Care Home: Leigham Lodge

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What the care home does well People planning to use the service needs are fully assessed before they move in. Care plans and risk assessments give good information about peoples support needs and how the service can meet these needs. People are offered a varied programme of activities that reflects their individual interests. Appropriate arrangements are made so that people can have contact with their friends and families. People have good access to appropriate healthcare professionals. Peoples complaints and concerns are listened to and there is a clear complaints procedure. There are policies in place for safeguarding adults and staff is attending training on adult protection. The service is well managed. What has improved since the last inspection? In August 2008 Leigham Lodges previous providers Beacon Care were taken over by CareTech a large provider of learning disability care services. Managers have recognised that there are areas of the building that require refurbishment and redecoration, plans are in place and work is underway to make the building more homely and comfortable for the people who use the service. Managers are introducing new systems such as care planning and person centered planning and CareTechs policies and procedures are also being introduced. The service received a 4 star rating from Score on the Doors for food safety. What the care home could do better: The pharmacist could stamp the returns of medication book upon receipt of medication. Staff could attend training or refresher training if required on safeguarding adults and CareTechs Safeguarding Adults Procedures could be discussed at the staff meeting. The working surfaces in the kitchen must be replaced. The kitchen could be fully refurbished. The stained carpet in one persons room and the flooring in another persons en suite bathroom should be replaced or repaired. The worn furniture in the living room could be recovered.The lighting in the living room could be repaired or replaced. The dining room, bathrooms, hallways and living rooms should be redecorated. Staff that have not attended annual fire safety training must do so at the earliest convenience. We would like to thank the people who use the service, staff, the area manager and the registered manager for their comments and support during the inspection process. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Leigham Lodge 64 Leigham Court Road Streatham London SW16 2PL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: James OHara     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: Leigham Lodge 64 Leigham Court Road Streatham London SW16 2PL 02086646640 02086646640 leigham@beaconcaregroup.co.uk 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) : Leigham Lodge Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 6 In August 2008 Leigham Lodges previous providers Beacon Care were taken over by CareTech a large provider of learning disability care services. Leigham Lodge was registered on 31st December 2004 to provide care and accommodation to six people with learning disabilities and challenging behaviour/autism. Leigham Lodge is a two storey semi-detached building entered via an electronically operated gate with entry phone. There is limited room for parking on the forecourt and there is a medium sized garden at the rear. Leigham Lodge is within 5-10 minutes walking distance from Streatham High Street which has full community facilities and bus and rail routes into central London and out to the coast. The ground floor has two lounges, a kitchen, a dining room, a bathroom with toilet and two bedrooms, each with en-suite. There is access to the garden via a door in the dining room and also via a French door in one of the bedrooms. Upstairs there are four bedrooms, three of which are en-suite, a bathroom with toilet, a double cupboard that houses the laundry facilities and a very small office.The current fee for a placement at Leigham Lodge range between £949.24 and £1611.03 per week. Care Homes for Adults (18-65 years) Page 4 of 32 Care Homes for Adults (18-65 years) Page 5 of 32 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 2 star. This means the people who use this service experience good quality outcomes. We spent six hours at the service and talked with one person who uses the service, one member of staff, the area manager and the registered manager. Records and documents examined during the inspection included the care plans, activities, medication, staffing and training and health and safety. An expert by experience, a person that has experience of using a learning disability service, also attended the inspection and spoke to a number of people who use the Care Homes for Adults (18-65 years) Page 6 of 32 service and members of staff. Some of the experts by experiences comments are included in this report. What the care home does well: What has improved since the last inspection? What they could do better: The pharmacist could stamp the returns of medication book upon receipt of medication. Staff could attend training or refresher training if required on safeguarding adults and CareTechs Safeguarding Adults Procedures could be discussed at the staff meeting. The working surfaces in the kitchen must be replaced. The kitchen could be fully refurbished. The stained carpet in one persons room and the flooring in another persons en suite bathroom should be replaced or repaired. The worn furniture in the living room could be recovered. Care Homes for Adults (18-65 years) Page 8 of 32 The lighting in the living room could be repaired or replaced. The dining room, bathrooms, hallways and living rooms should be redecorated. Staff that have not attended annual fire safety training must do so at the earliest convenience. We would like to thank the people who use the service, staff, the area manager and the registered manager for their comments and support during the inspection process. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 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 32 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 planning to use the service can be sure that the service can meet their needs because their needs are fully assessed before they move in. Evidence: In August 2008 Leigham Lodges previous providers Beacon Care were taken over by CareTech a large provider of learning disability care services. The Statement of Purpose is currently under review to reflect the aims and objectives of the new providers. The Service User Guide is in a format that is suitable to the people who use the service. As required at the last key inspection information about fees and what they cover to have been added to the Service Users Guide. People planning to use the service and their relatives and advocates have access to the information about the service. Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: No new people have moved in since the last key inspection. The service caters for people with learning disabilities who may also have additional challenging needs, including autism. The Statement of Purpose states that when potential placements are referred by social services they are assessed by senior staff and the placement officer to ascertain if the service can meet their needs. They also consider if they are compatible with the existing people who use the service. If the service feels that they can meet the new persons needs then the new person can visit the service to meet the people who live there and staff and have overnight stays before deciding to move in. The Statement of Purpose includes a checklist of things the new person would expect to happen in the first three months of moving in. One person is moving to another service more suitable to their assessed needs. This person is being supported by staff to visit their new placement. The expert by experience told us peoples welfare is upheld as the regional manager told them that one person who has challenging behaviour is moving to a more suitable smaller service. Care Homes for Adults (18-65 years) Page 12 of 32 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 can be sure that they are properly supported and safe because care plans and risk assessments give good information about their support needs and how the service can meet these needs. Evidence: We looked at two peoples files at random. The files included a care plan that was reviewed by their key workers on a monthly basis, care plans were comprehensive and involved people and their representatives, including family or advocates and other professionals. People had clearly been involved in the setting up of their care plans. Care plans covered areas such as the persons general health and mental health needs, communication skills, daily living, relationships and sexual needs, community presence and participation, leisure activities, education, employment, training and a cultural and spiritual needs assessment. The files also included a clients induction programme. Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: The registered manager produced evidence that these people had their placements reviewed by a care manager from their placing authority. People also had person centred plans. These were completed words and pictures and included important information about the person and their wishes and hopes for the future. Files included initial risk assessments carried out at admission and reviewed on a six monthly basis. Where risks were identified procedures and care plans reflected how these were being managed. There are also guidelines appropriate to peoples behaviours, such as absconding or obsessive behaviours. Independence is promoted where possible. Any restrictions placed are minimal these are recorded in the care plan and would be for the safety and welfare. The expert by experience told us that people are involved in their care plan reviews, and the company is in the process of updating peoples files, as the service has only been recently taken from another provider. Meal times and menus varied and people have choices of what to eat at each meal. People are free to go to bed when they want as there two waking night staff. Care Homes for Adults (18-65 years) Page 14 of 32 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 can be sure that their social and leisure needs are met because they are offered a varied programme of activities that reflects their individual interests. Appropriate arrangements are made so that people can have contact with their friends and families. Evidence: We looked at peoples activities. One person attends a day service three days per week and attends a luncheon club specific to their religion and culture, another person goes to college once a week. The registered manager told us that another person is enrolling at a college. The service has a minibus and people are supported to go to activities such as tenpin Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: bowling, swimming, meals out or just out for a drive. People also go for walks in parks or to local cafes. In house activities include art sessions, sensory sessions and dancing. An aroma therapist visits some people. People have weekly activity charts located on the walls in the staff room and their bedrooms, these have a photograph of the person and times for the activity scheduled each day. The registered manager told us that all of the people who use the service went on individual holidays last