Care Home: Heathfield Gardens

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What the care home does well The home provides good opportunities for the people living at the home with several of them taking holidays aboard. The home offers good day to day choices about how people can spend their day and provides individual support for the people living there. Completed questionnaires indicated that staff are developing peoples` independence. Good communication between the staff, which ensures they are kept informed about changes to the care of the people they are looking after. The home was comfortable in appearance, was maintained to a good standard and set in pleasant surroundings. What has improved since the last inspection? The requirements made at the previous site visit have been addressed. The home continues to improve its care planning and is moving a more person centred approach to care planning. The home calls their care plans support plans. The role of the key-worker as developed since the last site visit. The home continues to improve the standard of the home and facilities it offers. The people at Heathfields Gardens now have there own Gentleman`s Club. What the care home could do better: The home must have a registered manager in place to ensure the effective running of the home. There has been no registered manager at the since 2007. The recording of significant events must be improved as outlined in the report. All staff must receive the appropriate training as outlined in the report especially infection control and safeguarding vulnerable adults.. The home must maintained the required level of qualified staff. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Heathfield Gardens 163-165 High Street Tibshelf Chesterfield Derbyshire DE55 5NN     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: Nancy Bradley     Date: 1 1 0 6 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: Heathfield Gardens 163-165 High Street Tibshelf Chesterfield Derbyshire DE55 5NN 01773872229 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) : a.buljeean@mgbcareservices.co.uk MBG Care Services care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 10 The home is situated within the rural community of Tibshelf, Derbyshire, which provides many local facilities. Many of the service users access these local facilities within the village. The home consists of two converted adjoining houses to provide one registered home, which provides nursing care for 10 service users with learning disabilities. There are two lounge/dining rooms and bedrooms situated on the ground and first floor. There is the provision of a minibus and local transport. Care Homes for Adults (18-65 years) Page 4 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 an unannounced key inspection and took place over a total of five hours. We spoke with the manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since the last key inspection. This included the following: The Annual Quality Assurance Assessment (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well Care Homes for Adults (18-65 years) Page 5 of 31 outcomes are being met for people using the service. It also gives us some numerical information about the home. Two people living at the home were case tracked. Case tracking is a method used to track the care of individuals from the assessments undertaken before they are admitted to a service through to the care and support they receive on a daily basis. This includes looking at support plans and other documents relating to that persons care, talking to staff regarding the care they provide and if possible talking to the individual. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. The home provides care for ten people and at the time of this site visit there are no vacancies. We sent out ten Have Your Say questionnaires and we received ten completed questionnaires, from people living there who confirmed they were very happy at the home and were looked after by the staff and could not wish to live anywhere else. Only two people indicated they would like to speak with us. The staff completed questionnaires on behalf of the people living at the home. We received twelve completed questionnaires from staff all were very positive about the home, were happy and enjoyed working there. We received four completed relative questionnaires who stated they were happy with the care their relative received. We received a warm, friendly and enthusiastic welcome from the people living at the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 7 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 8 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. Arrangements are in place to ensure that peoples needs are fully assessed and met prior to admission. However the inconsistencies in information from placing Authorities may comprise service delivery. Evidence: The majority of the people living at the home have been there for a long time; there has been one new admission since the last site visit. The home provides care for ten people and at the time of the site visit they had no vacancies. There was evidence on file to indicate that the care needs assessments for the majority of the people living at the home were are being reviewed by the referring agency. The previous acting manager had undertaken a care needs assessment of the most resent admission. This was in line with the Companys policy and based on the Activities for Daily living model. Care Homes for Adults (18-65 years) Page 9 of 31 Evidence: The care needs assessment provided by the referring agency did not fully inform the home as to the persons assessed care needs nor the level of care they were requesting from the home. There has been limited contact between the referring agency and the home since the person was admitted. The referring agency has yet to formally review the placement. Care Homes for Adults (18-65 years) Page 10 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. There is a care planning and review system in place, which ensures that peoples individual needs are being addressed. However the inconsistencies in risk assessments and in recording of information may affect the care people receive. Evidence: During the visit care plans of two people who live at the home were seen. The acting manager for each person at the home had compiled the support/care plan. Evidence was seen of care plans being reviewed on a regular basis. People living at the home who were case tracked had a support/care plan, which was in accordance with their assessed need and formulated within a risk assessment. All care plans detailed