Care Home: Island Place

What the care home does well Staff and management of the home have a strong desire to provide a good service to people who live at Island Place. Staff and management treat people living at Island Place with sensitivity and respect. Staff were observed managing challenging situations well. People living at Island Place are encouraged to maintain relationships with their family and friends. What has improved since the last inspection? More areas of the home have been redecorated and refurbished making a better living environment. The home has good standards of hygiene and cleanliness. What the care home could do better: The service should ensure it can fully meet the needs of all new people on admission. We case tracked a person who had recently been admitted to the home, and it was clear the service could not fully meet their needs. We saw some errors and omissions in the records linked to the administration of medication. The service must ensure that staff work to the good practice guidelines issued by the Royal Pharmaceutical Society of Great Britain. Care plans are reviewed regularly, however it was not clear whether there were sufficient systems in place to ensure that all staff have an up to date knowledge of the care needs of each person living at Island Place. Staff spend the majority of their time supporting residents with preparing, cooking and cleaning up after meals, domestic cleaning, and medication management. There is little time left available to support residents with their emotional, and mental health needs. Our last inspection report recommended that this be addressed, through reviewing staff numbers/deployment, and through buying a dishwasher to reduce the amount of time staff spend in the kitchen - neither recommendation has been acted upon. People living at the home are continuing to smoke in non designated areas. This has not been sufficiently addressed by the new manager. Although each apartment in Island Place has a dedicated shower room, due to the size of the cubicles and the step-up to the shower unit, not all residents can shower in their own apartment. This means some have to go to the apartment of other service users to have a shower. This is not in keeping with the philosophy of the home outlined in the Statement of Purpose. The manager is not making effective use of formal management processes to ensure that the service is run in an open and transparent way. The manager is not yet effectively communicating a clear sense of direction for the service. Since the inspection we have been informed by senior management that they had taken seriously the issues raised at the inspection, and have undertaken an internal review of management and management systems in the home. A new manager has been appointed to Island Place, whom Prime Life are confident will improve the performance of the service. We have been advised that action has already been taken to improve on the issues raised at inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Island Place Gooding Avenue Braunstone Leicestershire LE3 1JS     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: Fiona Stephenson     Date: 2 2 0 3 2 0 1 0 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. 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. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 29 Information about the care home Name of care home: Address: Island Place Gooding Avenue Braunstone Leicestershire LE3 1JS 01162855518 01162855518 islandplace@prime-life.co.uk info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jason Reece-Sumner Type of registration: Number of places registered: care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 36. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Island Place is registered for up to 36 people who have mental ill health, to live in one of ten apartments in the home. Island Place is part of the Prime Life Group. Car parking is available to the front of the home and it is a ten-minute bus journey to the town centre and the nearby shopping centre, Fosse Park. The living area is located over three floors, accessed through the main reception and entrance to the home. The office, staff room, the large communal lounge and kitchen are located on the ground Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 36 Brief description of the care home floor. The upper floors are accessible via the stairs or the passenger lift. Each flat accommodates either three or four people, who have their own bedroom and share a communal lounge, kitchen and dining area and two shower toilet facilities. During our inspection visit we were told that fees charged in the home have not changed since the last inspection. Fees begin at GBP 309.00 and increase where someone has been assessed as needing greater levels of care. Additional charges are made for one to one care. There are also additional costs payable for things such as transport, activities and personal items. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This key inspection included a visit to the service. We (the CQC) visited the home on the 22nd March 2010. The new manager and staff in the home helped us during the visit. The visit started at 8.45am and finished at 5.20pm. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by: - talking to people who live at Island Place - talking to staff and the manager - watching how people are given support - looking at written records. Care Homes for Adults (18-65 years) Page 6 of 29 We spoke at length with two residents, and more briefly with a further two. We spoke at length to all staff on duty at the time of the inspection. