Care Home: Lifeways

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What the care home does well Lifeways, 4 Duncan Street provides a pleasant and homely respite service for adults with learning disabilities. People who use the service seen during the visit to the home had little communication skills but the families contacted were very much in favour of the service describing it as "great" and "no major problems". The premises are homely and well suited to the care of people with disabilities. The company has a full range of policies and procedures which enable users of the service to be cared for based on good principles and in a safe manner. The home provides care based on individual care plans so they are suitable for the individual needs of people who use the service. The home is fully staffed and has developed its key worker role so that continuity of care is provided and individual responsibilities are clearer. It provides activities and meals based on individual preferences so that the wishes of people who use the service are respected. What has improved since the last inspection? Since the last inspection there has been a distinct improvement to the quality of the premises both internally and externally, resulting in a much more pleasant environment for users of the service and staff alike. The home has greatly improved its health and safety checks so that the safety of people using the service is enhanced. The home has improved the training both in terms of provision and recording meaning that training programmes can be better organised. Formal supervision is now planned systematically leading to greater support for staff. What the care home could do better: There has been a distinct improvement in staff supervision but this would be improved by appraisals so that a review of their work is undertaken. The home has full care plans but these are not always either dated or signed which detracts from their usefulness and needs to be corrected. In the same way, although complaints are being recorded this needs to be improved so the home can clearly show the outcome of complaints and the timescale within which they were resolved. The home could further promote the independence of people who use the service by reminding staff of the importance of this principle and encouraging them to motivate people using the service in this area. Risk assessments remain an outstanding problem although the home has started to address this but this process needs to be completed so that risks are fully documented and known. The manager has put in place measures to protect users of the service but further work is needed to resolve the question of water temperatures so that this is finally resolved. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lifeways 4 Duncan Street St Helens Merseyside WA10 3TE     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: John Mullen     Date: 1 4 0 4 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 28 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Lifeways 4 Duncan Street St Helens Merseyside WA10 3TE 02088771338 02088779543 lancashire@lifeways.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) : Lifeways Community Care Ltd care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 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: Learning disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home Lifeways 4 Duncan Street is registered to provide personal care and accommodation for up to four adults with learning disabilities. Lifeways Community Care Limited manages the home and there is currently no registered manager although an application is in the process of being made. The home is a part replacement for St Helens Councils in-house respite facility in this field and provides respite care for adults considered to have high dependency needs. It is located in premises previously used for supported tenancies and takes referrals exclusively through the Social Services Department. The home charges approximately 77.80 per week according to an assessment of service users means. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 28 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 stars. This means that the people who use this service experience good quality outcomes. This was a key unannounced inspection of Lifeways 4 Duncan Street Care Home which included a visit to the service. All key standards were assessed in addition to a selection of other standards. The inspection encompassed information received since the last key inspection including an improvement plan which was sent by the home following the last inspection. In addition it included information provided by the agency through its Annual Quality Assessment Assurance document (AQAA). The AQAA gives an overall Care Homes for Adults (18-65 years) Page 6 of 28 picture of the performance of the agency as well as factual information about the service. Interviews took place with the manager and three care workers. Three users of the service were case tracked; that is their support was examined in detail and this included interviewing members of their families. People who use the service were observed and others were spoken to. The premises were inspected and a large amount of documentation examined. 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 set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 28 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. The home obtains assessment material on its users so that work can be both individualised and relevant to their needs. Evidence: An interview with the manager confirmed that full assessment material is provided by St Helens Council prior to admission and this is supplemented by their own assessment so that full information is available. The manager hopes to further develop the assessment material to cover all aspects of daily living. An examination of case files found assessment material in each which could be used in the planning of care. Interviews with care workers found them happy with the material which they felt gave them a good background of information. Interviews with family members confirmed that they felt that their relatives needs were being met, resulting in an appropriate placement for them. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home needs to fully promote the individual skills of people who use the service so that their skills are fully developed. Evidence: An examination of service user files found care plans and support plans in each in order to guide staff and provide a plan of care. The manager stated that she felt the care plans were more useful than the support plans which was also the view of staff interviewed who felt the former were detailed and provide a good guide to the care to be provided. The care plans examined were not always dated and the record of reviews was not always in accordance with guidance so that the process was deficient in some respect. However, the care plans themselves were very detailed and interviews with family members found them happy with the manner in which care was being provided. The AQAA stated that more meetings had been arranged with users of the service and Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: family members so that the latter could have a greater impact in the running of the home. An interview with one care worker, supported by documentation seen, showed that more user meetings had been held and that their views were being sought in a number of areas which impacted on their daily living. However, both the manager and a care worker interviewed also felt that there is still a tendency amongst staff to provide care rather than to encourage independent action by users of the service. A large proportion of people who use the service have a limited capacity which makes staff actions understandable but it would be preferable if more independence was promoted so that the skills and abilities of people using the service can be developed. The AQAA stated that the home still needs to further develop risk assessments in the home, confirmed by the manager during the visit to the home, so that risks can be managed more thoroughly. An examination of files of people who use the service found a wide variety of risk assessments, some of which were undated and which did not always give a clear picture of the specific risks associated with people using the service. However, the manager did show a copy of a new risk assessment format which has started to be introduced and which is very detailed and comprehensive and gives a clear picture. Observations during the visit to the home found that the home was caring for its users in a responsible and appropriate manner meaning that their care was safe. Care Homes for Adults (18-65 years) Page 13 of 28 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. The home promotes an individualised and appropriate lifestyle for users of the service. Evidence: The home provides respite care and, therefore, is not primarily concerned in the area of education and occupation. However, all users of the service do attend either school or day care so that they are occupied during the day. The manager stated there had been an increase in the younger age group which was confirmed by the visit to the home when two of the people who use the service were attending school. A father of a person who uses the service seen during the visit to the home confirmed that she attended various forms of day care which supplemented her respite care and which he was very pleased with. The AQAA stated that the home was well integrated into the local community which Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: was also confirmed by interviews during the visit to the home. Interviews with staff showed that local facilities are being used to occupy people using the service dependent on individual wishes. During the visit to the home one user of the service was being actively occupied outside the home, which she clearly enjoyed. There has been no recent incident of disruption to the home by any of the neighbourhood which confirms that the home is now well established within the local community. The manager stated that the home has reduced its coffee mornings for families to two a year due to limited attendance and this had resulted in a much greater participation from families. In addition, the home has introduced the key worker role for staff which includes regular contact with families so that they are actively involved in the work of the home. This was confirmed by staff interviewed and also by family members contacted who could identify the key worker within the home. Family members were very positive about 4 Duncan Street which they felt was providing a good service to their relatives. Comments from family members included my daughter enjoys coming here and my daughter is well looked after. They felt that there was good communication between families and the home so that information could be shared. The AQAA committed the home to promote the independence of people using the service within a safe context. Care plans seen showed that consideration is given to people using the service having a key to their bedroom even though, in practice, this often cannot be achieved due to their abilities. Observations during the visit to the home showed pleasant and active interaction between staff and users of the service to confirm an appropriate relationship. Interviews with staff members, confirmed by observation, showed that where users of the service have the capacity and the willingness to participate they are encouraged to do so. The last inspection found no concern in the area of meals and mealtimes and this was confirmed by the visit to the home. Although the AQAA stated there had been a shortage of food hygiene training this was not confirmed by the interviews and training records seen, which found that staff interviewed had had such training within the required period. The manager confirmed that individual likes and dislikes were known and acted upon within the home and although generally, people using the service lacked communication skills, their relatives confirmed that they enjoyed attending the home. A review of the information received since the last inspection has found no concern in the area of meals served which confirmed good practice. Care Homes for Adults (18-65 years) Page 15 of 28 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. The home promotes an individual and safe level of support for people using the service. Evidence: The manager confirmed that she has started to implement a key worker role for staff to improve the continuity of support. In addition, the movement of staff between homes, which was a matter of some concern at one stage, has now almost completely ceased which further promotes consistency. Family members spoken to could identify their key worker which demonstrated the effectiveness of this. An interview with one care worker confirmed a good understanding of the key worker role which further showed its effectiveness. Observations during the visit to the home showed that the home has enough technical equipment to promote the independence of its users and that personal support was being provided in accordance with the principles of privacy and dignity. Family members contacted were complimentary about the care being provided and included comments such as the care is great and, in terms of arranging for the respite care Im glad I did it. