Care Home: Parkcare Homes (No 2) Ltd (Roseneath Avenue)

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What the care home does well The staff at Rosneath Avenue have a good understanding of peoples needs. People do access community activities, which enriches their lives. The registered manager is experienced and clear progress has been made. The home takes the inspection process seriously. What has improved since the last inspection? Clear information is recorded in people`s care plans with regard to activities which ensures that information is more effectively recorded and provides a clear picture of people`s achievements. Risk assessments have been reviewed and updated. This ensures that people`s identified risks are minimised.This promotes the health and safety of the people living in the home. Risk assessments are now in place for the identified person who refuses to attend medical appointments. This further promotes their health and safety. One person`s identified health and safety chart is now completed in sufficient detail for the document to be effective in providing clear information in relation to the person`s health care needs. One identified person`s bowel chart now records the information requested by care professionals with regard to a persons bowel movements. This ensures the persons health care needs are met. The kitchen ceiling has been investigated and the ceiling has been painted. This ensures that a safe environment is maintained. People`s activity records are more accurately recorded an is in line with the activity programme. This ensures that clear recording mechanisms are in place. What the care home could do better: The chiropody appointments in relation to the people living in the home need to be more effectively recorded. This will ensure that comprehensive health care records are maintained. The home needs to ensure that the identified environmental inprovements are undertaken. This will ensure the home continues to be well maintained. Staff need to undertake training to ensure staff have the knowledge and skills to fully meet the needs of the people living in the home. Supervision must be undertaken on a regular basis to ensure that staff are adequately supported to provide consistent professional care to people living in the home. The one identified deputy manager position must me appointed to so that the manager can be assisted to effectively manage the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Parkcare Homes (No 2) Ltd (Roseneath Avenue) 15 Roseneath Avenue Winchmore Hill London N21 3NE     The quality rating for this care home is:   two star good 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: Wendy Heal     Date: 1 6 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 28 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Parkcare Homes (No 2) Ltd (Roseneath Avenue) 15 Roseneath Avenue Winchmore Hill London N21 3NE 02082922715 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) : roseneath.ave@craegmoor.co.uk Parkcare Homes (No2) Ltd care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users who can be accommodated is: 12 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 care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home The service provides twelve places for people with a learning disability. The age range of the people that live in the home is mid twenties to mid fifties. There are four female and five male adults living in the home. There is an ethnic mix of people in the home. All of the people living in the home have complex behavioural needs. Roseneath Avenue is located in a quiet residential street in Winchmore Hill. The home is a house converted into three flats each with its own bathroom, kitchen, and combined lounge and dining area. All of the people living in the home have their own bedrooms. The home has an office and small meeting room on the ground floor. There is an enclosed garden accessed by all the flats. There is also a communal laundry external to the home within the garden area. Only female staff supports the female occupants living on the ground floor flat. All staff rotate the support they provide to Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home people living in the home. The stated aims of the service is to treat people as individuals and to promote independence and ensure that privacy and dignity is maintained. The service promotes a holistic approach to care where physical, social and psychological needs are given equal importance and appropriate care plans and interventions are put into place. The fees in the home range from one thousand four hundred pounds to one thousand five hundred pounds. Interested parties can access the homes Purpose and Function Document and inspection report as it is on display on the homes notice board. Care Homes for Adults (18-65 years) Page 5 of 28 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 was an unannounced inspection and took place as part of the inspection process. Compliance was checked against key standards and took approximately 8 hours. We undertook an inspection of the building spoke with people who live in the home and members of the staff team. We gained further information from the Annual Quality Assessment Form, by an inspection of the documents kept in the home, including care plans and health and safety documentation. The registered manager offered their assistance throughout the period of the inspection. Care Homes for Adults (18-65 years) Page 6 of 28 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 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. People have all of the information they need to make an informed choice about whether the service is suitable for them and their needs. The service has not completed any new assessments regarding peoples aspirations and needs as no new admissions have been made to the home since the previous inspection. Evidence: Since the previous inspection there have been no new admissions to the home. The service user guide has been updated and is available in a pictorial format. The document can be translated into various languages and can be made available in Braille and audio tape on request. This ensures that accessible information is available to all of the people that need to access the service user guide. The document was available in the individual peoples files that were inspected. This further allows the document to be fully accessible to the people living in the home. The statement of purpose has also been further updated and the service is ensuring that the updated staffing structure is included in the document. This will ensure that Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: up to