Care Home: Malbary House

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What the care home does well The home is clean and has a homely atmosphere. One person told us that `they like the home and `I like my bedroom`. Another person said `they look after us well`. We were told that the `food is very nice` and `the staff are very nice`. The people were able to tell staff if they are not happy. They told us that they like their bedrooms and choose the paint colour for their room. One person said that the staff `close the door when they are having a bath` this is to preserve their privacy and dignity. We were told that they go on holidays with staff and enjoy this. The two members of staff were observed talking and listening to the people in a dignified manner on the day they were having training. What has improved since the last inspection? The carpet had been replaced in the lounge. An electric chair had been purchased for one of the people living in the home. What the care home could do better: The home should ensure all staff receives at least 6 supervisions per year to find out how they are working with the people. Ensure that the paperwork in the office is better managed so information is easier to find. Ensure people using the service are involved in their care plans and they are updated on a six monthly basis or sooner. Provide more structured activities to ensure that satisfactory stimulation and motivation is gained for all people living in the home. Ensure that there are adequate staff on duty so the people can do activities and go out Ensure that advocates are involved in helping people to make decisions about their care. Provide Person Centred Planning to help the people with meeting their goals and aspiration. Provide staff with skills in care induction training when they first start work at the home. Provide questionnaires to the people, their families, staff, and other professionals to find out their views about how the home is meeting the needs of the people. Ensure that all staff are provided with the relevant training they need to meet the needs of the people. Keep a record of the fire drills undertaken by the home. This is to show that the homeknows what to do if there was a fire. Ask the Fire Officer to visit the home. This is to check that all the health and safety checks are being done properly by the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Malbary House Malbary House 45 Carlton Street Kettering Northants NN16 8ED     The quality rating for this care home is:   one star adequate 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: Ansuya Chudasama     Date: 0 9 0 5 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 31 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 31 Information about the care home Name of care home: Address: Malbary House 45 Carlton Street Malbary House Kettering Northants NN16 8ED 01536481708 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) : Mrs Jacqueline Mary Miller care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 All service users must have a learning disability No Service Users with a Learning Disability may be admitted to the home where there are already 6 service users in the home. No further service users within the category of OP may be admitted to the home. The total number of service users must not excees six (6). Date of last inspection Brief description of the care home The home currently provides accommodation for four service users in the category of Young Adults with Learning Disability, and is registered for 6. The accommodation is laid out over two floors, offering four single first floor rooms, and a further ground floor double room, occupied by two service users who have chosen to share. The home also has a large lounge diner, a smoking lounge, a kitchen and utility room. There is a first floor bathroom, separate shower room, and a ground floor walk in bath. Fees currently charged at the home are £450 per week. Care Homes for Adults (18-65 years) Page 4 of 31 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: one star adequate 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: This inspection was carried out in accordance with the Care Quality Commission (CQC) policy and methodologies which require review of key standards for the provision of a care home for older people that takes account of the peoples views and information received about the service since the last inspection. Evidence used and judgments made within the main body of the report include information from this visit. We looked at the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment tool that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Care Homes for Adults (18-65 years) Page 5 of 31 We also looked at the information from the last key inspection and the records of any other visits that we have made to the home in the last 12 months. Information we have about how the home has managed any complaints and things that have happened in the home, which are reported under notifications and are a legal requirement are also looked at. The report refers to we this is because the report is written on behalf of the Quality Care Commission. This key inspection was carried out on the 12th of May 09. The registered manager helped out with the inspection process. During this inspection we tracked the care of two people who use this service. This involved reading their care records and also talking to them wherever possible to obtain their views on the service. We also spoke to all the other people who live in the home. At the time of the inspection, there were six people living in the home. Documentation relating to staff recruitment, training and supervision, medication administration, complaints and health and safety were also examined. What the care home does well: What has improved since the last inspection? What they could do better: The home should ensure all staff receives at least 6 supervisions per year to find out how they are working with the people. Ensure that the paperwork in the office is better managed so information is easier to find. Ensure people using the service are involved in their care plans and they are updated on a six monthly basis or sooner. Provide more structured activities to ensure that satisfactory stimulation and motivation is gained for all people living in the home. Ensure that there are adequate staff on duty so the people can do activities and go out Ensure that advocates are involved in helping people to make decisions about their care. Provide Person Centred Planning to help the people with meeting their goals and aspiration. Provide staff with skills in care induction training when they first start work at the home. Provide questionnaires to the people, their families, staff, and other professionals to find out their views about how the home is meeting the needs of the people. Ensure that all staff are provided with the relevant training they need to meet the needs of the people. Keep a record of the fire drills undertaken by the home. This is to show that the home Care Homes for Adults (18-65 years) Page 7 of 31 knows what to do if there was a fire. Ask the Fire Officer to visit the home. This is to check that all the health and safety checks are being done properly by the home. 