Care Home: Karenza

What the care home does well Visiting is flexible enabling people to maintain important relationships at a time that suits them and staff welcome visitors. People living at the home have access to a range for Health and Social Care Professionals to ensure any health care needs are met. People who live at the home are able to personalise their bedrooms to reflect their individual tastes, age, gender and culture, so they feel comfortable in their surroundings. The premises were light, airy and clean with ample space and facilities that fit in with the ethos and aims of the service. A range of activities were available for people living at the home enabling them to lead a stimulating and fulfilling life. What has improved since the last inspection? This was the first inspection since Karenza was registered in March 2009. What the care home could do better: The medicine management must improve to ensure people recieve the medication prescribed for them and ensure thier well being. A quality assurance system must be implemented to enable regular monitoring of the service, so action can be taken to ensure continuous improvements are achieved for people living in the home. The Service User Guide needs reviewing to ensure it contains all the information people need to make a decision about moving into the home. Also consideration should be given to providing it in alternative formats, so that it is accessible to everyone. Care plans need to include a record of the rehabilitation plans for each person living in the home. The rehabilitation plans guide staff as to the support people require to achieve thier goals, but more importantly demonstrate people living in the home have been involved in the process. Interview notes should be kept in relation to recruitment of new staff to demonstrate gaps in employment have been explored and how decisions have been made. This will demonstrate a robust recruitment procedure and ensure people are protected. Staff need training is needed in a variety of areas to ensure they have the up to date knowledge, skills and competences to meet peoples needs effectively. The complaint format needs to be revisited and produced in formats that are accessible to everyone living or who visits the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Karenza 14 Waterfall Lane W Midlands B65 0BL     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: Karen Thompson     Date: 1 7 0 9 2 0 0 9 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 30 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) 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Karenza 14 Waterfall Lane W Midlands B65 0BL 01215611737 01215611737 karenza.care@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Janet Wyatt Name of registered manager (if applicable) Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 8 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 Dementia (DE) 8 Date of last inspection Brief description of the care home Karenza is a newly refurished care home opened March 2009 to provide care for people with dementia under the age of sixty five. The property is close to the centre of Rowley Regis. The home has a car park to the rear of the building and a garden and paved patio area. The home is a three storey building. The top floor of the building is not used by people living in the home but is staff accomodation. The first two floors of the home can be accessed by lift. All bedrooms are single with an ensuite facility. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 Brief description of the care home The communal areas are on the first floor and consist of a large open plan type arrangement of sitting areas, kitchen and dining area. There is a conservatory which also acts as a dining area. Additional charges are made for hairdressing and some activities. Information provided by the owner about fees indicated they are £850 per week. For up to date information on fees people are advised to discuss the details when making enquires. Care Homes for Adults (18-65 years) Page 5 of 30 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 focus of inspections undertaken by the Care Quality Commission (CQC) is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet peoples needs and focuses on aspects of service provision that need further development. The home was registered with us to provide care in March 2009 and this was the first key inspection. Prior to this key inspection visit we gathered information from a range of sources to plan the inspection which included notifications received from the home or other agencies and an Annual Quality Assurance Assessment (AQAA). This is a questionnaire that was completed by the manager/owner and it gives us information about the home, staff, people who live there, any developments in the home and their plans for the future. One inspector undertook the visit to the home which last one day. The manager/owner Care Homes for Adults (18-65 years) Page 6 of 30 was present for the majority of the inspection visit. The home did not know that we were visiting. At the time of the inspection seven people were living in the home. Information was gathered by speaking to and observing people who lived at the home. Two people were case tracked and this involves discovering their experiences of living at the home by meeting and observing the care they received, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also looked at during the inspection Care Homes for Adults (18-65 years) Page 7 of 30 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 Care Homes for Adults (18-65 years) Page 8 of 30 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 30 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 30 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. Staff undertake a pre admission assessment before people move into the home, so they can ensure systems are in place to meet thier needs and people can be confident their needs will be met upon moving into the home. People wishing to move into the home do not have all the information they need to make a decision. Evidence: The home specializes in providing dementia care for younger adults. There was a detailed Statement of Purpose that was specific to the individual home and the service it provided. The Statement of Purpose had details about the quality of accommodation, the service provided and how to make a complaint in addition to numerous contact numbers of agencies that will offer people support. The Service User Guide was seen in individuals bedrooms visited. The Service User Guide did not contain all the information necessary to ensure it was a comprehensive document and information is required in respect of the complaint procedure, the fire procedure and the range of fees the home charges. The owner informed us the range of fees was published on their website. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The Pre admission assessment was of a satisfactory standard, enabling staff to identify peoples needs and determine if they could meet them following admission to the home. Staff informed us that prior to someone moving into the home they were informed of thier needs and the support required, so systems were put in place to meet the persons needs appropriately when they moved into the home. People can visit the home before moving in so they can have lunch, view the facilities, meet the staff and other people who live there in order to sample what it would be like to live at the home . Staff members and a relative informed us people do visit the home prior to deciding whether they would like to live there. Following admission to the home there is a trial period of one month, which provides further opportunity to discuss whether the person would like to continue living there and if their care needs were being met or any changes are required. Care Homes for Adults (18-65 years) Page 12 of 30 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 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 fully involved in decisions about their lives and are supported by staff. Evidence: Each person living in the home had a care plan. This is a document that is developed by staff following an assessment of individuals needs. It outlines what they can do independently, the activities people require assistance with and the actions staff need to provide in order to support them. The care plans were detailed, focused on all aspects of well being and were reviewed on a regular basis, so they provided up to date information for staff. People living at the home were encouraged to make decisions about their lives with the assistance of staff on a daily basis. Discussions with a visitor who had a relative living at the home confirmed they had been involved in the planning of parts of the persons care ensuring a person centred Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: approach and and an enhanced quality of life. They confirmed they had seen the care plan and agreed with the content. The staff spoken to confirmed they had access to care plans were aware of the contents and were able to describe describe peoples care. Records indicated there was involvement of a psychiatrist ensuring peoples mental health needs were being met. Although rehabilitation was taking place care plans did not always clearly demonstrate how rehabilitation goals would be met. Staff will need to ensure these details are included in care plans to ensure consistency in practice. Risk assessments were completed in a number of areas. Risk assessments are completed by staff in order to determine if there are any areas of risk and the action required to reduce the risks in order to promote peoples independence and safety, so they can lead and a meaningful life and risks are reduced. Care Homes for Adults (18-65 years) Page 14 of 30 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 who live in the home are able to make choices about their lifestyle and are supported to maintain their life skills. Social, cultural and recreational activities meet peoples expectations. Evidence: The homes main objective is to support people with working age dementia to maintain their life skills. The staff actively encourage people living in the home to develop and maintain social, emotional, communication and living skills. Each morning staff meet with people living in the home and decide what activities they would like to undertake during the day. Activities include going out, helping to prepare meals, doing the laundry, hoovering and so forth. On the morning of inspection three people decided they would like to go for lunch at a local public house which maintains and promotes both physical and social skills. Records demonstrated these choices were offered on a regular basis and taken up by people living in the home. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Activities for people living at the home are planned on an individual basis and also include group activities. One of the group activities is to visit another home within the organisation so people do not become socially isolated. We were informed two people living in the home had recently been on holiday and other people living at the home had the option to visit them at the hotel for a day trip and this had occurred. Visitors are welcome at any reasonable time and have a choice of areas to meet e.g. lounge or bedroom. People living in the home can have access to all areas as they choose. People living in the home are offered a choice of meals and help in the preparation of meals. Not all meals are taken in the home and people eat out if they wish. On arrival at the home people were observed arriving in the kitchenette area and being offered an early morning drink by the night staff on duty. Breakfast was individualised and served at a time that the person preferred. Care Homes for Adults (18-65 years) Page 16 of 30 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. The health and personal care people receive is based on their individual needs and they are assisted by a supportive workforce. Evidence: People living at the home had a care plan, which outlined their needs and the action required by staff to meet them. Each person case tracked had their own care plan and peoples mental health needs were clearly recorded along with information in respect of any other relevant health needs. The care planning documentation was being reviewed regularly and was found to be up to date and reflect the persons needs, so staff had the relevant information to ensure peoples needs were met effectively. People were supported with personal care if needed, but independence was promoted as part of the maintenance of life skills. There was also a range of risk assessments that highlighted potential risks and the action required to minimise them, so people could lead a meaningful life. All the risk assessments we saw had been regularly updated and amended to show the changing needs of people living in the home. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: All people living at the home were registered with a G.P. People had access to other health and social care professionals as required including social workers, chiropodist, dieticians and hospital consultants. This ensures peoples health care needs are being monitored by other professionals. The homes medication system consisted of a box system with printed Medication Administration Records (M.A.R) being supplied by the dispensing pharmacist on a monthly basis. The home had copies of the original prescription (F.P 10s) for repeat medication, so they were able to check prescribed medication against the MAR chart when it entered the home. On inspection of the medication it was found some of the audits were not correct indicating people had not received their medication correctly. No one living at the home was administering their own medication. Care Homes for Adults (18-65 years) Page 18 of 30 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 who use the service are able to express their concerns, are protected from abuse and have their rights protected. Evidence: The home has a complaints procedure which meets the standard, however this was not accessible to people in the Service User Guide. Staff have a meeting with people living in the home every morning which forms part of the ongoing monitoring of peoples concerns and needs. On discussion with people no one expressed any concerns . One relative spoken to during the visit was happy with the care provided and told us the owner was always accessible if they had any queries. The home had a robust Adult protection policy and procedure. Staff spoken to demonstrated a good knowledge of safeguarding procedure in the home, but were unsure what happened after issues were reported to the management team. Staff need to be fully aware of how the safeguarding process works so they can be confident that people in their care are fully protected. Staff need to be aware of how the safeguarding process works so they can be confident people are being fully protected. The training matrix demonstrated only two of the eight staff had received training in safeguarding, however, elements of the National Vocational Qualification (NVQ) training does cover safeguarding. Records indicted staff had not recieved any training in respect of the Mental Capacity Act or the Deprivation of Liberty safeguards. It is recommended that these areas be reviewed and staff given the appropriate Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: training to ensure they are aware of the responsibilities in supporting people who lack capacity to make decisions and safeguarding people . The home opened six months ago and had not received any complaints during that period. There have not been any safeguarding issues at the home in the last six months and we have not recieved any complaints about the service. Care Homes for Adults (18-65 years) Page 20 of 30 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 live in a safe, well maintained, clean and comfortable environment that meets their needs. Evidence: The premises were found to be bright, airy and comfortable. The home is located within walking distance of Rowley Regis town centre. There is a vertical lift and good access for all people to the communal areas of the home. The ground floor communal is open plan and is divided into sections consisting of lounge and kitchenette area with a conservatory attached. The environment was found to be clean and free from any unpleasant odours. People spoken to were happy with their rooms and the accommodation at Karenza. People living in the home have their own single room, with an en-suite shower, toilet and wash basin. We were informed in the AQAA that difficulty was being experienced with the new flooring in the showers. All en-suite showers in the home need the flooring to be replaced to ensure the safety and comfort of people living in the home. We have been reassured by the owner this will take place. We looked at a number of bedrooms and they were well furnished and personalised to peoples taste, gender and culture. People living in the home had a lockable facility in their bedrooms to keep their valuables in, enhancing arrangements for privacy. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Laundry for people living at the home is taken to the care home next door, which is owned by the same organisation, on a daily basis. Care Homes for Adults (18-65 years) Page 22 of 30 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. People living at the home are supported by staff in sufficient numbers. Staff need training in a number of areas so they can fully meet the needs of people living in the home. Recruitment procedures could not demonstrate a robust selection process. Evidence: The home was found to be appropriately staffed on the day of the visit. We were told by a relative that they had no concerns about the care provided at the home. They stated girls alright...do a great job... this place is like home.... can trust them. We looked at four recruitment files and found all the information required by legislation was available ensuring a robust process and people were safeguarded. There was no evidence of interview notes in the files, so the home could not evidence that gaps in employment had been explored at the time of interview. This area should be reviewed to ensure robust procedures. We looked at the training matrix which gave us an overview of training staff had undertaken. We looked at staff files