Care Home: Lyons Gardens

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What the care home does well The home provides a flexible service which is a valuable resource to people living in Peterborough and Cambridgeshire. The service provides longer term and short term care as well as permanent care. The range of needs is effectively managed by the home who often are expected to support and care for people at short notice, or in an emergency. Overall, the home is a pleasant place to live where staff provide the balance between essential support and allowing independence to flourish. Staff training is provided for essential elements of care and staff can request additional and further training should they feel they need this. The environment is spacious, very clean and well maintained and is not overcrowded. The two bungalows provide the ideal accommodation for the people living at the home. People`s comments included: `They (staff) are all very easy to talk to and very helpful`. `They also helped my family and for this I would like to thanks them`. `The carers do seem to care`. `The home is lovely, clean and well laid out`. One person who is planning to move from the home quite soon, told us she had received lots of help and support from the home. She said,`they have helped me to find somewhere else to live`. Relatives also wrote to us and told us that they considered the care to be good. Their written comments praised the home. One person wrote, "Lyons Gardens is a first class care home and there should be more like it in the country". Another comments received was, "the care staff and manager are really good with looking after our daughter.... we have full confidence in the care she gets"; and "the staff and manager listen to the needs of our daughter"; Another person stated that her daughter, "is very well looked after and she always comes home happy". What has improved since the last inspection? The five requirement made at the last inspection have been met. The environment has improved although it was judged good at the last inspection. Further redecoration and carpeting have been achieved and the colours and style have been chosen by people living at the home. Staff had been safely recuited and had not commenced employment until their Criminal Records Bureau (CRB) disclosure and POVA First check had been received. What the care home could do better: Some elements of people`s care plans should be reviewed, so that changes to people`s ambitions and aspirations are fully recorded. Where a person is fed by a PEG feed , there should be in place a contempraneously recorded chart of the precise times of all fluids, nutrition and medication provided. The induction for staff during their very first days of commencing employment should be reviewed in line with the discussions held with the manager about safeguarding awareness and the comments and recommendation made in this report. The home should adopt the Learning Disability Induction Award that covers the Common Induction Standards. All staff should be trained in infection control. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lyons Gardens 36 Lincoln Road Glinton Peterborough PE6 7JS     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: Don Traylen     Date: 1 2 0 8 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: Lyons Gardens 36 Lincoln Road Glinton Peterborough PE6 7JS 01733254261 01733254263 lyonsgardens@herewardcare.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) : Hereward Care Services Ltd care home 11 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 11 Service users with a learning disability who also have a physical disability or mental disorder may be admitted Date of last inspection Brief description of the care home Lyons Gardens is a purpose built care home on the outskirts of the village of Glinton, about six miles north of the centre of Peterborough. The home consists of two bungalows which are set back from the main road through the village. Each bungalow has a lounge, dining room, kitchen, toilets, bathroom and shower room as well as a laundry, office and staff facilities. One of the bungalows has five single bedrooms, the other has six. All the bedrooms have ensuite fascilities. There is parking space at the front of the bungalows and a large paved patio area between the two. Betwen the two bungalows there are easily accessible and safe garden areas that have been laid to lawn. People stay at Lyons Gardens for varying periods of time. Some people stay at Lyons Gardens whilst alternative accommodation and care is being arranged. The home provides for people whose ages range from 18 to 65. The eleven places at the home have been pre-purchased by Peterborough Primary Care Partnership. Fees charged are Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home approximately £1326.00 per week. There are no other additional charges, except a contribution towards some of the outings. The CQC inspection reports are available at the home or can be accessed from the CQC webpage. 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: We conducted the inspection on the 12 August 2009 between 15:00 and 20:30 hours. The registered manger was present throughout the inspection. We spoke to several people living at the home to two care staff and the manager. We looked at the written assessments and the care plans for three people; the staff training records and staff recruitment records. The procedures for safeguarding people were assessed and were discussed with two care staff and the manager. Some of the homes policies were read, as were some records relating to the safety of the home. The home completed an Annual Quality Assurance Assessment prior to the inspection and 8 service user surveys were completed and returned to us. We have used notifications the home has sent us to inform us of any significant events in the home. The previous Key inspection was carried out on the 12/10/2009 and an Annual