Care Home: Machlo

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What the care home does well The service has a Statement of Purpose and Service User`s Guide that provides people with information they may need to make a decision about moving into the home. Before the organisation offer a place to someone their needs are thoroughly assessed by the registered manager and this minimises the risk of someone being admitted whose needs cannot be met. People lead active lifestyles in the local community and staff provide them with support to achieve this. Staff support people to maintain relationships with family and friends where appropriate. The environment of the home is comfortable, spacious, clean and meets the current needs of the people that live there. The organisation`s recruitment procedures are robust and this ensures that people are not put at unnecessary risks. Staff receive training that covers a range of mandatory topics as well as specialist ones that help the staff meet the needs of people in the home. Health and safety is managed effectively through regular checks and training and this minimises the potential risks to people in the home. What has improved since the last inspection? First site visit inspection. What the care home could do better: Plans for staff to follow when people become anxious must contain greater detail to ensure that all staff are reacting consistently. As we have identified earlier in the summary this service has only been open for a short period of time which means in some areas there is only limited evidence available to support good practice. From this evidence it is clear that the since the home has been open the outcomes for the two people in the service have been good. From speaking to the manager and her fellow director they have clear goals for what they want to achieve and assured us that documents like care plans will become more comprehensive as they get to know people. The other services owned by this organisation that are regulated by us provide good evidence of this being achieved. Key inspection report Care homes for adults (18-65 years) Name: Address: Machlo 17 Windmill Field Abbeymead Gloucester Glos GL4 4RQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Paul Chapman     Date: 2 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Machlo 17 Windmill Field Abbeymead Gloucester Glos GL4 4RQ 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cardell Care Ltd Name of registered manager (if applicable) Mrs Carol Dyer Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia physical disability Additional conditions: The Maximum number of service users to be accommodated is 3 The registered person may provide the following category of service only: Care home only - Code (PC) to service users of either gender whose primary care needs on admission to the home are within the following categories: Physical Disability (1) Mental Disorder (3) Learning Disability (3) Date of last inspection Brief description of the care home Machlo is a service for up to three people in a detached house on a popular housing estate in Gloucester. Each person has their own bedroom and this is complimented by good-sized communal areas. To the rear of the property is a secure garden. The Care Homes for Adults (18-65 years) Page 4 of 29 3 3 1 Over 65 0 0 0 Brief description of the care home homes double garage has been professionally converted into a large en suite bedroom/flat that is suitable for a person with a physical disability. The home has its own vehicle but the house is situated near a a good bus route and there is a local shopping centre within walking distance. The service is staffed at all times when people are in the home. The home has a Statement of Purpose and a Service Users Guide that is made available to people who may wish to move into the home. The fees to live in the home vary dependent on peoples assessed needs. Care Homes for Adults (18-65 years) Page 5 of 29 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: Before completing the inspection site visit to this service we (the CQC) sent the registered manager an AQAA (Annual Quality Assurance Assessment) to complete. This document asks a service provider/registered manager to rate the services performance against the National Minimum Standards (NMS). A service provider/registered manager will be asked to provide evidence of what the service does well, what has improved in the past 12 months and their planned improvements for the next 12 months. What the registered manager tells us in this document helps to form a hypothesis and focus on different areas depending on what the AQAA tells us. In addition to providing evidence about how the home meets the NMS it also provides us with a Dataset (information about staffing, health and safety, complaints, the environment, policies and procedures and the people living in the home). This service has been registered since 14/12/2009 but only opened on 01/02/10. The first site visit to this service was unannounced and started at 0930hrs on Wednesday 21st April 2010. On arrival at the service we were met by the deputy manager who informed us Care Homes for Adults (18-65 years) Page 6 of 29 that the registered manager was not on duty. After discussing the areas we wished to examine with the deputy manager we completed a tour of the communal areas of the premises with them. After this we spent some time examining records whilst the deputy manager supported one of the people in the home. During our first site visit we observed practices and spoke to one of the people living in the home and both of the staff on duty. This was helpful in providing us with evidence of peoples needs being met. The second site visit was announced and we met the registered manager and her fellow director to discuss the findings of the first site visit and standards relating to staffing and management of the service. At this site visit the other person in the home was given the opportunity to speak to us but they declined. