Care Home: Lanchester Court Care Home

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What the care home does well Gets very good information about the care and support needs of people who wish to use the service so that everyone is sure they can be met. Produces service user plans in a very person centred way, making it clear that they have been involved, and detailing what each person wishes to achieve. Helps and supports people living in the home to see a wide range of healthcare professionals as their different and diverse needs require. People can see professionals in the home or the local community as they choose. Promote independence and encourage people to re-gain skills they may have lost during the time they have been unwell. They try to instil confidence in people and get them to travel independently, take on work placements or go to college. They take seriously the views of people living in the home, listen to them and even make changes that they have suggested. Provide everyone with a fabulous place to live that gives them not only their own private accommodation, but a range of shared areas including a sensory garden, relaxation room, games/cinema room and hydrotherpy pool. Help people to recieve their medication in a safe way and to take control of it if they wish and feel they are able. Throughout the inspection both residents and staff were seen spending time together, laughing, joking and helping each other. The service employs its own director of clinical services, registered nurses, occupationan and physio therapists, who support both staff and residents on a daily basis. What has improved since the last inspection? The new hydrotherapy pool is due to be installed on the 2 November 2009, for the comfort and pleasure of the residents. What the care home could do better: Only one requirement was made as part of this inspection and that was for the organisation to decide whether they are going to continue keeping staff records centrally or whether they will, in the future, be available in each service. Key inspection report Care homes for adults (18-65 years) Name: Address: Lanchester Court Care Home Lanchester Court Care Home Lanchester Avenue Wrekenton Gateshead Tyne and Wear NE9 7AL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Elaine Charlton     Date: 2 9 1 0 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: Lanchester Court Care Home Lanchester Court Care Home Lanchester Avenue Wrekenton Gateshead Tyne and Wear NE9 7AL 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): nevillesx@aol.com Careline Lifestyles UK Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 22 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category(ies): Learning disability, not falling within any other category - Code LD, maximum number of places: 12 Physical disability, not falling within any other category - Code PD, maximum number of places: 10 Date of last inspection Brief description of the care home Lanchester Court is a purpose built service in a residential area of Wrekenton. It provides care and support to 22 people with either a learning or physical disability. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 12 10 Brief description of the care home The accommodation is brand new and of a very high standard. People have the chance to live in a bedroom with full en-suite failicites or a private flat. There are a range of communal facilities including dining room, lounges, cinema/games room, sensory room and hydrotherapy pool. Both care and nursing staff are employed on the staff team, and the organisation also employs its own clinical director, occupational and physio therapists. Fees for the service are between £900 and £1650 per week. Information for people who wish to use the service or professionals is available in a range of formats and there is an organisational web site. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star, this means that the people who use this service experience good quality outcomes. As this was the services first key inspection this is the highest rating that they could have achieved. An unannounced visit was made on the 29 October 2009. A total of five hours were spent in the service. The care manager was present throughout the inspection. Before the visit we looked at Information we have received since the service was registered. The Annual Quality Assurance Assessment (AQAA) that gives CQC evidence to support what the service says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are. How the service has dealt with any complaints and concerns since our last visit. The providers view of how well they care for people, Care Homes for Adults (18-65 years) Page 6 of 30 and the views of people who use the service, their relatives, staff and other professionals who visit the service. We have also reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. During the visit we Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building/parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since our last visit. We told the care manager what we found. 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 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. Care Homes for Adults (18-65 years) Page 8 of 30 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. People who wish to move into the home have their very differing and diverse needs fully and properly assessed so that everyone is sure they can be met. Evidence: The organisation can provide both people who might wish to use the service and healthcare professionals with lots of information about what life at Lanchester Court might be like. This can be provided in a range of formats including DVD and there is also an up to date web site for the service. Pre-admission assessments are carried out and the person approaching the home for a service is provided with a comprehensive letter that sets out the prospective clients needs, what Lanchester Court can offer, how this will be offered and the cost of the service. We saw copies of assessments from healthcare professionals as well as the organisation own assessment. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: After the assessment process the home works with the person to produce a very person centred care plan that identifies their needs, how they wish to be supported, and how they can be helped to develop their skills and lives. We saw that care and support can be provided tailored very much to the individual persons needs. Although the service is a registered as a residential home people who live in the flats can choose if they allow staff in, when they do this and which staff they are happy to see. Health and social care professionals are able to visit the service to see what can be provided as well as people who may wish to use the service, their relatives and friends. Once a person has had a full financial assessment and their benefits have been sorted out, the organisation provides them with a contract setting out the responsibilities of both the individual resident and the organisation. Where a person needs, nursing care can be and is provided. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make their individual needs, wishes and choices known so that they can be supported to achieve them and to have their care provided in a way they choose, by who they choose. Evidence: Everyone who moves into the home has a person centred plan put together, with their involvement, so everyone is sure what it is they need, what they can do and what they would like to be able to do in the future. Residents are very involved in what is going on in the home, what they want to do, when they want to do it and whether they can do it independently. One person has their own car and goes out shopping. We saw comprehensive risk assessments in place covering a wide range of areas and tasks. Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: Records are kept securely in the home and people can speak to someone in private if they wish. Care plans are supported by risk assessments and guidance. This includes moving and transferring and behaviours that may challenge daily routines. We looked at the service user plans for two people who have moved into the home. These were very comprehensive, person centred, sensitive and showed that not only the resident but an appropriate range of healthcare professionals had been involved in putting the plan together. The organisation employs its own physio and occupational therapists who support residents and their staff. They are also involved in assessing a persons ability to travel or do tasks independently. We saw evidence of independent travel checks being carried out. Everyone who lives at Lanchester Court has an important say in what goes on, whether changes need to take place or how they think improvements can be made. A recent example of this was that residents said they would prefer to use an upstairs room, close to a small kitchen, as their dining room instead of the area on the ground floor. This change has now taken place. Staff are aware of the procedures to use to make sure that people get to make their own choices. An application for one person who wishes to move in has gone to the Best Interests Panel as a member of their family does not agree with the move. The organisation is well aware of the need to meet and use Deprivation of Liberty legislation. 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 are encouraged to live an independent life, to get out and about as and when they choose, and to re-gain skills they may have lost whilst being un-well. Evidence: People are encouraged to be as independent as possible and to expand their social contacts, employment opportunities and college opportunities. Each person has a separate activities file where their weekly schedule is set out, timed and planned. There is also a chance for staff to update the record to say whether the person has achieved what they wanted during the week. There is an additional sheet that records each persons progress towards meeting their personal rehabilitation goals. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: People are encouraged to take up educational and training courses, voluntary work that may lead to a full time placement, and to get out and about in the local community. One person has their own car, and others make use of the local transport systems. During the inspection one person told us that he was going out with another resident and a member of staff. They were going to the metro centre, out for a chinese meal and then to the pictures. He checked on the televisions Cefax system to show us the timings of the film he wanted to see. He also told us about a staff/resident meeting that had recently taken place and where fire procedures had been discussed. Throughout the inspection relationships between the people living at Lanchester Court and their staff team were seen to be warm, sensitive and professional. It was evident that everyone knew each other well and were able to make jokes about things that were going on. On the lower ground floor there is a relaxation room, cinema/games room and a hydrotherapy pool was due to be installed on 2 November. Two people have had internet connections installed in their flats. Another person has started to make use of a local gym and goes independently for a regular workout. Efforts are being made to increase links with the local community, family and friends are very welcome and meal times are flexible. There is a central kitchen on the lower ground floor, but also a more domestic style one on the first floor where people can make themselves drinks, can try out cooking and baking, or make a light snack. We were told that two of the gentleman had made a lasagne the previous night for a birthday party and that this had gone down very well. Routines within the home are extremly flexible, and very much lead by each residents choices and commitments. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can choose how and from whom they receive their personal and health care support. They are encouraged to be as independent as possible and can see healthcare professionals when they want, either inside or outside the home. Evidence: People can choose how and when their personal and healthcare needs are supported. We met a healthcare professional who visits the home regularly and has placed several residents there. We were told that the care provided has made huge changes to the lives of the people who live in Lanchester Court and that staff know how to meet their differing needs and moods. The organisation employs its own Physio and Occupational Therapists who are regular visitors and help people with their plans to carry out tasks independently and with risk assessments. They are also involved in the review and evaluation processes. The organisation has a comprehensive policy on the safe handling of medication. Five care staff and three nurses have completed training in the safe handling of Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: medication. We carried out a random check of medicines held in the home. Records and storage systems were in place, are secure and only two minor issues were identified. These were: - the need for a photograph of each resident to be affixed to the front of their MAR chart to minimise the risk of the wrong person being given another persons medicine; - handwritten entries on the MARs should be double signed. Once by the person making the entry and the second time by another person who has checked that the information written on the MAR is correct. There is also a separate folder which holds a copy of each residents individual medication profile. This can be taken to appointments or used when GPs wish to review a person medication. The GPs name and address, residents dob, pharmacy contact number, date chart started, known allergies/drug sensitivities/special instructions etc are all recorded. The chart also lists which medicines are being taken and when. This is good practice. People are also helped to access services like the Sight Service where they can access advice and/or equipment to make their life easier. 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 live in the home are protected through policies, procedures and staff training that promote the acceptance, recording, investigation and proper feedback on compaints, concerns and allegations. People know they will be listened to and that their comments are valued. Evidence: The organisation has comprehensive policies and procedures in place that promote the acceptance, recording, investigation and feedback on complaints, concerns and allegations. There is a whistle blowing policy that encourages people to speak up if they witness practice or behaviour they know is wrong or that gives them cause for concern. There is a complaints file in place and staff are encouraged to complete a form for even the smallest issue. We saw the file and where it had been necessary to make CQC aware of the event a copy of the Regulation 37 notification used for this purpose was being kept with the complaint form. This is good practice. Protection of vulnerable adults training is being provided during week commencing 2 November 2009. Everyone who works in the home has to have a Criminal Records Bureau (CRB) Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: checked carried out at an enhanced level to make sure they are able to work with vulnerable adults. Care workers are employed in accordance with the General Social Care Council (GSCC) code of conduct and nurses are required to prove that their registration with the Nursing and Midwifery Council (NMC) is current and up to date. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Lanchester Court live in a purpose built, very modern and exceptionally well equipped home where there is lots of space, a sensory garden and a number of private, spacious flats. Evidence: The home was purpose built this year to provide 12 en-suite bedrooms and 10 self contained flats. The facilities are excllent. The entrace forms a Cafe bar area, cinema room, dining room, main kitchen and residents kitchen where they can do food preparation/practice. Lots of up to date equipment has been provided and the both corridors and rooms are spacious. A hydrotherapy pool is due to arrive on the 2 November. Additional equipment is provided to meet the needs of new people moving into the home. The sensory garden can be access from the cafe area by both able bodied people and those who may need to use a wheelchair. There is also a fountain in the garden that glows with different colours at night. Additional fibre optic lights are being installed to make the garden a more interesting place. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: In one raised bed, all the plants being grown are perfumed and can be eaten. Staff and residents are getting to know these so they can be used in meal planning. On the lower ground floor there is the kitchen and laundry, a sensory room, cinema/games room and a hydrotherapy pool room. All the bedrooms we saw were spacious and had a full en-suite wet room. The flats contain a lounge/kitchen, bedroom, bathroom, entrancehall and suitable storage room. The latter could be used as a computer room. The level of furnishing and decoration is excellent. The flats have their own front door and a further private side door when leaving the building. The main entance to the home is on Lanchester Avenue and access is through a call bell/phone system. The whole builidng has been set up along the lines of a City chic hotel. Clear signage directs people to the bedrooms, flats and other facilities within the home. 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 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 protected through recruitment and selection procedures that we are told are regularly followed, staff training and supervision. Residents can also be helped to take part in the interviews for people who are going to work with them. Evidence: The organisation has recruitment and selection procedures to protect the people who live in the home when new staff are being sought. Staff records are currently kept in the Head Office but consideration is being given to either placing them in the homes or signing up to the CQC agreement to keep a minimum of records in the home for the purposes of staff safety and inspection. We were told that all the relevant checks were carried out as part of the recruitment process including CRB, NMC pin number checks, references and the obtaining of a comprehensive application form. We were unable to verify this on the day of the inspeciton. A mixture of care and nursing staff have already been employed to work in the home, and they are continuing to take part in training to help them do their job. The Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: organisation also has a clinical lead director, who plays an active role in the running of the services. During the inspection staff told us about the training they had had, what they were expecting and how they were getting on with their jobs. No issues of concern were raised by any of them. We were told that one person had recently taken part in interviews for members of his staff team and it was suggested that this is a good way forward. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in an open and inclusive way and in the best interests of the people who live there. They are kept safe through good health and safety procedures, are listened to and valued as individuals. Evidence: The home does not currently have a registered manager but we were provided with a copy of their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was extremly comprehensive and told us all about the services beliefs and how they hoped to provide services in the future. This is a unique style of home, and has created interest in the local area. Seven people are living there at the moment but the Care Manager has a list of people who are making applications to move in. We spoke to one care manager who has placed people in the home and is happy with the style of life they are living and the improvements they have made with some of their daily routines. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Comprehensive policies and procedures are in place that promote safe working practices, health and safety and control of infection. There is a system in place for the safe keeping of residents monies, and we saw during the inspection people coming to take money out, sign for it, and return any unwanted change and their receipts at the end of their trip. If staff escort a person to withdraw money from they bank a receipt is always obtained and staff are required to sign the reverse of the receipt to indentify who was with them when the withdrawal was made. This is good practice. All the records we saw were up to date, and in good order with the exception of the recording of fire equipment checks and emergency light checks. There had been some confusion between staff about whether it was them or the handyman who should do this. 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 34 19 The provider must decide whether to keep staff records in each establishment or enter into an agreement with CQC about the keeping of centralised records. This will mean that everyone is clear about what records will be kept where and how they can inspected for the protection and safety of people living in the home. 02/12/2009 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 20 A photograph of each resident should be included with their MAR chart to minimise the chance of medicine being given to the wrong person. Handwritten entries on the MAR should be double signed so that it is clear the correct instructions have been transcribed. This will promote the health and well being of people living in the home. Page 28 of 30 2 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 3 24 The treatment room, domestic room and other areas would benefit from shelving so that products can be kept in an orderly way, off the floor. This will aid stock and infection control. Staff should be clear about who is responsible for carrying out fire safety checks and how these should be recorded. This will promote the health and safety of both people who live and work in the home. 4 42 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. 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