Service Review was carried out on Care Homes for Adults (18-65 years) Page 6 of 28 10/11/2008. What the care home does well: What has improved since the last inspection? What they could do better: Some elements of peoples care plans should be reviewed, so that changes to peoples ambitions and aspirations are fully recorded. Where a person is fed by a PEG feed , there should be in place a contempraneously recorded chart of the precise times of all fluids, nutrition and medication provided. The induction for staff during their very first days of commencing employment should be reviewed in line with the discussions held with the manager about safeguarding awareness and the comments and recommendation made in this report. The home should adopt the Learning Disability Induction Award that covers the Common Induction Standards. All staff should be trained in infection control. Care Homes for Adults (18-65 years) Page 8 of 28 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.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. People are assured their needs are assessed before they move into the home. Evidence: The Statement of Purpose described the service provided by the home. The home is valuable resource for people in need of emergency, or respite care services. The home has managed to provide both temporary and longer term care, or permanent care for people who have been assessed to be in need of this support. They provide encouragement to people who are aspiring to move on and have been assessed as able to lead a more independent life. The home works in close co-operation with the local Primary Care Trust (PCT) and the Learning Disability Partnership (LDP) who commission services from Lyons Gardens and provide the assessment details for people whom they wish to place at the home. Occasionally, the full details of the PCT assessment are delayed, although we saw that one person who had been placed at the home as an emergency on the previous day, the home had received an assessment from the PCT and had an understanding of his needs. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: We looked at the assessment detail for two people and we discussed with the manager the admission process for other people living at the home. Where it is practicable for people to visit the home before they move there, they are always given this opportunity to indicate whether they like the home and choose to move there. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured they will recieve support to make decisions about their lives and are consulted as part of this process and that their goals are recorded and written in their care plans. Evidence: Three peoples care plans showed their needs had been fully recorded. We spoke to two people specifically about their care plans and about their aspirations and future plans. They each told us that they knew they could see their plans at any time, although one person expressed she did not want to do this. They both gave clear accounts of why they were living at the home and were enthusiastic about their intentions to secure a more independent lifestyle. These aspirations had been recorded in their written care plans, although extra detail of the current or topical situation was not totally recorded. Their circumstances and their plans for more independence were supported by their Social Workers and Advocates and therefore, some aspects of their care planning were outside of the control of the home, although the discussions we Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: had with support staff and the manager showed the home was fully aware of each persons aspirations and the reality of creating an independent life for them. Some of the risks were undertsood and were expressed by the two people and by staff and the manager. One person told us, I would still need support and added that, I cant wait for a phone call to tell me I have got my flat. Relatives informed us that staff have helped a lot and are easy to talk to. Risk assessments had been completed as part of their care plans and the sgnificant risks that had been identified were clearly undertsood by staff. The review process for updating plans was not clear. For instance, the progression of one person who was self-medicating and acheiving a level of independence had not been fully reflected as a change in her care plan. The care plan for one person, who was staying at the home on respite during the inspection, did not indicate when it had been updated. The manager agreed to record on a separate chart the actual fluid intake for one person who was fed via a Percutaneous Endoscopic Gastrostomy (PEG) feed tube. This persons care plan showed a very clear regime for food and fluids and medication. Although the daily notes had recorded that all fluids had been given and the regime had been followed, it was discussed with the manager that a separate fluid chart could be used to show the precise times and amounts of fluids and food that had been given and should be contemporaneously recorded. Care Homes for Adults (18-65 years) Page 14 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. People are assured they are offered choices and can lead a lifestyle where they can make appropriate choices. They are assured that they will be provided with appealing and nutritious food. Evidence: The opportunity for people to do things is good. Many of the people attend a day centre as part of their established routine. As many of the people who use the service for respite, their care arrangements and day centre attendance, or work experiences are already established. Of the five peole who were living permanemently at the home, four attended a day centre on the day of inspection and arrived home between 3.30 and 4.30 pm. Two people go to work and one person decribed to us what she had done that day after going to work and getting up early at 5pm. She described how she is independent and how she has