peoples individual lifestyle preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily/nursing records are also maintained on each person who lives at the home. The home is looking to develop a person centred approach to care planning. The acting manager stated that this will be led by the persons key-worker. Information in the AQAA indicates the home is looking Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: to starting Life Story work with people from the home. There was evidence to show that support/ care plans are being reviewed on a regular basis. The acting manager currently reviews them on a monthly basis then annually with the referring Authority. The detail and information in the support/care plans has improved since the last site visit and the home now has a good direction on how they are providing care to people living at the home. However there is little consultation with outside professional regarding behaviour management plans. People living at the home knew who their key worker was and told us how they help them on a daily basis. The acting manager is developing this role further with them being involved in the planning and reviewing of support plans. Care plans have been explained to the people living at the home and they have signed where possible that they agree and understand. In cases where they are not able to sign, family has done this. All of the staff have signed the care plans showing their commitment to people living at the home. Risk assessments were in place covering such issues as, peoples health and safety, physical health, nutrition, mobility, behaviour management and risks associated with social activities. However the risk assessments do not fully identify the need to record and access any incidents of behaviour management within the home. At present these are recorded as accidents not incidents and would require notification to the appropriate Authorises. Risk assessments must be monitored and updated as required. We discussed with the home about people who live there having access to the local Advocacy Services. Relatives are actively involved in their care and act on their behalf if required. Several of the families are responsible for their relatives finances. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were arrangements in place to enable people to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: The care records of two people from the home seen provided detailed needs assessment and care planning information regarding their social, recreational, educational and occupational activities both within the home and outside in the community. Discussions with people from the home during the visit confirmed they were very happy living at the home. Information in the AQAA and from discussions with people indicates that the home provides a varied activities programme. The people who live in Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: the home told us the home is taking them on holiday to Skegness and Spain. Recent trips have been to Drayton Manor Park, London, Matlock and Twycross Zoo. On the day we visited several people had gone to Wales for the day, another person was on holiday. Various photographs were around the home showing the trips and activities people had been involved in. The relationships observed between care staff and people who live at the home appeared open and good-humoured. People at the home told us they have a close relationship with the staff who play an important part in their lives. The staff encouraged the people living at the home to take pride in their appearance and their dress sense is respected The daily routines are flexible with every one being able to make their own decisions about how they spend their day. The people living at the home are encouraged to be as independent as possible, taking responsibility for some of the household tasks, like tidying their rooms, keeping the communal living area tidy and helping to wash the pots. The majority of the people who live at the home are unable to work due to their level of disability. Several have attended adult education classes in the past. Their personal goals, choices and preferences were identified and properly recorded risk assessments were in place for each person in relation to the activities they were engaged in. Individual risk assessments for activities and holidays were not in place. The home has converted the activities room in to aGentlemens Club. Family and friends were invited to the grand opening. The club has music and drinks. People living at the home are involved in the planning of all activities during house meetings. Evidence of consultation was seen through direct observation and through house meeting minutes. Activities programme is displayed in the home. Information on peoples records indicated that contact with family and friends were appropriate. Any restrictions on contact is recorded in care plans. People at the home can speak with family and friends by telephone. One person communicates with their family who live aboard through e-mail. This enhances his communication skills and facilitates good communication at all times. Information in the AQAA showed that the home has also arranged social occasions for family and friends. Examination of the menus shows the home is providing a healthy well-balanced and nutritious diet. People at the home made positive comments about the meals and said their likes and dislikes are taken in to account. The cook discusses with the people what they liked and disliked and worked a four-week menu around their preferences. During lunchtime everyone was given a choice of menu. We joined people for lunch. Care Homes for Adults (18-65 years) Page 14 of 31 Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and wishes. Evidence: During the visit it was clear that peoples privacy and dignity is respected, and where people need supervision during personal care this is recorded in their care records. Records seen and discussions with staff indicated that peoples health and personal needs were being met . People living at the home were generally healthy and records showed that staff promptly contacted the appropriate medical services. People living at the home are registered and attended services within the community including doctors optician, podiatry, dentist, and audiologist. Discussions with the manager confirmed the people access general medical services from Ashgreen hospital. The people a living at the home all have their own My Health Care Passport booklet which the take with them to all appointments. The home maintains records of all hospital and doctors visits. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The home maintains a record of peoples weight as part of maintaining a health lifestyle. The medication administration practices of the service were assessed. Peoples photographs were in place on medication administration records confirming their identity. The home is in the process of updating signatures of staff authorised to administer medication. The controlled drugs register was examined and this had been completed correctly. The storage of medication was looked at and was found to be satisfactory, this included medication stored in the clinical fridge, where fridge temperatures had been recorded to ensure this medication was stored at the required temperature. However several of the temperatures were high. The manager agreed to continue to monitor these and replace the fridge if required. The medication is supplied from the local pharmacy. Discussions with the manager confirmed that the pharmacy has undertaken an audit of the homes medication procedures. Several people living at the home are still without an end of life plan. Care Homes for Adults (18-65 years) Page 17 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. Arrangements are in place to safeguard peoples welfare and ensure that their concerns are listened to and acted upon. However incontinences in recording and failure to follow procedures may leave people vulnerable. Evidence: The complaints policy was seen and included a timescale of five days for a response to complaints. The complaints procedure is included in the service user guide. The manager confirmed they have received two complaints about their service since the previous site visit. However the details of these were not available. The manager sends all complaints details to head office. The Care Quality Commission have not received any complaints about the service. The home holds regular meetings with people who live at the home. Some of the minutes of these meetings were seen and demonstrated that issues raised, were dealt with promptly and appropriately. People living at the home indicated that they knew who to speak with if they were not happy. The complaints procedure is clearly displayed in the entrance to the home and in various prominent places within the home and is an easy to read format. The homes safeguarding vulnerable adults policy was seen. This makes reference to Derbyshire Social Services safeguarding vulnerable adults and the homes whistle Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: blowing procedures. The contact details for the local Social Services office were also included in the policy. There has been one reported incident of Safeguarding of Adults since the last inspection. This was investigated under Derbyshire Social Services Safeguarding Vulnerable Adults procedures. The Care Quality Commission requested details of the safeguarding /physical intervention at the safeguarding meeting and at the time of writing this report they are still outstanding. The concerns about notifications are recorded in the management section of this report. The AQAA indicates that all staff completed safeguarding vulnerable adults training in March 2009. The new staff have yet to undertake this training. Staff training records and the AQAA indicated that the majority of the staff have received training on physical interventions (SCIP). Several staff are due for re-fresher training. Their families administer the majority of peoples monies. Although the home has several living under Guardianship. The home was not aware of the actual number. The acting manager stated all monies are checked as part of the Regulation 26 visits and audited centrally. Care Homes for Adults (18-65 years) Page 19 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. The home is clean, well equipped and maintained, which promotes peoples independence. Evidence: We carried out a full tour of the home, accompanied by the manager. All communal areas were seen. Peoples bedrooms were inspected with their agreement and all rooms had been furnished to their personal choice and were being personalised. The home was clean, well maintained, well furnished, equipped and well lit and heated. Where personal items, furniture and fittings have been removed for health and safety reasons has been risked assessed and included in peoples care plans. House meetings indicated that people living at the home had contributed to the decoration of the home. All of the bedrooms are single with en-suite facilities. People living at the home stated they were happy with their bedrooms and the home. The tour of the building identified that carpets in some parts of the home have become worn. The manager confirmed that new carpets were on order. The home has a full ongoing maintenance programme. The home was free of any unpleasant odours or smells on the day of the visit. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The home has infection control procedures in place. The AQAA indicates that staff have yet to receive infection control training Care Homes for Adults (18-65 years) Page 21 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. The home has recruitment and selection procedures in place to ensure that the appropriate staff are employed to care for vulnerable people. Evidence: Information in the AQAA indicated that there have been several new staff appointed since the pervious site visit. The acting manager confirmed that they have been successful in appointing new staff and now have a good compliment of staff. Direct of observation of the staff showed they worked flexibly to meet the developmental and social needs of the people who live at the home. The home operates a key-worker system and the staff spoken with during the visit were aware of the individual needs of the people living there. Rotas showed that five staff work in the day with two staff covering the waking night. Information received from the AQAA shows that the home has a total of fifteen staff. This is down one from last year. Currently the home has four care staff holding a NVQ level 2 or above with several working towards or having been registered for. The previous AQAA indicated there were three registered nurses at the home, this year it shows two. There is a cook and housekeeper. The cook is enrolled on a NVQ level 2 in Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: catering. The home has a recruitment procedure in place, which ensures that staff appointed are suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance and complete a probationary period. As part of providing a full employment history applicants need to provide an accurate