Care Home: Newcroft

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Newcroft 2 Todenham Road Moreton-in-Marsh Gloucestershire GL56 9NJ two star good 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: Paul Chapman Date: 2 1 0 4 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 © (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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Newcroft 1 & 2 Todenham Road Moreton-in-Marsh Gloucestershire GL56 9NJ 01608652886 01608652886 Denise.mumford@hft.org.uk www.hft.org.uk 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) : Home Farm Trust Ltd care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (code LD) The maximum number of service users who can be accommodated is 4. Date of last inspection 2 4 0 4 2 0 0 7 A bit about the care home Newcroft is a semi-detached property offering accommodation for up to 4 people. The house was purpose built. The home is well-decorated, and personalised with peoples’ possessions. People lead active lives that are led by their needs; the service provides a member of staff dedicated to providing day services. The home is staffed twenty-four hours a day, seven days a week. The home has a Statement of Purpose and Service User Guide. Fees for the home are based on peoples assessed needs. 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 & Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct and Management of the Home Poor Adequate Good Excellent How we did our inspection: This is what the inspector did when they were at the care home This inspection site visit was completed over a day, Tuesday 21st April 2009. The manager was present throughout the visit. Before visiting the home we received information from the manager. We also received completed questionnaires from people in the home. Whilst we were at the home we spoke to the people living there and staff. We examined records relating to peoples care and other policies and procedures that help to maintain their safety. What the care home does well The home supplies people with information about the home. People are assessed before being admitted to the service. PCP All people have Person Centred Plans (PCP) People’s rights are respected. People living in the home have a good social life and are part of the local community. The food is nice and chosen by people in the home. People’s health needs are addressed. There is a complaints procedure and people said they could make a complaint. Staff help people to manage their money. People live in a homely, friendly and comfortable environment that meets their current needs. Staff receive training to meet peoples needs. What has got better from the last inspection House meetings have recently been re-introduced and minutes showed people being given the opportunity to state their views, and make decisions. Day services are now based in the home and people receive a more individualised service based on their needs. What the care home could do better Support plans must be reviewed to ensure that they accurately reflect people’s needs. 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 Paul Chapman Colston 33 (4th floor) 33 Colston Avenue Bristol BS1 4UA 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are only admitted to the service after they have been thoroughly assessed and this minimises the risk of a person being offered a service whose needs may not be met. Evidence: 1 person has been admitted to the service since the previous inspection was completed. We examined the admission procedure which showed that the following steps had been taken. The manager completed thorough assessment of the persons needs based on meeting them, speaking to previous carers/family and an up to date Community Care Assessment provided by the funding authority. The person was invited to spend time at the home before they decided whether they wished to move in and we evidence of them staying at the service overnight. Only after the assessment was completed did the manager offer the person a service and we saw letters to the person and their funding authority making this offer. A copy of the persons funding contract was available in their personal file. The AQAA completed by the manager states that an area they could do better is in Producing a brochure in a DVD/CD Rom format with more photographic evidence of the service for prospective clients. This would be a really good idea as it would enable people with communication difficulties to more easily decide whether the service would meet their needs. 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 . Support plans are in place for each person covering a wide range of their needs but greater detail is required to ensure that there is a consistent approach by staff. People are empowered to make choices about their lives and it is clear that the service provided is led by the needs of the people living in the home. Risk assessments minimise potential risks to people. Evidence: The service uses a computer system named SPARS (Support Planning Assessment Recording System) to record peoples care and support needs. As part of the process of moving peoples records to this system the manager and staff have re-assessed peoples needs. Assessments we examined covered the following areas: - support needed with personal care, to keep healthy, with looking after their home and tenancy, with employment, college and day services, leisure and hobbies, maintaining friendships and relationships, cultural aspects of life, managing money and dealing with paperwork, challenging behaviour, with issues around consent. All of the assessments we examined provided a good level of detail about peoples needs. From these assessments staff are expected to complete support plans to address the identified needs. We examined the support plans in place with the manager. This showed that although the plans were in place there was insufficient detail to accurately reflect exactly what support the staff needed to provide. This could lead to peoples needs not being met consistently by staff and making it more difficult to identify peoples changing needs. We discussed this with the manager who agreed that more detail was required and gave their assurances that this would be addressed. It Evidence: becomes a requirement of this inspection report that all support plans are reviewed to ensure that they accurately reflect peoples support