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 8 of 31 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 9 of 31 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. Needs assessments are carried out for people admitted the home to ensure that their needs will be met. Evidence: The home has a statement of purpose and this was completed in 2005. Some of the information needed updating so prospective people had up to date information about the home. One person spoken to said that they had no choice in coming to the home and had not seen other homes. However they told us that they like it here and wants to stay. Most of the people had visited the home with their family or social worker. All the people spoken to say that they were happy living at the home. They say the staff are very nice. The peoples files looked at showed that need assessments had been carried out by the manager for people who came to live at the home. All the people had contracts with the home but all the information stated in the standard needs to be included in the document. It is good practice to have a Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: representative of the person supporting them when signing the contract. This is to help them understand the information that they are signing better. Care Homes for Adults (18-65 years) Page 11 of 31 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 people are not involved in writing their care plans so there fore they do not know how the home is meeting their goals and aspirations. Evidence: We looked at two peoples care plans in detail. Most of the people spoken to stated that they had not seen their care plans. One person said that the manager did the care plans and they were not involved. We were informed by the manager that the care plans were explained to the people. The care plans seen were not being reviewed on a six monthly basis. But they were being reviewed on a yearly basis. The information in the plans needed expanding in some areas as stated in Standard 6 of the National Minimum Standards for younger adults. This was to provide more information in how the peoples needs were being met. The plans did not state who had been involved in writing the information. The home did not have person centred planning (PCP) where the peoples goals and Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: aspirations are discussed in detail with them. The manager was going to discuss with the funding authority regarding attending training on this. There were risk assessments recorded for the people. The five steps to risk assessment process needed recording as discussed at the inspection. The people in the home should also be involved with this so they are aware of the risks facing them indoors and out doors. There were risk assessments seen for some activities but this information was not recorded in the care plan. The risk assessments also needed expanding in some areas as discussed at the inspection. We were told that service users confidentiality was maintained by staff. The peoples files were locked away securely in the office, which was kept locked. Care Homes for Adults (18-65 years) Page 13 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Meals served are nutritious and plentiful so that the people have a balanced diet with some choice Evidence: We observed the people having their dinner. This was eaten in a relaxed atmosphere with the manager talking to the people. Some people sat in the lounge combined with dining room and some sat in the conservatory to have their meal. The people tell us that the food is very nice. All the people complimented the manager for cooking a very nice meal. One person asked for napkins at meal times to wipe their hands and mouth but these were not available. Some of the people were observed helping clear up after eating their meal. One person said that the food is nice but they do not have the food that Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: they want. The meals eaten are recorded in the communication. The home did not have a menu displayed for the week so the people do not know what they are having for lunch and dinner. A record of food choices made by the people was not seen. The meals recorded were healthy and the manager had good understanding of the peoples likes and dislikes of food. The people did not get involved with cooking. It was said that this was done by staff. Some people told us that they did not want to help out with cooking but a few did want to help out with this. The AQAA received from the home stated that they wanted to promote more interaction in the preparation of meals. One person said that they helped the staff bring in food shopping from the car. Another person told us that they used to make their own cup of tea before they came to live at the home. But now they have to ask the staff to make them a cup of tea. One of the people told us that they did not like other people going into their room. They asked the manager to put a lock on their door. The other people in the home were not able to lock their doors because they did not have a lock on their doors. The people told us that they liked their bedroom, and each persons bedroom seen was individualised to their taste. We were also told that they had chosen the colour for their room. The people are given their mail to open and those who need help to understand the information are supported by staff. On the day of the inspection, the home was having a training session on safe guarding of vulnerable adults procedures and health and safety. The people in the home were invited to attend the training with staff. We observed staff talking to the people in a kind manner when they were having their lunch. Some people attended day care a few times a week, and one person went out seven days a week. One person spoken to stated that they went out with staff to the cinema, or shopping. We