year. People went to places such as Brighton, Blackpool, Kent and Romney Marsh. The registered manager told us that all of the people who use the service have regular contact with their friends and family. Some people receive visits at the service and some people have regular visits to their family. People can also keep in contact by telephone. One person who is non verbal contacts their relative by telephone so that their relative can speak to them, this ensures weekly contact and maintains the relationship. Some people have framed photographs of their families in their bedrooms, which help to strengthen their family links. Daily routines are flexible according to peoples choices and needs. For example, one person chooses to get up at 4am each morning, whilst another person sleeps in till 9am unless it is a day centre attendance day. Similarly, people go to be at a time of their choice. One person whose autistic needs requires a fixed routine, this is charted out and provided daily. The kitchen is kept locked because some people could damage themselves or the equipment if given unsupervised access. These people can access the kitchen under the supervision of staff. Independence is promoted where possible. Any restrictions placed are minimal these are recorded in the care plan and would be for the safety and welfare. Menus evidenced that people are given an imaginative, varied and nutritionally good range of food, which includes plenty of fresh fruit and vegetables, and a range of foods suited to peoples cultural backgrounds and preferences. People have a number of choices of what they want to eat each day. The registered manager showed us recipes for meals that reflect the cultural needs of some of the people who use the service, these included West Indian and Portuguese meals. Once a week staff assists people to choose the next weeks menu using photographs and pictures of different meals. People can also indicate their choices when they accompany staff on weekly shopping trips. The expert by experience told us the service is well staffed and people have various Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: activities which they they like to do. During the visit one person had been out in town with staff, and also went out later for a walk. People activities are well planned and activities charts, which are in easy read, and in pictures have been put up in peoples bedrooms and on a notice board in the dining room. One person likes trampolining, there is a trampoline in the back garden, this person is supported by staff and a net has been put in place to prevent them jumping over the fence. Care Homes for Adults (18-65 years) Page 17 of 32 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 be sure that their health care needs are met because medication is well managed and they have good access to appropriate healthcare professionals. Evidence: People who use the service have severe learning disabilities and or autism traits and all but one cannot communicate verbally. All staff has attended training on autism. Some people present challenging behaviour. Appropriate guidelines, risk assessments and records are in place to support people that present challenging behaviours. The majority of staff has attended training on challenging behaviours. Throughout the course of this site visit staff were observed to treat people with dignity and respect. It is the service policy that people receive personal care by same gender staff. The deputy manager showed us the medication system. Medication is obtained mainly in a blister pack system and is stored in a locked cabinet in the office. The deputy Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: manager produced evidence that medication is audited on a daily basis by staff at handover and on an ad hoc basis by the registered manager. Medication administration records checked were up to date and accurate. There are guidelines in place for administering as required medication and sheets for recording the reasons for non-administration of medication. The deputy manager produced a book for receipts and returns of medication. Currently when medication is returned to the pharmacist the pharmacist signs the book. It is recommended that the pharmacist stamp the returns of medication book upon receipt of medication. The registered manager told us that they have a contract with the local pharmacist for support and advice on medication. The local pharmacist visited in July 2008 to advise on medication procedures and recorded that there were no problems with medication and that all of the people who use the service had their medication reviewed by their General Practitioners in the last six months. People are registered with a local general practitioner and can access dentist, community learning disability team, psychologist, optician, chiropodist and behavioural support service if and when required. Peoples files had an accident and emergency grab sheet which has full details of any health needs that would need to be considered by medical staff in the event of an emergency. Files also included health action plans and records of health care appointments. Care Homes for Adults (18-65 years) Page 19 of 32 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 can be sure that their complaints and concerns are listened to because there is a clear complaints procedure. People are protected from harm and abuse because there are policies in place for safeguarding adults and staff is attending training on adult protection. Evidence: There are policies and procedures in relation to complaint management. A system was in place to record complaints made about the service. As required at the last key inspection the complaints policy includes details on how to contact