Care Home: Lighthouse

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What the care home does well This home has been registered with CQC since the beginning of 2009; however on the day of the site inspection it had only been open to residents (being admitted) in the last four weeks. Therefore documentation was still being fully completed, however information that was sampled did manage to produce good outcomes for all of the residents. Visitors are made very welcome and the staff are friendly. All relatives spoke highly of the staff team and manager. We spoke with two social workers and they told us that they were very satisfied with how the residents were supported and cared for. All residents told us that they were happy and felt they are supported by staff to live the lifestyle that they choose. What has improved since the last inspection? This is the home’s first Inspection.LighthouseDS0000073188.V375974.R01.S.docVersion 5.2 What the care home could do better: The manager needs to ensure that the lift is repaired within an acceptable timescale and that all new staff have the relevant induction process available to them. Key inspection report CARE HOME ADULTS 18-65 Lighthouse 403-405 Westborough Road Westcliff on Sea Essex SS0 9TW Lead Inspector Mrs Ann Davey Key Unannounced Inspection 28th May 2009 10:00 Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. 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 home adults 18-65 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. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 2 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 Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lighthouse Address 403-405 Westborough Road Westcliff on Sea Essex SS0 9TW 01702 308893 01702 586943 nhassan@lighthouseld.org Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Nusrat Hassan Mr Mahmood UL Hassan Manager post vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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 7 2. Date of last inspection First Inspection Brief Description of the Service: The Lighthouse Care Home is situated in a residential area of Westcliff and is very close to local amenities. The home provides a people carrier and there are plenty of bus routes near by. The Lighthouse is a care home for people with learning disabilities who want to pursue an independent lifestyle. The home has seven rooms with en-suites and there are three vacancies at the time of this key inspection. Apart from the ensuites in every room, there are additional bathrooms and a shower room. There is a large lounge, dining room area, laundry room, lift, garden and a well equipped kitchen. All residents are encouraged to choose their own bedroom in the home (three vacant rooms still available), bedroom furniture, materials and colour schemes. Fees are based upon assessments being carried out alongside the local Social and health departments, or with the person if privately funded. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a Two star service this means that the people who use this service receive good outcomes. The unannounced site visit took seven hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the manager and the provider. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. This is the first key inspection since being registered in 2009. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since being registered. Four staff, all of the residents, two professionals and all relatives were spoken with during the site inspection. The manager was sent an (AQAA) Annual Quality Assurance Assessment form by us (CQC), this is a self assessment required by law that asked how well the home is meeting the needs of the people who live at the Lighthouse Care Home. All information obtained was triangulated and reviewed against the commission’s key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. What the service does well: What has improved since the last inspection? This is the home’s first Inspection. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 6 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. EVIDENCE: The manager told us that should a person enquire about a place in the home they would be provided with information such as, a statement of purpose and resident’s guide, which provides information about the home to help people decide if they could be happy at the service. We looked at the information provided about the home. The resident’s handbook included information such as, staff structure, their qualifications, the complaint process, support, accommodation, local area, health, any specialist services and activities. The manager told us that the person would be then assessed by the manager to complete details of the prospective residents needs. A copy of the social services or local authority needs assessment would also be obtained. We saw that the assessment covered details such as, the persons physical and health needs as well as the support the individual required to maintain personal and oral hygiene. In all documentation each persons communication needs, their Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 9 likes, dislikes and hobbies is also recorded to help determine that the home would be able to meet their needs. On the site inspection we look at completed assessments and found that they were all fully completed and gave the level of detail required. All people said that they had been fully involved in their assessments. The manager said that people are invited to visit the home before they move in and once they do a contract would be agreed. When we visited the home we looked at this information and could see that it was in place for all four residents. All residents told us that they were given enough information to help them make a decision about moving into the home and that they all had a number of visits prior to admission. They all felt that this process was good. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People using the 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 using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that each person had a care plan, which would be reviewed at least every twelve months or more often where this was appropriate. They told us that emphasis was put on enabling residents to make decisions and choices about the home. We saw in residents’ information, that they were involved in making choices such as new activities to be introduced, social events, food and menus, contact with family or friends, what they wished to do during the day and evening, work opportunities and general house issues and this was confirmed by all people living at the lighthouse. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 11 The manager said that residents meetings were held and we saw minutes that confirmed this. Some of the policies and procedures were available in formats, which would help to enable residents understand them or to express their views about how the home was run, such as the complaints procedure. All residents confirmed to us that they are actively encouraged to make informed choices and are kept up-to-date about any changes to do with their care, the staffing group and the home. When we visited we looked at care plans for all four people who lived in the home. We saw that staff recorded long term and short term goals for residents. The person’s views about these goals or how they could be achieved was recorded in the plan. Goals could be as simple as, what meals they had, day activities, community involvement and choice of clothes to wear. Risks to resident’s health and safety were well managed while allowing residents to participate in activities such as preparing meals or accessing the community. Where the level of risk to a person was assessed as high and there was the likelihood that the person may injure themselves (such as risks associated with road safety or risks associated with cooking meals) then staff imposed some limitations and supervised residents appropriately. Where this was necessary then it was recorded clearly (and always agreed with the individual) within the plan of care. When we visited we saw that residents were supported in making decisions, participating or contributing to the running of the home, such as, carrying out laundry, helping with lunch and making drinks. All relatives confirmed that all people that lived at the Lighthouse had lots of choice, were respected and the staff encouraged independence. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 and 17 People using the 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 using the service can be assured that they will have the opportunities for personal development and build upon their daily living skills so that they are able to lead a lifestyle that they choose. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that residents are supported to develop skills and to participate in activities of their choice both in and outside of the home. The manager said that residents were encouraged to participate in activities. When we visited the home we looked the care plans for all of the four residents. We saw that all residents had a plan of care which described their wishes for the activities they wish to participate in. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 13 All of the residents are capable of living an independent lifestyle and this was reflected in their care plans. We saw that people attended colleges, used the local community (pubs, clubs and shops), used public transport, maintained personal relationships, learnt skills to improve their daily living skills and managed their finances independently. The manager told us in the Annual Quality Assurance Assessment that residents are supported to contribute to their care plans so that they can have the opportunity to fulfil the lifestyles of their choice. Each resident had a care plan which described the support the individual needed and involvement of that person was recorded well. In the care plans it was recorded what that person had in terms of skills for carrying out domestic chores in order to give them a sense of purpose. This included activities such as setting places at the table for meals, laundry, preparing of meals. We looked at the arrangements for supporting residents with choosing and preparing food and meals. We saw that staff supported residents in buying and preparing food and that there was a planned menu, which reflected residents likes and dislikes. They told us that when relatives visit they are invited to take meals with residents. All relatives confirmed that they regularly went to the home to have dinner with their relatives and could drop in any time or call and felt very comfortable and welcome by all the staff. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good care plans ensures that all residents healthcare needs are well supported by the staff team. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that the health and personal care needs of residents are met and that staff are trained to administer medicines safely. When we visited the home we looked at how the personal and health care needs of the residents were assessed and how residents were supported. We looked at the care plans for all the residents. We saw that they way in which all people wished to be supported in maintaining health was recorded and kept under review. It was recorded that residents enjoyed good health and residents looked well cared for. We saw that all residents were supported in attending routine appointments for health care monitoring and there were minutes of meetings, letters and Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 15 conversations recorded with a number of other specialist services, such as, community psychiatric nurses, consultants, social workers and in general a number of NHS community services when needed. We spoke with two members of staff and looked at training records and saw that staff had appropriate training in the safe handling and administration of medication. When we visited the home we looked at how information is recorded about how medication is managed, for instance, the correct receipt, recording, storage and handling, administration and disposal of medications. Four of the staff confirmed to us that they knew procedures well and were aware of individual need. We looked at the medicine administration records and these were completed accurately to show that residents received medicines that are prescribed for them. Looking through all residents records it revealed to us that no one self medicates and risk assessments highlighted clearly the issues around this and also had good guidelines for staff to follow. Residents spoken with confirmed to us that they felt staff managed their medication well. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected so that they are kept safe against abuse. EVIDENCE: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. When we visited the home we looked at the policy and procedure in place for recording and dealing with complaints. We saw that the manager has a good complaints procedure in place, which recorded all the different stages that a complaint would take with the outcomes included. All complaints were recorded, maintained and outcomes recorded. We observed that a pictorial format is available to all people who live at the Lighthouse so that they could understand this procedure more clearly. All residents said they knew how to make a complaint and who to if necessary. The manager told us that resident’s relatives are provided with information on how to complain and how their concerns would be dealt with. All relatives confirmed this to us. They also told us that staff received information about dealing with complaints and whistle blowing and had training in safeguarding when they commence work at the home. We spoke with two members of staff and looked at training records and saw that staff had appropriate training in the protection of Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 17 residents. The manager told us that residents living in the home would be capable of making a verbal complaint. They told us that there had been no formal complaints made about the service within the past twelve months. All residents told us that they felt the manager and staff listened to them and felt that if they were to raise a concern then it would be dealt with satisfactory. There was a safeguarding policy and procedure in place and the manager told us that all staff were given this information when they commenced work at the home. Two members of staff were on duty during the inspection. They told us that they had received safeguarding training and they demonstrated that they understood their responsibilities if they witnessed or suspected any ill treatment of residents. There was a whistle blowing policy which staff had access to. This helps assure staff that they will be protected from harassment should they need to raise concerns about the home or other staff. We saw that staff were recruited thoroughly and all the relevant checks to a person’s fitness were carried out before they started work at the home. We saw that all staff had received safeguarding training to keep them up to date with local policies and procedures and help ensure that all concerns would be treated properly. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean safe environment. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that some general refurbishment had been carried out to the home. She said that home was clean, resident’s bedrooms were individually personalised and the home was safe. All residents said that the home is always fresh and clean. We carried out a brief inspection of the premises when we visited the home. One of the residents showed us around. The home was clean and comfortable and was decorated and furnished with items which reflected the people’s personality and likes. The residents told us that the house was decorated to their tastes and the furniture and fittings were all of their choosing when the Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 19 house was being completed. All residents bedrooms were personalised and all had en-suites. When we visited the home we observed that the lift had been taped up and that people could not use it. Speaking with all of the residents they told us they did not need to use it and looking through peoples care plans they did not highlight any mobility issues. The manager said that the lift had been out of use for four weeks as it needed repairs and this was an expensive outgoing, however they did show us that a contractor had been round to complete this work within the next two weeks. We advised the manager that this needs to be repaired as planned, so that it did not present an on going health and safety hazard as well as generally detracting from people’s enjoyment and comfort of their surroundings. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are well supported by a competent and effective staff team. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that staff are recruited thoroughly and trained to meet the needs of residents. We looked at how staff was recruited to work in the home. We reviewed the information for one person who had been employed at the home. We saw that before the person commenced work that they had provided information about their previous employment and satisfactory references had been obtained. Criminal Records Bureau disclosure and POVA First checks had been carried out and the person had been interviewed. The manager told us that they were implementing the Common Induction Standards induction. This is a set of nationally recognised standards and helps to ensure consistency in the delivery of care and support to people who receive Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 21 social care. The manager told us that she was completing a training and development analysis for staff working in the home. We saw that staff had received training in safe moving and handling, administration of medicines, communication, infection control and health and safety. Staff had received training in respect of caring for people who have learning disabilities, communication and training around supporting people to make choices. When we visited the home residents were in and out of the home for the majority of the day. However when they returned we chatted with all people and all residents told us that staff listen to them and act on what they say. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People using the 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 management strategies of the home were stable which ensures the health, safety and welfare of all residents. EVIDENCE: The manager told us in the Annual Quality Assurance Assessment that there was a system in place for monitoring the quality of the service, including obtaining the views of residents. They told us that where less positive comments were received that an action plan would be put in place to address the issues raised. They also told us that regular staff and residents meetings are held to discuss and consult people on matters affecting them. When we visited the home we looked at the arrangements in place for Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 23 obtaining the views of the people who live in the home, people who are important to them such as family and advocates and other people who are involved in their care. We saw that people were provided with questionnaires and that residents were asked if they were happy with their surroundings, lifestyles, opportunities available, privacy, dignity, independence and choice. All residents told us that they were encouraged to express their views and all relatives felt that all people were well looked after. We looked at how the home was managed and maintained. There were records and certificates to show that the home was maintained and fit for purpose. Checks were carried out to ensure that systems and equipment such as heating and hot water systems, fire detection installations and electrical equipment were maintained in good safe working order. We saw reports from the local environmental health officers and these indicated that the manager complied with their regulations. We looked at accident records and there had been no accidents or incidents affecting the health, safety or welfare of residents within the previous five months of being registered. Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 Lighthouse DS0000073188.V375974.R01.S.doc Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA29 Regulation Reg 23 (2)(b)( c) Requirement The registered person shall not use the premises for care home unless; the premises is kept in a good state of repair and that all equipment used for the home by residents or people who work in the care home is maintained and in good working order. This means that the lift needs to be repaired so that it does not put residents or staff at possible risk. Timescale for action 30/09/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations All new staff need to follow the ‘Skills for Care sector’ criteria for induction. This means implementing the Common Induction Standards induction. This is a set of nationally recognised standards and helps to ensure consistency in the delivery of care and support to people who receive social care. DS0000073188.V375974.R01.S.doc Version 5.2 Page 26 Lighthouse Lighthouse DS0000073188.V375974.R01.S.doc Version 5.2 Page 27 Care Quality Commission Eastern Region Care Quality Commission Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: 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). 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