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The home provides respite care and, as such, accesses healthcare support as required to promote the wellbeing of people who use the service. The AQAA noted that there had been three admissions to the Accident and Emergency department over the last twelve months which, given the disabilities of people who use the service, is a low number. A review of evidence since the last key inspection revealed no concern surrounding the healthcare needs of users of the service which further confirmed a safe service. Case files of people who use the service which were examined showed that their healthcare needs were considered both at the assessment and care planning stage so that these would be met as required. A review of evidence since the last inspection, confirmed by the AQAA, showed that there had been no issue surrounding the area of medication to give any cause for concern. The manager stated that there had been an improvement in the cooperation of families in the area of medication so that proper recording has been improved. At the time of the visit to the home only one of the people using the service was receiving medication and his record sheets were correct. An examination of training records confirmed that staff are receiving training in this area to confirm their competence. A tour of the premises showed that there are safe arrangements for the storage of medication so that safety is not compromised. Care Homes for Adults (18-65 years) Page 17 of 28 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. The policies and practices of the home protect users of the service. Evidence: A review of evidence since the last inspection confirmed that there has been a significant reduction in the number of complaints received about this home. No matter has been referred to us over the last twelve months and the home itself has received only one complaint. An interview with the relative who made the complaint revealed that she was happy with the manner in which it had been managed. The complaint was recorded in the Complaints Book but the recording of the outcome needs to be improved, including outcome dates, so that the home can demonstrate it manages these incidents speedily. The home has a full complaints procedure and this is widely known to users of the service so that they can have recourse to it. The AQAA stated there had been no safeguarding issue in the last twelve months thus confirming a safe service. A review of evidence showed that there had been one matter referred to us in respect of inappropriate behaviour by a staff member although this did not involve any user of the service. The manager stated she had taken advice on this matter and that the case had not required the attention of the relevant authorities or further action. Examination of staff training records showed that safeguarding of adults is a mandatory training subject for staff and has been provided regularly for the safety of people who use the service. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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. The premises are fit for purpose resulting in a pleasant and homely environment. Evidence: The AQAA confirmed the report of the improvement plan that there had been action taken to redecorate and refurbish the premises. A tour of the premises found that there had been a great improvement since the last inspection resulting in a pleasant and homely environment. The bedrooms were much improved in terms of decor and furnishing and the living areas were comfortable and pleasing so that people who use the service can be accommodated appropriately. Since the last inspection the home has provided access to the outside garden which, it was reported by one member of staff, has greatly improved the quality of life for users of the home. The people using the service at the time of the visit to the service had limited communication skills but their relatives were contacted and all expressed great satisfaction with the home which they were happy to use on a regular basis. One member of staff described the premises as ideal. A tour of the premises confirmed the improvements of the building was also extended to the area of hygiene and cleanliness. Since the last key inspection, the laundry facility has been repaired which means that the home can manage all its laundry on Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: site. The laundry is fully equipped, including a sluice facility within the washing machine, so that all soiled linen can be managed appropriately. The home has now proper arrangements for the disposal of clinical waste to further enhance the hygiene procedures. The home does not employ domestic staff but observations on the day of the visit to the home confirmed that a good standard of cleanliness was being maintained by care staff. Care Homes for Adults (18-65 years) Page 21 of 28 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. The home recruits, trains and supports staff to a good level resulting in an effective workforce. Evidence: The manager reported that the home was now fully staffed which meant that the situation has eased since the last key inspection. She expressed general confidence in the staff group which she felt was fully capable of carrying out the role of the home. She felt there was a good mix of staff in terms of gender, age and experience and this was also confirmed by a new member of staff who also felt the staff group was of a good standard. The AQAA, confirmed by training documents seen, showed that there is a high level of training of staff in a national qualification, including at a higher level. An interview