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 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 29 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 Statement of Purpose and Service Users Guide provides people with the necessary information they may need when deciding whether they wish to live at the home. Evidence: The home has a Statement of Purpose and a Service Users Guide. We examined a copy of the Statement of Purpose and found it to be a detailed document providing the reader with a wide a range of information enabling them to gain a good overview of the service offered at the home. To support people with communication difficulties it makes good use of pictures to support the text. At our first site visit to the service the deputy manager was unable to find the completed admission assessments for the people living there. At our second site visit the manager produced them enabling us to examine them. We found that the assessments were comprehensive in identifying peoples needs and formed the basis of the care being provided in the home. Care Homes for Adults (18-65 years) Page 11 of 29 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 documentation available to detail peoples needs is in the early stages of development but good progress is being made in identifying peoples needs and implementing the guidelines to support staff practices. Records and observations provided us with good examples of people being given choices in their day to day lives. Risk assessments minimise potential risks to people in the home. Evidence: Each person has a thumb sketch in place. These provide the reader with a summary of information about medication, family history, risks, significant others, medical history, next of kin, communication, Psychological health, potential triggers, pre-cursor to behaviours, religion, problematic issues, things they enjoy and dislike. With only two people living in the home we assessed the care packages for both of them. Care plans have been created for each person highlighting a range of their needs. The care plan document highlights the concern, action and the short and long term goals. Speaking with the deputy manager about the care plans they explained Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: they were still getting to know the people (both were admitted to the service on 01/02/10, eleven weeks ago). We feel that the current care plans provide a broad overview of peoples needs but insufficient information explaining how staff meet those needs. When examining the risk assessments for one person we found some detailed guidelines to address a persons needs. We had some concerns about this approach and discussed it with the manager at our second site visit. The manager explained that the care plans would continue to be developed over the coming months and would provide much greater detail as they got to know people. The manager explained that it was the organisations approach to include detailed guidelines to meet peoples needs in risk assessments, rather than care plans. It is the managers decision how guidelines are developed and we are satisfied that detailed guidelines are available to meet peoples needs and enable the staff team to meet them consistently. The care plans and guidelines we examined did not provide evidence of either person being involved in their creation. Wherever possible the manager should ensure that plans and guidelines provide evidence of this in the future. This becomes a recommendation of this inspection report. Speaking with the staff on duty, observing practices, reading daily notes and speaking to one of the people in the home provided us with good examples of people being given choices in their day to day lives. When examining care plans we found an example of where it appeared a persons freedom of choice was being restricted and brought this to the attention of staff on duty. They explained that this was a health issue and was in place to protect them. We understand the need for this practice but feel the care plan does not sufficiently explain the need for this approach. We discussed this with the manager at the second site visit and it was agreed that the care plan should be re-worded to accurately reflect the reasons. Each of the people living in the home has a range of risk assessments in place that identify the potential risks and the steps taken to minimise them. Care Homes for Adults (18-65 years) Page 13 of 29 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 lead active lifestyles supported by the staff team. Both people see their relatives regularly and staff support them to maintain these relationships where required. The home provides people with a range of healthy and nutritious meals. Evidence: We spoke to one of the people living in the home, examined both peoples daily notes and spoke to staff on duty about the activities that regularly take place. At our first site visit we witnessed staff supporting a person to go shopping locally, and both people were visiting the theatre in Cheltenham to watch a show during the afternoon. Both staff we spoke with agreed that people lead active lifestyles lead by the choices they make. Staff and daily notes gave examples of people completing activities including horse-riding, working in a charity shop, using the gym, attending social clubs/coffee mornings, shopping and eating out in local restaurants/pubs and making use of local transport to visit Gloucester and Cheltenham. In addition to activities Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: outside the home staff spoke about completing art and craft activities indoors. As identified earlier in this report the service has not been open for long and therefore staff are still getting to know peoples interests. Staff stated that holidays have not been discussed as yet. Both people have involvement from family members and staff provide support as