Care Home: Jomar House

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What the care home does well Mrs Cocker continues to provide people with a homely, comfortable and clean environment that suits their needs. People live with her as part of the family, sharing facilities and say they are "happy" at Jomar House.People have several holidays each year. There were three last year and people tell us they are already planning another one for this year.People have lots of things to do and are members of several clubs as well as going out to bingo which both say they enjoy. They also go on regular trips out depending on the season and weather. Indoors, people can make use of their own rooms, or spend time in communal areas to watch television, listen to music or use the computer. They also enjoy the company of Mrs Cocker and her dogs. What has improved since the last inspection? Mrs Cocker has improved the way that she records her involvement in supporting people to manage their money so that there is a better trail of what has happened.Menus have been reviewed following input from a dietitian so that these are more healthy but also take into account people`s likes and dislikes.Mrs Cocker has attended some short training in person centred planning so that she can start work to improve individual plans with people. She has also had some training in Deprivation of Liberty safeguards. This should help her understand how to support people with decisions and ensure they are not unnecessarily restricted. Mrs Cocker has updated some of the information about the home, including how to complain which now includes up to date information about where and how people can contact us if they need to. What the care home could do better: The size and nature of the home makes it difficult for Mrs Cocker to comply with all the outcomes we expect from a registered care home and the regulations that underpin this. She could apply to become part of an adult placement or "shared lives" scheme. This would give her support and guidance and would not require her to comply with all the regulations and law that applies to a registered care home. She has chosen not to do so, and must take action now to ensure that she understands andcomplies with the rules that apply. She will also need to show that she complies with new rules when she registers with us again later this year. Although Mrs Cocker was able to tell us what has happened, the improvement in the standard of record keeping we saw at our last visit, particularly in relation to medical appointments, has not been sustained. These records are needed so that guidance, advice, treatment and changes can be properly recognised and monitored. Where she has updated some information she has not dated it. This means she cannot show she looks at people`s needs between formal reviews.Some of the language used in records is not acceptable in that it is not respectful or objective. This needs to improve so that Mrs Cocker can show she has insight into people`s difficulties and that she upholds their dignity. Mrs Cocker needs to improve how she shows she promotes people`s safety, particularly in the event of fire. She must also update her first aid training so she can respond properly to accidents and emergencies. Key inspection report Care homes for adults (18-65 years) Name: Address: Jomar House 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS 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: Judith Last Date: 1 4 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 38 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 38 Information about the care home Name of care home: Address: Jomar House 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS 01603745974 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Joy Cocker,Mr Mark Cocker care home 2 Number of places (if applicable): Under 65 Over 65 2 0 learning disability Additional conditions: The registration of two people with a learning disability refers solely to the two people currently accommodated at Jomar House and who are named in the Commission`s files. Only these people can be accommodated at Jomar House. Date of last inspection 2 4 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Jomar House is a care home providing personal care and accommodation for 2 adults with learning disabilities. The Proprietors are Mrs Joy Cocker and her son Mr Mark Cocker. Mrs Joy Cocker lives on the premises and is the manager. The home is located in Old Costessey on the outskirts of the city of Norwich. The Home is close to shops, pubs and other local amenities. Care Homes for Adults (18-65 years) Page 5 of 38 The accommodation is provided on two floors and people have their own rooms. The Proprietor, Joy Cocker lives in the home and shares all communal facilities with the services users. The home has an attractive garden with a patio area. The Proprietor has dogs that live with her and the homes residents. Care Homes for Adults (18-65 years) Page 6 of 38 The home has steps to the back and front and would not be suitable for adults with mobility difficulties. There are no vacancies at the home. It costs from £1468 per month to live at the home. This includes things like food, laundry, heat and light. People contribute to mileage for outings in the owners car. People pay for their own personal expenditure and holidays. Care Homes for Adults (18-65 years) Page 7 of 38 Mrs Cocker has inspection reports in the room used as an office, which is accessible to people at the home. Care Homes for Adults (18-65 years) Page 8 of 38 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 9 of 38 How we did our inspection: This is what the inspector did when they were at the care home Before we visited Jomar House, we looked at all the information we had about it. This includes the history of the home, the information the manager sent to us, and written comments from people living there. Care Homes for Adults (18-65 years) Page 10 of 38 We gave Mrs Cocker some notice of our visit. This is because she runs the home on her own and people have busy lives so they are not always