Care Home: Maplin House

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well Each resident has a health action plan and staff ensure that people living in the home receive the medicines they need, attend routine appointments for health checks and that they see the doctor (or other health care professional if need be) if they are unwell. Staff record daily notes routinely so that any health issues are dealt with appropriately. What has improved since the last inspection? There has been a new manager appointed and they have put in an application to be registered with us. What the care home could do better: The new manager has been in post for the last 5 months and has inherited many issues from the previous management of the home. Since the last inspection much documentation that was seen in staff and residents files was incomplete on this site inspection. We found that in general the service held poor quality records such as residents files, staff records and safety checks and certificates. Information such as the service users guide and statement of purpose has not been have not been reviewed annually. Additionally they are not readily available in a format of a persons choice such as, video, photographic, Braille or Audio. (The manager is presently working on a pictorial format.) There is a very limited health care plan and support needed for each individual, which `briefly` sets out how they are to be supported. The plans seen were not reviewed yearly or amended to reflect progress and any changes to the person`s treatment and their needs. Risks to each person`s health, safety and welfare were not sufficiently identified or appropriately planned for and inadequate actions plans were in place to manage individuals care. The home`s policies and procedures for dealing with complaints are not fully followed. The arrangements for safeguarding residents from potential abuse must be strengthened and this includes ensuring that all staff paid or voluntary are subject to appropriate checks are made prior to any persons being employed to work in the home. Staffing levels must be reviewed so that there are sufficient staff available to meet the needs of residents and that appropriate arrangements are in place for covering absences due to illness or holiday etc. Supervisions, appraisals and regular staff meeting must go ahead. People living in the home told us that they did do not go out to local pubs, restaurants and places of interests. They also told us that they do not have regular visits to and from friends and spend time with other people who are important to them. (Unless the people that are important to them visit on their own and are able to do so independently) Any complaints or concerns received, are not investigated fully as could be and residents told us that they do not feel happy to discuss any issues with staff or the manager. The home must be managed more effectively and run in the interests of the people who live at Maplin House. Key inspection report Care homes for adults (18-65 years) Name: Address: Maplin House 117/119 Church Road Shoeburyness Essex SS3 9EY     The quality rating for this care home is:   one star adequate 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: Sarah Axam     Date: 3 1 0 3 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 33 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 33 Information about the care home Name of care home: Address: Maplin House 117/119 Church Road Shoeburyness Essex SS3 9EY 01702297494 F/P01702297494 laycraftlimited@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Mohammud Yousouf Meeajun Name of registered manager (if applicable) Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability Additional conditions: The maximum number of service users who can be accommodated is 16 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE, Learning Disability - Code LD Date of last inspection Brief description of the care home Maplin House is a large detached care home set in a sought after residential area in Shoeburyness/Thorpe Bay. The home provides accommodation for up to sixteen older people with dementia and some degree of learning disabilities. Accommodation is provided on two floors, the home has eight single and four double bedrooms. There is a two bed roomed flat provided for staff living accommodation which is situated on the third floor of the building. The home has adequate communal areas on both floors and Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 0 16 16 1 7 0 7 2 0 0 9 Brief description of the care home a shaft lift has been provided. There is limited outdoor space; the garden surrounds the property and has small areas that are suitable for seating. The home has its own mini-bus that is used for taking out residents that includes trips to the beach, shops and local parks. There is a bus route within a short walk of the home that goes to Southend town centre. There is a small car park at the rear to building. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with information on the home. The current range of fees is from £350 to £600 per week and there are additional charges for chiropody, magazines, newspapers, toiletries and day trips. Care Homes for Adults (18-65 years) Page 5 of 33 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 health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Due to serious safe guarding issues raised in 2009 and complaints received (2009 and 2010) around the alleged poor health care support received by the home of all residents, the planned inspection was brought forward. As a result we did not have resident, relative or staff surveys returned or an Annual Quality Assurance Assessment. (This is a document, which providers are required by regulation to provide us with. The document describes how the service is managed, provides evidence about what the service does well and where improvements can be made.) When we visited Maplin House we looked at information provided to potential residents who were interested in Maplin. We looked at how the needs of people moving into the home would be assessed and how their care and treatment would be delivered. We looked at how complaints and concerns were dealt with and the arrangements for safeguarding residents from