were told that they wanted to go out more often. The AQAA stated they needed to find out about day centres and education activities. Some people had family visit them or they visited their families. The manager talked about having an advocate for a person who had no family.This was to help the person to become friends with some one who they could socialise with. The people told us that they got on well together. This was observed on the day of the inspection. We were told that they were going on holiday very soon and they were very excited. There was evidence to show that the people went on a day trips. Three people in the home smoked but there are three other people who do not smoke. One person told us that they do not like the tobacco smoke so they sit in the lounge combined with dinning room. This was observed on the day of the inspection. We were Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: also told by another person that they did not like the smell of tobacco. This persons room was down stairs and their bedroom door which was always open, lead into the conservatory which was used for smoking. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of the people are met by the home Evidence: One person said that they have a bath and the staff helps them with this. It was said that the staff keep the door shut when they are having a wash. They also said that staff helps me get out of bed and takes me out. Another person said that the staff cut my hair because it was too expensive at the hairdressers. They told us that the staff are very nice. We were told that they have a special toilet and bathroom that they are able to use. Most of the people in the home are able to do their own personal care but staff helps out when they this is needed. One person said that the staff takes them out to buy their clothes and they like going out. Another person said that their sister choose their clothes because they did not like doing this. There was evidence in the care plans to show that the health professionals are accessed when required. The people also told us that if they are not well, the staff Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: look after me and call the GP. All staff gave out medication. One staff had completed medication training but the other member of staff had not had this training. The medication records looked at showed that this was satisfactory. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The peoples concerns are being listened by staff and acted upon to meet their needs. Evidence: The home has a complaints policy, and the procedures for making a complaint is recorded in the statement of purpose. The complaints procedure needed updating as this has not been updated since 2005. The home has received complaints from the people about the people living in the home. This was resolved by talking to the people. The home has not received any complaints from any families or professionals. On the day of the inspection the staff and some of the people were having training on safe guarding of venerable adults procedures. All the people in the home were able to communicate verbally and informed us that if they were not happy, they would tell staff or their family. They told us they had no complaints. One person told us that the staff listens to them if they are not happy about another person in the home. One persons finances were inspected and these were satisfactory. The manager has one persons money going into their account. We were told that they are going to open a separate account for that person very soon. Detailed paperwork was kept for this account. Care Homes for Adults (18-65 years) Page 19 of 31 Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a relaxing atmosphere and the programme of redecoration is on going to make the place pleasant for the people living in the the home. Evidence: A tour of the home showed that the place is clean and homely. However the tobacco smoke from the conservatory spread into another persons bedroom and this could be smelled in the lounge combined dining room. The bedrooms seen were indivualised to the people and those spoken to tell us that they like their rooms. The rear lounge combined dinning area was showing signs of wear and tear and needed decorating. The dining room chairs were wobbly and needed replacing. The settees were also showing signs of looking old. The table also needed vanishing or replacing as this was old. Discussion with the manager stated that she was aware that a lot of the areas needed decorating. This is also confirmed in the AQAA. The kitchen and utility rooms were domestic in character and pleasantly decorated. The pink bathroom upstairs needed updating to make it pleasant for the people who use this. A carpet in one bedroom was replaced. The tap in one of the bedroom sinks Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: was not working properly, and a ceiling needed attention. The manager informed us that the cleaner had left recently and the cleaning was being carried out by staff. The television in the conservatory needed assessing to ensure that the height was appropriate for the people watching the TV. The home has a lovely garden but a risk assessment needed to be undertaken to ensure all the people are able to access this facility. A risk assessment needed to be undertaken for the small step leading from the ground floor bedroom to the conservatory. This was to ensure that the person in the room was able to get out safely. Care Homes for Adults (18-65 years) Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing rota needed reviewing to ensure there are adequate numbers of staff on duty to meet the needs of all the people Evidence: The staff recruitment files were looked at in detail. Evidence showed that the home is managed by two staff and the manager. The home also has a handyman. The home did not have any bank staff. The staff working rota needed reviewing to show that one staff on duty is able to meet the needs of all the people, as well as undertaking their own chores such as cooking the meals, giving out medication, cleaning, doing laundry work, and administrative work. It was evident that the manager did not have enough time to undertake their duties as stated in the standard. This was due to working full time on the staff working rota. This was also confirmed in the AQAA. On the day of the inspection the staff were doing the training on health and safety and safe guarding of vulnerable adults procedures. The training records of staff showed that they had completed moving and handling, dementia, food