required to maintain those relationships. We looked at the food/meals provided by the home. Speaking to staff they explained that one person has input from a dietician/nutritionist to enable them to have a healthy nutritious diet that enables them to lose weight steadily. This means the person has a set menu, but staff said the person still has a choice; if they wish to eat something else staff will advise them about the benefit of sticking to their diet. The other person in the home has more choice about what they eat and staff ask them weekly what they would like. We saw previous menus where for both people and on a lot of occasions both people eat the same meals. Staff explained that the menu for this person is only a guide and if they wish they can change it when they wish. Speaking to this they said that the food was nice. Care Homes for Adults (18-65 years) Page 15 of 29 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 have guidelines in place that detail their personal care needs and minimise the risk of peoples needs not being met. Peoples health needs are addressed as necessary and staff provide people with support to do this. Medication administration is managed effectively and this minimises the potential risks to people in the home. Evidence: Personal care guidelines are in place where required. Both people are registered with the local GP and there were a number of examples of staff supporting people to attend appointments with other health professionals and writing up notes detailing the outcomes. Medication administration and storage were examined and seen to minimise the potential risks to people in the home. Before staff are allowed to administer medication they complete the necessary training to provide them with the skills and knowledge to necessary to maintain peoples safety. In addition to staff training there is also a medication policy/procedure that staff must follow. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: At the time of this site visit we did not see any plans to address peoples needs around increased mental and physical frailty. It is a recommendation of this inspection report the manager addresses this. Care Homes for Adults (18-65 years) Page 17 of 29 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. There is a complaints procedure in place that enables people to make a complaint if they are unhappy and ensures that all peoples concerns are examined thoroughly within an acceptable period of time. Staff support people to manage their finances and records were available to evidence transactions of income and expenditure. Guidelines available for supporting people when they become anxious are insufficient and need to be developed to minimise the risk of staff to reacting inconsistently. Evidence: The home has a complaints procedure available for all to use as required. At the time of our visits there had not been any complaints made to the manager or her team. Staff have completed training in safeguarding adults. Staff record peoples income and expenditure, we examined the records available for both people. These were seen to be correct but we would recommend that where ever possible each transaction is signed by two staff. We found the majority of transactions were signed by only one person and this puts staff and people in the home at unnecessary risks. Both people can display some behaviours that may be seen as challenging when they become anxious or frustrated. One persons file contained a behaviour management plan from their previous placement. Staff explained that this was a source of supporting information. We saw a care plan that identified what staff should do if a Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: persons anxieties increase, but we feel more information is required to ensure all staff support the person consistently. The plan we examined stated that staff should redirect the person, but gave no further information. It becomes a recommendation of this inspection report that detailed plans are implemented to ensure when staff are supporting people in this area their approach is consistent. When staff have supported people when they have become anxious they have completed records to show what happened, what their input was and how the person was. Care Homes for Adults (18-65 years) Page 19 of 29 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 provides people with a comfortable, homely and clean environment that meets their current needs. Evidence: At our first site visit we completed a tour of the communal areas with the deputy manager. As we have identified there are currently two people living in the home and there is one vacancy. The owners of the home have converted part of the building to provide a good sized flat on the ground floor. This part of the accommodation will provide a person with their own front door, lounge/diner, sleeping area and an en suite bathroom designed to accommodate a person with a physical disability. This room was being completed at the time of our site visit. The communal areas of the home include separate lounge and dining room and a kitchen. All of these areas were decorated to a good standard. Neither of the people living in the home wanted us to see their bedrooms, therefore we cannot comment on the standard of decoration and how the rooms have been personalised. The bathroom and toilets were seen to be appropriately decorated and equipped to meet peoples needs. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: When speaking to staff and people in the home they explained when people moved in they were given the opportunity to choose pictures for the communal areas and the colours/style their bedrooms were decorated. On both occasions when we visited the home we found it was clean and tidy, and there were no offensive odours. Care Homes for Adults (18-65 years) Page 21 of 29 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 safety of people living in the home in maintained by the robust recruitment procedures followed by the organisation. Staff receive training in a wide range of topics that minimise potential risks to peoples safety and enables staff to meet peoples specialist needs. Evidence: We examined a sample of the staffs personal files for evidence of recruitment practices minimising potential risks to people in the home. From the sample we examined we were able to see that the organisation has robust recruitment procedure that meets the criteria of these regulations, and minimises the potential risks to people in the home. We examined the staffing rota for the home. The rota covers staffing for this home and another home in the organisation. Seeing the rota showed that staff are supplied in adequate numbers to support people appropriately and it is reactive to the needs of people in the home. In the files we sampled there were comprehensive records (including certificates) of training being completed across a wide range of subjects. Evidence showed staff completing the LDAF (Learning Disability Award framework)and NVQs (National Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Vocational Qualification)in care and management. Other courses included; Moving and handling, food hygiene, health and safety, physical intervention and breakaway techniques, fire safety, communication, safeguarding vulnerable adults, medication administration, Mental Capacity Act/Deprivation of Liberty. In the AQAA completed by the manager they state that the aim for the coming twelve months is to ensure that staff receive updates in mandatory training. Speaking with the directors of the organisation about the future training aims for staff they showed good awareness of the training required to meet mandatory requirements and specialist training to meet the needs of people in the home. Speaking with staff they confirmed they were receiving supervision. This was confirmed by the records seen in the staff files. Appraisals have not been completed yet and the manager stated this would be achieved within the next few months. Care Homes for Adults (18-65 years) Page 23 of 29 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 manager and her fellow director are clearly committed to ensuring this service provides good quality outcomes for the people living there. Health and safety is taken seriously and this minimises the potential risks to people in the home. Evidence: The manager of the service has many years of experience working with this client group and is appropriately qualified. Speaking with staff at our first site visit they were enthusiastic about working at the home, the training they received and the management of the service. Staff commented that the, the manager is easy to talk too. As we have already identified this is a new service that is still in its early development, speaking with the manager and her fellow director it is clear they are very committed to providing a quality service and have a hands on approach to this. In line with regulation 26 visits to the service are completed by the other director each month. We were able to see copies of the completed reports. Annually surveys are sent to people being supported by the organisation, their families and other professionals involved with the organisation. Surveys were sent out for this service but Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: none were returned, the manager stated that this was due to it being so new. Due to this service only being opened recently it is difficult to confirm that quality assurance procedures are effective as there is limited evidence available at present. Health and safety is taken seriously in the home; we examined an environmental risk assessment completed in March 2010, we saw that hot water outlets are checked monthly,cooked food temperatures are recorded and fridge/freezer temperatures are monitored twice daily. In addition to these checks staff complete a range of mandatory training to minimises potential risks to people in the home. The AQAA completed by the manager states they have recently employed a maintenance person who will undertake health and safety training enabling them to become the health and safety officer for the organisation. At the time of this inspection the original fire safety equipment record of checks had been mislaid. As a result a new book had been started and therefore there were no records of checks being completed. We were assured by the manager that the checks had been completed regularly. The fire alarm system and all of the fire safety equipment are new as a result of the home only being open for a short period. The home had recently been inspected by the local environmental health agency and been awarded 5 stars for their food hygiene standards. All new staff complete food hygiene training as part of their induction. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 The manager should ensure that when creating future care plans and guidelines they are person centred and provide evidence of people being involved in the creation of their care plans. These plans should also be created in a format that the person understands. The manager should ensure that the wording used in documentation is appropriate and accurately reflects the actions to be taken by staff. The manager needs to ensure that care plans continue to be developed over the coming months to ensure they accurately reflect peoples needs. The manager should ensure that each person has a care plan/guidelines in place to address the criteria of this standard. The manager should ensure that the behaviour management plan we identified is reviewed to provide staff with greater detail about the steps they should take. The manager should ensure that two staff sign documentation confirming transactions of peoples income and expenditure. Page 27 of 29 2 6 3 6 4 21 5 23 6 23 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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