abuse. We spoke with one resident about their experiences of moving in and four about the care and support they presently receive. We spoke with three members of staff about Care Homes for Adults (18-65 years) Page 6 of 33 the training and support they received and we looked at how staff were recruited and trained. We looked at the environment and the layout of the home. We looked at the residents personal accommodation and the communal areas available to them such as lounge, dining room and the availability of equipment needed to treat and support residents. We looked at some of the policies and procedures, which underpinned the running of the home and we spent time speaking with the home manager. Following the inspection we reviewed all the evidence and information obtained during the visit. We used this to form judgements about how the service was delivered and outcomes and experiences for people who use it. We referred to the Key Lines of Regulatory Activity (KLORA). These are designed to help us make judgements in a consistent, fair and proportionate manner. Care Homes for Adults (18-65 years) Page 7 of 33 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. Care Homes for Adults (18-65 years) Page 8 of 33 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 33 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service cannot always be assured that their individual needs will be met. Evidence: The statement of purpose and service user guide did not include all of the information as required under current regulations. There was little information about the complaints section about the stages, timescales and other agencies people could use such as, advocacy or information regarding the safe guarding unit . The statement of purpose and service user guide stated that the service provided a home to people with all levels of dependency and age. These documents were not available in alternative formats and a draft version of both is still being developed. We looked at the latest persons file to be admitted and found a lack of relevant risk assessments, care plans and other professionals involvement such as Occupational Health and the Blind welfare Society for any additional support and advise that would have been essential and useful when placing this person. The file did however contain Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: a Com 5 (a document of risk assessment and care plans written by the funding authority) a review had taken place after six weeks of this individual being in place and we could see that there was some involvement of the resident and their family by preferences written down and signatures. Additionally due to recent problems with safeguarding issues raised and an on going investigation, commissioners (people who purchase services) were not placing people within Maplin House at present. Care Homes for Adults (18-65 years) Page 12 of 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are not always providing appropriate care or information to all residents at all times. Evidence: When we visited Maplin House we looked at how staff supported residents to achieve their personal goals, make decisions about their care and treatment and to take appropriate risks. We looked at the care plans for five residents. Within the care plans looked at we found that none of the residents goals were recorded. We saw that care plans were devised into sections with some information around risks. Looking through plans they showed us that there was no consistency in approach or clear plans in respect of each persons health care needs. (including that risk assessments are reviewed, such as, falls, pressure sores, nutrition etc) We could see by looking at daily notes that if there were concerns that they are discussed and then if appropriate referred onto the appropriate professional, such as, the GP, District Nurse, Continence Advisor or Psychiatry etc. We saw by letters and summaries that Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: the staff and management team work closely with external professionals and specialists (consultants, District nurses etc) for advice and support. However in most cases information was fragmented, hard to cross reference and we found that most assessments and reviews were incomplete of vital details and in some cases missing. During a tour of the premises and looking through individuals care plans we could not see that the manager was using specialist equipment (Braille signs for exits, toilets or audio fire alerts and within peoples private rooms there were little or no grab rails or specialist equipment to get around the house to promote independence ) or that any assessments or recommendations by other professionals had taken place. Additionally there were no or little reference in peoples files to these needs or their requirements for such adaptations. When looking through five peoples files there was very little evidence to show that people were included within this process. Again no documents or care plans were available in Braille, audio, pictorial or photographic and there was very little evidence of signatures from all of the residents or their representatives to show their agreement to the care plan and support they would receive. Care Homes for Adults (18-65 years) Page 14 of 33 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Maplin House are not always able to carry out and live the lifestyles that they choose Evidence: The manager told us that they continued to offer residents opportunities to express their social, emotional and lifestyle choice. The residents we spoke with told us that they went to bed and got up when they chose, and that if they wanted a lay in or a cup of tea in bed they could do so. One resident also told us that their family could and did visit anytime and that there were no restrictions on this. On the day of the inspection two advocates visited (and carried out activities with people and this happens every two weeks), during this visit, we heard two residents Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: telling the advocates that the last activities that they had carried out since seeing them last, was to go to their hospital appointments. Later on when we routinely chatted with four of