively new. All new referrals have a full assessment of their needs carried out. Records showed that their views and those of their families/friends, and health/social care professionals are all taken into account when a potential service user is considering coming to the home. Visits to the home take place prior to someone moving in to ensure their needs can be met, and they are happy with their new accommodation. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Care plans and risk assessments have not been kept up to date. This judgement has been made using available evidence including a visit to this service. Standards 6, 7, and 9 were inspected. Evidence: All the people who live in the home have care plans that cover their health, personal and social needs, likes/dislikes, and preferred lifestyles. We looked at care plans belonging to the three case tracked service users. Although all had plans for the key aspects of their care, it was unclear when they were meant to be reviewed and updated. For example One service users had care plans dated 30.11.08, but there was no indication whether these had been reviewed or updated since then. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Another service users care plans were reviewed on 01.07.09, but prior to that they had been reviewed haphazardly with gaps of between one and four months between reviews. A third service users care plans had been regularly reviewed and updated up to April 2009, but then the process appears to have stopped. We then looked at risk assessments. One service users had five in place. Some of these were too vague to be of use, none were dated, and there was no indication when they should be reviewed. Another service users risk assessments were dated 24.07.06 and did not appear to have been reviewed since. To ensure service users care needs continue to be met regular reviews of their care plans/risk assessments must take place and it must be clear to service users and staff when this should happen. A system of review should be put in place to facilitate this process. One service user (identified at the inspection) has a health care issue that is connected to their mental health. A care plan must be put in place for this so staff are clear what to do if this issue arises. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Service users have access to recreational, educational, and vocational activities. Service users are not satisfied with the meals and would like more choice. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16, and 17 were inspected. Evidence: All service users have their own programme of recreational, educational, and vocational activities, depending on their needs and what they want to achieve. We talked to them about the sort of things they like to do. One service user has created a vegetable garden at the back of the home. He showed us what hed been growing and said staff cook the vegetables for the service users to eat. Other service users told us about their attendance at day centres, voluntary and paid jobs, and college courses. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: We looked at the records of the service users we case tracked to see what activities they took part in. These included shopping, walks, meals out, trips to the pub, and visits home. The home caters for service users from different faiths and social backgrounds. Those who wish to are supported to attend their preferred places of worship and to take part in community festivities. Visitors are welcome at the home at any time and can meet with service users in their own rooms or in communal areas. If requested, staff will accompany service users when they visit friends and relatives in the community. We discussed the food served in the home. One service user told us, The foods nice, its lovely. Another said We had sausage casserole tonight. I enjoyed that. However, some of the service users we talked to were dissatisfied with the arrangements for meals and snacks in the home. Comments included If were hungry we cant go and make anything. At present we can make tea or coffee but we cant make snacks. I keep asking for faggots but weve only had them twice in two years. Id like a fry up. The food varies, it depends which staff are on. They put crab paste in the sandwiches but they know I dont like crab paste. They choose the sandwiches, they dont ask us. We get choices for meals but not for sandwiches. We dont often have cheese sandwiches, wed like them more. They ask us what we want for meals and we tell them and they say no because its too expensive. Id like lamb chops but we never have them. We were also told that milk constantly runs out, and that one member of staff had been seen watering it down to make it go further. While it is understood that no home can offer an unlimited supply of food and drinks, action must be taken to address service users concerns. They are expected to have a choice at every meal, be able to make occasional snacks (with staff support if necessary), and have enough milk for their breakfast cereals and a reasonable amount of hot drinks. This situation must be addressed, in consultation with service users, with a view to finding an acceptable solution. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Service users have their personal and health care needs met in the way they want by staff in the home. Some healthcare records need updating. This judgement has been made using available evidence including a visit to this service. Standards 18, 19 and 20 were inspected. Evidence: All the service users we spoke to said they were happy with the care provided at Hambleton House. One told us, Maureen and all the staff look after us and run baths for us every night. We saw that routines vary for individual service users. This is good practice as it means the home isnt being run on institutional lines. For example, during the evening some had baths, put their night clothes, and then came down to watch television. Others were still up and dressed when the inspection ended and said they werent getting ready for bed until much later. Records showed that service users have medical attention when necessary and regular health checks and appointments with GPs, consultants, chiropodists, opticians, etc. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: All service users have accident and emergency grab sheets which are used if they are admitted to hospital. However some of these are undated and unsigned so it is difficult to tell if the information is current or not. They must be audited, updated where necessary, and signed/dated to ensure they are accurate. Some service users are weighed monthly but records were incomplete and it was not always clear why they were being weighed in the first place. For example, did they ask to be weighed, or was their a medical reason why it was being done? This needs to be determined and appropriate records kept where necessary. We inspected medication records and storage facilities. Both were well organised and tidy. Most records are double signed which is good practice as it helps to prevent mistakes being made. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Service users are willing to speak out if they have any concerns. The homes safeguarding policy/procedure needs updating. This judgement has been made using available evidence including a visit to this service. Standards 22 and 23 were inspected. Evidence: All the service users said they would speak out if there was anything in the home they were unhappy with. One told us, If theres something wrong I tell the staff or Maureen the Manager. The homes complaints procedure is in the Statement of Purpose/Service User Guide. No complaints have been made to the CQC since the last inspection. At the last key inspection we asked for the homes safeguarding policy/procedure to be made clearer and more straightforward so staff could follow it easily. Although some changes have been made, the document is still confusing. Staff need to be clear that social services are the lead agency in any safeguarding investigation, and they need to be involved from the start. The safeguarding policy/procedure must be rewritten to reflect this. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: During the inspection we discussed safeguarding with the person in charge. She was knowledgeable about the signs to look for and said she would inform the Manager immediately if she had any concerns about a service users well being. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. The home is community-based, comfortable, and clean. Some repairs are needs to parts of the premises. This judgement has been made using available evidence including a visit to this service. Standards 24 and 30 were inspected. Evidence: The home is separated into two units. Ten service users can be accommodated in the main part of the home, and eight in the adjoining annex. Both units have their own kitchens, lounges and dining areas. At the rear of the home is a secluded garden with a terrace and lawn. On the day of inspection the home was notably clean, tidy and fresh throughout. The homes cleaning programme is effective and we saw that staff work hard to maintain it. Since the last inspection the following improvements have been made to the home One of the communal bathrooms has been completely refurbished. A chair lift has Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: been installed on the main staircase to make it easier for service users with limited mobility to get upstairs. As smoking is no longer allowed on the premises, a smoking shelter has been erected in the garden for the sole use of service users who choose to smoke. The games room has been redecorated and has had a new floor laid. However further improvements are needed. The freezer in the annex has broken down and needs replacing/repairing. Service users and staff said this was inconvenient as it meant they had to keep going to the main part of the home for supplies. In addition, the microwave and toaster in the annex have been removed, although the service users and staff were unclear why. These must be replaced so service users and staff have the equipment they need to prepare meals and snacks. With their occupants permission, we looked at three bedrooms. Although two were in good order, one had windows that were in a poor state in that they didnt close properly and the frames were cracked and appeared rotten in place. These must be repaired or replaced, along with any other windows in a similar state. In addition the shower head holder was broken and held together with an elastic band, and the wash basin tap only produced cold water. These issues must also be addressed. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is good. Friendly and professional staff meets service users needs. This judgement has been made using available evidence including a visit to the service. Standards 32, 34 and 35 were inspected. Evidence: Most of the staff employed at Hambleton House have worked there for a long time. This has helped them to build up good relationships with the service users and provide them with some continuity. Agency staff are not used at present as they are not necessary due to the home being fully staffed. During the inspection we saw the staff were warm, friendly and professional. They got on well with the service users, and shared jokes with them. We talked to one senior member of staff and, briefly, to two carers. All were happy working at the home and knowledgeable about the needs of the service users who live there. The Manager and Owners have confirmed that the homes recruitment policy ensures all staff are CRB/POVA checked, and references obtained prior to employment. A member of staff told us they had not been able to start work until these checks were Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: carried out. This will help to ensure service users are safeguarded. The home has been awarded Investors in People status. All staff have access to training and regular supervisions. Records showed that a wide range of courses are offered including NVQs (National Vocational Qualifications). This will help to ensure the staff have the skills and knowledge they need to provide a good standard of care. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. Areas of the home that have scored adequate must be addressed at management level and an action plan produced. Service users requests must be followed up. This judgement has been made using available evidence including a visit to this service. Standards 37, 39, and 42 were inspected. Evidence: The Manager has been employed at the home fro a number of years and knows the service users and staff well. She is qualified to NVQ (National Vocational Qualification) Level 4 and has her RMA (Registered Managers Award). These are recognised qualifications for people who run care homes. Since the last inspection she has attended courses on the Mental Capacity Act/Deprivation of Liberty Safeguards and Health Facilitation. Although many of the outcomes at the home are good, areas which have scored adequate need addressing at management level. These include care planning/review, Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: and the homes documentation. An action plan must be produced to show how this is going to be acheived. In May 2009 a Service User Satisfaction Survey was carried out. We looked at the results and saw that most respondents classed the home as good or excellent in most areas. There were very few fairs and no poors. However some service users made requests in their surveys, for example, for day trips, a meal out once a week, and egg and chips once a week. It is unclear how, if at all, these were followed up. To ensure service users have a say in how the home is run, and are able to make choices, these requests must be followed up. Systems are in place to help ensure the health and safety of service users, staff and visitors is protected and promoted. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 1 6 The Statement of Purpose/Service User Guide must be kept up to date. To ensure accurate information about the home is available to interested parties. 09/09/2009 2 6 15 Care plans must be put in place for all service users needs. To ensure all needs are met. 09/09/2009 3 6 15 Care plans (including risk assessments) must be kept under review. To ensure service users needs continue to be met. 09/09/2009 4 17 16 The home must provide service users with a varied diet and facilities to prepare their own food. 09/09/2009 Care Homes for Adults (18-65 years) Page 28 of 31 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 To help ensure service users enjoy their meals and can make drinks and snacks. 5 19 13 Service users medical details must be kept up to date. To help ensure health professionals have the information they need if a service user is admitted to hospital. 6 19 13 If service users have to be weighed regularly then appropriate records must be kept. To help ensure records are meaningful. 7 23 13 The homes safeguarding policy/procedure must be re-written to make clear the role of social services in any investigation. To ensure staff know who to contact if there are concerns about a service users wellbeing. 8 24 23 The repairs and/or replacements identified in this inspection report must be carried out. 09/09/2009 09/09/2009 09/09/2009 09/09/2009 Care Homes for Adults (18-65 years) Page 29 of 31 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 To help ensure the home is kept in a good state of repair. 9 37 24A An improvement plan must be produced to show how the registered persons intend to improve the service. To ensure the home provides a good service for the people accommodated there. 10 39 12 Service users requests must 09/09/2009 be followed up. To ensure they have a say in how the home is run. 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 09/08/2009 1 1 The Service User Guide should be written in a user-friendly way to make it more accessible to the people it is intended for. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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