Care Home: Oakland House Nursing Home

What the care home does well A number of people were spoken to during this visit. People living in the home were very positive about all aspects of the care and support services provided. People told us that they felt involved in their care planning and in making decisions about their lifestyle arrangements and personal preferences. They told us that staff listened to them. comments included: "I like the freedom. I like the staff, they are lovely. I go out with staff. For my birthday I went out for fish and chips in a pub". "I like the freedom. Staff help me with family matters and any concerns I have, they are basically there to support me". "The support is brilliant, they are always there if you need them, even if I`m in a bad mood, they stick with you". "I`ve got my freedom here". From discussion with people living in the home and from records available, it was evident that there was an emphasis on supporting people to maintain Independence. The staff team were well trained and showed us that they had a good understanding of the needs of the people they supported. Comments from staff included : "We listen to the people here, that`s what we are here for, the people here come to us and feel they can approach us. That`s why we don`t wear a uniform, there are no barriers" . The activities in the home provided people with plenty of opportunities for personal development and to establish social contacts. There was a wide range of activities available to people during this visit. People were seen joining in and enjoying positive social experiences. Support from staff was meaningful, and there was evidence of a mutual respect between the staff and people living in the home. Meals were nutritious and appetising. Good systems were in place to ensure that people were involved in contributing to menu planning and they were assured that their views were listened to. Good management systems were in place to audit and monitor care practices in the home. The staff felt well supported by the manager and they had access to a good range of personals training and development opportunities. What has improved since the last inspection? Extensive Improvements have been made to the fabric of the building. this has resulted in a bright and pleasant environment for the people living in the home and for their relatives and visitors. All of the people spoken to were highly complimentaryabout the improvements and were looking forward to more external improvements for the Summer months. Records show that there have been further improvements in training opportunities for staff and in the audit and monitoring systems of care practices in the home. What the care home could do better: There have been no requirements or recommendations made as a result of this inspection visit. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Oakland House Nursing Home 290/292 Dickenson Road Longsight Manchester M13 0YL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ann Connolly     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Oakland House Nursing Home 290/292 Dickenson Road Longsight Manchester M13 0YL 01612572395 01612480652 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) : Beamdouble Limited care home 38 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 38 The registered person may provide the following category/ies of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 38 Date of last inspection Brief description of the care home Oakland House Nursing Home is a care home that provides 24 hour nursing care and accommodation to 38 residents, of whom up to 12 may be above pensionable age. The home provides a service to people with enduring mental health needs. Equilibrium Healthcare Limited owned the premises. The home is situated in a busy residential area in the Longsight district and it is close to public transport routes and within easy reach of Manchester City Centre. The home is close to local facilities, shops, a market and other community facilities. The home consists of a large converted building with a large purpose built extension. Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home The home provides accommodation on three floors for up to 38 residents. There are 12 or 13 residents accommodated on each floor in single bedrooms. None of the rooms has an en-suite facility. Each floor has a lounge and separate dining area, communal toilets, one bathroom and one shower room. A smoking area is provided to the rear of the building. The home has an off-road parking for approximately 10 vehicles. The entrance to the home is at ground level and is accessible to wheelchair users. A small-enclosed garden area is accessible on the ground floor. Fees range from eight hundred and forty two pounds per week to one thousand, three hundred and twenty nine pounds per week. Care Homes for Adults (18-65 years) Page 5 of 30 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection that included a site visit to the home. The manager was not told beforehand that we were coming to inspect, this is called an unannounced inspection. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social care (CSCI) about the service provided at the home since the last inspection. During the site visit a selection of records, care plans, policies and procedures were examined. Discussions took place with the people living in the home, the manager, staff working in the home, and some relatives and visiting professional. A tour of the building took place and residents were asked for their comments and views about the environment. Before the inspection, we also asked the manager of the service to complete a form Care Homes for Adults (18-65 years) Page 6 of 30 called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This is one of the ways that we get information from the manager of the service about how they are meeting outcomes for people using the service. The information provided on this occasion was detailed and comprehensive and showed us that this was an organisation committed to the ongoing development of the service and staff team so that residents in the home benefit from positive