the residents, they told us that they could make decisions of what they wished to during the day, evenings and at weekends, but that a lack of staff to take them out prevented them from doing activities they would like to do outside of the home. All residents spoken with expressed to us that they would like to have the opportunity to get out of the home much more than they presently do. Residents told us that they had no planned activities during the week and looking at the residents notice board it showed that activity plans were out of date. Observation throughout the day showed us that no activities (other than the advocates provided that day) had taken place. In general we observed very little interaction between residents and staff. Additionally at the end of the inspection we discussed with the manager the need to provide activities for all residents, such as, reminiscence, quizzes, exercises, talking books, audio newspapers and newsletters from the southend blind welfare organisation and the need to use the community more frequently than at present. The manager informed us that they were in the process of buying a new minibus and that activities were being looked at by him and that consultation with people is due to go ahead. We then looked at how residents are supported to maintain relationships with people who were important to them (one resident told us that they would like to visit an old friend of theirs but never got this opportunity as there were never enough staff on duty to carry this out) and discussed with the manager that on weekdays and weekends they arranged time for residents to visit and spend time with people important to them and we were reassured that this was being looked into. The home employs a part time cook during the week and at weekends the staff on shift cooks the meals for people. Their information showed us that all staff held the relevant qualifications need for this role. Kitchen equipment and regular checks were all in order during the weekday period, however we found that records were not being completed on the weekends by staff such as the fridge and freezer temperature checks and residents consumption of food and fluids. There was a four week menu in place that showed us that the meals being provided and residents confirmed this to us that this was of their choice, however little or no information around peoples preferences of food were consistently recorded in their files, so we could not cross reference this information. The meals provided were varied, however looking at the nutritional value was seen to be of a poor standard. Upon inspection of the food stores it revealed to us that 90 of foods such as bread, Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: sauces, spread, cereal, tins, tea and biscuits were of value products of various supermarkets. Additionally value frozen value foods such as sausages, pies vegetables were in stock. Very little fresh foods were seen. Food stocks in general were very sparse and very limited of choice. However observation of the lunch time meal provided to a few residents seemed of good quality and home cooked and was presented nicely, but equally some residents meals seen by us, such as, curry, meatballs in sauce were out of a tin (value products) and not freshly cooked. Care Homes for Adults (18-65 years) Page 17 of 33 Personal and health care 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service do not always receive the correct support according to their needs and therefore may experience an adequate quality of care provided by the service. Evidence: When we visited the home we looked at the care plans for five residents. We saw that all people had an individual health care plan. However none of these care plans etc were available in a format of the residents choice, such as, Braille, audio, photographic or pictorial. We looked at how residents were supported for their individual health care needs. We saw that staff did support residents to attend doctors appointments, that each person received appropriate medicines and that staff monitored their general health and welfare and that this was recorded well in the daily notes looked through. However Health care plans were not always reviewed and amended where there were changes made to the support that the individual needed. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: Additionally we looked for any reviews which had been carried out by the people who pay for people to live in the home (Social services, the health authority and relatives) and saw that some peoples care had either not been reviewed or that documentation by their social workers (minutes of reviews carried out) were not available within the home. Therefore we could not assess if they were satisfied by the way that the residents were supported and cared for at Maplin House. We saw that there was information recorded about how medication is managed by looking at records and notes made by staff, such as, the correct receipt, recording, storage and handling, administration and disposal of medications. The home has audit systems in place to check that medication is correct and there are no missed medications. It was noted that bottles of medication had been dated when opened and residents on PRN medication had written guidance to staff on when this may be required. When we visited the service two of the staff confirmed to us that they knew procedures well and were aware of individual need. The manager told us that all staff who administers medication had up-to-date training and information so that they handled and administered medicines to residents in a safe way. Care Homes for Adults (18-65 years) Page 19 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems that are in place may fail to ensure that all peoples views are listened to or acted upon at all times and therefore does not protect all people effectively enough. Evidence: When we visited Maplin we looked at the arrangements in place for dealing with complaints and safeguarding people who live at the home. We looked at policies and procedures and we spoke with management team, staff and some of the residents who were at home at the time of the inspection. We spoke with four residents who told us that they had all raised