Care Home: Orchard Street Care Home

What the care home does well The premises were well maintained and comfortable. The staff group was stable, with some staff having worked in the service for a number of years, which helped to provide consistency of care. The admission procedure was well established to ensure the service available met the needs of any new people. Health services were called in when required and specialist help and advice was sought as necessary. Care and support needs were reviewed regularly with a health professional. This ensured that health needs were met and healthy living promoted. There were comprehensive care and support plans that gave details of action staff need to take to support people. Peoples` individual choices were respected. People received support in maintaining a positive lifestyle with as much independence as possible and they told us they were happy with the support they received with their personal care. One person said they were `happy enough`. A relative spoken with described the service as `wonderful` and said they `couldn`t speak highly enough of it`. A visiting professional spoken with also praised the service and described it as `brilliant` and `very well run`. Concerns, complaints and allegations were taken seriously and appropriate actions were taken to safeguard people from any abuse. What has improved since the last inspection? Supervision of staff had commenced. A new manager had been appointed and was due to make an application to be registered with the Care Quality Commission. Some improvements to medication practice had occurred but more needs to be done. What the care home could do better: There must be clear documentation to show that the process of monitoring peoples` ability to manage their medicines takes place and that people are safe to do so. The service should acquire a refrigerator to store medicines that require a low temperature. Recruitment procedures must ensure that a full employment history is obtained before people commence work at the service. Nutritional assessments should be undertaken for everyone using the service to monitor their nutritional needs and ensure they are eating a healthy diet appropriate to their needs. Each member of staff should have a training and development plan, with clear records of training they have completed, so that they receive regular training appropriate to the work they perform. This was recommended at the previous inspection visit in November 2008 but has yet to be addressed. They should also receive supervision on a two monthly basis. More staff should obtain a National Vocational Qualification (NVQ) at level 2. Key inspection report Care homes for adults (18-65 years) Name: Address: Orchard Street Care Home 2-8 Orchard Street Hucknall Nottingham NG15 7JZ     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: Janet Morrow     Date: 1 5 0 1 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 27 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Orchard Street Care Home 2-8 Orchard Street Hucknall Nottingham NG15 7JZ 01158443675 01159104267 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.ncha.org.uk NCHA care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Service users shall be within category MD Date of last inspection Brief description of the care home Orchard Street provides accommodation for up to twelve adults with mental health needs excluding Dementia. There are four bungalows, connected by a covered walkway. People live in three of the bungalows and the fourth is used by staff. Each bungalow has its own kitchen, bathroom and sitting room and each person has a single bedroom. At the rear of the premises is an enclosed garden with sheds and seating areas. The service is close to shops, public houses, cafes, a cinema, library, tourist sights and other local amenities in the town centre of Hucknall. The fees for using this service are £332 per week. More information and copies of the most recent inspection report are available on request at the service or on the Care Quality Commissions website, www.cqc.org.uk. 2 4 1 1 2 0 0 8 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit was unannounced and took place over one day for a total of six hours. Case tracking methodology was used, which means that the records of two people using the service were examined and relevant people spoken with to assess what impact the service had on those peoples quality of life and well-being. Care records, maintenance records, a sample of policies and procedures and staff records were examined. A tour of the building was undertaken. Four of twelve people currently accommodated were spoken with. Three members of staff, the acting manager and a visitor were spoken with. One relative and one visiting Care Homes for Adults (18-65 years) Page 5 of 27 professional were spoken with by telephone following the inspection visit. Written information in the form of an Annual Quality Assurance Assessment (AQAA) was provided by the service prior to the inspection visit and informed the inspection process. It is referred to as the AQAA throughout this report. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: There must be clear documentation to show that the process of monitoring peoples ability to manage their medicines takes place and that people are safe to do so. The service should acquire a refrigerator to store medicines that require a low temperature. Recruitment procedures must ensure that a full employment history is obtained before people commence work at the service. Nutritional assessments should be undertaken for everyone using the service to monitor their nutritional needs and ensure they are eating a healthy diet appropriate to their needs. Each member of staff should have a training and development plan, with clear records of training they have completed, so that they receive regular training appropriate to the work they perform. This was recommended at the previous inspection visit in November 2008 but has yet to be addressed. They should also receive supervision on a Care Homes for Adults (18-65 years) Page 7 of 27 two monthly basis. More staff should obtain a National Vocational Qualification (NVQ) at level 2. 