chosen to get up early at 5-5.30 am so that she can Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: do this job. There are a number of musical events and sports facilities that people attend. One person was using the washing machine to wash her own clothing. The home has its own mini bus. Some people are encouraged to walk and excercise. Holidays have been arranged. One person told us he went to Blackpool. Local places of interest are frequently visited and include Duxford Air museum and local pubs and restaurants. One person said she is having a holiday by the coast. A local disco is a regular place that people use. One person was helping to cook the evening meal and we spoke to her and to staff whilst they worked together. A significant number of people are well supported by their families and have regular contact with them. The response that families had made in the surveys indicated they were fully involved in the care provided by the home and had liaised with the home in establishing the essential support and keeping regular contact. We sat and ate an evening meal of roast pork and three fresh vegetables with the people living in one of the bungalows. This meal had been prepared by one person living at the home with the support from staff. The food was plentiful and was very tasty and appeared nutritious. It was presented and eaten at neatly laid tables with tablecloths and seating for three or four people. Assistance and encouragenment was provided to some people who required this. Another person had cutley appropriate to her ability, so that she could hold these implements comfortably. A menu for a cooked evening meal is offered every day and people are offered a choice or food even when people may decide on last minute changes. Care Homes for Adults (18-65 years) Page 16 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. People are assured their medication is safely managed and can retain their medication where this is appropriate. Evidence: Care plans indicated that nursing support is available for people who need it. Working closely with the Learnning Disability Partnership ensures this element of their care can easily be requested and alerts can be made to nurses whenever necessary. One person had a clear nursing instruction for managing the regime for her peg feed. The emotional wellbeing of people was observed to be good. Staff ineracted well with people at all times and people made clear choices about the activities thay wanted to do and what they were doing within the home. The home felt relaxed and there was an atmosphere that people owned their space, chose when to communicate, made comments and were eager to communicate and were not overpowered or restricted by staff. Medication administration records were assesed and amounts of medication checked Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: and were found to be accurate. One person whom we spoke to, told us that she retains her own medication and self adminsters this, with some marginal support from staff, whenever she requests their assistance. Care Homes for Adults (18-65 years) Page 18 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. People are assured they are safeguarded and could be more assured by improvements to safegaurding awareness during the initial induction of newly employed staff. Evidence: The complaints process is well displayed within the home. Two people said they would speak to staff and the manager should they want to complain. The home had a satisfactory safeguarding policy. Safeguarding is included as mandatory training and is provided via the companys training programme. The immediate induction provided for new staff in the first few days after they have commenced employment does not facilitate awareness of safeguarding. Safeguarding awareness should be provided during the immediate and initial first few days when new staff commence employment. This would ensure that people are satisfactorily safeguarded by staff who have been made aware of safeguarding and safeguarding protocols. This was discussed with the manager during the inspection and when feedback was provided and has been made a recommendation under the staffing group of outcomes. 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. People are assured their accommodation is clean, spacious and comfortable and the home is fitted with specilaist equipment wherever this is needed. Evidence: The accommodation is made up of two purpose built bungalows. Each bungalow is spacious and comfortably furnished to a high standard. Both bungalows have been built recently and were maintained to a high standard of cleanliness and hygeine. There is ample individual and communal space. Both bungalows were built as a specialist provision for people who have physical disability related needs. Since the last inspection the home has decorated some rooms and has had new carpetting laid. All of the home was well decorated and there were no offensive aromas or worn areas of furnishings. There was a pleasant smell of cooking that pervaded both buildings and this noticeable aroma was a talking point for all. The atmosphere created through gentle and careful staff interaction, was relaxed and made the home ordinary. There were no visible or audible expression of stress. Individual rooms had been furnished, or fitted with peoples personal possessions. Even people there for respite had brought with them many of there own belongings Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: and were using them in their rooms and in the communal lounge where one person had a collection of music and videos that he was sorting. The gardens were well maintained and appeared free of obsticles. There was a large table with enough chairs for people from both bungalows to get together and use. 