some concerns with the staff at some point about various issues such as, food, money and personal care. Two told us that they were not aware of the complaints procedure and that the staff sometimes made them feel silly and that they wouldnt want to make a complaint. Another two residents said they were aware of how to make a complaint, who to and that they would feel comfortable making a complaint. Two residents told us that they felt the new manager was good and was easy to speak to. We asked the manager if we could see how the concerns had been dealt with. No resident incidents had been recorded as complaint or concern since the last inspection. The manager told us that no residents had made any complaints. We were provided with a copy of the complaints policy and procedure. This was held within the service user guide and the statement of purpose document which contained some brief Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: information about how complaints could be made and how they were to be dealt with by staff and management team. Within the document it was recorded that a person may complain orally or in writing and that all complaints should be recorded (which was not the case). Once again whilst looking through the complaints section we found that there was insufficient and incorrect information describing who to complain to or how complaints would be dealt with at the different stages. (This was raised at the last key inspection). At present Southends safeguarding lead, Essex and Southend social services have placed an embargo on the home. (Due to serious safe guarding issues raised in 2009 and complaints received (2010) around the alleged poor health care support received by the home of all residents) This means that no new residents can be admitted to this service until this embargo is lifted. (At present there are on-going monitoring and meetings held between the home, social services and CQC to support the raising of quality of care and provision of service) All staff have had the updated training in the safe guarding of vulnerable adults. Care Homes for Adults (18-65 years) Page 21 of 33 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. People who live at Maplin enjoy a comfortable but adequate environment in terms of being appropriately suited to their individual needs. Evidence: Walking around the home we saw that it was clean, with no odours and safe for most residents. however we observed that there were no specialised equipment in place for one person who was non sighted and looking within their care plan no risk assessments or involving other professionals had been sought.Therefore a lack of fire (audio) equipment, grab rails, braille signs or cutlery, plates that would help the non sighted keep independence as much as possible were lacking. Additionally many of the fixtures and fittings were tired and in need of replacing and most of the decor needed upgrading. There was no maintenance plan in place. We discussed with the manager the need to have an action plan that addresses general maintenance issue so that the up keep of the service as a whole is gradually addressed and put into place. This will reassure the people who live there that these things will be achieved and completed at some point. Looking through staff files it showed us a lack of training around infection control and that checks on health and safety were not yet fully in place. For example when inspecting the laundry room we found that the laundry door was kept unlocked (fire Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: guard on main door needed as it was wedged open) as was the COSHH cupboard itself(no coshh folder in place). One door cupboard was held closed with sticky tape.The dryer was broken. There were no gloves, no soap, no paper towels, no aprons readily available. There was no sluice in place, no red bags used for heavily soiled washing or yellow bags for continence and no continence bin were seen. Additionally the bathroom used by resident who is non-sighted was cluttered with various equipment stored, including a commode stored opposite the toilet The shower door needs replacing as it was rusty and in bad repair. Again there were no special aides in place for non-sighted residents to help support them in maintaining skills (Braille signs or audio tools to help independence around the home or give information) A number of wedges used around the house for doors (room 4) No specialised fire appliances or alerts such as sound aides or braille used around the house for non sighted people. Care Homes for Adults (18-65 years) Page 23 of 33 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. A lack of specialist training may mean that residents are not supported according to their needs and may experience an adequate standard of care and support provided by the staffing team. Evidence: We looked at the recruitment files for five people who had been recruited to work in the home. We saw that candidates had completed an application form and provided detailed information about their previous employment. Checks including references and Criminal Records Bureau disclosures had been obtained and candidates had been interviewed to help determine their suitability to work in the home. While appropriate checks had been carried out, not all staff had job descriptions or clarification as to their roles or contracts held within their files. We looked at the arrangements for training and supporting staff to enable them to care for residents. We were provided with copies of staff duty rotas. These did not reflect an accurate picture of staff working in the home. Where staff were absent due to illness or planned holidays etc, these was not recorded nor were the arrangements for providing staff cover in these instances. The manager told us that they filled in when needed. Care Homes for Adults (18-65 years) Page 24 of 33 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 service is not presently run in the best interests of the people who live at Maplin House. Evidence: When we visited the home we looked at the management arrangements and the ways in which people that used the service were consulted with about their views and opinions. At present and since the last key inspection no quality assurance to gain the views of people has gone ahead. The manager informed us that this would be completed by the end of the year and that residents meetings would resume shortly. We looked at a number of documents including policies and procedures, which underpinned the management of the home. As described within other areas of the report some policies and procedures did not reflect some practices and some were not specific to the service and the people who use it. Record keeping in respect of the residents needs and the treatment they received were poorly maintained and did not evidence how needs were assessed, reviewed or met. Care Homes for Adults (18-65 years) Page 25 of 33 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 5 That there is an up-to-date service user guide. This is because the service users guide has the wrong information regarding CQC and is not in a friendly user format. 