needs, and provide sufficient detail to enable staff to work consistently with people. At the end of each shift staff are expected to complete handover notes detailing what people have been doing and any concerns. The records we examined provided a good record for the reader. In addition to these notes staff have just started to complete monthly key worker recording sheets. The aim of this is to minimise the potential risk of key information being missed. This is a good practise. Person Centred Plans (PCP) are recorded for each person. PCPs identify goals that people wish to achieve and there was evidence that staff were supporting people to achieve these goals. The current format of SPARS is not very user friendly for people with communication difficulties. This has been recognised by HFT and there are plans to develop the system to address this in the future. In the mean time the staff are in the process of developing paper versions of PCPs making good use of pictures, plain English and large type. We examined 2 of these documents and these provided good evidence of people being supported to make choices about what they would like to do and evidence that the goals were achieved, or in the process of being achieved. People are being supported to create picture day service life stories. The day service co-ordinator is taking the lead in developing these and it is planned that at peoples annual reviews they will be able to show a slide show, or present a printed document showing what they have been doing. In addition to people being supported to develop a picture history of their activities in day services they are also creating picture life stories. Staff are supporting one person to create a photo album that has a commentary of who is in the picture and when the picture was taken and where. The manager has a good understanding of the Mental Capacity Act (2005) and this is reflected in a procedure for staff to follow that highlights a number of approaches to follow if someone refuses to do something. This is a good procedure but there needs to be more detail recorded about what staff are actually saying to people. The records we examined were unclear about how staff were approaching people when asking them to do something. The manager agreed that to ensure staff are using a consistent approach more detail was required and they would ensure this was addressed. This becomes a recommendation of this report. Not all of the people had these guidelines in their files and the manager said she would ensure they were added to each persons file. House meetings have recently been re-introduced. We examined the minutes of 2 recent meetings. Minutes showed that people are asked to contribute about what activities they would like to complete and asked for their opinions about the service. There are a range of risk assessments completed by the manager. The sample we examined had been regularly reviewed (last review April 2009) and minimised potential risks. To support people with communication difficulties some risk Evidence: assessments have also been developed in a picture format. This is good practise as it enables people to understand some of the potential risks they may face. We received completed questionnaires from all of the people living in the home. Although their were no direct comments about the service they received all of the questions were answered positively, no concerns were raised. Whilst completing the site visit we spoke to 3 people about the service. All of the comments we received were positive. People were happy with the support they received from staff and confirmed that they had been involved in creating their PCPs. The AQAA states that the manager wishes to continue promoting forums within HFT where people can have a voice and look for opportunities similar in the wider community. 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 lead active lifestyles that are led by their needs and staff provide appropriate support to enable them to do this. People choose what they would like to eat and a range of choices are available. Evidence: Day services used to be based in a resource centre around the corner from the home. This has recently changed and a member of staff is now based in the home with the role of providing day services for people. We spoke to the member of staff about how they manage this and asked them for examples of the regular activities. There is a wide range of activities that take place regularly, this was confirmed by staff, records and people in the home. Examples we saw included gardening, cooking, art and craft, short walks, gym, in and outdoor games, literacy, swimming, horse riding. We spent some time with people in the homes garden whilst they showed us what they were growing, and told us their plans for the future. Other activities included: Two people have a be-friender that visits weekly and takes them walking. Each person gets a 1 to 1 walk every other week. People have recently visited a local butterfly park, various other trips are being arranged including visiting London for the day, The West Midlands Safari Park and 10 pin bowling was due to take place in the week after our site visit. Evidence: Two people have joined the Toad Club, this is a social club and they are planning on going on a boat trip in the near future. As a group all of the people are involved in tending the gardens/flowers at the local train station. Every week each person has a home management day where they are supported to complete chores like doing their laundry, cleaning their bedroom and personal shopping/banking in the local town. Holidays are being arranged at the moment and 2 people spoke about looking forward to going to Blackpool and Bournemouth. Records seen provided good evidence of people being supported to choose where they would like to go on holiday. The manager told us that they are currently in contact with pat dogs. This is an organisation who will bring a dog into the home enabling people to stroke them, and be around a dog. This is being done as a result of a person expressing an interest in dogs. Our observations of the relationships between the staff and people in the home showed that they were friendly, respectful and staff were really committed to supporting people to go about their day to day lives. Friends and family are welcome to visit people in the home. 1 person we spoke with