there for us to speak to. When we visited, the main method of inspection we used is called case tracking. This means we look at records and try to find out from observation and discussion how well peoples needs are being met. We used all the information and the rules we have, to see what outcomes are being achieved for people in their daily lives. Care Homes for Adults (18-65 years) Page 11 of 38 What the care home does well Mrs Cocker continues to provide people with a homely, comfortable and clean environment that suits their needs. People live with her as part of the family, sharing facilities and say they are happy at Jomar House. People have several holidays each year. There were three last year and people tell us they are already planning another one for this year. Care Homes for Adults (18-65 years) Page 12 of 38 People have lots of things to do and are members of several clubs as well as going out to bingo which both say they enjoy. They also go on regular trips out depending on the season and weather. Indoors, people can make use of their own rooms, or spend time in communal areas to watch television, listen to music or use the computer. They also enjoy the company of Mrs Cocker and her dogs. Care Homes for Adults (18-65 years) Page 13 of 38 What has got better from the last inspection Mrs Cocker has improved the way that she records her involvement in supporting people to manage their money so that there is a better trail of what has happened. Menus have been reviewed following input from a dietitian so that these are more healthy but also take into account peoples likes and dislikes. Care Homes for Adults (18-65 years) Page 14 of 38 Mrs Cocker has attended some short training in person centred planning so that she can start work to improve individual plans with people. She has also had some training in Deprivation of Liberty safeguards. This should help her understand how to support people with decisions and ensure they are not unnecessarily restricted. Mrs Cocker has updated some of the information about the home, including how to complain which now includes up to date information about where and how people can contact us if they need to. Care Homes for Adults (18-65 years) Page 15 of 38 What the care home could do better The size and nature of the home makes it difficult for Mrs Cocker to comply with all the outcomes we expect from a registered care home and the regulations that underpin this. She could apply to become part of an adult placement or shared lives scheme. This would give her support and guidance and would not require her to comply with all the regulations and law that applies to a registered care home. She has chosen not to do so, and must take action now to ensure that she understands and Care Homes for Adults (18-65 years) Page 16 of 38 complies with the rules that apply. She will also need to show that she complies with new rules when she registers with us again later this year. Although Mrs Cocker was able to tell us what has happened, the improvement in the standard of record keeping we saw at our last visit, particularly in relation to medical appointments, has not been sustained. These records are needed so that guidance, advice, treatment and changes can be properly recognised and monitored. Where she has updated some information she has not dated it. This means she cannot show she looks at peoples needs between formal reviews. Care Homes for Adults (18-65 years) Page 17 of 38 Some of the language used in records is not acceptable in that it is not respectful or objective. This needs to improve so that Mrs Cocker can show she has insight into peoples difficulties and that she upholds their dignity. Mrs Cocker needs to improve how she shows she promotes peoples safety, particularly in the event of fire. She must also update her first aid training so she can respond properly to accidents and emergencies. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 18 of 38 If you want to speak to the inspector please contact Judith Last Care Quality Commission (Eastern) Citygate Gallowgate Newcastle upon Tyne NE1 4PA Telephone 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 19 of 38 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 20 of 38 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need about their home. Their needs have been assessed so they would be sure that the home will be able to meet them. Evidence: Mrs Cocker has updated some of the information about the service so that it is more accurate then when we last visited. This means that the people living there have up to date information about how to contact us if they need to. She cannot make any more admissions to the home. This is because concerns some years ago led us to take action to restrict her to accommodating only the people she already has. This means that she would not be providing the information to prospective residents. Each of the people currently using the home has an assessment of their needs on file. This means Mrs Cocker should be aware of the support she is expected to offer them. Care Homes for Adults (18-65 years) Page 21 of 38 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in some decisions about their lives and the support they receive. However, Mrs Cocker does not show she is always professional and objective in the records she makes about peoples difficulties and problems. Evidence: We looked at the support plans for both people living in the home and spoke to them about these. Both told us that they felt Mrs Cocker helped them when they needed it. There are daily records about the activities people go to (but a lack of records about the outcomes of some health care appointments). At present there is little need for more detailed information because there are no staff employed who would need to follow care plans to ensure peoples needs are met effectively and consistently. Reviews take place with people and their care managers and Mrs Cocker does update some of the information in between. However, she does not always date the notes that she makes to show when the plans have been updated. People say