outcomes. Surveys were sent out to residents and staff and there was a good response which gave us more information about this service. There was evidence during this visit that the manger was handling complaints well and followed correct polices and procedures for manging complaints and safeguarding issues. What the care home does well: What has improved since the last inspection? Extensive Improvements have been made to the fabric of the building. this has resulted in a bright and pleasant environment for the people living in the home and for their relatives and visitors. All of the people spoken to were highly complimentary Care Homes for Adults (18-65 years) Page 8 of 30 about the improvements and were looking forward to more external improvements for the Summer months. Records show that there have been further improvements in training opportunities for staff and in the audit and monitoring systems of care practices in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided by Oakland House means that people can make an informed choice about their individual care and support arrangements. Care needs are fully assessed prior to admission to ensure the service can meet individual needs. Evidence: There was a service user guide available to anyone interested in the services and facilities at Oakland House. This provided up to date information about key policies and procedures and staffing arrangements. This information enables people to make an informed choice about their care arrangements. There is a clear policy and procedure for arranging assessments and admissions into the home. Experienced staff are involved in the assessment process. People are visited in their own home or current placement so that an assessment can be undertaken, and so that prospective residents can be actively involved in planning their future care arrangements. Information from social workers and other health care professionals is used so that sufficient information is obtained in order to make a decision about the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: suitability of the placement at Oakland House. People are informed in writing about the outcome of the assessment. This informs people if the service can meet assessed needs and includes a written explanation of the reasons behind the decision. Care Homes for Adults (18-65 years) Page 12 of 30 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 service involves service users in the assessment and care planning processes. Evidence: The assessed care and support needs were documented in the individual plans of care. Four care plans were looked at during this visit. The care plans included an index system so that staff could use it easily as a working document with a quick reference system. Files included personal details, risk assessments and an activity planner. The activity planner recorded discussions with individual people in the home about their lifestyle choices and preferences. The care plans were very detailed and comprehensive and an initial assessment covered key aspects of social, leisure and health care needs. There was evidence to show that information in the assessments was used to generate a working care plan. The detail showed specific needs and what kind of intervention was required from staff. Written information in the care plans showed that there was a consultation Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: process with people in the home and care plans were signed to show their involvement. There was evidence on files to show that regular reviews take place, where people using the service are encouraged to participate. One file included a self assessment which promoted a person centred approach. This showed that individuals were supported and encouraged to explore their life time ambitions and aspirations. A number of people were spoken to during this visit. All of them told us that they felt well supported by staff. One person said, The support here is brilliant, the staff are always there to help you if you need them. Even if Im in a bad mood, they stick with you, they are really good people. Staff and people in the home were seen engaging in meaningful conversations. Observations showed us that staff were good at listening to people living in the home, and were pro-active in supporting them to live their lives as individuals. Care plans were kept in the offices on each unit. The manager told us that all staff were encouraged to contribute to the daily recording and day to day care planning processes. We were told that all staff were scheduled to receive training in effective communication and care plan recording methods. Discussion with staff showed that they had a good understanding of individual care needs. The involvement they had with the people in the home demonstrated that they were following guidance as set down in the care plans. Care Homes for Adults (18-65 years) Page 14 of 30 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 excellent 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 take part in a range of activities in the home and the local community. A balanced, well presented and creative menu which provides choice is provided. Evidence: Assessments and care plans include information on individual social interests and lifestyle preferences. Written documentation showed that consultation had taken place with people in the home to develop a plan of social activities and lifestyle plan. The service employed two full time activity workers and a part-time art and craft worker. There was a planned activity programme on each unit and this was advertised in an appropriate format on each unit. We were told that this was subject to change depending on the wishes and feeling of the people living in the home, and that many Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: activities were on an individual basis and recorded appropriately in their care plans. The activities were individualised and age appropriate. These included trips out to the local shops and restaurants. There was a programme of in house activities such as art and craft, old favourites such as bingo and quizzes and cookery classes. There was