explained that they had recently returned from a break with their family. All of the people in the home attend a local church regularly. Menus are based on a 3-week rolling rota and these are regularly reviewed by people living in the home. Each person stated that they thought the food was nice. There is a picture menu on the notice board. If people do do want what is on the menu for that evening they are able to choose something else. Staff commented in questionnaires when asked what the home do well, It provides independence, safety, social choices, all of the opportunities that I have. Other comments included, Some times people in the home are unable to complete activities as there is only 1 staff member on duty. The AQAA states that in the coming 12 months the manager would like to ensure people are given opportunities to explore housing options, how this is achieved is currently being considered as part of the service development plan. In addition to this the staff will continue to work with individuals to further maximise their choices and opportunities in all aspects of their lives. 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 care support plans do not provide the reader with sufficient detail to meet the persons needs consistently. The risk of peoples medical needs not being addressed is minimised through the use of other health professionals. Medication administration and staff training minimises potential risks to people living in the home. Evidence: As identified earlier in this report support plans are in need of review to ensure they provide sufficient detail for staff to provide consistent care to meet peoples needs. This is also the case with support plans to meet peoples personal care needs. The requirement made earlier in the body of this report to review support plans also relates to these support plans. Each person has a completed My health assessment. This is a document completed with staff that identifies a persons needs, wishes and health needs should they be admitted to hospital. The documents we saw had been reviewed in March this year. There was good evidence showing that people make use of health professionals as required. Medical appointment sheets have just been introduced for staff to record appointments with other professionals. Each profession has a sheet. This had only been started in April. People can attend appointments by themselves if they wish, but if required staff will support them. Medication administration was examined and showed that through good record keeping and staff training people were not being put at unnecessary risk. Evidence: The AQAA states that a training programme is currently being devised within the service to support people to understand their medication, possible side effects, results of not taking their medication and the issues of choice and capacity. It is planned that this will be implemented over the coming 12 months. 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 . If people are unhappy about the service they are receiving they are able to make a complaint. Peoples finances are safeguarded through good recording and procedures that minimise potential risks. Evidence: There have not been any complaints made about the service since the previous inspection was completed. The service has a picture format complaints procedure to support people with communication difficulties. We spoke to people about the steps they would take if they were unhappy about something. Each person said they were knew about the complaints procedure but were sure they could speak to the manager if they were unhappy, as this is what they had done in the past. As part of the homes care planning and assessment system each person has a financial profile which identifies the support staff are required to provide to maintain the persons safety. These were reviewed in April 2009. All of the financial transactions we sampled were signed by both the person and staff. An external auditor recently completed an audit of financial records and did not highlight any discrepancies. Staff training records showed that all staff have completed safeguarding adults training within the previous 18 months. The AQAA states that over the coming 12 months staff will support people to gain further awareness around whistle-blowing and safeguarding. A training programme for the people using the service and staff has been devised to identify what is bullying and how it can be prevented and stopped. 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 clean, tidy and nicely decorated meeting the needs of people who currently live there. Evidence: Since the previous inspection the registration of the service with the CQC has been altered and the service is now registered for upto 4 people, instead of 8. The service used to be spread over 2 interconnecting houses, but the houses are no longer connected with the other house no longer being registered with the CQC. We completed a tour of the communal areas with 1 of the people living in the service, they explained that they really enjoyed living there. The home has a kitchen/diner that leads to a sitting room with a high ceiling and patio doors to the rear garden. The lounge provides people with a range of comfortable furniture, digital TV and a stereo. All of these areas are nicely decorated and feel homely with peoples possessions lying around and some of their artwork/photos on the walls. The only shortfall we identified was that the carpet in the lounge was dirty/stained and needed to be cleaned or replaced, this becomes a recommendation of this inspection report. 3 people showed us their bedrooms, all agreed that they were able to choose how they were decorated, each of the rooms was decorated to a good standard and reflected the personalities and interests of the people to whom they belonged. To the rear of the property is a good-sized garden as we have identified earlier in this report. Immediately outside the patio doors is a patio which is quite uneven, speaking to the manager about this she stated that she had reported this to HFTs maintenance department in July 2008, and there was still no date for it to be repaired. It is poor that 9 months later this is still in need of repair. It becomes a requirement of this inspection report that the patio is repaired as it poises a risk to people in the home whose physical frailty is increasing. Evidence: Since the previous inspection site visit the floor coverings in the bathroom and laundry have been replaced. Both of these areas were seen to be satisfactory. At the time of our visit the home was clean and tidy. The AQAA states that the manager and staff will continue to review the service and research further technological aids to support the needs of the people using the service as they become older. In addition to this they will continue to research systems to enable people to express their feelings and opinions about where they live, their surroundings and suggest changes they would like to make. 