Care Home: Harbour House

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What the care home does well Each person has a plan of support which contains information about them to help keep them well.The people living in the home and their families are supported very well to keep in touch with each other.People can arrange their bedrooms the way they like.The service also provides a day centre and a gardening project that people can go to which they said they enjoy. One of the people has one to one activities organised each day so that he can do what he wants which he said he really likes.People are helped to stay in good physical health and are supported to keep well if they have a medical condition that needs treatment.Medication is kept safely and the procedures are straight forward.Staff are supported to study for national vocational training to develop their skills and understanding for their job. What has improved since the last inspection? A member of staff has been employed so that people can have one to one time.Staff training has continued.People have been referred to specialists like the psychologist and speech and language therapist.One person regularly sees the speech and language therapist.People are helped to use the bus when going out and pay for themselves. What the care home could do better: People do not have access to essential written information about the service and about their rights and responsibilities. People do not have person centred plans.There are no risk assessments for people to develop their independence skills.We found some information about paying to use the home`s minibus but it was unclear who paid for what as there were no records.There is no complaints procedure.There is no fire risk assessment and record of checks.We could not find a training plan. We did see that staff have training as we saw certificates but we do not know how much everyone has and if it is up to date.The registered manager is not in day to day charge of the service.Management systems are not always identifying and sorting out problems with the running of the home.There is no development plan which tells us what improvements are planned. Key inspection report Care homes for adults (18-65 years) Name: Address: Harbour House 6 Margaret Street Folkestone Kent CT20 1LT 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: Julie Sumner Date: 0 9 0 4 2 0 1 0 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 38 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 38 Information about the care home Name of care home: Address: Harbour House 6 Margaret Street Folkestone Kent CT20 1LT 01303211180 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Tina Dennison care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Harbour House is a small Home in Folkestone near the beach and town. Three people with learning disabilities live there. It is on four levels and there are stairs inside and outside so it would not be a good home for people who need to use a wheelchair. Care Homes for Adults (18-65 years) Page 5 of 38 Each person has their own bedroom. There is a small, comfortable lounge and a separate dining room and kitchen. The home has two bathrooms, one of which contains the washing machine. There is a small enclosed garden to the rear of the property. Care Homes for Adults (18-65 years) Page 6 of 38 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 7 of 38 How we did our inspection: This is what the inspector did when they were at the care home The manager sent us a written assessment which tells us about the home and what is provided. We visited the home without telling anyone we were coming so that we could see what they do on a usual day. We were in the home from around 8 oclock in the morning and left at 11:45. We then went over to Anchorage House because this is where most of the paper work for the home is. We were Care Homes for Adults (18-65 years) Page 8 of 38 there until 1 oclock. We talked to all the people living in the home. We talked to the staff in the home. We talked to the senior staff member over at Anchorage House. We looked at plans and records for supporting the people living in the home. Care Homes for Adults (18-65 years) Page 9 of 38 We also looked at staff records like what checks have been made before they started work and training they have been given. We looked at some of the policies and procedures with the other inspector who was at Anchorage House. What the care home does well Each person has a plan of support which contains information about them to help keep them well. Care Homes for Adults (18-65 years) Page 10 of 38 The people living in the home and their families are supported very well to keep in touch with each other. People can arrange their bedrooms the way they like. The service also provides a day centre and a gardening project that people can go to which they said they enjoy. One of the people has one to one activities organised each day so that he can do what he wants which he said he really likes. Care Homes for Adults (18-65 years) Page 11 of 38 People are helped to stay in good physical health and are supported to keep well if they have a medical condition that needs treatment. Medication is kept safely and the procedures are straight forward. Staff are supported to study for national vocational training to develop their skills and understanding for their job. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 12 of 38 A member of staff has been employed so that people can have one to one time. Staff training has continued. People have been referred to specialists like the psychologist and speech and language therapist. One person regularly sees the speech and language therapist. People are helped to use the bus when going out and pay for themselves. Care Homes for Adults (18-65 years) Page 13 of 38 What the care home could do better People do not have access to essential written information about the service and about their rights and responsibilities. People do not have person centred plans. There are no risk assessments for people to develop their independence skills. We found some information about paying to use the homes minibus but it was unclear who paid for what as there were no records. Care Homes for Adults (18-65 years) Page 14 of 38 There is no complaints procedure. There is no fire risk assessment and record of checks. We could not find a training plan. We did see that staff have training as we saw certificates but we do not know how much everyone has and if it is up to date. The registered manager is not in day to day charge of the service. Care Homes for Adults (18-65 years) Page 15 of 38 Management systems are not always identifying and sorting out problems with the running of the home. There is no development plan which tells us what improvements are planned. 