Care Home: Morningside

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Morningside 4 Newton Road Penrith Cumbria CA11 9FA one star adequate service The quality rating for this care home is: 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: Ray Mowat Date: 1 9 0 3 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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 Information about the care home Name of care home: Address: Morningside 4 Newton Road Penrith Cumbria CA11 9FA 01768890768 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) : www.c-i-c.co.uk Community Integrated Care care home 5 Number of places (if applicable): Under 65 Over 65 5 1 learning disability Additional conditions: Five people over 18 years of age with a learning disability and who may be over 65 years of age. Date of last inspection A bit about the care home Morningside is a purpose built five-bedroom bungalow and provides care for five people with learning disabilities, some of who may also have a physical disability. It is owned and staffed by Community Integrated Care, a national not for profit organisation, providing care services and housing to people with learning disabilities. It is situated on the outskirts of Penrith in a quiet residential area, a short walk from local shops and amenities. It has an enclosed garden to the rear and front that is accessed by a gate with a coded security lock. All the bedrooms are single and en-suite. The home comprises a lounge, dining room, kitchen, utility room and an office. There is a bathroom with a high/low bath and toilet and a walk-in shower with a toilet. The current scale of charges is £926.44 per person per week, with additional charges for personal expenses such as toiletries. Information about the home is made available to people in a service user guide and the most recent inspection report is made available on request. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 1 star. This means the people who use the service experience adequate quality outcomes. During the visit we (The Commission for Social Care Inspection) met with people living in the home and spent time with supervisory staff on duty. We also met with care staff individually and talked to them as they went about their duties. The manager completed a self assessment questionnaire called an Annual Quality Assurance Assessment (AQAA) and sent it to us before the inspection visit. This provided us with information about how the home is run and the managers views on what the home does well, where they have improved and plans for the future. There is also information about the people who live in the home and the staff working there. Surveys were sent out as part of this inspection to people living in the home, staff and other professionals with their views being used to formulate the judgements in this report. We also examined records relating to the running of the home that are required by legislation, which included care plan files that guide staff in supporting people to achieve their goals and lead independent lives. We examined staff files and records relating to the maintenance and safety of the home. What the care home does well The staff work closely with a number of agencies to make sure they are meeting individuals complex and sometimes challenging needs. Detailed strategies and interventions have been agreed to guide their practice and make sure they support people in a personalised and consistent manner. Staff have a good understanding about peoples individual communication needs and how they make their needs known. These are well documented within their care plans giving staff information about the possible meaning of peoples words, utterances or gestures, based on previous experience of them. Handover meetings and daily diary notes which are completed at the end of each shift make sure staff share relevant information and provide a consistent service. Some care plans give staff a lot of valuable information about what is important in a persons life and their aspirations for the future. Daily routines are recorded in detail which is important to individuals to help them to cope and make sense of their lives. The use of photographs and personal pen pictures and personal histories in some care plans have been effective in making the care plan more meaningful to the person and the staff supporting them. A good range of risk assessments are in place that keep the people living and working in the home safe at all times both in the home environment and in the local community. People are given opportunities and support to pursue their interests and hobbies and enjoy their leisure time. Meal choices are provided on an individual basis with people involved in choosing, buying and cooking their food. Healthcare records are good making sure healthcare needs and interventions are recorded and responded to. Medication records are up to date and accurate making sure medication is stored, handled and administered safely. All areas of the home are decorated and furnished to a good standard and well maintained making sure it is a safe and comfortable home. Complaints and safeguarding concerns have been listened to, recorded and acted upon in a timely manner with the home liaising with other agencies to safeguard people throughout the investigation process. What has got better from the last inspection Although the home has been using agency staff on a regular basis they have managed to maintain reasonable staffing levels to meet the needs of the people living there. The range of activities provided for people has increased with people taking part in activities both in the home environment and in the local community relevant to their interests and abilities. Risk assessments and management guidelines have been kept under review to make sure people are safe at all times. How people make choices and communicate their needs is recorded in detail enabling staff to support people to be more independent. Peoples needs in relation to food and nutrition are closely monitored with individual food choices being provided and regular weight monitoring taking place so that changes can be responded to appropriately. Staff personnel records are being updated to make sure they contain relevant up to date information. A new bath has been installed in one of the bathrooms that is more accessible to the people living in the home. What the care home could do better Full assessments of need should be completed before new people move in to live in the home to make sure the home is suitable and peoples needs can be safely met. Care plans should be reviewed with a view to make sure that different strategies, interventions and risk assessments are cross referenced and up to date. A training and development plan must be developed to make sure all staff receive training relevant to their role and responsibilities. All staff, including agency staff, should receive regular supervision and support from the management team to guide and support their practice. The new manager needs to look at the most effective ways for her to complete meaningful quality monitoring of the service provided, to make sure it is meeting peoples needs and aspirations. Fire drills should take place at recommended intervals to make sure all staff are aware of fire precautions, fire equipment and escape routes. The fire risk assessment should be reviewed and updated to make sure it is up to date and accurate. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ray Mowat CQC North West Citygate Gallowgate Newcastle upon Tyne NE1 4PA 03000616161 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 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessment procedure should be reviewed to make sure a full assessment of need is in place before new people move into the home, making sure their needs can be safely met. Evidence: We examined three peoples care plan files to evaluate the assessment process and make sure peoples needs were being fully assessed. Two of the three files contained detailed needs assessments from which comprehensive person centred care plans had been developed. They included detailed assessments of peoples personal and healthcare needs as well as valuable information about their daily routines, likes and dislikes and an informative record called This is me,which gives staff an insight to what is important in the persons life, using photographs as well as text to tell their story. There was evidence of the staff working closely with a number of other agencies and professionals to make sure peoples specialist needs were also assessed. Detailed strategies and interventions are in place that were agreed with the multi disciplinary team to guide and support staff in responding in a consistent and appropriate manner to peoples complex and sometimes challenging behaviours. The third care plan file was not as well ordered and although it contained a social work assessment, which was dated November 08, the person moved into the home in September 08 suggesting that they moved in without a full assessment in place. The staff on duty described the admission process for this person, which included visits to the home and staff visiting them in their day centre environment. In addition they liaised with the behaviour intervention team for advice and guidance and interventions were agreed for staff to follow. Evidence: Unfortunately the home was experiencing a disruption to the management team at this time, which has impacted on the assessment process for this person. The manager should make sure suitable assessments are in place and kept under review for all prospective new people moving into the home to make sure their needs can be met. Despite major disruption to the management and staffing of the home in the last six months the impact on peoples day to day lives has been minimised with contracted staff working closely with relief and agency staff to maintain a consistent service. Regular agency staff have been employed who are familiar with the routines of the home and the people living there, enabling them to respond appropriately to peoples needs and aspirations. Based on feedback from staff they acknowledged at times it has been difficult for them with staff shortages and changes but there has been a lot of commitment from staff to keep the home running smoothly. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples individual needs and preferences are recorded in detail, which helps staff to support them to lead an independent lifestyle. Evidence: The home is developing comprehensive person centred care plans for people that give staff valuable information to guide and support their practice. As described previously there are a lot of detailed multi disciplinary strategies in place to make sure staff understand peoples needs and behaviours and respond to them appropriately. Daily routines and pen pictures are recorded as well as other valuable information about peoples individual needs and aspirations that make the care plans both very personal and more meaningful. It is recommended care plans are reviewed with a view to making sure that different strategies, interventions and risk assessments are cross referenced and not contradicting each other. In one file a day service care plan was included, which could cause confusion as there was no reference to why it was there and some of the information it contained was not relevant now. Staff are receiving relevant training in relation to person centred care that will help them to continue to develop informative care plans that help and support people to achieve their goals. The care plans contain detailed information about how people make their needs known and make choices in their day to day lives. They include information about peoples behaviour and utterances or gestures and what the possible meaning is and how to respond to them. This is particularly important with some people being autistic and requiring fixed routines and patterns of behaviour to help them make sense of their environment. In addition there are other people who live in the home who have very limited or no verbal communication. Each person has a daily diary completed at the Evidence: end of each shift to record their daily activities appointments and the care and support provided to them. A good range of risk assessments have been developed for each person living in the home, which are regularly reviewed. These include personal risk assessments as well as assessments relating to the home environment and community settings. They reflect individual needs and challenges so that both the person and the staff supporting them are safe at all times. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead an independent lifestyle both in their home and in the local community. Evidence: Two of the people living in the home attend diffent types of day services five and three days respectively. This provides them with a good range of educational and leisure activities in community settings as well as being a valuable social experience where they mix with their peers. The other three people are supported by staff from the home to pursue their interests and hobbies. If staffing levels are down then this impacts negatively on the range of activities the home staff can provided for this group. However a weekly timetable of activities has been developed that is providing both in house and community activities including, relaxing with music, hand massage, watching a DVD, cooking meals, baking and helping with other household chores. Going out for walks or trips in the car always prove popular as well as people going out for personal and household shopping or going to a local pub or cafe for a drink or a meal. Staff are aware of peoples personal interests and hobbies and help them to pursue these, a good example being one person who is a keen fan of a cult TV show. Staff have helped them to decorate their room as they choose and support them to purchase goods and take part in relevant activities. Important relationships in peoples lives and the support they need to maintain relationships and friendships are documented in peoples care plan files. Staff actively Evidence: support people to visit friends and family as well as welcoming visitors to the home. Some people have weekly contact with relatives, which is important to them, whilst other people have less frequent contact. Peoples daily routines are well documented including morning routines, day time activities and evening routines. These are helpful to staff in maintaining a good continuity of care and are particularly important for some people who demand a regular routine and structure in their lives. Rather than using set menus people are offered choices at each meal giving them a lot more choice, which has worked well. People are involved in planning and shopping for food and also get involved in making meals. Individual likes and dislikes are recorded and staff have a good awareness of peoples particular tastes and preferences. People have their weight checked at regular intervals and any nutritional or dietary concerns are responded to. 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. Personal and healthcare needs are well documented ensuring peoples individual needs are responded to appropriately. Evidence: Staff have developed with people some very detailed strategies and guidelines relating to both personal and healthcare needs and individual daily routines that are important to the person and their well being. This helps the staff team to provide personalised care based on their abilities and understanding, which is particulrly important to people with complex needs and limited verbal communication. Staff we met showed a good awareness of the differing needs of people and the type and level of support they require. Health action plans are completed for each individual that records in detail their personal and healthcare needs including interventions by other health professionals and agencies. A record is maintained of all routine and one off health appointments and their outcome, which is shared with staff on a need to know basis. A health facilitator is identified for each person who will work closley with them, their family or representative and other agencies to record and monitor all healthcare related issues, including the medication people require. The majority of medication held by the home is in a monitored dosage system supplied by the Pharmacist. All other medication is clearly labelled and stored in the prescribing Pharmacists container. Medication record charts (MAR) were all up to date and Evidence: accurate, including a record of all PRN (as and when required) medication including creams. PRN guidelines are in place to guide staff when, how and why PRN medication is required, which helps them to administer it safely and consistently when it is required. Robust systems are in place to monitor all medication coming into or leaving the home. Stock levels are checked at the end of each shift enabling any errors or discrepencies to be identified at an early stage. Some staff who are responsible for administering medication, although they have had their competence checked and been directly observed, have not had appropriate safe handling of medication training. 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. Complaints and safeguarding concerns have been recorded and responded to making sure peoples concerns are listened to and acted upon. Evidence: All the people living in the home have been issued with their own copy of the organisations complaints policy and procedure. Two complaints have been recorded one of which has been resolved with the other one under investigation. In addition there have been three safeguarding referrals made since the last inspection. Staff have acted quickly and appropriately when concerns have been raised, making referrals to the appropriate agencies in line with local policies and procedures. The safeguarding referrals have resulted in thorough investigations taking place, with people safeguarded through the investigation process. The investigations have had an impact on the staffing levels in the home with agency staff being used to cover staff vacancies as a result of the investigations taking place. Some staff have not received relevant safeguarding training to guide their practice, which should now be addressed. The homes policies and procedures have worked effectively ensuring people feel safe and their concerns are listened to and acted upon. 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. Morningside is furnished and decorated to a good standard providing a safe and comfortable home environment. Evidence: Morningside provides a safe and homely living environment with suitable private and communal space for people to relax. There is an ongoing programme of redecoration and refurbishment with a handyman supporting the home with all aspects of routine maintenance and repairs. Morningside is a non smoking environment. All bedrooms are personalised and decorated to suit individual tastes with people bringing in their own furniture and belongings such as photographs and pictures. All the rooms are lockable enabling people to keep their belongings safe and enjoy the privacy of their own room when they choose. Shared space is decorated with a neutral colour scheme with low arousal colours used to create a relaxed atmosphere. Good infection control principles and procedures are adhered to to ensure a clean and hygieneic environemtent is maintained. There are two bathrooms one with an accessble bath and toilet and the other with a walk in shower and toilet, which helps to promote peoples independence and safety. There is a seperate laundry, which is equipped with an industrial quality washer with a sluice facility and dryer. The laundry is kept locked at all times and contains a lockable COSHH cupboard for the safe storage of hazardous subsatnces. There are secure garden areas to the front and rear of the home with patio and seating areas for people to enjoy when the weather allows. 