with a newly recruited member of staff showed that he had been immediately enrolled on this course to introduce him early to relevant topics. Contact with family members found them very content with the staff of the home which meant they had confidence in sending their relatives to the home. As noted on previous inspections, the main recruitment material is held centrally and not at the home which meant it was not available. However, staff files seen did contain evidence of police clearance and showed that relevant material such as a Code of Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Practice and terms and conditions are being made available to staff. In addition, an interview with a recently appointed member of staff revealed he felt the process was fair and robust and that the selection process was equitable. An interview with the manager confirmed that she was positive about the staff of the home and that the company is planning to further improve recruitment procedures by involving people who use the service in this process. The AQAA made strong reference to the improvement in the training opportunities being made available through the regional training officer. An interview with the manager confirmed this and showed that training is now being recorded thoroughly and systematically so that it can be planned. Interviews with staff found them very appreciative of the training on offer. A recently appointed member of staff said that training is really good and another said there are no problems with training. An examination of training documents confirmed that training is being provided regularly for staff so that their knowledge remains current. The improvement plan resulting from the last inspection stated that supervision of staff had been divided between three managers and that supervision had been arranged for the full year so that a regular system was in place. The visit to the home confirmed this to be the case with staff folders including planned dates of supervision to the end of the year. The staff records also showed that staff supervision is now generally being provided regularly to provide direction to staff. Staff interviewed were positive about the support they were receiving which they felt helped them in their work. The manager did confirm that appraisals have not recently been arranged to further help and guide staff. Care Homes for Adults (18-65 years) Page 23 of 28 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 being well managed in the interests of people who use the service. Evidence: There has been no change to the manager who has been in post for some time and has the required experience for the post. Her application for registration has unfortunately had to be returned due to the lack of some documentation plus some gaps in the records she has submitted. At the time of the visit to the home she was attending to this to resolve the matter. An interview with the manager, plus training documents seen, confirmed that she continues to undertake training so that her knowledge remains up to date. Interviews with staff and family members all confirmed there has been an improvement to the management of the home which has also been confirmed by a review of information received by us on this care home. The AQAA stated that the home has made a significant effort to improve the involvement of users of the service and family members in the development of the service. The manager confirmed that a recent open meeting for families had been very Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: well attended and resulted in constructive comments on the way forward. In addition, the use of the key worker role has enabled more constant contact with families to be maintained. The home has started regular meetings with people who use the service and the care worker responsible for these could show how these meetings have translated to some changed practices in the home. The manager also stated that a questionnaire is being sent to families although no responses have yet been received. With one slight exception, families contacted felt there was a good level of communication between them and the home, which meant that their views were known. A tour of the premises found that there had a been a distinct improvement to the health and safety checks being made for the safety of the service. This included in the area of water temperatures although this remains a chronic problem despite the efforts of the manager. The manager did however confirm that full checks are made on water temperatures prior to the use of appliances and this was confirmed by documents seen. Other documents seen confirmed that full health and safety audits are being made with the certification of facilities where necessary to confirm their safety. Since the last inspection the checks have been considerably improved, including through an environmental risk assessment, which was promised through the improvement plan. Training documents seen showed that staff are being introduced to health and safety issues on appointment and that this training is being refreshed so that they remain up to date. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 13(4)(b) Risk assessments to be 01/06/2008 concise, clear and updated to ensure that they provide clear guidance to staff. Care Homes for Adults (18-65 years) Page 26 of 28 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 6 15 The home must rationalise, date and review care plans at the required intervals. So that they show that they are up to date and relevant. 01/07/2009 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 7 Staff should be further reminded of the need to promote independence amongst people who use the service so that their abilities are promoted. The new format for risk assessments should be uniformly introduced so that there is a clear picture of the risk surrounding each individual user of the service. The recording of complaints should be improved so that the outcome is known and the date it was resolved is recorded. Appraisals should be arranged for staff so that there can be an assessment of their performance and development. The company should take the matter of water temperatures further so that this chronic problem can be resolved. 2 9 3 4 5 22 36 42 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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