Care Home: Meadoway Homes

What the care home does well Overall, the inspector believes that the home provides a generally good standard of care and support. Service users spoken to expressed satisfaction with the home. Comments from service users included "It`s nice here." "I like it all here." and "It is all alright for me." Service users are able to visit the home before making a decision as to move in or not, and there was evidence that service users have a large degree of control over their daily lives. The physical environment was generally well maintained, and food was of a good standard. What has improved since the last inspection? There have been considerable improvements at the home since the previous inspection, and the overall number of requirements set has fallen from nineteen at the last inspection to six on this occasion. Service users are now involved in the care planning process, and risk assessments are now subject to regular review. Only trained staff now administer medications, and service users are able to see relevant health care professionals as appropriate. What the care home could do better: Despite improvements, there are still some issues that must be addressed, and a total of six requirements have been made in this report, along with one good practice recommendation. Although the quality of care plans has increased, further developments are still needed so that plans cover all areas of assessed need. The home must ensure that CRB checks are carried out for all staff, and that staff undertake training in working with adults with mental health issues. Key inspection report Care homes for adults (18-65 years) Name: Address: Meadoway Homes 613 Barking Road Plaistow London E13 9EZ     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: Robert Cole     Date: 0 3 1 2 2 0 0 9 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 28 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Meadoway Homes 613 Barking Road Plaistow London E13 9EZ 02082578183 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Meadoway Homes Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home The home is registered with the Care Quality Commission to provide accommodationand and care to four people of either gender, with mental health difficulties and support needs. The premises are situated in East London, Plaistow area on a busy road, close to public transport and other amenities such as Afro-Caribbean Community Centre and West Ham Stadium. . 1 9 0 1 2 0 0 9 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and 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: This inspection took place on the 3/12/09 and was unannounced. The inspector had the opportunity of speaking with service users and care staff at the home. The homes manager arrived shortly after the beginning of the inspection, and remained in the home until the end of the inspection. One of the homes proprietors was also present for part of the inspection. In addition to these discussions, the inspector was able to tour the premises, and observe staff as they carried out their duties. Records and other documents were examined. Prior to the site visit, the home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CQC. All this has contributed to the overall inspection process, and to judgements made within this report. Care Homes for Adults (18-65 years) Page 5 of 28 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. 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 6 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and 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 7 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that prospective service users are provided with sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. Evidence: The home has a Statement of Purpose and Service Users Guide in place. Both documents are written in plain English, and made available to service users. The Statement states We aim to provide therapeutic and supportive accommodation within a safe environment for service users who experience long term mental health problems. The Statement also includes details of the staff team and management, and of the services provided. The Service Users Guide includes a list of the care values within the home. These include respect for individuals, offering information and choice and having good employment practises. Service users are also provided with an individual contract. These have been signed by the service user and the homes manager. Contracts Care Homes for Adults (18-65 years) Page 8 of 28 Evidence: include details of fees payable and the rights and responsibilities of both parties. There has been one new admission to the home since the previous inspection. The home has an admissions procedure in place, and there was evidence that this was followed with the new admission. Initially the home will receive a referral from the Primary Care Trust, and a written assessment of the service user. If it looks like it may be a suitable placement, the manager will then go and meet with the service user, and carry out their own assessment. The assessment seen by the inspector was of a satisfactory standard, covering needs around physical and mental health needs. The service user then has the opportunity of visiting the home, including for overnight stays, before a decision is made as to moving in or not. The service user will initially move in to the home on a three month trial basis, after which a placement review meeting is held. Care Homes for Adults (18-65 years) Page 9 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans in place are of a good standard, although they need to be broadened to cover more subjects. Service users have a large measure of control over their daily lives. Evidence: Individual care plans are in place for all service users. Since the previous inspection these are now subject to regular review, and are signed by the service user to indicate their involvement in and agreement with the plans. Service users spoken to said they were indeed involved in the care planning process. On the subjects covered, care plans were of a good standards, sufficiently detailed and comprehensive, for example around mental health needs and support with financial matters. However, there were gaps in the issues that care plans covered. For example, there were not plans in place around cultural issues, or social and leisure issues, or around service users physical health, although the homes manager said that the home does indeed take steps to work with service users around all of these issues. To help ensure that service users are supported in a comprehensive and consistent manner clear individual care plans Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: should be in place covering all areas of support. Three of the four service users are on the Care Programme Approach, and there was evidence of regular review meetings for this. Risk assessments are in place for all service users. As with care plans, these have been signed by the service user. Assessments identify risks, and include strategies to manage and reduce those risks, for example risks around self harm, neglect and violence and aggression. Service users are able to take reasonable risks. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. Service users were seen to be able to get up at a time of their choosing, eat when they wished, help themselves to drinks and snacks and come and go from the home (although staff ask that they sign out when they leave the home). All service users have their own bedroom, and a key to their bedroom door. One service user has an independent advocate. Service users have some opportunity of been involved in the day to day running of the home, for example service users are involved in the recruitment procedures for new staff. Service users have regular meetings which are minuted, which discuss activities and give service users the opportunity to raise any issues of concern they have. In addition to these meetings, they have a weekly meeting specifically to plan the menu for the coming week. Since the previous inspection the manager told the inspector that the home has purchased a new sofa, television and oven, but that these items were chosen by staff, and service users were not given the opportunity to be involved in choosing such items. As it is the service users home, they should be able to choose any new furniture, electrical good etc for themselves. The home has a confidentially policy in place, and confidential records are stored securely. Staff and service users can access their records upon request. Care Homes for Adults (18-65 years) Page 11 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to live valued and fulfilling lives, and are involved in a variety of community based activities. Food is of a good standard. Evidence: One service user currently does some secretarial work on a voluntary basis, with the view to finding paid employment at some point. Although no service users are currently involved in any formal educational opportunities, they are involved in a variety of programmes designed to develop skills, for instance one service user attends a gardening project, while another attends cooking classes run by a community based mental health project. Due to their level of independence, to a large degree service users choose and plan their own activities without staff support. However, the home does support them with some activities, such as playing badminton, going swimming, going to the gym and Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: attending yoga and relaxation groups. The home is looking in to the possibility of one service user attending a hearing voices group. The home also supports service users on occasional day trips, for example to the Millennium Dome and Madame Tussuads. Service users access a variety of community based facilities, including cafes, pubs, shops, markets, librarys and public transport networks and the cinema. In-house there are a variety of activities available, including satellite television, music, board games and the home has a pool table. Service users are involved in the daily routines of the home, such as laundry, cooking, keeping the home tidy etc. Service users are set weekly goals to achieve, such as making sure they clean their room, attending appointments, visiting the gym etc. If they fulfil there goals for the week they receive a £5 bonus from the home. Service users spoken to said they liked this set up, and that they were involved in choosing the goals for the week. Service users are able to maintain contact with family and friends, and visitors are welcome at any reasonable time. Service users have access to a telephone they can use in private. One service user informed the inspector that the are given their own mail to open, but that staff will help them with the mail if they request it, for example if the letter is about arranging an appointment. As mentioned, service users are able to plan the menu themselves, and records are maintained of food provided. These indicated that the home provides a varied, balanced and nutritious diet. Service users are involved in buying and cooking food. Fresh produce is used, and fresh fruit was available on the day of inspection. The kitchen was clean and tidy, and food was stored appropriately. Records are kept of fridge and freezer temperatures. Care Homes for Adults (18-65 years) Page 13 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has taken steps to help meet the health and personal care needs of service users. Medication is managed in a safe way, and service users have access to health care professionals as appropriate. Evidence: For the most part, service users are able to manage their own personal care, although the home will offer prompting and encouragement to service users around this. Records of a Care Program Approach meeting indicated that since moving into the home earlier this year, there has been a considerable improvement in the personal care and hygiene of one of the service users. All service users are registered with a GP, and records are maintained of medical appointments. These indicated that service users have access to health care professionals as appropriate, including CPNs, psychiatrists, dentists and opticians. One service user is also working with a dietitian. There was evidence that the home seeks to promote healthy lifestyles in the form of regular exercise, such as visiting the gym and going swimming. