Care Home: Heathcotes (Arnold)

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What the care home does well Care plans are organised and are very person centred. People living in the home get to write information their own care plans.People living in the home have lots of things to do and are helped to go to work and to go on trips. They get involved with planning the menu and shopping and cooking meals. People living in the home told us that they got to make lots of decisions about what they did each day. One person living in the home said, "I get up in the morning and I know I can decide what I will do for the day and staff will help me". What has improved since the last inspection? This is the first inspection at the home as it did not open until July 2009 and people have only just moved in. What the care home could do better: Medicine procedures could be better but the manager is already addressing this.People living in the home could be involved in recruiting staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Heathcotes (Arnold) Redhill Farm Bestwood Lodge Drive Arnold Nottingham Notts NG5 8NE The quality rating for this care home is: two star good 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: Lynda Dyer Date: 0 6 0 1 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 33 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2010) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Heathcotes (Arnold) Redhill Farm Bestwood Lodge Drive Arnold Nottingham Notts NG5 8NE 01159679619 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.heathcotes.net Cotes developments LLP Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 7 Number of places (if applicable): Under 65 Over 65 7 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category/ies 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 category/ies, Learning Disability - Code LD. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 33 A bit about the care home Heathcotes (Arnold) Redhill Farm is a detached family home with views looking out over fields and wooded areas. The home is in Arnold, Nottingham and is close to shops and bus routes. Heathcotes has seven single bedrooms and five of them have their own toilet. There are two lounges and a dining room for people to use. Care Homes for Adults (18-65 years) Page 5 of 33 There are bathrooms and a large wet room with a shower that people with mobility problems can use There is a secure garden with a patio and a grassed area. It costs between £1600 and £2255 per week to live in the home. Care Homes for Adults (18-65 years) Page 6 of 33 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 33 How we did our inspection: This is what the inspector did when they were at the care home The manager and the regional manager were there when we visited and they were very helpful and friendly. We also asked the manager to fill out a form for us. We call this an Annual Quality Assurance Assessment (AQAA). We sent out a survey to people that live in the home, staff that work there and people that visit. 10 people filled in the surveys and sent them back to us. Care Homes for Adults (18-65 years) Page 8 of 33 We looked at the care plans of two people who live in the home. We looked at records that were kept in the home, which included staff records and health and safety records. We spoke with four people living in the home and we also spoke with three staff that work in the home. All of this helped us to plan what we needed to look at when we inspected the home. Care Homes for Adults (18-65 years) Page 9 of 33 What the care home does well Care plans are organised and are very person centred. People living in the home get to write information their own care plans. People living in the home have lots of things to do and are helped to go to work and to go on trips. They get involved with planning the menu and shopping and cooking meals. People living in the home told us that they got to make lots of decisions about what they did each day. One person living in the home said, I get up in the morning and I know I can decide what I will do for the day and staff will help me. Care Homes for Adults (18-65 years) Page 10 of 33 What has got better from the last inspection What the care home could do better Medicine procedures could be better but the manager is already addressing this. People living in the home could be involved in recruiting staff. Care Homes for Adults (18-65 years) Page 11 of 33 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 Lynda Dyer East Midlands CQC Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 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 12 of 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 13 of 33 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. People’s needs are properly assessed before admission to ensure that peoples needs can be met in the home. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that comprehensive assessments are carried out before a new service user moves into the home and that the manager visits the service user within their home, school, day centre and college settings if possible, collecting assessments from other professionals involved. We spoke with two people living in the home and they told us that they had received enough information about the home and had a chance to visit before they decided to move in. We spoke with staff and they told us that they received a great deal of knowledge about people before they were admitted to the home so that they knew how to support them. We viewed the care plans of two people living in the home and they both contained evidence that a full needs assessment had been carried out prior to them moving into the Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: home. Care Homes for Adults (18-65 years) Page 15 of 33 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. Staff members have a good understanding of peoples needs, and care records show how people are supported to live, as they would like. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that support plans cover all aspects of support in relation to mental, physical and social needs. They told us that support plans are audited weekly and reviewed monthly and that people living in the home are encouraged to take part in their care plan review. They also told us that people living in the home are supported to make decisions about their lives and staff use various aides to support them in decision making, including Makaton, pictures and objects of reference. We looked at the care plans of two people living in the home and we discussed the plans with them individually. The plans were very person centred and held information that was important to the person it was written for such as how they keep safe, their goals and aspirations, their skills and abilities, and how they make choices in their life. The Mental Capacity Act had been implemented into the care plans with assessments being Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: completed to ensure the home was acting in the best interest of the people living there. The care plan held lots of evidence to show that the individual was involved in putting the plan together and reviewing it with the staff. One person living in the home said, I ask staff for my care plan and I sit and go through it and make changes with the support of the staff. Lots of the information in the care plans were in an easy read format to enable people living in the home to understand them better. Formal reviews of the care plans are held and this is completed by the person living in the home inviting the people they wish to be involved in the review and then chairing the meeting so that they have extensive input into the review. People living in the home told us that they got to make lots of decisions about what they did each day. When we asked one person living in the home what the best thing about living there was, they said I get up in the morning and I know I can decide what I will do for the day and staff will help me. We spoke with staff and they told us that the home supported people to be as independent as they could and offered support when needed. Where this involved the people living in the home taking risks, a full risk assessment and action for staff to manage the risk was in place. We asked staff what the service did well and three said, Supports independent living. We saw lots of positive interaction between staff and people living in the home with support being given to people living in the home to make their own decisions. Care Homes for Adults (18-65 years) Page 17 of 33 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. People living in the home are actively encouraged to develop and maintain social, emotional, educational and independent living skills. People are supported to make informed choices and maintain family and personal relationships. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that comprehensive risk assessments are carried out and address the risk to the service user and to others. There is active staff involvement in support planning and risk assessing and staff refer to these for information on how to respond to service user needs. They also told us that service users are given the opportunity to access activities of their own choice and are encouraged to get involved in community based activities to encourage inclusion into the local community and promote a sense of belonging. Care plans that we viewed showed evidence of people living in the home being supported to be independent and involved in all areas of daily living in the home, including where appropriate, taking responsibility for shopping, planning meals and meal preparation. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: The plans also showed evidence of people being supported to access external educational and work based opportunities and being involved in activities, trips and attending social events in the community. The two people that we case tracked had an active social life and their care plan contained evidence of their hopes and goals for the future and how staff were supporting them to fulfill these goals. We spoke to these two people living in the home and they told us how they were working toward their goals for the future. The manager told us that rather than all of the service users going on holiday together, each person living in the home gets an allocated sum of money and they choose where they would like to go for their annual holiday. One person living in the home had already been on their chosen holiday despite only being in the home for two months. The home looks out over a country park and on the day of the inspection both people that we case tracked went over to the park to take photographs of the snow as their usual activities for the day had been cancelled due to bad weather. A member of staff told us, There are lots of activities for the service users and another said, There is always something going on here for service users to get involved in. When we asked staff what the service could do better they said, “Have a co-coordinator for events. People living in the home were observed having their choices around food and when and where to eat it respected. The people living in the home have a meeting each week and they plan the menu for the following week. The menu was viewed and although it contained some areas of nutrition there was no evidence that people were being supported to get their five a day. We discussed this with the manager and they told us that they had booked a community nutritionist who was going to come to the home and deliver training to the staff and to the people living in the home. Once the training was complete the nutritionist was going to help the people living in the home to produce menus which would be healthy and well balanced. Care Homes for Adults (18-65 years) Page 19 of 33 Personal and health care 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 living in the home have their health care needs met and they receive personal support in the way that they prefer. Medication procedures are generally safe. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that service users receive personal care in the way that they prefer and their health and medication needs are met. Capacity assessments are also completed around personal and health care to ensure that service users are given appropriate support in these areas. They also said that each service user is registered with a local GP and see a dentist at least bi-annually, an optician annually with chiropody and community nurse referrals being sought for those service users who need it. The manager told us that Heathcotes employs the services of a consultant psychiatrist who visits the home regularly to conduct clinics and give appropriate feedback. We received surveys from members of staff and they said that they had been given training that gave them enough knowledge about people’s health care and medication. We asked staff what the home did well and one said, Always meets the needs of the service users. Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: We saw records of external health care appointments and routine health and well person checks that had been arranged. We viewed the care plans of two people living in the home and they showed how they liked to spend their days and how much support they needed with their care. The plans also gave information on their health care needs. We looked at the homes medication procedures and found that the medication was being administered to people as prescribed and we saw evidence that staff were trained in the safe administration of medication. We found the medicines trolley to be disorganised with medicines hard to find. Although generally staff were gaining a witness signature for handwritten entries and dating bottles when they were opened, there were occasions when staff had failed to follow these procedures. The home does not have the required storage facilities in place for controlled medicines, although they do not currently have any controlled medicines on the premises. We discussed the medication storage and procedures with the manager and she provided evidence that she had arranged for the pharmacist to visit the home and do a full audit on the medication and any storage and administration weaknesses. The pharmacist was then to give the home advice and an action plan for improvements. We have since received verification from the pharmacist that this audit has been completed and the manager has been given some recommendations. The manager has sent us an action plan to show us that they will be making changes to meet the recommendations within a specified timescale. Care Homes for Adults (18-65 years) Page 21 of 33 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. People living in the home are safeguarded from abuse and people know how to make a complaint. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that a complaints policy is in place detailing how complaints can be made and that it is available in a simplified format that may be understood by service users. They also told us that all staff receive training on adult protection and made aware of all key policies relating to protection, including whistle blowing, with all staff receiving the required safety checks before commencing work in the home. We received surveys from two people living in the home and they told us that they knew who to speak with if they were not happy. We received surveys back from members of staff working in the home and they said that they knew what to do if someone told them they had some concerns. The home has a complaints procedure in place which is in an easy read format and this is displayed in the main entrance to the home and also in individual care plans. The Commission has not received any complaints about the service since registration and the manager told us that they have not received any complaints since the home was registered. Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: The home has the local current safeguarding adult’s policies in place and the manager has carried out the referral training. We saw evidence that staff are booked to complete the safeguarding vulnerable adults training imminently and we spoke to staff who verbally demonstrated that they had a good understanding of the homes procedures to safeguard the people living there. The manager has completed the Mental Capacity Act and Deprivation of liberty training and staff are booked to attend this very soon. Care plans showed that assessments of best interest are being carried out for people living in the home. Care Homes for Adults (18-65 years) Page 23 of 33 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. The home is clean and provides a safe environment, giving people a pleasant place to live. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that the home is well maintained and damages or breakages are either repaired or replaced promptly in order to maintain a safe, homely environment. We received surveys from people living in the home and they told us that the home was always fresh and clean. On the day of the inspection we found the home to be clean and fresh. There are separate communal areas for people to use and one person living in the home told us that they liked this as they sometimes wanted to sit and watch television alone. We viewed the bedrooms of five people living in the home and we found that most of them were personalised and there was evidence that the people living in the home had decided on what they wanted to have in their room. Some bedrooms and communal areas were quite bare but some of the people living in the home have not been living there very long and they have not yet personalised their Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: room. One person living in the home told us that they had taken some photographs in the country park and were going to have them framed and hung on the wall in the lounge. The regional manager told us that the environment was still being developed with the input of people living there and that these areas would be made more homely as people settled in. The home has health and safety systems and procedures in place and staff are trained in how to put them into practice. The home also has infection control systems in place to prevent the spread of infection and staff are trained to maintain the systems. Care Homes for Adults (18-65 years) Page 25 of 33 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. The home operates a safe staff recruitment process and staff are trained effectively in supporting people living there. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that service users are supported by well trained and competent staff and that the organisation has a training manager to ensure training is delivered in a timely manner. They also told us that the recruitment and selection process is designed to protect people who use our services. We looked at the staff files of two members of staff and these were well organised and provided evidence that the home is completing the required checks before staff commence working there. We spoke with staff about the recruitment procedure and they told us that people living in the home had not been involved in the interview process. The home has only been operating for a few months but there was evidence that staff have attended some training and the manager provided us with a training plan which showed that training had been booked for staff to attend more training very soon. The manager told us that there are plans for all staff to commence working toward a Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: recognised qualification in health care. When we asked people living in the home what the home did well they said, Listening, They look after us well and people are chatty and there can be a really nice atmosphere and be a laugh, The staff are brilliant and I wouldnt change a thing about them and You can talk to staff if you have a problem and they help you work through it. They respect our background and they are bubbly and they lift my spirits when I am feeling low. When asked what the home could do better, one person living in the home said, It could be less secretive when there is an incident in the home rather than expecting us to ignore the incident and we would prefer to be aware of problems. We received surveys from staff and spoke with them on the day of the inspection and they said that they had received an induction and that they were given training that helped them to understand the needs of people and kept them up to date with new ways of working. Some members of staff told us in the surveys that there was only sometimes enough staff to meet the needs of people they supported. We spoke with staff and people living in the home about this on the day of the inspection and they told us that things were improving with more staff being recruited now. We asked staff what the home did well and they said, Communication between the staff over the service and what is involved in the work is brilliant and two members of staff said Staff always communicate well. Care Homes for Adults (18-65 years) Page 27 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the people living there. The new manager should give some consistency to the leadership of the home. Evidence: The manager told us in the homes Annual Quality Assurance Assessment (AQAA) that the home has a wide range of policies, procedures and practice guidance that underpin good practice and that the manager has been successful in helping the team translate these policies and procedures into good practice. Since the home was registered with the Commission (6 months) there has been three managers in place in quick succession. This has caused people living in the home and staff to feel a little unsettled. However the regional manager has been involved in the management of the home which has given some consistency and the home has developed with each manager. The current manager has only been in post for a short time but is the registered manager with another Heathcotes home in a nearby area and has the required qualifications and experience. She plans apply to the Commission to be the registered manager at both Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: homes with a deputy manager to support this. People living in the home told us that they had known the manager for some time and liked her and felt confident in her and her abilities. They told us that in the short time she had been at the home they felt that there had been positive changes. Staff also told us that the new manager was making changes that were benefiting the home. One person living in the home told us, The manager is lovely, she sorts things out, The support staff and the manager are brilliant and The manager and staff give me freedom and trust. We saw evidence that the home involves people living in the home in the way it is run by holding weekly menu meetings and monthly meetings to discuss what had happened in the home and what was planned for the next month. The regional manager of Heathcotes conducts an annual quality assurance survey involving people living in the home and their relatives as well as staff. The results of these surveys are then collated and an action plan given to the homes. People have not been living in Heathcotes, Arnold for very long and so this survey has not been completed but there are plans for it to be completed shortly. We saw evidence that equipment in the home is regularly maintained and that staff are trained in areas of health and safety. Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 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 1 20 13 The home must have in place 02/08/2010 a metal storage facility for controlled drugs, which meets the requirements of the misuse of drugs regulations 1973. This will safeguard the health and welfare of people living in the home. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 20 20 20 The temperature of the area where medicines are stored should be taken and recorded each day. External and internal medicines should be stored separately. Any medicines stored in the fridge should be kept separate to any food. Care Homes for Adults (18-65 years) Page 31 of 33 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 4 5 6 7 20 20 20 20 The medicines in the trolley should be addressed so that they are more organised and easy to find. The Medication Administration Record should contain a photograph of the service user. Any bottles of medicines or external preparations should be dated with the date of opening. Handwritten entries on the medication administration record should be signed and a further witness signature obtained. Service users could be involved in the interview process when new staff are being recruited. 8 34 Care Homes for Adults (18-65 years) Page 32 of 33 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2010) Care Quality Commission (CQC). 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