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 . The providers recruitment procedures minimise the risks to people living in the home. Staff training is well organised and this helps to ensure that peoples needs are met and not put at unnecessary risks. Evidence: Since we completed the previous inspection the manager has only recruited 1 new staff member. We examined records for the recruitment process and this showed all of the documents required by these regulations were in place. At the time of this site visit the staff team were made up of 3 support staff plus the manager. The rota showed that there is usually 1 member of staff on late and early shifts and 1 member of staff working during the day, plus the day service staff. Staff training is well organised by the manager. HFT use a staff management system which enables the manager to track what training staff need to complete and what training staff have completed. Certificates were available for all of the training completed by the team. All staff have completed their NVQs (National Vocational Qualifications) in social care, other training that had been completed included: Autism needs, health and safety, medication, induction (where required) and safeguarding adults. The manager stated that they had arranged some training in the weeks following this site visit, this included: - Food safety and moving and handling. Staff supervisions are completed regularly with staff appraisals being completed annually. People living in the home are asked to be involved in staff appraisals.This is achieved by asking them to complete a document giving their opinion of the staff member. This document is also produced in a picture format to support people with communication difficulties. The AQAA states that the manager would like to increase the involvement of the Evidence: people living in the home in staff recruitment. A recruitment training programme is currently in the planning stage for people living in the home which will cover issues including equality and discrimination. 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 people living in the home benefit from a competent well trained team led by a highly experienced manager who is committed to providing a high quality service led by peoples needs. Regular quality assurance assessment of the service should minimise the risk of a quality service being poor but we are concerned that peoples care/support plans were judged to be acceptable. Potential risks to peoples health and safety are minimised through staff training and regular checks and procedures being completed and followed. Evidence: The manager has extensive experience of working with this client group having worked with them for many years and this is reflected in their knowledge of peoples needs. The manager is registered with the CQC and has completed their NVQ in Management. As this report reflects there are a number of very good practises being adopted by the service to enable people with making decisions about their lives and live varied and fulfilling lifestyles. We received completed questionnaires from all of the staff. These showed us that this is a team committed to providing a high quality service led by the manager. Staff commented, The home is managed well and we work well as a team. Each month the managers line manager completes a quality assurance review of the service. We examined 2 completed reports available in the home, these showed that a wide range of areas are reviewed and goals are set for the manager to achieve. One of the questions asked of the reviewer is whether goals/steps and routines are written in enough detail reflecting the individuals preferred method of communication. The report seen by us made no mention of the shortfalls we identified with peoples Evidence: care/support plans. This is a concern as we believe it should have been identified as part of the quality assurance audits. HFT employ a health and safety officer who completes a periodic inspection of the service. The previous inspection highlighted a couple of shortfalls and we saw evidence that these had now been addressed. The last inspection had been completed in July 2008. Other steps are taken to minimise risks to peoples safety, we saw records showing that: Fridge and freezer temperatures are monitored daily. A food probe is used to test all cooked meat. There is a HFT COSHH risk assessment in place. First aid boxes are stock checked regularly. Qualified engineers regularly check the fire alarm systems and equipment. A fire risk assessment is in place and is regularly assessed. All staff completed fire safety training in July 2008. Hot water outlets are checked monthly. 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 6 15 (2) The manager must review all of the support plans to ensure that they contain sufficient detail to enable staff to meet peoples needs consistently. 26/06/2009 If there is insufficient detail in support plans there is a risk of peoples needs not being met consistently by the staff team. 2 18 15 (2) The manager must review all of the support plans to ensure that they contain sufficient detail to enable staff to meet peoples needs consistently. 26/06/2009 If there is insufficient detail in support plans there is a risk of peoples needs not being met consistently by the staff team. 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 7 When people are being supported by staff to make decisions it should be recorded what staff are saying to the person. This will help to ensure a consistent approach by staff. Quality assurance assessments for peoples care and support plans should be more thoroughly completed to accurately reflect the findings. 2 39 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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