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. Inconsistent staff supervision and training could put people living in the home at risk. Evidence: All new staff are issued with a code of conduct and a clear job description when they are appointed. They all complete a probationary period and structured induction, which enables their skills and knowledge to be assessed and the chance for staff to be introduced to the people living in the home and the systems and routines that are in place to support them. Currently less than 50 of staff have completed their National Vocational Qualification. All new staff should be provided the oportunity to complete an NVQ 2 or 3 to make sure they have the necessary skills and knowledge for their role. We examined the staff rotas for the home and on the whole the staffing levels have been maintained to an adequate number to meet the needs of the people living there, apart from occasional unforseen circumstances such as staff sick leave. Due to recent staff suspensions the home is using agency staff on a regular basis as a short term solution. However a good continuity of care has been maintained by using regular agency staff who are familiar with the home and have developed good relationships with the people living there. The home is currently recruiting new staff to fill some vacant posts, which will reduce the need for agency staff to be used. We examined staff files for new staff employed since the last inspection, all necessary checks and references were in place making sure staff are safe and suitable for the role. New staff have a six week and twelve week probationary review meeting which looks at their practice and any training and personal development needs. After twelve weeks they then have formal supervision with either the manager or one of the senior staff. Looking at the supervision records of staff it was evident that bank staff do not receive any supervision with the homes management team and some contracted staff have Evidence: not been having regular meetings as required. Staff changes in the management team will have impacted on this, however supervision meetings with all staff should now be planned for the year to ensure all staff receive the supervision and support they require. The training and development records for staff reflected that some staff training had not been taking place as required in key areas such as medication, manual handling and safeguarding. The new manager is in the process of updating all staff files including training audits for each staff member. Once completed a training programme for the coming year should be agreed that will meet any training shortfalls identified. All new staff complete a structured induction training programme over three days with additional training days provided dependent on the previous skills and knowledge of the person. 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 management of the home has been disrupted by recent staff changes. Evidence: Wendy Wilson is the new manager who will be registering with the Commission. She is suitably experienced and has a good knowledge of the role of Registered Manager. The home has been in a period of uncertainty due to the changes to the management and staff team in the last six months. This has had a negative impact on the home, however the home should benefit from a period of stability now that new appointments to the management team have been made. There was no eveidence of recent formal consultation taking place regarding the quality of the service other than care plan reviews with families and other professionals. The new manager needs to look at the most effective ways for her to complete meaningful quality monitoring of the service, to enable her to evaluate its effectiveness in meeting peoples needs and aspirations. The servicing and maintenance records for services and equipment were all up to date and accurate and in line with the legislative requirements. Suitable insurance cover is in place to protect the home and business. A good range of risk assessments are in place to safeguard the people living and working in the home. However the fire risk assessment is in need of review to ensure it is up to date and accurate. Also fire drills have not been taking place as required for both day and night staff. All the areas of the home we inspected were free from hazards and well maintained. Evidence: Are there any outstanding requirements from the last inspection? Yes  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 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 Description 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 Description Timescale for action 1 35 18 The manager must produce a 01/07/2009 training and development programme that provides training for all staff that is appropriate for the work they are to perform. Some staff have not received relevant training to support and guide their practice and ensure they have relevant skills and knowledge. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 2 6 Full assessments of need should be completed before a new person is admitted to the home. It is recommended care plans are reviewed with a view to make sure that different strategies, interventions and risk assessments are cross referenced and up to date. 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 3 4 32 36 All new staff should be offered NVQ training within six months of their employment. All staff, including agency staff, should receive regular supervision and support from management staff to guide and support their practice. The new manager needs to look at the most effective ways for her to complete meaningful quality monitoring of the service provided, to evaluate its effectiveness in meeting peoples needs and aspirations. The fire risk assessment should be reviewed to make sure it is up to date and in line with relevant legislation. Fire drills should take place at recommended intervals to make sure all staff are aware of fire precautions, fire equipment and escape routes. 5 39 6 7 42 42 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). 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