also the introduction of new technology such as computer games, for example- Wii fit, suitable for all ages and in particular the younger people living in the home. A number of people were involved in the activities during this visit. Conversations with people in the home showed us that there was a strong focus on providing opportunities for personal development and maintaining independence. People spoken to were very positive about the lifestyle available to them. They were complimentary about the activities available and comments included: I go out with staff, a group of us went out for fish and chips. It was for my birthday. We had a lovely time. I like the freedom. The meals are good and you can choose your menu. The staff help me with my family matters and any concerns I have, they basically support me. Its lovely here, the staff are marvelous. Ive got my own freedom, the staff just help me when I need it. Information in the AQAA informs us that people are supported to exercise choice and control, to participate in voting and to access local services, illustrations were provided to evidence this. People in the home told us that other events took place which included themed meals, and bar-b- qs in the good weather. Meals were prepared in the central kitchen and delivered in heated trolleys to each unit. The meal served during this meal was a well presented healthy option. The choices included cheese and ham omelettes with a rice salad, a variety of sandwiches and soup. The meal was sampled and was tasty and well flavored using fresh produce. The choice for the evening meal was fish pie, mash potatoes and peas with an alternative of chicken nuggets and chips. The chef on duty demonstrated an enthusiastic approach to her role. There was documentary evidence to show that consultations had taken place with people living in the home about their personal dietary preferences. The findings were used to create meals and menus which reflected individual choices. The chef had a good understanding of special diets. People who were spoken to were Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: very positive about the meals available to them. comments included: The meals are very good, you can choose what you want. The meals are fantastic, I like the meat and potato pie and the ploughmans lunch. Theres always a choice of two meals. Meals are always well prepared and theres always a choice. In addition to the main kitchen, each unit has a small kitchen where people can make their own drinks and snacks. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are supported to receive support in a way that suits their individual need and preference. Evidence: Care plans were detailed and comprehensive and gave staff the relevant information to support people in an appropriate way. Staff were seen treating people with respect and promoting dignity. During the day there were several examples of staff supporting individual people in a caring and sensitive way. In one case a member of staff was seen diffusing a potentially challenging situation which resulted in a positive outcome for the person. This member of staff showed a good understanding of specific individual care and support needs. Records in the home showed that people in the home had access to a range of healthcare services and that reviews were carried out appropriately. When it is necessary the service works with other healthcare professionals. Discussion with staff showed that there was a good understanding of using a person Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: centred approach and listening to the views of each individual. Staff had a good understanding of issues around equality and diversity and they used the information about the social, cultural and leisure needs of people living in the home. This means that staff can make sure that the care and support provided for that person is right. One member of staff said, We spend time to find out about the individual and how to meet their needs. When necessary we use advocacy services. As a staff team we are good at making sure that people have choice in a wide aspect of their lives. Its about being an individual. All staff are encouraged to work on the care plans and have access to information via the computer system on each unit. Medication systems were looked at. Records and medication stock levels were found to be in order. Appropriate secure storage was in place to store medication. There is no one in receipt of controlled medication and no one was self medicating. The current medication policy was under review to include a policy on self medicating. Records were in place of the signatures of staff who are responsible for the administration of medication and for the receipt and disposal of medication. There was evidence that audits were carried out quarterly, where shortfalls were identified, an action plan was put into place. Care Homes for Adults (18-65 years) Page 19 of 30 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. Polices and procedures are in place to ensure the rights of people living in the home are protected. Evidence: Information in the AQAA informs us that there have been three complaints in the last twelve months and that all of there were responded to within 28 days. One of these was upheld and one was a safeguarding referral. One complaint record was looked at and this showed an open transparent approach to managing complaints. The investigation carried out by the home showed us that all issues of concern had been treated seriously. The outcome of this complaint was that the service acknowledged the shortfall in a written response to the complainant. An action plan was put into place and staff training was organised to meet an identified training need. Cross reference was made to staff training files and showed that this training had been undertaken satisfactorily by the member of staff involved. Staff who were spoken to had a good understanding of issues surrounding abuse and what action was needed in the event of an allegation of abuse. Training in safeguarding adults was in place and was re-in forced in staff supervision. Staff were asked to consolidate