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The home has a medication policy in place. This needs some amendment, as it does not contain information on what to do in the event of a medicating error occurring. This was brought to the attention of the homes manager, who agreed to amend the policy accordingly. The inspector was pleased to note that since the previous inspection the home now has suitable storage facilities for medication, in the form of designated medication cabinets which are securely fixed to the wall. The inspector was further pleased to note that since the previous inspection all staff have now undertaken training around the administration of medication. One service user currently is able to self medicate, which helps to promote their independence. There are safety checks in place around this. No service users are currently on any controlled drugs. Records are maintained of medications entering the home and of those that are returned to the pharmacist. Medication Administration Record charts are in place. Those examined by the inspector were accurate and up to date. Care Homes for Adults (18-65 years) Page 15 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The inspector was satisfied that the home has taken steps to help ensure service users are protected from the risk of abuse. Appropriate procedures are in place, and staff undertake training in safeguarding issues. Evidence: The home has a complaints procedure in place. All service users are provided with their own copy of this, and service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home also maintains a complaints log, although the manager informed the inspector that no complaints have been received since the previous inspection. The manager also said that there had been no safeguarding referrals since the previous inspection. The inspector was pleased to note that the homes adult protection policy has been updated since the last inspection, and it now makes clear the homes responsibility to report any safeguarding allegations to the local authority. The home also has a copy of the local authorities adult protection procedure. All staff have undertaken adult protection training as part of their basic induction training. However, staff spoken to demonstrated only a limited understanding of their roles and responsibilities with regard to this issue. The manager said he planned to address this by providing more comprehensive training on the subject, and also through one to one discussions with individual staff members. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Two service users manage their own money independently of any staff support. For the other two service users, their families manage their money, and bring in an amount of cash each week for their relative. The home then holds this money on behalf of service users in a locked cabinet. Staff do not spend any money on behalf of service users, but hand it over to the service user upon request. When money is handed over both the service user and staff member sign to indicate this. Monies are checked and signed for by staff at the beginning of every shift. Service users spoken to said that they were happy with this arrangement. Care Homes for Adults (18-65 years) Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable to meet its stated purpose with regard to its physical environment. The home was generally well maintained, and service users have access to adequate communal and private space. Evidence: The home is located by a busy main road in the Plaistow area of the London Borough of Newham. The home is close to shops, transport networks and other local amenities. The home is in keeping with other homes in the area. The home was found to be generally well maintained both internally and externally, and furniture and fittings were domestic in character. It was however noted that the carpet throughout the communal areas was badly stained and in places quite threadbare. This was discussed with the homes proprietor, who informed the inspector that they were planning on replacing the carpet in the near future, and this is recommended. Communal areas consist of a living room, dining room, kitchen, quiet room and a spacious garden. The garden has an outhouse which is used by service users for smoking in. The home has two bathroom/toilets, and one shower room/toilet. All of which were found to be clean, tidy and free from offensive odours on the day of Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: inspection. Bathrooms have been fitted with working locks, which include an emergency override device. All service users have their own bedrooms, one of which was seen by the inspector. This was seen to be well maintained, with adequate furniture including chest of draws, chairs and a wardrobe. Curtains, carpets and bedding were domestic in character. The room had adequate natural light and ventilation, and was centrally heated. The service user has been able to, personalise the room, for example with their own possessions such as a television. All bedrooms contain a hand basin. Bedrooms meet National Minimum Standards on size requirements. The home has taken steps to help prevent the spread of infection. Laundry facilities in the home are appropriate in scale to the home, and Control Of Substances Hazardous to Health products were stored securely. Hand washing facilities were situated around the home, and protective clothing such as gloves and aprons are available to staff. Care Homes for Adults (18-65 years) Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience 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 staffed in sufficient numbers, and service users spoke well of staff. However, further training needs to be provided around working with adults with mental health issues. Evidence: The home provides 24-hour support. There was a staffing rota on display, this accurately reflected the staffing situation on the day of inspection. The inspector was satisfied that the home provides adequate staffing levels. The home has various employment related policies in place, including on recruitment and selection and equal opportunities. The inspector checked staff employment files. These were found to contain proof of identification and references. In addition to the manager, the home employs a deputy manager and four care staff. For one of the care staff, and the deputy manager, there was no evidence that the home had carried out a CRB check on them, although the manager informed the inspector that these had been done. It is required that