Care Home: Newhaven Community Care Ltd (Phoenix House)

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What the care home does well Phoenix House is situated within a lovely residential area of Westcliff and is very close to local amenities. The home provides a people carrier and there are plenty of bus routes near by. Visitors are made very welcome and the staff were friendly. Observation showed that staff were patient in encouraging individuals to retain skills and maintain independence. What has improved since the last inspection? A new manager has been employed since the last key inspection in 2009 and has put their application into CQC to be registered with us. All resident rooms have now been refreshed and they had the choice of colour schemes, furniture and how they wanted to personalise their bedrooms.All requirements and recommendations amde at the last key inspection have been achieved. What the care home could do better: The new manager needs to ensure that if any future complaints come in that they are dealt with appropriately to the homes own policy and procedures and by the criteria set by the Essex, Thurrock and Southend Safeguarding Agencies and that they follow the regulations and standards sated within the `Care Standards Act 2000`. During this site inspection, we suggested that the manager holds a practice meeting to give all staff the benefit of a `re-fresher safeguarding training session` to look at when and who to report a safeguarding incident and what constitutes abuse. Key inspection report Care homes for adults (18-65 years) Name: Address: Newhaven Community Care Ltd (Phoenix House) 124 Crowstone Road Westcliff on Sea Essex SS0 8LQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Axam     Date: 0 9 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Newhaven Community Care Ltd (Phoenix House) 124 Crowstone Road Westcliff on Sea Essex SS0 8LQ 01702337057 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): newhaven_manager@communitycaregroup.co.u k Newhaven Community Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 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 needs on admission to the home are within the following categories: Learning disability - Code LD - maximum number of places 6. Date of last inspection Brief description of the care home Phoenix House is a care home providing personal care and accommodation for up to six residents who have a learning disability. The home is a three storey detached house situated in a residential area and is close to all local amenities. There are six bedrooms for residents within the home and it has a large lounge overlooking the rear garden and an adjacent dining area. Additionally Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 6 2 9 0 4 2 0 0 9 Brief description of the care home there are two other lounge areas for residents use. The home has a rear garden which residents are able to access. Two mini buses are available to transport the residents to their activities and to college. The weekly fee charged to residents is currently £1853.00. Additional, charges incurred by residents relate to chiropody, transport, holidays, personal toiletries, hairdressing and some leisure pursuits. There is a Statement of Purpose and Service Users Guide readily available within the home. 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: The unannounced site visit took 5 hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the newly appointed manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since the last inspection. Two staff and two residents were spoken with during the site inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties and 6 were returned to us.(including the views of two relatives and two staff) Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us (CQC) that asked how well the home is meeting the needs of the people who live at Phoenix House. The homes own quality assurance results of 2009 were used as part of this process by looking at the outcomes that were recorded by the manager. Care Homes for Adults (18-65 years) Page 6 of 29 All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. 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 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is a statement of purpose and residents guide, which provides information about the home to help people who might want to live there decide if they would be happy at the home. The manager told us that should a person enquire about a place in the home they would be provided with information and the persons family or advocate would be given an assessment to complete with details of the prospective residents needs. When we visited the home we looked at the way in which two peoples needs had been assessed by the manager. We saw that these assessments covered detail of the persons health needs as well as the support the person as required to maintain physical, mental and emotional well being. We saw that a copy of the social services or local authority needs assessment is also obtained. The manager said that people are invited to visit the home before they move in and once they do a contract would be agreed. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: We saw that there is a current service user guide and statement of purpose in place. We saw in one persons information (that had just recently moved into the home) that these documents had been given and this person confirmed to us that they did receive the necessary information prior to moving in. When we visited the home we looked at the way in which a persons needs would be assessed. We saw that the assessment covered details of the persons physical and health needs as well as the support the individual required to maintain personal and oral hygiene, communication, next of kin, GP, contacts, diet, behaviour, social, spiritual leisure, educational, mobility, the level of support and a weekly activity plans. We saw that this system is based more on a person centred care approach and that all residents and families have been encouraged to be part of the reviews, care plans, needs assessment, risk assessments. Looking through the assessments and care plans we could see that they reflected each other and what the residents felt and wanted. Care plans recorded clearly how people wanted their care to be carried out, what support they need and knew what has been written about them by signing an agreement. 