hygiene. The manger and another member of staff had completed medication training. The manager informed us that first aid, Mental Capacity Act and infection control was booked for Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: June 09. The staff had not received fire training. The manager told us that she had verbal supervision with staff but this was not recorded. There was no induction recorded for staff when they first came to work at the home. We were told that this was done verbally with staff. We discussed the skills in care induction with the manager and she stated that this would be done when a new member of staff is employed at the home. We were told that the home retained their staff and this provided continuity to the people. We were told that one staff had NVQ level 2 in care. Care Homes for Adults (18-65 years) Page 24 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of the people and management is aware of the areas where they need to make improvements to meet the needs of the people Evidence: The manager of the home has many years experience of running a home. She has completed her NVQ level 4 in care and is aware that they need to complete the Registered Managers Award. The manager has good understanding of the areas that needed improving in the home. The people spoken say that the manager is very nice and looks after us well. The manager informed us that they talk to the people and some of the families of the people every day. However a survey has not been carried out to get the views of the people, staff, and families. The accident and incident records show that these were being recorded appropriately. The paperwork in the office needed to be better managed because information was Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: difficult to find. This was acknowledged by the manager. (See section on staffing regarding the manager working full time on the rota). We were told that fire alarm system was being tested on a weekly basis. The emergency lighting was done on a monthly basis. The manager told us that they know what to do if there was a fire. The manager needs to record the procedures that the staff would carry out if there was a fire. They should also record the practice fire drills being carried out. The Fire Officer has not visited the home for many years. The manager was advised to ring the Fire Officer to visit home. This is to check that the home is doing the things right about fire procedures. The staff did not have fire training from a trained person and first aid. The AQAA stated that the portable electrical equipment was serviced on the 10/2/08. The premises electrical circuits were tested in 03/2/09. Fire fighting equipment was tested on the 11/2/08. Emergency lighting was tested on the 11/2/08. The gas appliances were tested on the 12/2/08. The information in the AQAA read stated that the homes policies and procedures were reviewed on the 12th of February 08 and some in January 2009. We did not look at these documents at this inspection. The Environmental Health Officer visited recently and awarded the home 3 stars, which is good. A risk assessment needed to be undertaken for the radiator that is near the table in the conservatory. This is to find out that the people will not burn themselves on the radiator. A risk assessment must be undertaken for people who have poor mobility when they are accessing the garden. Care Homes for Adults (18-65 years) Page 26 of 31 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 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The care plan must state how the peoples goals and aspirations will be achieved and this should be drawn up with the involvement of the person. This is so they know how their goals/needs are being met at the home 31/08/2009 2 16 13 The home must review their smoking policy. This is to ensure that the needs of the people who do not smoke are met. 31/07/2009 3 32 18 Provide staff the relevant training that is needed. To meet the needs of the people 31/07/2009 4 33 18 The staffing levels must be reviewed. This is to ensure that there are sufficient staff on duty to meet the needs of the people. 31/07/2009 Care Homes for Adults (18-65 years) Page 28 of 31 5 42 13 A risk assessment must be undertaken for the radiator that is uncovered in the conservatory. This is to ensure that the people are kept safe. 31/07/2009 6 42 13 A risk assessment must be 31/07/2009 undertaken for accessing the garden. This is to ensure that all the people are safe using the garden. 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 2 Update the statement of purpose/service user guide so prospective people interested in coming to the home have up to date information about the home. Up date the contract with the information stated in the standard. So the people know their rights and responsibilities in detail. Ensure that the information in the risk assessment is included in the care plan. This is so the people know how this risk assessment is being met in the care plan. The risk assessments needed reviewing to ensure that the five steps to assessing risks are recorded. This is to minimise potential risk and hazards to the person. Provide napkins for the people so they can clean and wipe their hands and mouth with. Provide a written menu with the people involved. This is so the people know what meals they are having for the week. The activities needed to be further developed so the needs Page 29 of 31 2 5 3 6 4 9 5 12 6 12 7 12 Care Homes for Adults (18-65 years) of all the people who live in the home are met. 8 9 16 17 Provide locks on bedroom doors so all the people have the choice to lock their rooms. The people should be actively be supported to be more independent by helping plan, prepare and serve meals in the home. Ensure all staff who gives out medication have received the accredited medication training. Up date the complaints policy and ensure it is written in an easy to understand language for the people to understand. Provide all staff with skills in care induction training. This so they are aware of the health and safety issues. Provide at least 6 supervisions per year. This is so their practice can be monitored in how they are working with the people. Undertake the peoples surveys to find out how the home is meeting their needs. Provide first aid training to staff. Keep a record of when a fire drll has taken place. 10 11 20 22 12 13 35 36 14 15 16 39 42 42 Care Homes for Adults (18-65 years) Page 30 of 31 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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