01/09/2009 2 1 4 That there is an up-to-date statement of purpose. This is because the statement of purpose has the wrong information regarding CQC and is not in a friendly user format. 01/09/2009 Care Homes for Adults (18-65 years) Page 26 of 33 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 1 14 Information about the home 01/06/2010 must be reviewed and amended so that it accurately reflects the service and the conditions of registration. This will ensure that those people who are looking for a placement will have enough information of their choice, about Maplin to help them decide that it will be suitable. 2 7 15 Each person must have a 30/06/2010 say in their care plan, which describes their needs, the care and support they are to receive and that they agree to this. Care plans must be reviewed so that they accurately reflect the needs of residents. This is so that residents have accurate and current information about the Care Homes for Adults (18-65 years) Page 27 of 33 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 support they will receive from staff and that all residents have a clear plan in respect of their support and provided in a format of their choice. 3 9 13 Risks to the health and 30/04/2010 safety or welfare of people who live in the home must be assessed and plans put into place to minimise these. This is so as to help ensure the health, safety and general welfare of people who live at Maplin Care Home. Each person must have the choice and opportunity to access facilities within their own local community and have a plan provided which describes their wishes and interests and evidence that this is carried out. This is so as to help ensure the general welfare of people who live at Maplin Care Home. 5 17 16 Risks to the health and 30/06/2010 safety or welfare of people who live in the home must be assessed and plans put into place to minimise these. Food provided must be of good nutritional value and of 30/06/2010 4 13 12 Care Homes for Adults (18-65 years) Page 28 of 33 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 good quality and menus provided reflect fully the choices of the resident group. This is so as to help ensure the health, safety and general welfare of people who live at Maplin Care Home. 6 19 12 The provision for health and 30/06/2010 medical care and treatment must be clear and appropriate assessments must be completed and kept under review. This is to ensure that people using the service receive the health care support they need as part of their individual care programme. 7 22 22 Complaints and concerns must be received and dealt with in accordance with the policies and procedures for the service. This will ensure that all complaints are dealt with appropriately and assure people that their concerns will be taken seriously. Staff must only work in the home once the appropriate checks have been carried out. 01/06/2010 8 23 13 01/06/2010 Care Homes for Adults (18-65 years) Page 29 of 33 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 This is to ensure that residents are safeguarded from potential harm. 9 29 16 That all staff are trained in health and safety and universal infection control guidelines and that the environment is kept safe and equipment is in place. This is to ensure that all people are kept safe against infection and poor hygiene standards. 10 29 23 The provision for 30/09/2010 adaptations and equipment must be in place and appropriate for the individual. And assessments must be completed and kept under review. This is to ensure that people using the service receive the support they need as part of their individual care programme and are kept free from risks as much as possible. 11 33 18 Staff must be employed in sufficient numbers, which are reviewed according to the needs of people using the service and take into account staffs need for appropriate time off work. 30/06/2010 31/07/2010 Care Homes for Adults (18-65 years) Page 30 of 33 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 This would help ensure that residents needs are met by a competent staff team. 12 34 18 Staff must receive training in respect of their roles and the needs of people living in the home. This refers to training in skin integrity, medication and in general the care of people who are elderly and have a learning disability. This will ensure that residents receive the level of support and care they need. 13 34 19 Staff (including those 30/06/2010 employed on a voluntary or agency basis) must only be employed to work in the home once all of the checks as to their fitness have been completed. This is to help ensure that residents are safeguarded and supported by suitable staff. 14 37 3 The service must be 01/06/2010 managed in line with current regulatory requirements and its statement of purpose. 30/06/2010 Care Homes for Adults (18-65 years) Page 31 of 33 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 This is to ensure that the service is run in the interests of the people who use it. 15 41 17 Records must be kept in good order and reviewed when necessary. This is to ensure that records and information reflects the service provided to people who stay there. 01/06/2010 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 32 of 33 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. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!