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The service should ensure it can fully meet the needs of all new people on admission. We case tracked a person who had recently been admitted to the home, and it was clear the service could not fully meet their needs. We saw some errors and omissions in the records linked to the administration of medication. The service must ensure that staff work to the good practice guidelines issued by the Royal Pharmaceutical Society of Great Britain. Care plans are reviewed regularly, however it was not clear whether there were sufficient systems in place to ensure that all staff have an up to date knowledge of the care needs of each person living at Island Place. Staff spend the majority of their time supporting residents with preparing, cooking and cleaning up after meals, domestic cleaning, and medication management. There is little time left available to support residents with their emotional, and mental health needs. Our last inspection report recommended that this be addressed, through reviewing staff numbers/deployment, and through buying a dishwasher to reduce the amount of time staff spend in the kitchen - neither recommendation has been acted upon. People living at the home are continuing to smoke in non designated areas. This has not been sufficiently addressed by the new manager. Although each apartment in Island Place has a dedicated shower room, due to the size of the cubicles and the step-up to the shower unit, not all residents can shower in their own apartment. This means some have to go to the apartment of other service users to have a shower. This is not in keeping with the philosophy of the home outlined in the Statement of Purpose. The manager is not making effective use of formal management processes to ensure that the service is run in an open and transparent way. The manager is not yet effectively communicating a clear sense of direction for the service. Care Homes for Adults (18-65 years) Page 8 of 29 Since the inspection we have been informed by senior management that they had taken seriously the issues raised at the inspection, and have undertaken an internal review of management and management systems in the home. A new manager has been appointed to Island Place, whom Prime Life are confident will improve the performance of the service. We have been advised that action has already been taken to improve on the issues raised at inspection. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service must ensure that when people are assessed prior to admission, they only admit if the need meets the registration criteria, and the service can meet their needs from the start. Evidence: We looked at the admission process of one of the people currently living at Island Place. We were told that the person had been admitted on an emergency basis, with a view to the placement only being for three days. We looked at the information given to the service about this service user prior to admission, and saw that the this person should not have been admitted to the home, as it is not sufficiently geared up to support them, and they do not have a diagnosed mental health illness. The service user continues to live at the home. The manager and staff are trying their best to support this person whilst they continues to live at Island Place and until a new placement is found, but this is proving challenging, as not all of their needs can be met by the staff group or the environment. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of people living at Island Place are satisfactorily met. Evidence: We looked at the some of the recorded information about people who live at Island Place. We saw that the care files have information to support staff in having an overview of the needs of people who live at Island Place, and of their general care needs. We also saw that risks associated with each individual had been highlighted, we also saw that the care plans checked had been reviewed. We saw that although the care plans and risk assessments were up to date, they did not go into depth about issues. So for example, one resident was seen as presenting a very high risk of exploitation of vulnerable adults, but there was no information to say what forms the exploitation may present itself, whether there were triggers to this, and how staff should observe and monitor this. Staff spoken with had a general understanding of the needs of people living at the home, and were supportive of the people they care for. However, there did not appear Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: to be formal processes in place to discuss the care and support needs of people living at Island Place, and there was confusion about whether a key working system was still in place. Staff are expected to read the care plan of a service user, and sign to say they are aware of their care needs, but we did not see this signed by all staff living at the home in relation to all residents. There didnt appear to be an expectation that staff look at care plans on an ongoing basis to ensure they have up to date information about service users. Staff also appeared to have little time available to provide emotional and psychological support to residents as the majority of their time is taken up with other tasks. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience 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 Island Place have an independent lifestyle. Evidence: We saw that some people living at Island Place make their own meals and take responsibility for their needs, such as laundry and cleaning their apartment. The majority of people living in the home enjoy meals that staff cook for them. We looked at the menu and were satisfied that residents are having a varied diet. We were told by staff that all residents, whether they buy their own food, or not, can join in with a brunch on a Friday, and a roast dinner on a Sunday. During our visit we saw staff treat residents with respect, and we observed challenging behaviour being managed well. On the day of our visit, a number of residents went out for the day with a member of Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: staff on a planned trip. Other residents told us of activities they are involved in, such as going to day centres. Residents make use of local community facilities, and go into town. We were told by a resident, that staff had listened to them when they asked to move to a different apartment in the building, as they wanted to live more quietly than they were experiencing. This person had moved and was happy that their needs had been acknowledged. We saw during our visit, that visitors are welcomed in the home, and staff encourage residents to maintain friendships and family links. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Island Place are receiving satisfactory support for their health care needs. Evidence: People living at Island Place have access to health care services in the local community. Their health needs are monitored and action taken where necessary. The care plans generally provide information about health care treatment. Staff encourage residents to be independent and to take responsibility for their own personal hygiene, however we were informed during our visit that a member of staff had told a resident that they had to have a shower, and that this person felt humiliated because staff were monitoring them. This is currently being investigated. During our visit we spoke with one resident who administers their own medication. They told us of the processes involved to ensure that the medication is taken, and we were satisfied that these were safe. We observed staff administer medication to residents and we saw the administration Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: complied with good practice guidance. We looked at the Medication Administration Records (MAR sheets) and found that one of the members of staff responsible for booking in medication had not carried forward totals of medication making it difficult to audit whether there were the correct amount of tablets remaining. There was also crossings out on the medication sheet, but no reason given for this. We looked at the training for this member of staff, and saw that they had not completed accredited medicines training, although they had been provided with supervision in administration of medicines. We saw that the service has a separate fridge to house medication which requires refrigeration. It is good practice to take the fridge temperature on a daily basis to ensure the temperature meets the requirements of the medication. We saw that the temperatures were not being taken daily, and on a couple of occasions the temperature only just met the requirements of the medication. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are protected from abuse. Evidence: Island Place works with residents who have complex mental health needs. Since the last inspection there have been safeguarding incidents however we have been satisfied that the service has responded appropriately to these issues. We have also been satisfied with the information received via Regulation 37 notifications - these have given us a detailed account of events that have happened in the home, and action taken by staff as a result of the events. We at the CQC have received no formal complaints about the service since the last inspection. We looked at the complaints book in the home, and saw that the majority of complaints from service users had been addressed by the manager. There was one outstanding complaint which the manager was not aware had been placed in the book. The main number of complaints in the complaints log at Island Place was by staff about staff. This was an inappropriate use of the complaints process which should be for service users and their advocates. People we spoke with at Island Place knew how to complain, and felt comfortable sharing their views. Staff are aware of safeguarding adults policies and procedures. Care Homes for Adults (18-65 years) Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The day to day cleanliness of the environment is good, but the service has not complied with environmental laws supporting smoke free environments. Evidence: During our visit, we looked at the communal areas on the ground floor, the communal areas in the individual apartments, and some of the bedrooms. We saw that good attention had been paid to the cleanliness of the home. We saw that the improvements had been made to the decor of some of the bedrooms, and new flooring had been put down in some of the corridors. During our discussions about one of the residents living at the home, we became aware that the bathing/showering facilities are not always suitable. We were told that some residents are unable to use the showers in their apartments because the cubicles are too small, and so have to use the walk in shower installed in one of the other apartments. Although this is safer for the individual service users, it is not in keeping with the ethos of the home which is that each apartment is specifically for the individuals who live there. The walk in shower is in an apartment used by women, and so male residents have to be escorted. We were also told that some service users have requested bathing facilities, and we saw that this had been requested at the last Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: resident meeting in February 2010. We saw that the legislation which restricts smoking in residential facilities was not being adhered to. The manager was not aware of the legislation which exempts residential care facilities from banning smoking outright, but places an obligation on them to ensure that there are designated rooms for those who wish to smoke. We saw that smoking was not confined to the bedrooms of each individual, but was being permitted in the communal areas in the apartments. There was no system to determine which rooms were designated and which were not. Care Homes for Adults (18-65 years) Page 20 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels ensure that the practical needs of people living in the home are met. Evidence: We observed staff during our visit. We saw that staff have very limited time to sit and talk to residents, and to respond to their mental health needs. We arrived at breakfast time and staff were in the kitchen supporting residents getting their breakfast. Soon after breakfast staff then had to undertake the administration of medication. Once this was done it was getting close to lunchtime so staff had to go back to the kitchen to prepare lunch. As there is no dishwasher in the kitchen (this was recommended at the last inspection), staff spent more time than they needed to washing up the dishes after lunch. They then had medication to do again, the tea to cook and wash up after and then medication again. Staff are also expected to support residents in cleaning their apartments, and keeping the communal areas clean. They help with laundry, taking people to appointments, and dealing with visitors who come to the door. There are five staff on each shift to deal with both the practical care issues and complex mental health issues. Our observation was that most of the staff time is taken up with supporting residents with practical care needs. This was highlighted at the previous inspection and a recommendation was made, however this has not been acted upon by senior management. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The staff on duty during our visit had been working at Island Place for some time, and had undertaken the required qualifications to undertake their roles. We looked at the induction record of a new member of staff. This did not give clear information about what the staff member had learned, and whether the service was following the skills for care induction model. We also looked at the recruitment records of another member of staff. We were not satisfied that issues raised from one referee were followed up robustly. We also saw that promotion had been given to a member of staff, but no formal processes appear to have been followed. We observed staff with residents. A good rapport was evident between residents and staff. We saw staff deal with challenging behaviour during the visit, and saw that the staff member had a good awareness of how to manage the situation. Residents told us that they like the staff, and that staff were good to them. Care Homes for Adults (18-65 years) Page 22 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is not making use of formal procedures to work effectively with the staff team as a whole, and with individual members of staff. Evidence: The service has undergone a change of management since the last inspection. The new manager is not yet registered to manage Island Place, and has been working in the home since September 2009. For just over two months since his arrival, the manager has also been supporting the management of another Prime Life home, and was not based at Island Place on a full time basis. Through discussion with the manager we saw that he has a good understanding of the service user group, and wants people who live at Island Place to have a positive experience. During our visit we were made aware that there are issues amongst the staff group which are not being effectively addressed. The issues are affecting staff morale, and service users are beginning to be aware of them. The manager is aware of the issues, Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: but has not used formal processes and systems to deal with concerns raised by staff. We saw that there has only been one team meeting since the new manager has been in place and that formal supervision of staff has been limited. We also saw decisions had been taken regarding staffing, without proper documentation and auditing to inform of the decision making process. After our site visit we were forwarded evidence of management meetings which showed that the manager, director and senior carers had met on a monthly basis to delegate work and responsibilities. The records showed who had been delegated the tasks to complete, but did not inform whether they had been actioned fully. We were also informed by senior management that they had taken seriously the issues raised at the inspection, and have undertaken an internal review of management and management systems in the home. A new manager has been appointed to Island Place, whom Prime Life are confident will improve the performance of the service. We have been advised that action has already been taken to improve on the issues raised at inspection. Care Homes for Adults (18-65 years) Page 24 of 29 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 25 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 The manager must ensure 30/04/2010 that the service user identified in the inspection is found other accommodation which is more suitable to their needs. The service user does not have a mental health issue requiring residential care their primary needs is physical care, and as such the service is not registered to provide them with care. 2 24 13 4a. The service must comply 09/04/2010 with the Smoke free (exemptions and vehicle) regulations 2007 They have a legal responsibility to minimize the health risks associated with smoking, to residents and staff. 3 27 23 j. The service must inform 30/04/2010 the CQC of action it will take to ensure that the showering Page 26 of 29 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 Requirement Timescale for action facilities which meet the needs of individuals living at Island Place, are appropriately placed in their apartments. It is not appropriate for service users to have to use another apartment for them to be able to use showers to meet their needs. 4 33 18 1a. The service must provide 30/04/2010 the CQC with an action plan which addresses staffing levels to ensure that staff have sufficient opportunity to support residents with their mental health needs, and to be more fully involved in the care planning process. People living at Island Place have complex mental health needs, and staff currently do not have time to focus on their primary need. 5 37 24 The company must provide the CQC with an action plan detailing how it will support the manager in ensuring formal processes of management are used to provide more effective and transparent leadership The current processes are 30/04/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 not effective and may in the longer term affect the quality of care being provided. 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 The service must ensure that when people are assessed prior to admission, they only admit if the need meets the registration criteria, and the service can meet their needs from day one. The care planning process should be improved to ensure all staff have a clear and up to date understanding of the needs of each service user. Care plans should provide more comprehensive information about the individual service user and how staff can support the service user in managing their mental health issues. The medication processes should be audited regularly to ensure staff are working to the Handling of Medicines in Social Care guidance issued by the Royal Pharmaceutical Society of Great Britain. 2 6 3 6 4 20 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 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) 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. 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