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 27 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 27 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. There was sufficient admission information available to establish the service could meet peoples needs. Evidence: The AQAA stated that The AQAA stated that All service users will have the opportunity to visit the home appropriate to their needs, to see if we can meet their needs and choices. Family and friends are also encouraged to visit the home before the service user moves in, in line with service users wishes. Two peoples care and support files were examined and as both had been using the service for a several years, the original information had been archived. However, there was information from external professionals available and there was an assessment pro- forma available for any new people who started to use the service. Care Homes for Adults (18-65 years) Page 10 of 27 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. Peoples individual choices were respected and support was planned so that people retained their independence as far as possible. Evidence: The AQAA stated that there were comprehensive support plans for socialisation, maintaining relationships, community links and leisure. We looked at two peoples support plans and these showed that a comprehensive care plan was in place that demonstrated how individual needs would be met. Although the essential information was located, it was in three different places; in a paper file, on the computer and in a person centred file. Staff spoken with stated they understood what support was required and were clear about what they needed to do. Risk assessments were available in individual care files that showed how identified risks were minimised. Each part of the plan indicated when the next review was due and all plans were reviewed at least every 90 days. Day to day information was Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: recorded on the computer system and was up to date. People spoken with confirmed that they were consulted about their support and stated that they made choices and decisions on what to do each day and in important areas of their lives. One person had been assessed under the Mental Capacity Act regarding decision making and it was clearly documented that they were able to make decisions for themselves. The service had also convened regular meetings for people and the records of these were available and showed that people actively contributed and were assisted to make decisions on their daily lives and suggested improvements to the service. Care Homes for Adults (18-65 years) Page 12 of 27 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. Peoples quality of life and lifestyle choices were enhanced by well-managed meals, contacts with the community and activities. Evidence: The AQAA stated that Individuals are supported to have regular, meaningful contact with a wider network other than that accessed within the service and that it Provides meaningful and therapeutic activities in and out of the home for all the service users. We observed that people using the service had their own routines as far as possible, with some choosing to go out and others participating in hobbies of their choice such as artwork, which was displayed around the building. One person enjoyed gardening, one had pets (birds and fish) and another liked shopping. People told us about activities within the service in the evenings that included quiz games and video evenings. Spiritual needs were also catered for and several people participated in a Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: prayer group and attended the local church centre. One person we spoke with said they liked the freedom that the service offered and the ability to be independent and another said that staff went out of their way to support them. All people spoken with during the inspection visit described the food as good and a visitor described it as good. Nutritional needs were discussed with the deputy manager; a nutritional assessment was not being carried out for people, although this would be relevant for some people with eating needs and had been recommended at the previous inspection visit in November 2008. The AQAA stated that As part of an healthy living promotion staff discuss nutritional information with service users. There were monthly healthy eating days organized and there was a record maintained of what people ate although this was not very detailed. One persons support plan addressed nutritional needs but the other did not. The kitchens in each bungalow were viewed and were clean and hygienic. There was fresh fruit and vegetables available and food stocks were good. Some people were involved in preparing their own meals and one person in one bungalow said they did most of the cooking. Care Homes for Adults (18-65 years) Page 14 of 27 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. Peoples health and personal care needs were well managed, which ensured that good health was maintained. Evidence: Two peoples support files were examined and showed that access to health professionals was made available. The daily communication records available showed visits to dentists, opticians and