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 Julie Sumner CQC South East, Citygate, Care Homes for Adults (18-65 years) Page 16 of 38 Gallowgate, Newcastle upon Tyne, NE1 4PA Telephone: 03000 616161 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 17 of 38 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 18 of 38 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. Each person has their needs assessed prior to moving into the home. The information about the services offered in the home is unclear. Evidence: No one has moved into the home since the last key inspection. The information that is needed to tell people about the home, like a brochure, a statement of purpose and service user guide was not freely available. However, we did find the statement of purpose in a locked cupboard in the home where some of the paperwork is kept. We looked at this document. There was some information about the service provided which included the fees and what they paid for. There were no dates on the statement of purpose so we could not tell how up to date it was. There is a requirement at the end of this report about this. Each person has an assessment before moving in and these are updated as part of the plan of support. We looked at 2 of these. We also saw care plans written by care managers that form the basis of the guidelines in the support plan. Care Homes for Adults (18-65 years) Page 19 of 38 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. The people living in the home would benefit from person centred planning and to be supported to develop their skills and make decisions about their lifestyle. Evidence: Each person has a support plan that is contained in an individual file. These were locked in a cupboard in the lounge. We looked through one of them in detail and another at specific parts. They contained detailed information in a management style. The information was clear and gave a good picture of the persons needs. Goals had been set for each person. We read some of the guidelines but found that they did not give staff sufficient information to support individuals consistently. There were no person centred plans. However, there some information in one of the plans from visiting professionals recommending designing a person centred plan but there was no evidence that this recommendation had been acted on. We talked to the people living in the home about their lifestyle and how they are supported. They felt things were ok. One person said they did not like the home. We did Care Homes for Adults (18-65 years) Page 20 of 38 Evidence: not see any evidence of how people are supported to make decisions about their life. There was some support for day to day choices although these were limited. We saw people being asked if they would like a coffee and then were in the kitchen while drinks were being made. We looked at risk assessments in the support plan folder. These were largely behavioural identifying the possible behaviour and giving comments for how to respond. We did not see any risk assessments regarding developing independent living skills in the home or outside. We have made a requirement for this. We asked the staff how the people living in the home were supported with their money. She said that they have a small amount of money which they keep in their purses/wallets. When they go out and spend money they give the staff the receipts which they hand to the senior staff at number 12. They said this is where the finance records are kept. They said that the people living in the home like to pay for things themselves like bus fare when they go out and this is supported. We saw in the statement of purpose that the people living in the home contribute towards fuel costs of the homes minibus. There was no written account of the current arrangements for this. Therefore, we cannot be sure that any payments made by people who live in the Service are appropriate. We have made a requirement to have this information available. The staff use a communication book to pass messages between shifts. This book also contains personal information about the people living in the home and is a breach of their confidentiality. We found comments in the books and some verbal comments disrespectful to the people living in the home. Care Homes for Adults (18-65 years) Page 21 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live a reasonably active lifestyle and are supported to keep contact with their family and friends. Evidence: All the people living in the home were able to speak and talked a little about their lifestyle. One person was about to go to the day centre. The others said they were doing something later but were not sure what it was. We looked at the activity records in the home. The records showed that people do different activities most days. These included attending the social education centre, going shopping, drive through to Ramsgate and visit parents, walk in town and life skills. People also talked about the gardening project and one person talked about going away. Another said they particularly like the woodwork sessions. One person has some one-toone time with a member of staff who is employed for four hours a week. He said he enjoyed going out with her. Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: Each person has contact details of their families in their support plan folder. The records showed that a persons mum visited the previous evening and another person talked about their family and said they keep in contact. Staff said they visit and also keep in contact by phone. There are restrictions in the home due to one of the peoples behaviour. The bathroom door is locked and the kitchen is, when no one is downstairs. It was also recorded that the people had no road safety awareness and therefore the front door needs to be kept locked. The restrictions in the home need to be recorded in a risk assessment. The manager needs to make sure that restrictions are kept under review and that all the people are not being restricted due to one persons behaviour. The people seemed happy with the meals and refreshments were available when they asked the staff. The records showed people being involved with the shopping. Some activities indicated that they helped cook a meal once in a while but this was not a routine occurrence. One of the people said they did not like cooking. Records of what people had eaten during the day were kept in their individual diary book. Care Homes for Adults (18-65 years) Page 23 of 38 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. People are helped to stay well. There are safe systems to manage medication. Evidence: The people living in the home are fairly independent with their personal care needing verbal prompting and supervision. Each persons medical and health information is kept in their support plan folder. There was an extensive range of information to support individuals with their health needs. One person has a medical condition that needs to be monitored and we could see that they attend appointments and were supported by a specialist team and a specialist consultant. The staff keep records and there were clear and detailed guidelines provided by the specialist team for them to follow. Other professionals including those from the community learning disability team are involved. We saw assessments, reviews and referrals from them in the individual folders. One of the people attends weekly appointments with the speech and language therapist and there are recommendations in their folder. One of the recommendations was to use Makaton when talking to the person. We did not see any Makaton being used in the home. Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: We did not see any health action plans and there was no information that was presented in an accessible way for the people living in the home. Medication is given using a monitored dosage system. The member of staff popped the tablet out of the blister pack and gave it to the person living in the home. She said that none of the people living in the home administer their own medication. The newer member of staff said that staff from number 12 give the medication when she is working in the home as she has not completed her training yet. Medication is locked in a medication cupboard fixed to the wall. There is a medication administration procedure and staff completed the administration record when they had given the medication to the person. Staff said senior staff check the medication. Care Homes for Adults (18-65 years) Page 25 of 38 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. People are not supported to make complaints. The people in the home and the staff can not be confident that they are protected by the homes policies and procedures. Evidence: The Assessment said there is a formal complaints procedure in place and all policies are adhered to. It also stated that there had been no complaints. We could not see a complaints procedure in the home. There was no complaints log or records in the home. We saw an entry in the communication book referring to a complaint made by a neighbour about washing machine noise at night. We would usually expect to see this recorded in a complaints log with how they had responded to the complainant and whether they were satisfied with the response. A requirement has been made to have a suitable complaints system and method of recording. Meetings for the people living in the home to express their views are not held formally in the home. The member of staff thought they may have meetings in number 12 and that they would be invited. Some of the people living in the home need support with their mental health needs and they also need support to manage destructive or aggressive behaviour. We looked at risk assessments in the support plan files which identified some of the behaviour and guidelines for how staff are to respond. The language used indicated a controlling approach to behaviour. There were references to stopping someone and making someone do something as a consequence. Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: If there has been an incident of behaviour the staff complete an incident record. We read some of the recent reports. We later discussed the incidents with a member of staff who was involved. The staff said that there is no definite way to respond to the behaviour because one way does not work so they try different things. There was insufficient management response to these incidents, they were not sufficiently risk assessed and the staff were not sufficiently supported. Staff said they had attended training in safeguarding. When we talked to them about possible situations they sounded confident. The staff were not aware of a safeguarding procedure in the home but did say they would report it to the senior staff and would take it outside if necessary. Care Homes for Adults (18-65 years) Page 27 of 38 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their own space. Most of the home is presented to a normal domestic standard but there are areas that are worn and damaged. Evidence: One of the people showed us around parts of the house. He showed us his bedroom which was personalised with his favourite things. His room is lockable and he has a key for it. The home looked damaged and worn in places. There were holes in the walls, some of which had been partly repaired. The staff said that one of the bedrooms had reinforced wall due to the persons behaviour. The person showing us around explained that the bathroom is kept locked because one of the other people damages it if it is left open. The bathroom was bare of toiletries towels or homely features. He also explained that the toilet is regularly flooded by the person and he mops it up. The toilet on the landing was not locked. The lino floor covering in the toilet was torn, the floor was sticky, there was no light bulb which the person said he had told the staff needs replacing. The home looked in need of decorating. The kitchen was in good repair. Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: The people living in the home do not routinely do any housework or laundry. We saw some of the records that indicated that the staff do most of the household chores and there was no evidence that these are done with the people living in the home. There was a notice board in the hallway which had a small fire notice and some copies of a health and safety collaboration and public liability insurance certificate. The homes registration certificate was also on the wall. We could not find a fire risk assessment, fire log book or anything that would tell us that the home was checked to make sure it was protected from fire. A requirement has been made for this. Infection control training is provided to the staff and the certificates we saw confirmed this. The laundry facilities are domestic and suitable for the needs of the home. Care Homes for Adults (18-65 years) Page 29 of 38 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are inadequately supported to meet the assessed needs of each of the people living in the home. Evidence: There was one member of staff in the home when we arrived. She explained that she had worked the night shift and that another member of staff would come in at 9 oclock and then she would go home. We talked to both staff during the inspection. We looked at the duty rota. This included all the staff who work in both Anchorage House and Harbour House, as they work as one team, and we later found that this also included support given to 2 Margaret Street. It was difficult to see if there were enough staff to support the needs of the people in the home. The staff said that staff from 12 Margaret Street (Anchorage House) come