and found copies of certificates which matched the training matrix records. The majority of staff had received training from their previous employers. The home needs to implement its own training programme to ensure staff knowledge and skills are up to date and relevant to the current client group and Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: facilities in the home. Staff told us they had received induction training, which had taken place in another home owned by the organisation. Staff told us they had not received training in the Mental Capacity Act or Deprivation of Liberty Safeguards and were not aware of its implications. The Mental Capacity Act is an important piece of legislation, which came into force April 2009 and staff must have some awareness of this legislation so they area aware of thier responsibilities in supporting people who lack capacity to make decisions. Also only two members of staff had received training in dementia care. Training in dementia care is essential for staff working in a home providing care for people with dementia, so they have the knowledge and skills to supp rt people effectively. Care Homes for Adults (18-65 years) Page 24 of 30 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 home is run in the best interests of people living in the home. Evidence: The home is managed by the owner who is a registered mental health nurse and has a variety of experience mental health needs and running of care homes. There was no formal quality assurance system in place. We were told a meeting had been held with people living at the home in August 2009. There was no evidence that staff meetings had taken place. One relative spoken to during the inspection told us the manager was always available if they had any queries or concerns. The home manages money for one person. The system in the home consists of a transaction sheet along with receipts. We were told by the owner that copies of the receipts and the transaction sheets were sent to the next of kin on a regular basis. There was one discrepancy found on one of the transactions, the manager stated this Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: would be looked into. Staff prepare the meals for people, but training records demonstrated all staff did not have a current food hygiene certificate. This needs to be addressed to ensure appropriate hygiene standards for food preparation. The Annual Quality Assurance Assessment was returned to us in a timely manner. The AQAA contained clear, relevant information that was supported by a wide range of information. Staff had not received training in the Mental Capacity Act 2005 and the Deprivation of Liberty safeguards amd were unclear about what it meant for the day to day operations of the home. A sample of Health and safety records were inspected and they demonstrated appropriate checks and servicing of equipment had taken place to maintain the health and safety of people living in the home. The building had recently been refurbished and had been signed off by the building regulator and fire service as fit for the purpose of a care home. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 20 13 Staff must ensure that people living at the home recieve their medication as prescribed and records demonstrate this. To ensure people recieve their medication as prescribed. 30/11/2009 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 1 The Service User Guide should contain information about how to complain and be an accurate reflection of the services and facilities provided in the home. This will ensure people and or their representative have a clear account of what they can expect on moving into the home. Care plans should be comprehensive and include rehabilitation details. They should include clear strategies with clear goals that can be achieved by people living at the home with the support from staff. This will ensure focus on the development of skills and consideration for future aspirations. A quality assurance system should be implemented to Page 28 of 30 2 6 3 20 Care Homes for Adults (18-65 years) 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 assess staff competence in their handling of medicines. Appropriate action should be taken when these indicate medicines are not administered as prescribed and records do not reflect practice. This will ensure all medicines are administered as prescribed and peoples well beign maintained. 4 5 22 23 The home should explore a variety of formats which informs people living at the home how to raise concerns. The home should ensure staff are trained and knowledgeable about the whole of the safeguarding procedure to ensure people living at the home are protected. A replacement programme should be drawn up for the ensuite shower floors and these should be replaced in a timely manner, to ensure the health and safety of people living in the home. Interview notes should be kept in relation to the recruitment of new staff and they should demonstrate any gaps in the employment history are explored to ensure a robust recruitment procedure. Shortfalls identified in training needs such as Dementia, Mental Capacity Act, Safeguarding, Food Hygiene, First Aid and Health and Safety should be addressed in the appropriate learning style so that this training embeds. Staff competences following the training must be checked and any shortfalls addressed. This will ensure that staff knowledge and practice mirror and meets the needs of people living at the home. It is recommended that the home obtain a copy of the Department of Health guidance Mental Capacity Act 2005 core training set, published July 2007 and staff are provided with training, so staff are aware of their responsibility and peoples rights are protected. A quality assurance system should be implemented, so that people living in the home can be confident their views are listened to and there is a egular monitoring of the service and continuous improvment. 6 24 7 34 8 35 9 35 10 39 Care Homes for Adults (18-65 years) Page 29 of 30 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. Care Homes for Adults (18-65 years) Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!