General Practitioners took place. One person attended a dentist appointment during the inspection visit. The deputy manager also stated that weight was recorded monthly. The AQAA stated that Assessment of service users health take place prior to CPA reviews. There were Care Programme Approach (CPA) reviews on both peoples records that showed all aspects of care and support had been reviewed by a multidisciplinary team in 2009. We saw that personal support was offered sensitively and people spoken with stated that they found staff helpful. People we spoke with told us they were happy with the support they received with their personal care. General observation showed that there Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: were warm relationships between staff and people using the service. One person we spoke with said staff were very nice people and another confirmed they received the right support. A visiting professional described the service as perfect for the person they were involved with. Most people managed their own medication and both peoples files examined had a risk assessment regarding this that was completed in 2009. Two people collected their own medication from the pharmacist and others had it delivered. One persons daily communication record indicated that staff were monitoring that the person took their medication properly. Medication procedures and peoples competency to manage their medicines was discussed with the deputy manager. She stated that a self assessment would be completed by the person and we saw records for one person that showed it was completed in November 2009. The deputy manager stated that a new person to the service would be assessed over a period of time to check their ability; for example, one dose would be given initially and the person would be observed and this would be built up over a period of time until three days doses were being taken correctly. The box containing the medication would also checked. However, there was no documentation to support this process or that illustrated the efficacy of this system. The MAR chart for one person who received assistance from staff was examined and was completed accurately. Staff spoken with confirmed that that they had had a medication administration competency assessment in 2009 and we saw records supporting this. The deputy manager stated that there were no controlled drugs at the time of the inspection visit but there was secure storage for them should they be required. The service did not have a medication refrigerator and the kitchen fridges were used when required. We saw eye drops that were not labelled with the date of opening so it would be unclear if they were being used within expiry dates. The service had a medication policy that covered key areas of managing medicines and access to the Royal Pharmaceutical Society guidelines on handling medicines in social care. Care Homes for Adults (18-65 years) Page 16 of 27 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. A clear complaints procedure and comprehensive safeguarding information and procedures ensured that people using the service were listened to and safeguarded. Evidence: The AQAA stated that complaints were promoted to service users in service users meetings, information on display and that there had been no complaints received in the last twelve months. We saw the complaints telephone number on display and records of meeting showed that this was discussed openly. People spoken with said they knew who to speak to if they had any worries or concerns. There had been no complaints received at the office of the Care Quality Commission since the previous inspection visit in November 2008. There had been a recent allegation of financial abuse and this had been investigated appropriately and relevant action taken to safeguard the person concerned. Staff spoken with were aware of their responsibility to report any suspicions of abuse and the acting manager stated that safeguarding training was booked for February 2010. The service had its own policy on safeguarding vulnerable adults and access to Nottinghamshire Local Authority safeguarding procedures via the internet. There were financial procedures in place to ensure that peoples personal money was dealt with properly and cash was stored securely. We saw two peoples financial Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: records and these showed that the record corresponded accurately with the cash held and that there were receipts available for individual purchases. Care Homes for Adults (18-65 years) Page 18 of 27 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 service was furnished and maintained to a high standard, which ensured homely and spacious facilities for people to safely enjoy. Evidence: The AQAA stated that Orchard Street is a homely environment with lots of scope for individuals space and personalisation. Our project is homely and in keeping with the surrounding area. There were four people living in each of three bungalows. We saw two of the bedrooms and three shared kitchens and lounges. We also saw an additional large shared lounge. All areas were clean and well maintained and odour free. There was a communal laundry area and there were also washing machines in the bungalows. Staff spoken with knew how to control the spread of infection and confirmed they had received training in this area. They also stated there was a plentiful supply of protective equipment such as gloves and aprons. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were inadequacies in training and support for staff that did not ensure staff were competent in their roles. Evidence: We looked at the rota for the week of the inspection visit and this showed that there were always two support staff on duty and the acting manager was in addition to this. This was consistent with the staff on duty during the inspection visit. The AQAA stated that there was A low turnover of the staff team and all staff spoken with on the day of the visit had worked at the service in excess of three years. However, staff spoken with commented that more regular staff were needed as bank staff were covering some shifts, although the service tried to use the same bank staff to ensure consistency for people using the service. There had been no new staff employed since the last inspection visit in November 2008. We looked at two staff files for recruitment information and found that the service operated a thorough procedure that included a completed application form and two references and there was evidence of satisfactory checks carried out by the Criminal Records Bureau (CRB). However, neither of the application forms seen gave a full employment history. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: The AQAA stated that there were five of fourteen care staff that had achieved a National Vocational Qualification (NVQ) at level 2. This meant that the service was not yet meeting the target of having 50 of care staff with an NVQ2. We were able to establish that staff had received training in mandatory health and safety areas and safeguarding vulnerable adults in 2009 through certificates seen on their files. However, there was no evidence that people had undertaken any training in areas relevant to the support they were providing and this was confirmed by those staff spoken with. The acting manager stated developing a training programme for staff was one of her priorities. There was evidence on the files examined that staff supervision had taken place in 2009 and staff spoken with confirmed that this had taken place. However, it had not been established on a two monthly basis. Care Homes for Adults (18-65 years) Page 21 of 27 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 service was well run in the best interests of people using it. Evidence: The AQAA stated that an improvement would be to improve the management structure within the service. A new acting manager had been appointed since the last inspection visit in November 2008. She had commenced work at the service on the week of the inspection visit and was therefore still in the process of developing priorities and addressing any identified shortfalls in the service. She had commenced supervision sessions for staff and stated that developing a proper staff training programme was a key area for development. She was in the process of completing an application to be registered with the Care Quality Commission. A visiting professional we spoke with said the service was efficient and brilliantly run and a member of staff thought the service was getting better now. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: There was a systematic procedure used to regularly assess the quality of the service. This included regular audits by managers from other services owned by the same provider. The acting manager also told us that questionnaires and self assessments were used and some copies of these were seen on the two care files examined. These showed that feedback was generally positive about the service provided. She also told us that visits were undertaken in relation to Regulation 26 of the Care Homes Regulations 2001, although the records of these visits could not be located at the time of the inspection visit. Feedback on the service was also sought via meetings with service users and the last meeting recorded occurred in December 2009. Thank you cards on display in the service also gave positive feedback; one commented that we appreciate your care and kindness so much. The AQAA stated maintenance checks were undertaken. We saw a random sample of maintenance records for fire alarms, fire fighting equipment and portable electrical appliances that confirmed these checks were all undertaken in 2009. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 20 13 The medicines of people who 31/03/2010 self-medicate must be clearly documented and the process of assessing competence must be recorded. This is to ensure that people take their medication as prescribed and to meet legal guidelines. 2 34 19 A full employment history 26/02/2010 must be obtained for all staff prior to employment commencing. This is to meet legal requirements and to ensure suitable people are employed and peopel using the service are safeguarded. 3 35 18 A training programme for 30/04/2010 staff must be developed that covers issues related to care and support relevant to the service user group. Care Homes for Adults (18-65 years) Page 25 of 27 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 This is to ensure that staff are competent and people using the service receive the right support and guidance. 4 37 9 The current acting manager 31/03/2010 must make an application to be registered with the Care Quality Commission. This is to ensure legal requirements are met and that a suitable person runs the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 4 5 6 6 15 20 20 32 36 The care and support records should be streamlined to ensure all required information is easily located. Everyone using the service should have a nutritional assessment undertaken to establish their dietary needs. The service should acquire a medication refrigerator. Eye drops should be labelled with the date of opening. 50 of staff should have a National Vocational Qualification (NVQ) at level 2. Staff should receive supervision every two months. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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