training by completing a questionnaire relating to the Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: course. People in the home expressed confidence in reporting their concerns and told us that they could speak to the manager of a member of staff if they had any worries. Systems were in place to support people in managing their individual finances. The home had a separate account for residents. Records showed that accounts were regularly audited internally and externally. Small amounts of money was held for individuals so that they could access their finances at any time. Care Homes for Adults (18-65 years) Page 21 of 30 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. A safe and homely environment is provided for people living in the home. Evidence: Since the last inspection visit in November 2006 the home has undergone extensive re-refurbishment. The people living in the home and members of staff were very complimentary about the improvements and told us that it had resulted in a positive impact in the home as everywhere now felt bright and positive. All rooms and communal areas had been decorated with new carpets and furnishings. A new administration area provided a staff training room and new offices. A maintenance action plan was available which detailed cyclical repairs, jobs and decoration. This was held in the main IT system and reported centrally to head office to be actioned. The kitchen was looked at and was cleaned to a high standard and was well maintained. Individual bedrooms were personalised to reflect individual tastes and showed that Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: there was an emphasis on ownership of individual rooms. Some changes had been made which included an extended communal sitting room and separate dining areas. There is a no smoking policy in place and the the statement of purpose and service user guide is currently being updated to reflect this change. A smoking area has been provided to the rear of the building. There were no en-suite facilities, but there were adequate bathing and toilet facilities throughout the building. All bathroom facilities had been modernised in a modern contemporary style. The rear garden area was in the process of being landscaped to provide a safe flat paved and lawn area. People in the home told us that they enjoyed using the outdoor space in the summer, and these new improvements will provide additional benefits to people living in the home. The information in the AQAA provided information to confirm that there was regular maintenance of equipment and monitoring of heath and safety in the home. Care Homes for Adults (18-65 years) Page 23 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are experienced and appropriately qualified. Supervision and training opportunities are available to staff. Evidence: Four staff files were looked at and these contained all the documentation required by legislation, for example, application form, Criminal Record Bureau check (CRB), and induction details. This means that people in the home can be confident that recruitment procedures are followed. One staff confirmed that she had received induction which was linked to skill for care which is a recognised induction tool. The training matrix was seen and provided an overview of all the recent staff training that had taken place. A new schedule was in place for 2009. Staff told us that there were plenty of opportunities for training and development within the organisation. All staff were qualified or in the process of completing NVQ Level 2 or 3. A new supervision policy was introduced in 2009. This involved a contract with staff which agreed times and frequency. The appraisal system looked at areas of work performance and included personal development. The probationary period for new staff was currently being looked at with a view to extending this if assessments show Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: that additional supervision and induction is required. Care Homes for Adults (18-65 years) Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run in the best interests of the people living in the home and policies and procedures are in place to protect them. Evidence: There are a number of systems established to monitor all aspects of care practice and the general day-to-day running of the home. Regular meetings take place with the senior management team and the staff team. Supervision, training and monitoring programmes ensure that staff receive the right level of support and guidance to help them to carry out their duties in a professional way. Consultations and surveys are carried out formally and informally to seek the views of people living in the home. Key areas of practice are audited regularly to assess the quality of practice and these included monitoring of medication administration, financial transactions and general health and safety in the home. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: Staff have access to all policies and procedures and these are re-in forced in the induction and staff training events and supervision. Robust systems are in place to support people to manage their finances and these are audited on a daily basis. All expenditure was noted with numbered receipts and transactions signed by two people. There was evidence that the manager was committed to ongoing personal development and had a personal portfolio that provided written evidence of recent updated training in equality and diversity, mental capacity and accident investigation. Staff in the home told us that they felt well supported by the manager and that particular attention was paid to assessments and reviews of placements. Examples were given where the manager arranged for reviews of placements if these were considered inappropriate and where the service was unable to meet assessed needs. Staff told us that they felt there were sufficient staff on duty to meet the needs of individuals. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 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 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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