chronology of their employment history with the days date month and year. From recent staff recruitment records examined, applicants were only providing the year in one instance. This area of shortfall was discussed with the personnel department for the Company. The staff personnel records were generally well presented. Information in the AQAA stated the Company has a training room facilitate which is open to staff. This is based at head office in Nottinghamshire. The home has a training matrix for the year, which includes updates on all mandatory training and re-fresher for physical intervention (SCIP). Several staff are currently on induction. Information in the AQAA indicated that formal supervision will be conducted on a monthly basis. Records seen indicated that formal supervision was outstanding for several staff. Records seen indicated that the staff meetings are regularly taking place. All staff have a Personal Development plan. Care Homes for Adults (18-65 years) Page 23 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. The lack of an adequate and purposeful management structure may comprise service delivery. Evidence: The acting manager present at the previous inspection has now left the Company and a new manager was appointed. However they have since resigned the post. The home has been with out a registered manager since 2007. We have been notified of the management arrangements, and the Responsible Individual will be managing the home from the 1st of July until a manager is appointed. The acting manager stated that a process for monitoring care and services provided has been established and is in line with the policy operated within MGB Care Services Ltd. The AQAA indicates there is regular feedback obtained from questionnaires house meetings and regulation 26 visits. We were shown easy read questionnaires given to people living at the home and completed questionnaires from family. The homes currently do not seek views from stakeholders about the quality of care provided by Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Heathfield Gardens. Discussed with the home about how quality assurance finding could be made public. Although the AQAA states a copy of the previous report is available, the home did not have a copy. Information received indicates this is kept at the head office. The registered provider is not routinely sending the Regulation 26 reports to the home. Several incidents have been recorded by the home as accidents as staff have received an injury. On examination of these accident reports, they should have been recorded as incidents and sent through to the Care Quality Commission as notifications under regulation 37. The Care Quality Commission has not received any notifications under this regulation within the last two years. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided to us by way of the AQAA. Systems were in place for the monitoring and maintaining the hot water temperatures. Care Homes for Adults (18-65 years) Page 25 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 26 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 2 14 The referring agency must provide the home with a full up to date care needs assessment for the person they wish to place at the home. This is to ensure the care needs of the person is fully assessed and the home can meet that need. 31/07/2009 2 7 12 The home must consult with 31/07/2009 the appropriate services and professionals where trends in behaviour management have been identified. This is to ensure people receive the appropriate care. 3 7 12 Support /care plans and risk assessments must include a behaviour management strategy. This must include actions to take, assessment of behaviour, recording and observations of any trends which may become apparent. 31/07/2009 Care Homes for Adults (18-65 years) Page 27 of 31 This is to ensure people receive the appropriate care. 4 22 22 The home must maintain 31/07/2009 and keep a record of all complaints. This record must include the complaint, actions and outcomes. This is to ensure that peoples views are listened to and acted upon. 5 23 13 All staff must complete their re-fresher training on physical intervention (SCIP)in order to undertake any physical intervention action. This is to ensure people are protected and kept safe . 6 23 18 All staff must complete training in Safeguarding Vulnerable adults. 31/07/2009 31/07/2009 This is to ensure the staff are aware of the homes policy and procedures and know how to keep people safe. 7 34 19 All staff must provide a full employment history. This is to ensure people are protected by the home recruitment procedures 8 35 18 All staff must receive formal 31/07/2009 supervision in line with the National Minimum Standard. 31/07/2009 Care Homes for Adults (18-65 years) Page 28 of 31 This is to ensure people benefit from a well supported staff team. 9 37 8 The home must have a 31/08/2009 registered manager in place. This is to ensure the home is run in the best interest of the people who live there. 10 37 37 The home must maintain and record events in accordance with regulation 37 . This is to ensure the safety and wellbeing of the people who live there. 11 39 26 The home must have copies of all visits carried by the Registered Provider This is to ensure the home is run is operate effectively 12 42 18 All staff must receive training on infection control. This is to ensure the home is maintained to a good standard of hygiene. 31/07/2009 31/07/2009 31/07/2009 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 2 2 7 The referring agency should formally review the placement within an agreed time scale. The home should obtain a full life history for people they admit. As part of person centred planning the home should look to Care Homes for Adults (18-65 years) Page 29 of 31 undertaking Life Story work with people. 4 20 The home should keep the fridge used to store medication under review, and if the temperatures continue to rise take the appropriate taken. The home should ensure that people living at the home have an end of life plan. The home should have knowledge of the people who are living there under Guardianships orders all the conditions of the Guardianship under the Mental Health Act. The home must maintain the fifty percent level of qualified staff. The homes applications form should be amended to show that the dates date month and year are required when providing a full employment history. The Care Quality Commissions reports should be displayed within the home. 5 6 21 23 7 8 31 34 9 39 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. 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