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. People are assured they are given support and care from competent staff who have been safely recruited. Evidence: Staff receive appropriate training arrangements. The manager explained that all staff are expected to acheive a National Vocational Qulaification (NVQ) level 2 award in care. The homes Annual Quality Assurance (AQAA) states that 90 of staff are trained in, or are currently undergoing training in NVQ level 2, or Skills for Care Induction. The home had not made a clear enough distinction between these two different training awards and routes. The Skills for Care Council advise that, The 12week CIS induction period enables care workers to give high quality care and support, provide recognition for their work, and prepare them for entry onto NVQ health and social care programmes. The home had identified in their AQAA that they need to encourage more staff to undergo further NVQ training. Some staff have acheived the Learning Disability Qualification Award at level 3. Overall, a range of suitable training for care staff working with people with people who have a learning disability is provided, as well as training around physical disability needs. Not all staff had been trained in Infection Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Control. Induction is arranged for all new staff. The arrangement is for the company to provide a Skills for Care, Common Induction, where staff are assessed by the manager as competent. Staff are also enrolled on the local PCTs induction training which is a thorough induction process also covering the same six common standards. The names of new staff who have sucessfully completed this induction are forwarded to the Skills for Care Council and are used in their data. When new staff commence work they usually have to wait until these two induction training opportunities can be provided, as they do not often coincide with the dates when new staff commence employment. In their first two days staff are given a brief induction by the home about house rules and conduct. At this stage staff had not been made aware of the six common induction standards which are: understanding principles of care; understanding the organisation and role of the worker; maintaining safety at work; communicating effectively; recognising and responding to abuse and neglect; developing as a worker. It is expected by the Skills for Care Council that care workers need to know about these before they can work unsupervised. The last report for a Key Unannounced inspection of the 12/10/2007 made a requirenment for staff to be trained in safeguarding as soon as possible after they start work, as part of their induction. Whilst this is being acheived through the two induction processes, it was discussed with the manager that people using the service must be protected at all times by staff who have had some awareness training about safeguarding and understand their responsibilities from the very first day they commence employment. It was discussed with the manager that awareness training could be provided by the home during the first days when a new member of staff commence employment. This has been made a recommendation within this group of outcomes. The home stated in their AQAA that, all new staff undergo checks for CRB and POVA prior to commencing any work, which is then followed by a detailed induction programme (p11). The recruitment records for one care worker confirmed her CRB and POVA First check had been received prior to commencing employment. All staff had been regularly supervised by the manager. 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. People are assured they will receive a good quality service. Evidence: The manager was registerd by the commission after the last key inspection on 12/10/2007. The home was observed to be run in a friendly, yet professional manner. Staff were focused on peoples needs and were communicative. This example was set by the manager who is a good communicator. He was observed to speak to people in away that was respectful and demonstrated their interests were his priority. The manager has acheived the Registered Managers Award. Annual surveys are used by the home to determine the views of relatives and people living at the home. However, the daily contact with people ensures a greater degree of insight into the vews of people living at the home. The home work very closely with Peterborough and Cambridgeshire Primary Care Trusts and Learning Disability Partnerships to ensure their service is geared to the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: commissioning expectations and contractual requirements. Monthly team meetings and residents meetings are held to ensure the views of people living at the home are heard and considered. Internal audits by the owning company are conducted to ensure standards are being acheived. Records showed that fire alarms had been tested weekly and had been serviced annually. Hot water temperatures were appropriately controlled and there were not any hazardous material accessible. No health or safety hazards were observed. Care Homes for Adults (18-65 years) Page 25 of 28 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 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 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 6 Where a person is fed via a PEG feed, there should be in place a fluid chart to keep an accurate and contemporaneous record of the times of all nutrition, fluid and medication given. The home should consider adopting the Learning Disability Induction Award that covers the Common Induction Standards. New care staff should receive a basic version of the more comprehensive induction during their first few days of employment ,so that they are made aware of their responsibilities to safeguard people and can assure people living at the home that they are consistently and continuously safeguarded. All staff should be trained in infection control. 2 35 3 35 4 35 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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