CRB checks are carried out on all staff working within the home. Through observation and discussion there was evidence that staff have a good understanding of service users needs, and were seen to interact with them in a Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: friendly and respectful manner. Service users spoken to spoke well of the staff, one commented The staff are good. while another said Staff here are quite nice people. At the previous inspection, the only permanent member of the staff team was the manager, all other staff used were provided by an agency. The inspector was pleased to note that the home now directly employs five more staff members, who all began working in the home in August 2009. Some of these were the same staff who had worked for the agency, thus the home was able to provide some continuity of care. At the date of this inspection, these new staff had undertaken training courses in medication and record keeping. In addition, they had each taken part in a two day training course covering adult protection and various health and safety subjects such as fire safety and first aid. The manager said that further training was planned, including a more comprehensive training course on adult protection. However, it was noted that no training had been provided or was planned around mental health issues. As the home provides care specifically for service users with mental health needs, the inspector believes that staff should be provided with training in this area which would give them some understanding and insight into the needs of service users. All of the current staff team have a relevant care qualification. Care Homes for Adults (18-65 years) Page 21 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is knowledgeable and experienced in the provision of care to service users with mental health needs. Appropriate systems are in place around quality assurance, and health and safety is generally well managed. However, regular monthly Regulation 26 monitoring visits must take place. Evidence: The homes manager is registered with the CQC. They have fifteen years experience of working in care, including nine years in a managerial capacity. They are a Registered Mental Nurse, and informed the inspector that they are currently working towards the Registered Managers Award. Service users were seen to interact with the manager in a relaxed manner. The home also employs a deputy manager. Record keeping within the home was of a generally good standard. Confidential records are stored securely, and staff and service users can access their records upon request. The standard of policies and procedures at the home has greatly improved since the previous inspection. Relevant policies are now in place, and these are generally of a satisfactory standard. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Service user meetings, staff meetings and care plan reviews all contribute to the quality assurance processes within the home. Since the previous inspection the home has developed a quality assurance policy, which states that surveys will be sent out periodically to service users to gain their feedback on the home. Although no surveys had been sent out by the date of this inspection, the manager was able to demonstrate that arrangements were already in place to send out surveys the week after the date of this inspection. The inspector was however disappointed to note that a requirement from the previous inspection about Regulation 26 monitoring visits has still not being met. The home could only evidence one such visit has taken place since March 2009, and this requirement is therefore repeated. The home has two fire extinguishers, and a fire blanket, these were last serviced on the 15/12/08. Smoke/fire detectors are fitted in every room, these are tested weekly, and the home holds regular fire drills. The home had in date safety certificates for PAT testing and electrical installation. However, the home has not had a landlords gas safety check carried out since 2/10/08, and it is required that such tests are carried out at least once every twelve months. The home has in date employers liability insurance cover in place. Care Homes for Adults (18-65 years) Page 23 of 28 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 39 26 The Registered provider must 30/09/2006 arrange for monitoring visits to take place on a monthly basis. The subsequently produced reports must be made available to the Manager of the home and the Commission for Social Care Inspection. Care Homes for Adults (18-65 years) Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person must ensure that comprehensive care plans are in place, covering all areas of need. To help ensure that service users needs are met in a comprehensive and consistent manner. 28/02/2010 2 8 12 The registered person must ensure that service users have the opportunity to be involved in choosing any new furniture and electrical goods for the home. To promote the choice of service users. 31/12/2009 3 34 19 The registered person must 31/01/2010 ensure that satisfactory CRB checks are carried out for all staff working in the home. To help ensure the safety of service users. Care Homes for Adults (18-65 years) Page 25 of 28 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 4 35 18 The registered person must ensure that all care staff working in the home undertake training on working with adults with mental health needs. To help ensure that the home is able to meet the needs of service users. 31/03/2010 5 39 26 The registered person must arrange for Regulation 26 monitoring visits to take place on a monthly basis. The subsequently produced reports must be available to the home. To help ensure the smooth running of the home, and that service users needs are being met. 31/01/2010 6 42 23 The registered person must ensure that the home has a landlords gas safety check carried out at least once every twelve months. To help ensure the health safety and welfare of service users and others. 31/01/2010 Care Homes for Adults (18-65 years) Page 26 of 28 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 24 It is recommended that the home replaces the carpet in the communal areas, as the current carpet is stained and threadbare. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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