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 manager and staff offer appropriate support to all people which keeps them safe from risk. Evidence: The manager told us in the Annual Quality Assurance Assessment that each person had a care plan, which was reviewed at least every twelve months or more often where this was appropriate. They told us that emphasis was put on enabling residents to make decisions and choices about their daily lives including what meals they eat and what clothes they wear etc. Two residents who completed surveys, indicated that they could make choices and do what they wished to do during the day and evening. We looked at 4 of the care plans of residents and we saw that staff consistently recorded all peoples long term and short term goals. We saw that all the goals set in care plans reflect what the individual wanted to achieve and there was evidence that the plans and goal setting had been carried out with the individual. (We saw this in the notes and recordings made by staff and by what 2 residents told us and 2 surveys returned to us) Additionally appropriate risk assessments and vital information needed Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: (This included information in case someone may need urgent medical attention and was taken into hospital, missing persons profile and a medication self administration guidelines or risk assessment) were in place and would help a person to be kept safe as possible. By looking in four peoples information and speaking with the residents who live at Phoenix House, we saw that each person is provided with a personal care and support plan. We saw that the support plan clearly outlines activities, information, support and risk assessments needed to keep them safe. Activity charts for the individual looked at showed us that they had plenty of choice available to them. Two people told us, that they use the community regularly such as, the local shops, banks, hairdressers, pubs, going for walks along the sea front and overall felt that staff supported them well when they wanted to access any of these local amenities. 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. People can be sure that they will be offered appropriate activities and social pursuits. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents are supported to develop skills and to participate in activities of their choice both in and outside of the home. We saw that all residents had a plan of care which described their wishes for the activities they wish to participate in. One of the residents who was more capable of living a more independent lifestyle attended college one day per week to learn skills to improve living skills. They also accessed activities such as clubs and pubs within the local community. Information showed us that all residents have planned activities both in the home and outside within the community. Residents told us that they use the local cinema, theatre and evening clubs. The manager told us that all residents have Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: access to the homes vehicle, local taxi service, buses and trains, so that they could enjoy more outings outside of the home. We looked at the arrangements for supporting residents with choosing and preparing food and meals. We saw that staff supported resident in buying and preparing food and that there was a planned menu, which reflected residents likes and dislikes. Each resident had a care plan which described the support the individual needed. Staff told us that one resident could read the menu and the others were supported in choosing meals through the use of picture cards. (Photographic references had been fully developed for the use of people who live at Phoenix House, in regards of what meals they would like to eat, what food they would like to buy, what fluids they choose to drink and when they want these things.) Two residents told us that, I choose the food that I want to cook and I go out to the shops to purchase what I want to eat for that day. 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. Staff are successful in delivering appropriate care to all residents and documentation has been improved so that all staff consistently meet all needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that the health and personal care needs of all residents are met and that staff are trained to administer medicines safely. Residents completed surveys told us that they felt that staff treated them well and usually always act on what they ask for. When we visited the service we saw that in peoples information that they have a good access to all other health professionals, such as, GPs, consultants, nurses and social workers. We saw by looking within the recording of the outcomes of all appointments, (from written daily notes or summaries) are picked up on and action taken within an acceptable time scale. Two residents told us that they felt the staff looked after their health care needs well and that they had plenty of access to dentists, GPs and other health care that they needed. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: We saw there was information recorded about how medication is managed by looking at records and notes made by staff, such as, the correct receipt, recording, storage and handling, administration and disposal of medications. When we visited the service two of the staff confirmed to us that they knew procedures well and were aware of individual need. Looking through all residents records it revealed to us that one resident who self -administered some medication now had appropriate medication risk assessment and guidelines in place for staff to follow. (this was lacking at the last inspection) The manager told us that all staff who administers medication had up-to-date training and this was seen in their personal files. Speaking with two of the staff on duty and two surveys returned to us confirmed this. Care Homes for Adults (18-65 years) Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. The manager told us that residents relatives are provided with information on how to complain and how their concerns would be dealt with. They also told us that staff received information about dealing with complaints and whistle blowing when they commence work at the home. The manager told us that there is a policy and procedure for dealing with complaints. They told us that the home has an open door policy where people are encouraged to come and raise any concerns they may have. The manager told us that most residents living in the home would not be capable of making a verbal complaint, but that they would be able to express displeasure and that staff would be able to pick up on this. We looked at care plans to see if there was any information recorded about the way in which residents express displeasure and what signs staff should look for and saw that there was appropriate and useful information recorded. The manager told us that there had been no formal complaints made about the service within the past 5 months since they had been in post. The Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: new manager was presently in the process reviewing all complaints made to the home prior to her appointment. As a result she had discovered that a complaint (that was made some time ago to the former manager) around restraint of a resident within a hospital setting was not properly dealt with. (The former manager had failed to report this to the local safeguarding lead and had investigated this herself). However since then the new manager has risk assessed every individual residents when a possible restraint may be needed, has booked medication review, put in guidance for staff and restraint monitoring forms are now in use. We discussed other ways in which the new manager could ensure future safety and protection of all residents especially around safeguarding issues such as the complaint formerly made. Looking at training and speaking with two of the staff on duty and two staff surveys returned, showed us that, they knew procedures well and knew about reporting of any kind of abuse. All staff had updated training in the safe guarding of vulnerable adults. Care Homes for Adults (18-65 years) Page 19 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. People live in a clean safe environment. Evidence: When we did a tour of the premises we found that residents bedrooms were individually personalised and the home was safe. All residents who completed surveys said that the home is always fresh and clean. There were no apparent odours and residents rooms were all clean and well maintained. All bathrooms, showers and toilet are in good working order, clean and provide plenty of facilities for all residents to use. When we visited the service last year we saw that there was a big drop from the doorway to the patio area to access the garden. This has now been rectified and is now safe for all residents to use. The manager told us that residents had all of the equipment that they needed and that bedrooms reflected each persons individual personality through their choice of furniture, decor and personal belongings. They told us that there had been improvements to the environment with the redecoration and refurbishment of some areas of the house. Each of the residents who completed surveys told us that the home is always fresh and clean. When we visited the home we were invited by some residents to view their bedrooms. We saw that these rooms were bright, clean and Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: reflected each persons individual taste. Rooms were nicely decorated and decorated in colours, which residents told us they had chosen. This was seen by us when a tour of the building was undertaken. Residents we spoke with told us that they were happy with their home. We saw that there were procedures in place and that staff had training to promote good hygiene practices and to reduce the risk of infection. We saw that the home was well maintained, that checks were carried out regularly to ensure that equipment was in good working order. Care Homes for Adults (18-65 years) Page 21 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. Residents are offered positive relationships by well-supported and caring staff and are protected by staff recruitment, induction and training. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home did not rely on the use of temporary agency staff. They told us that staff are recruited thoroughly and trained to meet the needs of residents. Residents told us that they felt that staff listen to them and act on what they say. We reviewed the information for one person who had been employed at the home since the last inspection. We saw that before the person commenced work that they had provided information about their previous employment and satisfactory references had been obtained. Criminal Records Bureau disclosure and appropriate checks had been carried out. Two staff confirmed to us that once they had commenced work at the home they undertook a period of induction to help familiarise themselves with policies, procedures and the needs of residents. The manager told us that they had implemented the Common Induction Standards induction. (This is a set of nationally recognised standards and helps to ensure consistency in the delivery of care and Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: support to people who receive social care) We looked at 5 staff files and found that they held relevant qualifications and training, such as, Health and Safety, Food hygiene, Safeguarding, Manual Handling, Epilepsy, and Fire safety. Two seniors and two care staff are NVQ 3 qualified. One senior is NVQ 2 qualified and one care staff is currently carrying out their NVQ 2 training. That means that out of the 11 staff 5 are currently qualified. Training is on going and identified through supervisions. Two staff confirmed to us that supervisions, staff meeting and training were all regular and supported them in their roles. Records were seen of these things and issues that were discussed. This shows us that residents needs, welfare and safety is monitored and reviewed regularly. When we visited the home we looked at the rota showed us that there was enough permanent staff to cover all shifts and be able to support all residents appropriately. We saw that staff had ceased carrying out such long working hours (an issue that was raised by us at the last key inspection). This provides all residents with a safe, consistent staff team and who can give a good quality of care/support. Two of the residents told us that they felt staff supported them well and that there was enough staff on duty to carry out their choices. Care Homes for Adults (18-65 years) Page 23 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 management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The new manager has been in post for 5 months and has achieved a lot in that time. She has addressed all requirements and recommendations from our last key inspection. The new manger has applied for registration with us and holds the NVQ 4 and Registered Managers Qualification. She has had twenty years of experience within this field. The manager told us in the Annual Quality Assurance Assessment that there was a system in place for monitoring the quality of the service, including obtaining the views of residents. She told us that regular staff and residents meetings are held to discuss and consult people on matters affecting them. We saw that this was in place by looking through minutes of meetings, 5 staff folders and speaking with two residents and two staff. (Surveys from 2 relatives and 2 staff Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: confirmed this to us). When we visited the home we looked at the arrangements in place for obtaining the views of the people who live in the home (annual quality assurance surveys), people who are important to them such as family and advocates and other people who are involved in their care. We saw that people were provided with questionnaires and that residents were asked if they were happy with their surroundings, lifestyles and opportunities available. They were also asked if staff allow them privacy, dignity, independence and choice. We saw that the new manager had revised these surveys and now used photos and symbols to allow all residents to understand the questions in the format that they chose. We saw that surveys completed by relatives and residents indicated that they felt that they were looked after well. Two staff spoken with told us that they felt well supported by management and that there are clear lines of accountability among the team. Two residents told us that they liked the new manager and felt supported by them. When we visited the home we saw that there were risk assessments in place to identify where each person may be vulnerable such as in managing money. Staff supported residents to access money from their bank accounts and kept good records where monies were held for safekeeping on residents behalf. The manager and responsible individual carry out monthly checks and there is an independent financial audit in place. The manager has the only key to the safe where accounts, monies and residents financial details are kept. This ensures that there is a better accountancy and procedure in place to keep all peoples monies safeguarded. We looked at the arrangements for ensuring that the home was maintained safely. We saw that regular checks were carried out on equipment such as hot water and heating systems, fire alarms and fire fighting equipment, gas and electrical installations and equipment. All equipment was well maintained and repaired as required. Care Homes for Adults (18-65 years) Page 25 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 26 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 22 22 The manager needs to 31/05/2010 ensure that if any future complaints are received that she follows the homes own policy and procedures criteria and regulations made under the Care Standard Act 2000. This is in reference to a complaint not being fully completed or actioned appropriately. The manager needs to ensure that any complaints received are dealt with as expected by regulation and their own policies. (timescales and expected outcome results) 2 23 13 The manager needs to 30/04/2010 ensure that if any future safeguarding issues are raised, follow the services own policy and procedures. That the Essex, Thurrock and Southend safeguarding Care Homes for Adults (18-65 years) Page 27 of 29 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 agencies criteria is adhered to. This is in reference to a safeguarding issue not being actioned appropriately. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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