Care Home: Milbury 46 Flambard Road

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What the care home does well `I go out whenever I want. I like to go to Portobello Road on Fridays`. Comment from a resident. `The patients are very well looked after and treated with respect and dignity`. Comment from a health care professional`s survey. People living in the home told us that they were happy with the care and support they received. The home had good care planning and risk management systems. Care plans were reviewed regularly and residents were fully involved in planning the care and support they received. The home provided a good standard of accommodation. Residents bedrooms were personalised, well decorated and furnished. The provider had made sure that important documents and policies were made available in formats that made information easier for residents to understand. `I`ve got all my things in my room`. Comment from a resident. `I like all of the staff`. Comment from a resident. What has improved since the last inspection? When we inspected the home in 2008 we made seven requirements to improve outcomes for people admitted to the home in an emergency and to improve the recording of complaints and significant incidents that affected people living in the home. During this visit we found that all seven requirements had been met. There had been no emergency admissions since our last visit and the manager told us that the provider`s referral and admission procedures would be followed if this happened in the future. The provider had made sure that we were told about significant incidents affecting residents and safeguarding adults policies and procedures were available for residents, staff and other people. What the care home could do better: Following this inspection we have asked the manager to make sure that all staff working in the home have formal supervision at least six times a year to make sure that they have the support they need to do their work effectively. We have also asked the provider to update policies and procedures to reflect the appointment of a new manager and the role of the Care Quality Commission. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Milbury 46 Flambard Road 46 Flambard Road Harrow Middlesex HA1 2NA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 0 8 0 6 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 29 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 29 Information about the care home Name of care home: Address: Milbury 46 Flambard Road 46 Flambard Road Harrow Middlesex HA1 2NA 02089075896 F/P02089075896 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) : Milbury Community Services Ltd care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is: 8 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: Learning disability - Code LD Date of last inspection Brief description of the care home 46 Flambard Road is registered to provide care and accommodation to a maximum of 8 people who have learning disabilities. The home is located on a residential road fairly close to central Harrow and Kenton. It is close to a variety of shops, health and social care facilities and services, public transport and other community leisure facilities. The building is on two floors. All bedrooms are single and are located on both floors. The home has a lounge, dining room and conservatory. There is a laundry room and kitchen. There is a large garden to the rear of the property. The home has some parking spaces on the front driveway. Otherwise there are some metered street parking places available. The home has its own vehicle that can be used by people living in the home to access the community, providing there is a member of staff on duty who can drive. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The provider told us the fees are approximately £1,100 per week. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place on Monday 8th June 2009 from 09:15 - 13:30. During this visit we reviewed outcomes for people living in the home against the national Minimum Standards for care homes for adults. We did this by talking with residents, managers and staff, checking care records kept in the home and looking at communal parts of the home and some residents bedrooms, with their permission. The homes manager also completed and returned the Annual Quality Assurance Assessment (AQAA) we sent to him as part of this inspection. The AQAA is a selfassessment where the provider tells us how they make sure residents experience good outcomes. The AQAA also gave us some numerical data about the home and we have used information from the AQAA in this report. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a statement of purpose that is specific to the home and the residents they care for. It clearly sets out the objectives and philosophy of the home, supported by a Service Users Guide. The Guide clearly details what prospective residents can expect and is available in a format that makes the information easy to understand. Evidence: We have assessments of need, support / care plans, risk assessments, person centred planning, pictorial Service User Guide and Statement of Purpose. The latest inspection report is visible in the home. The home demonstrates the ability to meet the needs of the service users by providing specialist / appropriate staff training. Allocated key workers facilitate introductory visits where possible. Extract from the providers Annual Quality Assurance Assessment (AQAA). When we visited the home in 2008, we made a number of requirements to improve outcomes for people admitted to the home in an emergency. During this visit we found Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: that all of these requirements had been met and the manager told us that the providers procedures would be followed for any future emergency admissions. Since our last visit there had been no new admissions to the home. The manager told us that the homes admission procedures included an assessment of the care needs of any person referred to the home and a series of planned visits to the home, whenever possible. We saw that the provider had produced a very good Statement of Purpose and Service User Guide, using pictures to make the information easier for some residents to understand. There was a need to review and update both of these documents to reflect the change of manager and the role of the Care Quality Commission. As part of this inspection we reviewed the care plan files for two people living in the home. We saw that both of the files included a personalised copy of the Service User Guide and a contract / statement of terms and conditions that had been signed by the residents. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home involves individuals in the planning of care that affects their lifestyle and quality of life. Staff understand the importance of residents being supported to take control of their own lives. Evidence: The plan is drawn up with the involvement of the service user, family, friends and advocate where possible and relevant agencies as appropriate. Service users are enabled and supported to make decisions in all areas of their lives. Extract from the providers Annual Quality Assurance Assessment (AQAA). When we last inspected the home in July 2008, we made requirements to improve the care planning and risk management for people admitted in an emergency. During this visit the manager told us that there had been no emergency admissions since our last inspection. During this visit we checked the care plan files and risk assessments for two people who had lived in the home for a number of years. We saw that both of the Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: care plans had been regularly reviewed and the residents had been involved in planning the care and support they received. The plans were very person centred and covered all areas of personal and health care. Both of the plans included clear goals that sought to maximise each persons independence. For each area of the care plan, clear guidance was given for staff on how to deliver support to the individual. A strength of both support plans was the consideration of the residents cultural and spiritual care needs and how these would be met in the home. We saw good evidence that the residents, their families, friends and other significant people had been involved in writing and reviewing their support plans. Both of the care plans files we checked during this visit included detailed risk assessments that had been reviewed regularly, at the same time as the support plans were reviewed. We saw that the risk assessments made sure that people were supported to be as independent as possible. Potential risks were clearly identified and risk management plans gave staff clear guidance on how risks should be mimimised for each resident. We also saw that the provider had produced a clear policy on confidentiality and access to information. The policy had also been produced using pictures to make the information easier for some residents to understand. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a strong commitment to enabling residents to develop or maintain their skills. individuals are supported to identify their goals and work to achieve them. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. Evidence: We provide individual activity plans and person centred plans. We facilitate attendance at external learning opportunities, access to a behaviour therapist and enable service users to experience a wide range of leisure activities. We ensure a well balanced, varied and chosen diet is available, based on individuals preferences. Extract from the providers Annual Quality Assurance Assessment (AQAA). I go out whenever I want. I like to go to Portobello Road on Fridays. Comment from a Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: resident. I like the food. I can have what I want. Comment from a resident. I eat here (the dining room) or sometimes in my room. Comment from a resident. During this visit we reviewed the daily lifestyle of two people living in the home. We did this by talking with them and staff who supported them and checking care records kept in the home. Both people told us that they could go out whenever they chose, independently or with staff support. The care records we checked included monthly social diaries and daily shift plans. These showed us that both people did go out regularly. We also saw that each person had a daily activities programme that included a mix of activities in the home and the local community. These programmes showed us that people regularly used local shops, cafes and other local amenities. The daily shift plans we saw also showed us that people were offered choices about activities and staff respected the choices people made. We also saw that people had access to leisure activities in the home. we saw that people were free to choose to spend time in their rooms or the communal parts of the home. During this visit we saw people making use of the attractive garden and the conservatory, as well as their bedrooms. We saw that both of the care plans we reviewed included details of the residents relatives, friends and other significant people. The care plans also included information for staff on how each residents should be supported to keep in touch with these people. The daily shift plans we saw showed us that residents were enabled and supported to speak to and visit people important to them. We also saw that both of the residents had been registered to vote in local and general elections. Staff told us that they would support people to vote, if they wished to. During this visit we saw that staff kept a good record of what each resident ate each day. This showed that people were supported to choose their own meals and were provided with a varied and nutritious diet. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal and health care support using a person centred approach. Personal and health care needs are well recorded and give a comprehensive overview of individuals needs. The home has a efficient medication policy supported by procedures and practice guidance for staff. Evidence: We provide service users with the personal support they require in their preferred way, we meet the physical and health needs of the service user and ensure service users within their individual capabilities are given the opportunity to administer and control their own medication. Extract from the providers Annual Quality Assurance Assessment (AQAA). I see the doctor and the staff give me my tablets. Comment from a resident. The patients are very well looked after and treated with respect and dignity. Comment from a health care professionals survey. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: During this visit we reviewed the care plans and Health Action Plans for two people living in the home. We also checked the homes medication management and recording systems. The care plans we checked showed us that people living in the home were asked about how they wanted to be supported with their personal care. Staff were given guidance on how care and support should be given to each person. Personal care plans concentrated on what people could do for themselves and also detailed the levels of support needed. We also saw that staff in the home kept good records about the health care that people received. One of the people we tracked had a review of their physical and mental health care needs in November 2008 and January 2009 by a psychiatrist from the local learning disability services. This person had also had a full review of their medication in April 2009. This persons file also included a good record of appointments with health care professionals. The second persons care plan file also included good information about their health care needs and details of appointments with health care professionals. We saw that this persons mental and physical health care needs and medication were fully reviewed in January 2009. This persons care plan also included a goal that they should be supported to eat healthily in order to lose some weight. The monthly weight record kept by staff showed us that this person had been able to lose a stone since August 2008. One health care professional returned a confidential survey we sent out as part of this inspection. They told us that peoples health care needs were met in the home, staff sought advice and acted on it, people were supported to live the life they chose and managers and staff had the right skills and experience to support peoples health care needs. The manager told us that the home used a monitored dosage system provided by Boots. All prescribed medication for residents was delivered monthly and was securely stored in the home. We checked the medication administration records for each person living in the home. We saw that staff kept a very good record of any medication given to residents. In particular, we saw that staff kept a very good record of any medication given to residents as required. We also saw that all staff working in the home had completed an assessment of their competency to administer medication in January 2009. We saw that one persons care plan included information about their wishes regarding end of life care and funeral. This information had been recorded sensitively by staff working with this person. The second persons file told us that this person did not want to discuss these sensitive issues with staff and instructed staff to consult the persons relatives, in the event of illness. Care Homes for Adults (18-65 years) Page 17 of 29 Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are cared for safely and any complaints are taken seriously by the provider. The home has a complaints procedure that is clearly written and easy to understand. The policies and procedures for safeguarding adults are available and give specific guidance to those using them. Evidence: We provide a clear and effective complaints policy and ensure all service users are aware of its existence and how to use it. We provide a robust procedure for responding to any suspicion, allegation or evidence of any type of abuse and a whistle blowing policy. Extract from the providers Annual Quality Assurance Assessment (AQAA). When we inspected the home in 2008 we made 3 requirements to improve the recording of complaints and the homes communication with us and the local authority about any safeguarding adults issues. Since the last inspection, the homes manager had made sure that we were told of any significant incidents affecting residents welfare, a requirement of the Care Homes Regulations 2001. During this visit we saw that the provider had produced a complaints procedure that was easy for people to understand and follow. The manager told us that most complaints were dealt with by staff informally and there had been no formal complaints recorded since our last inspection. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: We saw that the home had a copy of the local authoritys Safeguarding Adults policy and procedures available for staff in the office. The manager told us that there had been no safeguarding referrals or investigations since our last visit. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is suitable for the specific needs of the people who live there. The home is a pleasant, safe place to live. People are encouraged to personalise their rooms. Evidence: We provide an accessible, homely, clean, hygienic, safe, well maintained and comfortable environment to meet individual service users needs and current legislation. We have an enhanced training programme to ensure staff are competent to maintain a safe and clean environment. Extract from the providers Annual Quality Assurance Assessment (AQAA). I like my room. Comment from a resident. Ive got all my things in my room. Comment from a resident. The home is located on a residential road fairly close to central Harrow and Kenton. It is close to a variety of shops, health and social care facilities and services, public transport and other community leisure facilities. The building is on two floors. All bedrooms are single and are located on both floors. The home has a lounge, dining Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: room and conservatory. There is a laundry room and kitchen. There is a large garden to the rear of the property. The home has some parking spaces on the front driveway. Otherwise there are some metered street parking places available. During this visit we saw all communal parts of the home and some residents bedrooms, with their permission. We found that all parts of the home were clean and hygienic. There were enough bathrooms and toilets for residents use. Peoples bedrooms were well furnished and decorated and very individual. People told us that they liked their bedrooms and were comfortable in the home. During our visit we saw that residents were enjoying sitting in the homes large and attractive garden. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the staff who care for them. There are consistently enough staff available to meet the needs of residents. All staff receive training that is focused on delivering improved outcomes for residents. Evidence: Staff have clear roles and responsibilities, staff are appropriately trained and qualified. The company provides a robust recruitment policy and practice adhering to relevant current standards and legislation. All staff are supervised and appraised on a regular basis. Extract from the providers Annual Quality Assurance Assessment (AQAA). I like all of the staff. Comment from a resident. When we arrived for this unannounced visit, the manager was on duty with two care staff. The providers Operations Manager also arrived later in the morning to complete an annual service review of the home. The manager told us a that there was a minimum of two staff on duty at all times and we confirmed this by checking the homes staff rota. We also saw that there were two staff on duty in the home each night, one person awake and the second asleep in the home but able to provide help and support, if needed. We saw that all of the staff worked well together during our Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: visit to make sure residents were supported appropriately. As part of this inspection we checked the personnel files for four people working in the home. We saw that all four files included a job description, employment contract, copies of two written references, training records and pre-employment checks, including Criminal Records Bureau (CRB) checks. These showed us that the providers recruitment policies were followed, making sure that people employed in the home were suitable to work with vulnerable people. The training records showed us that all staff had completed their induction training, as well as mandatory and other training courses. The providers Operations Manager told us that one member of staff had completed their National Vocational Qualification (NVQ) Level 2 training and three other staff had recently started this training. The staff files showed us that staff did receive formal supervision from senior staff, but this was irregular and infrequent. The manager must make sure that all staff working in the home receive supervision at least 6 times a year. This will help to make sure that staff have the support they need to do their work effectively. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the required qualifications and experience and is competent to run the home. He has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. The AQAA contains clear, relevant information that is supported by a range of evidence. Evidence: We provide service users with a well run home with an effective manager that respects the individuals rights and ensures their best interests are safeguarded. Service users views underpin monthly monitoring and annual service reviews. Policies and procedures are in place to ensure the health, safety and welfare of service users are protected. Extract from the providers Annual Quality Assurance Assessment (AQAA). Since we last inspected the home in 2008, a new manager had been appointed. The new manager told us that he was a qualified mental health nurse and had completed his National Vocational Qualification (NVQ) Level 4 award for care home managers. He Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: had previously been the Deputy Manager in the home and had left to manage another of the providers care homes. The manager also told us that he had applied for a Criminal Records Bureau check and would apply to us for registration as the homes manager, once this was received. the manager also sent us the homes Annual Quality Assurance Assessment (AQAA) when we asked for it. The AQAA is a self assessment that shows us how the service provides good outcomes for residents. We have used information from the AQAA in this report. We saw that people living in the home were regularly asked for their views on the care and support they received. his was done as part of monthly monitoring visits to the home by the providers Operations manager and also as part of the annual service review. We saw that residents had been given copies of the 2008 review and this was provided in a format that made the information easier to understand. The review included action points to improve outcomes for people living in the home. We saw that staff had access to all of the policies and procedures they needed to do their jobs effectively. We also saw that the provider had made selected polices and procedures available in accessible formats for residents and other people. During this visit we checked a selection of care records kept by staff in the home, including residents care plans and risk assessments, medication records and daily and monthly summaries of the care and support provided to individual residents. We found that standards of record keeping were good and all of the records we reviewed were up to date and well maintained by managers and staff. We also saw that all the required health and safety checks were carried out and recorded by managers and staff. The manager told us that a representative of the provider made unannounced visits to the home each month to review the day to day running of the service. We saw copies of reports sent to the home after visits which had taken place in May and June 2009. The reports included the views of residents and staff and included actions to improve the services provided. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 36 18 The manager must make sure that all staff working in the home receive supervision at least 6 times a year. This will help to make sure that staff have the support they need to do their work effectively. 30/09/2009 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 1 The provider should review and update the Statement of Purpose and Service User Guide to reflect the change of manager and the role of the Care Quality Commission. Care Homes for Adults (18-65 years) Page 28 of 29 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. 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