that they can make Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: decisions about the things they do and have their say at reviews. We had concerns about the way Mrs Cocker made some of these records. In reporting an incident where one person had changed their mind about a previous decision and Mrs Cocker did not think this fair, she had recorded that she told the person I can get just as nasty as you can. Another entry describes someone as being bad enough without trying to be silly. Mrs Cocker helps people manage their money and we could see that they sign for monies returned to them when she has held this for safekeeping. There has been an improvement in recording the withdrawals of amounts of money from peoples bank accounts to cover holiday costs. People say that they are happy with arrangements and that Joy helps me. There are risk assessments on file for some activities and we have previously seen assessments to cover use of the iron, kettle and managing medicines and whether people are able to do this safely. We asked people about the things they do around the home. Both keep their rooms tidy and share other tasks such as helping clear away after meals, put crockery away or make drinks. People are not involved in recruiting staff (there are none), or in reviewing policies and procedures due to the nature and size of the home. Care Homes for Adults (18-65 years) Page 23 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their lifestyle suits their needs and expectations. Evidence: People told us they have lots of things to do and can decide how they want to spend their time. One person has full time day activities outside the home and another is supported with a variety of activities including bowling, swimming, a computer class and traditional day services. Mrs Cocker keeps a record of outings and activities and people tell us that they look out for different places to go for social clubs and bingo which they both say they like. They have been planning holidays and told us about one they have picked from a brochure recently. People can spend time where they like in the home, watch television together if they wish and have access to the lounge, dining room and office as well as their own rooms. The computer one person likes to use has been moved into a corner of the lounge which Mrs Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: Cocker says is warmer than the office. The person who uses it told us, Yes, Im happy with the arrangement. We saw that advice has been taken from a dietitian about one persons needs and guidance has been obtained about increasing opportunities for healthy eating. We spoke to the person about this who was able to tell us what they were doing and the kinds of meals they prepared to take in their pack up. This shows that they understood the guidance they have been given and Mrs Cocker supports them with it. The person confirms that Joy would explain if there was anything they did not understand. The daily record of meals supplied confirms that changes have been made and with fewer meals of chips and pies. One person told us that they like the food at the home and that they like pies but that was my downfall. They added it is not good for you to have too many. People generally eat their meals with Mrs Cocker at a table in the kitchen. There is a larger more formal dining room available for events when there are visitors. Care Homes for Adults (18-65 years) Page 25 of 38 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met as they require, but there has been a decline in the standard of recording to support this. Evidence: People are independent in their personal care and do not require support from Mrs Cocker to manage this. However, records about dental treatment suggest that one person may require some prompting and discussion about how to manage their oral hygiene better. We know from discussions with Mrs Cocker and people living in the home that issues of concern about peoples health are followed up. She supports them with making and keeping appointments. People also told us that she explains things they do not understand. Since our last visit, Mrs Cocker has not been recording what the outcomes of the appointments are and what follow up might be needed. For example, in one persons records no appointments at a clinic were recorded since March 2008 although there were letters setting up subsequent appointments. However, Mrs Cocker was able to tell us what had happened. Chiropody appointments are not recorded but the person concerned confirms this Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: happens. One person continues to manage their own medication. Mrs Cocker records when she has supplied tablets to them. The person told us about how they managed these. They also told us about monitoring their own blood sugar and when they would tell Joy if there is a problem, because she has the phone number. The person was able to tell us about changes to their medicines and the tests they need to make and this matched what Mrs Cocker told us. Another does not manage their own medicines and told us I like Joy to do it for me. Storage of medicines held on behalf of people living in the home, does not meet expected standards for care homes. Care Homes for Adults (18-65 years) Page 27 of 38 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns would be taken seriously and they feel safe in their home. Evidence: There have been no changes for some years in the group of people living in the home. As on previous visits, we heard people chatting with Mrs Cocker about the news and weather forecast and laughing, indicating they were comfortable in her company. Each person has a copy of information about how to complain on their file. Mrs Cocker has updated the information to show how people can contact us if they need to. Both people told us they were happy with the way the home was run, and were clear that they could talk to Mrs Cocker if they had a complaint. Both also identified other people outside the home that they would be able to raise concerns with. Mrs Cocker has had training about