the Commission. The registered manager told us that one person had made a complaint since the last inspection. This complaint had been investigated by the service and resolved to the satisfaction of the person concerned. The registered manager produced a copy of Lambeth Inter Agency Adult Protection and CareTechs Safeguarding Adults Procedures. These are used to make sure that people are protected from harm and abuse. Staff training records indicates that of the twelve staff, five had attended training on adult protection in 2007 and 2008. The registered manager told us that other Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: members of staff had attended adult protection training some time ago. The registered manager told us that two members of staff are due to attend safeguarding training in a weeks time. The registered manager told us that they are due to undergo training with Lambeth to become a Safeguarding Adults trainer. The area manager told us that they had identified the need for staff training safeguarding adults at a number of their services and had planned training for staff. It is recommended that all staff attend training or refresher training if required on safeguarding adults and that CareTechs Safeguarding Adults Procedures are discussed at the next team meeting. Care Homes for Adults (18-65 years) Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Managers have recognised that there are areas of the building that require refurbishment and redecoration, plans are in place and work is underway to make the building more homely and comfortable for the people who use the service. Evidence: Peoples bedrooms are furnished and decorated to comfortable standards and reflect their individuality and personal interests. However the carpet in one persons room was badly stained and the flooring in another persons en suite bathroom was not properly affixed the floor. The en suite shower room in another persons room was being repaired. It is recommended that the stained carpet in one persons room and the flooring in another persons en suite bathroom be replaced or repaired. Both of the ground floor bedrooms and two of the four upstairs bedrooms have en suite facilities. There is a communal bathroom with toilet on both floors that people with non en suite bedrooms can use. There are many homely touches around the premises including photographs of social Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: events such as holidays and parties. There are two living rooms, one had some comfortable furniture however some of the furniture was worn. This living room had a large television however the top of the television was cracked. When this was pointed out to the area manager they immediately raised funding for a new television. The area manager also told us that they would arrange for the worn furniture to be recovered. The lighting in the other living room had had been damaged. It is recommended that the worn furniture in the living room be recovered. It is recommended that the lighting in the living room be repaired or replaced. The dining area has comfortable furniture and is set out in a way that people prefer. The decoration in the communal areas was generally poor however the registered manager and the area manager produced an action plan that covered redecoration and repairs of the bathrooms, bedrooms, dining area and kitchen. The plan included timescales of when the work should be completed. It is recommended that the communal areas including the dining room, bathrooms, hallways and living rooms are redecorated and repaired. A requirement was set at the last key inspection that all areas of missing tiles etc. in the kitchen are made good and that the temperature markings on the oven are repaired or replaced. The registered manager told us that a new cooker had been purchased and installed since the last inspection. CareTechs estates manager was on the premises carrying out an assessment of the kitchen. They told us that they planned to replace the sink and working surfaces and possibly replace the whole kitchen. The registered manager must ensure that the working surfaces in the kitchen are replaced. It is recommended that the whole kitchen be refurbished. There is an entry phone system, which controls an electronically operated gate to the front of the house. The gate was being repaired after it was damaged in an accident. The expert by experience told us the house was spacious with a separate dining and Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: lounge areas and a quiet room which is used by people when they want a quiet moment away from the others. There were decorators working on one persons bedroom. People have a choice of colours that they want in their rooms. Most bedrooms have en suite facilities. The back door is kept locked but the key is stored just by the side of the door in case someone wanted to get out. The expert by experience told us in all the rooms they visited there was some broken cupboards. The garden was small and the trampoline had taken up most of the garden space. One of the bedrooms had a strong smell of urine and the front door had an entry code which people are not able to operate in case they wanted to go out in the front yard. Care Homes for Adults (18-65 years) Page 24 of 32 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 can be sure that they are safe because there are enough competent well trained staff on duty at all times. They can have confidence in the staff because checks have been done to make sure that they are suitable to care for them. Evidence: There is currently twelve staff working at the service. Ten staff has completed NVQ level 2 or 3 in Care. All staff has completed the Skills for Care Common Induction Standards on Social Care for Adults. Staff training records indicate that most staff has attended training on first aid, health and safety, medication, autism, fire safety, food hygiene, moving and handling, infection control however some staff require refresher training in these areas. The deputy manager showed us a completed training analysis for the service. This had been forwarded to the CareTech Training department and training is being arranged. It is recommended that all staff attend training or refresher training if required on safeguarding adults and that CareTechs Safeguarding Adults Procedures are discussed at the next team meeting. Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: Seven staff had attended annual fire safety training however five staff has not. The registered manager told us that this training has been booked later in the year. The registered manager must ensure that all members of staff that have not attended annual fire safety training do so at the earliest convenience. We looked at all members of staffs personnel files. All of the files included Protection of Vulnerable Adults and Criminal Record Checks, a recent photograph, a copy of their passport, proof of identification, two written references, a health declaration and contracts. The files also included completed application forms and job descriptions. Most of the references obtained from previous employers on behalf of staff had been signed by the referee and included their role however the references did not include their address and had not been returned on company headed paper or include a company stamp. In order to protect the people who use the service it is recommended that references taken up for any potential staff are requested on company headed paper or includes a company stamp. The files indicated that staff are receiving regular formal supervision and an annual appraisal. Records show that regular staff team meetings are being held. Staff members expressed positive comments on their experience of working at the service. Care Homes for Adults (18-65 years) Page 26 of 32 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. People can be sure that their needs are met and their wishes are taken into consideration because the service is well managed. People can be sure that are protected from harm because good health and safety arrangements are in place. Evidence: The registered manager has managed the service for three years and has fourteen years experience of working with people with learning disabilities who present challenging behaviours. The registered manager has completed the Registered Managers Award and NVQ level 4 in Care and is due to undergo training with Lambeth to become a Safeguarding Adults trainer. The registered manager produced regulation 26 visit reports for the service. The area manager was carrying out such a visit during this site visit. The regulation 26 visits covered the outcome areas as laid out in a Commission for Social Care Inspection Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: report. The registered manager also produced monthly audits drawn up and agreed by the registered manager and the area manager. Surveys are sent out annually to peoples relatives and professionals with links to the service. People who use the service also complete an annual survey. The registered manager told us that feedback from the surveys is used to improve the service. CareTech have provided the service with company policies and procedures and the registered manager has shared these with staff. The registered manager produced evidence that fire alarm system is being checked on a weekly basis. Engineers serviced the fire alarm system and extinguishers in November 2008. Portable appliances and legionellas were tested in January 2009 and the registered manager produced a landlords gas safety certificate dated 23rd of December 2008. The service received a 4 star rating from Score on the Doors for food safety. Care Homes for Adults (18-65 years) Page 28 of 32 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 29 of 32 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 24 13 The registered manager must ensure that the working surfaces in the kitchen are replaced. To reduce the risk of the spread of infection and to protect people who use the service. 15/05/2009 2 32 23 The registered manager must ensure that all members of staff that have not attended annual fire safety training do so at the earliest convenience. To protect people who use the service in the event of fire. 31/03/2009 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 It is recommended that the pharmacist stamp the returns of medication book upon receipt of medication. Page 30 of 32 Care Homes for Adults (18-65 years) 2 23 It is recommended that all staff attend training or refresher training if required on safeguarding adults and that CareTechs Safeguarding Adults Procedures are discussed at the next team meeting. It is recommended that the worn furniture in the living room be recovered. It is recommended that the lighting in the living room be repaired or replaced. It is recommended that the communal areas including the dining room, bathrooms, hallways and living rooms are redecorated and repaired. It is recommended that the kitchen be refurbished. It is recommended that the stained carpet in one persons room and the flooring in another persons en suite bathroom be replaced or repaired. It is recommended that all staff attend training or refresher training if required on safeguarding adults and that CareTechs Safeguarding Adults Procedures are discussed at the next team meeting. 3 4 5 24 24 24 6 7 24 24 8 34 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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