over and give them support if they need it and they can also go out with them. Some of the people living in the home go over to Anchorage House but one of the people does not like to. One person receives 4 hours one-to-one support and a member of staff is employed specifically to do this. The person said that he enjoys this time and does different things, usually going out. Both staff we spoke to were quite new, one staff had worked in the home for 3 months and the other for 3 weeks. Both said they had induction training and had carried out the Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: training required for law for health and safety. We looked at 2 staff files over at Anchorage House (where they are kept). We could see that the registered manager requests the necessary safety checks like the Independent Safeguarding Authority First check, a criminal records bureau check and obtains references. We could not find actual employment start dates on the files we looked at and some of the terms and conditions of employment were incomplete and not dated. We could not find information about the recruitment process in the files. We could not find evidence of how the registered manager had assessed the suitability of staff to make the decision to employ them. The people living in the home are not involved in choosing new staff to work with them. They are also unclear who is going to work in the home at different times in the day. We could see induction training had been carried out but was not using the Skills for Care common induction standards. The induction training checklist covered basic areas only and was not adequate. The staff are provided with a range of training. The staff in Harbour House said they received training in management of epilepsy but there was no record of this. We saw some training certificates in the staff files. An overall training plan was not available for us to see what training was being provided to the team and whether health and safety training was up to date. A requirement has been made for this. Care Homes for Adults (18-65 years) Page 31 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Provider is not in day to day charge of the Service. There are shortfalls in parts of the quality assurance system. There are shortfalls in the health and safety and fire safety arrangements. Evidence: The registered provider is also the manager of the service. This means that she is responsible for directly supervising its day to day operation. She was not at the home when we visited. There is also a deputy manager but it was his day off. The registered manager states in the Assessment that Harbour House is run under the same management as Anchorage House and the staff work in both houses. She also states that there is always a senior member of staff on duty at all times. There was a senior member of staff at Anchorage House but not at Harbour House when we visited. The member of staff said to us that there is always back up if we need it. She said that they telephone number 12 if they need advice or support. We talked one of the people living in the home about what would happen if they had a fire. He spoke confidently and showed us the fire extinguishers and the fire exit and told Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: us what he would do. There was a small emergency fire notice on the notice board in the hall way. We found a basic fire procedure in the statement of purpose folder which was kept in the locked cupboard. We could not find a fire risk assessment or log and there were no records of staff fire drills or staff training in the home. There was no one in the home who was able to give us the information we needed, for this outcome area, to find out if the home was being managed safely and in the best interests of the people who live there. Some documentation was kept in a locked cupboard in the lounge but the member of staff said that she thought all the home administration records were kept in the office at Anchorage House. We therefore completed our visit at Harbour House and went to Anchorage House to continue. For further information about our evidence for these standards please see the key inspection report for Anchorage House which was carried out on the same day. Care Homes for Adults (18-65 years) Page 33 of 38 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 Care Homes for Adults (18-65 years) Page 34 of 38 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 1 17 The Registered Provider must 26/04/2010 ensure that there is a suitably detailed Statement of Purpose and Service Users Guide that are reviewed and up to date. To ensure that there is sufficient written information about the facilities and services provided. 2 7 17 The Registered Provider must 03/05/2010 ensure that there are appropriate arrangements for funding the use of the people carrier vehicle. To ensure that people are consulted about and agreed to any financial contributions they make. 3 9 15 The registered provider must 26/04/2010 write risk assessments with clear guidelines for staff to Page 35 of 38 Care Homes for Adults (18-65 years) 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 follow for activities that develop individuals independent living skills safely. To make sure that the people living in the home are supported in a consistent and effective manner to develop their independent living skills safely. 4 22 17 The Registered Provider must 03/05/2010 ensure that there is a suitable system for receiving and resolving complaints. To ensure that stakeholders can be confident that any concerns they have will be addressed. 5 24 23 The Registered Provider must 26/04/2010 consult with the Kent Fire and Rescue Service about the steps that need to be taken to ensure that a suitable fire safety regime is operated in the Service. To ensure that people who live in the Service and members of staff enjoy an adequate level of fire safety protection. 6 35 18 The Registered Provider must 01/06/2010 ensure that there is an organised system for making Page 36 of 38 Care Homes for Adults (18-65 years) 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 sure that all support workers have the skills and knowledge they need. To ensure that people reliably receive support in ways that are right for them. 7 37 8 The Registered Provider must 19/04/2010 be in day to day charge of the Service. To ensure that the Service is appropriately managed. 8 42 5 The Registered Provider must 03/05/2010 ensure that the electrical wiring installation is inspected in line with the requirements of the local Department of Environmental Health. To ensure that the installation is in a safeworthy condition. 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 37 of 38 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. 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