the protection of vulnerable adults so that she should know what she needs to do if someone expressed concerns or made allegations. Care Homes for Adults (18-65 years) Page 28 of 38 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a homely, clean and comfortable environment with a history of being well maintained and decorated. Evidence: People say that they are happy with the way things are in the home and that their rooms are comfortable. They help to keep them clean. Communal areas seen were comfortably furnished, warm and with no obvious concerns about maintenance. People have guidance about what they would need to do if there was a fire. However, Mrs Cocker does not record that she tests the detection system. She says she does this from time to time but it is not written down. We suggested she should do this the last time we visited, to show diligence in her arrangements. This is a registered care home and so must have a fire risk assessment, identifying hazards around the home and setting out how these are to be managed and minimised. Mrs Cocker was not able to produce this and show that it was kept up to date. However, she told us that she does make sure doors are shut at night and electrical equipment is in good condition, which contributes to some aspects of reducing risk. There are no continence issues that would present concerns for cross infection and the home is kept clean. Care Homes for Adults (18-65 years) Page 29 of 38 Care Homes for Adults (18-65 years) Page 30 of 38 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are no staff employed at the home against which to evaluate key standards, but Mrs Cocker is able to support people in a way that meets their expectations. Evidence: People living in the home say they are happy with their lives and the things they do, including opportunities to go out and about. This indicates that at present, no additional staff are needed to support them effectively. However, Mrs Cocker is aware that if day care arrangements or peoples care needs change significantly she would need to review the support she is able to offer and to supplement this. This means she will need to look properly at the standards for recruitment and training to ensure people are effectively supported. Care Homes for Adults (18-65 years) Page 31 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mrs Cocker continues to look at how things can be improved - but she has not sustained some of the improvements previously made. There are some shortfalls in showing how peoples safety is promoted. Evidence: Mrs Cocker is not able to complete management training as set out in standards, due to the size and nature of the service she runs. She does not have qualifications in care to the level expected of a registered manager but has participated in some short courses to increase her awareness, such as person centred planning. Mrs Cocker sent us the information we asked for - completing her self assessment about the quality of the service before the deadline. She told us some of the things that she needs to improve. The standard of records Mrs Cocker keeps has declined slightly since our last visit. We have commented about this under the personal and health care section of this report. Mrs Cockers first aid training has expired and she has not made arrangements to renew Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: it to show she continues to be able to respond appropriately in the event of an accident or emergency. She was not able to provide records to show how risks were assessed, monitored and minimised with regard to fire, and how often she tests the detection system so promoting peoples safety. We have commented on this in the section about the environment in this report. Care Homes for Adults (18-65 years) Page 33 of 38 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 34 of 38 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 7 12 Mrs Cocker must ensure reports she compiles use language that is neither derogatory nor threatening. 26/02/2010 This is so Mrs Cocker can show she is maintaining appropriate professional relationships with the people she supports, as well as respecting their dignity. Regulation 12 of the Care Homes Regulations 2001 sets out that registered persons must conduct the home in a way that respects peoples dignity and maintains good professional relationships with service users. 2 19 17 Mrs Cocker must record the outcomes of health related appointments. 26/02/2010 Care Homes for Adults (18-65 years) Page 35 of 38 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 This is to improve how she shows that she follows up issues and acts upon guidance given by health professionals. Regulation 17(1)(a) and Schedule 3 of the Care Homes Regulations 2001 sets out what records are required in respect of each service user, including a record of the persons condition and treatment. 3 24 23 26/02/2010 There must be an assessment of the risk of fire setting out the measures in place to reduce this. It must be monitored and kept up to date. This is so Mrs Cocker can show she has proper arrangements in place to promote peoples safety in this area. Regulation 23, 4A of the Care Homes Regulations 2001, requires that the registered person complies with the Regulatory Reform (Fire Safety) Order 2005. 4 42 13 Mrs Cocker must update her first aid training, which has now expired. 30/04/2010 This is because Mrs Cocker Care Homes for Adults (18-65 years) Page 36 of 38 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 staffs the home and needs to be able to respond appropriately in the event of an accident. Regulation 13(4) of the Care Homes Regulations 2001 sets out that the registered person shall make arrangements for training in first aid. 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 6 Mrs Cocker needs to ensure she dates all her records, particularly those she prepares for review so that she can show when changes are made. Care Homes for Adults (18-65 years) Page 37 of 38 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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