date information is available to people living in the home and those people who may wish to move into the home. Care Homes for Adults (18-65 years) Page 10 of 28 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 assessed and changing needs are reflected in their individual care plan. This assists to ensure that peoples needs can be met. People do make decisions about their daily lives which promotes their independence and empowers them. People are supported to take risks as part of an independent lifestyle. Evidence: The registered manager has developed person centred plans which include pictorial formats. Care plans are much more detailed and identify peoples wishes and preferences with regard to their care for example, if the person wants a bath or a shower, the prefered time, and the support required and in what form. This ensures peoples rights are respected. The manager and members of the staff team have worked to develop the care plans. Two peoples care plans were inspected. They were clear to read. The care plans identify basic information such as date of birth, chosen religion, next of kin and the medical professionals involved in the persons care. The care plans identify various areas such as personal care, communication, relationships, Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: recreaction leisure participation. The care plans inspected were linked to and reflected the assessed needs of the individual people. The plans identify peoples individual needs and goals that need to be achieved to ensure their individual needs are met. Service users make decisions about their lives with assistance and this is evidenced in the most recent service user meeting records. Peoples wishes in relation to the menu of food available was discussed and their wishes noted. The risk assessments to show potential risks for individual people are being reviewed and kept up to date. This minimises the potential risks to people living and working in the home. The risk assessments that were seen on the individual peoples files that were inspected covered areas such as fire, road safety, challenging behaviour, slips trips and falls, leaving the home via the main entrance or side gate without staff support, risks when in the community, hospitalisation, epilepsy, refusal to attend medical appointments and choking. The risks assessments identify the specific risks and confirmed the advantages of minimising the risks for the individual people. Care Homes for Adults (18-65 years) Page 12 of 28 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 personal development is promoted and encouraged. People are undertaking appropriate activities both inside and outside the home. People are encouraged to maintain their relationships. This promotes their emotional wellbeing. People are supported to choose nutritious meals, which benefits their health and wellbeing. Evidence: People living in the home undertake a range of activities both in the home and at external day centres. People undertake external activities from three to five days per week. There is a weekly activity programme which was inspected. The activities undertaken include music sessions by an independent person who visits the home. People living in the home visit a leisure centre to run on the indoor indoor sports track, aromatherapy sessions and dance therapy sessions are provided by independent people who visit the home. A number of people attend at a drum session and various Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: outings, such as trips to the science museum, bowling, cycling, they attend fun days,walking in the park, shopping, going to the hair-dressers/ barbers. This promotes social inclusion. People also undertake life skills such as baking sessions, completing their laundry and washing the dishes. These all assist the people to develop their individual life skills. The home has two seperate activity recording sheets. One sheet records community based activities and the other records activities undertaken in the home. There was several occasions when one identified persons activities had not been recorded on their activity sheet. It can be seen that the recording of activities in the home has improved greatly. This means that the achievements in the home are now reflected in the homes records. People living in the home have contact with their family and friends. This promotes peoples emotional well-being and makes them feel secure. On the day of the inspection the kitchens of the individual flats were clean and tidy. The fridge and freezers were inspected which were hygenic. There are colour coded chopping boards to prevent cross contamination during the preparation of food. Food was labelled and stored correctly. This promotes the health and wellbeing of the people living and working in the home. The home has a seperate menu available in each of the flats and these were inspected. The menus available reflects peoples individual and cultural needs and provide a varied choice with regard to meals offered to the people living in the home. Care Homes for Adults (18-65 years) Page 14 of 28 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 physical and emotional health care needs are met. This safeguards their health and wellbeing. The process for administering medication has improved. This promotes the good health of people living in the home. The recording of chiropody appointments needs to improve to ensure that all appointments are effectively recorded. Evidence: The record of peoples health care appointments for a number of people living in the home was inspected. They indicated that people are receiving regular input from healthcare professionals including the General Practioner, opticians psychiatrists, and dentist. This ensures that peoples health is being monitored. The health care information was recorded for the identified areas above. There were some occasions were chiropody appointments had not been recorded. The manager is going to draw this to the attention of staff members in the team meeting. However the consistency of recording appointments has improved since the last inspection. This improves the quality of care for people living in the home. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: There was a record of peoples weight charts. This are being kept up to date. This means that peoples weight monitoring programme is being effectively monitored. This assists to promote peoples health and well being. The epilepsy charts have been improved and include a specific area for staff to sign the document and information is recorded in sufficient detail. This means a more effective recording system is in place. The identified person who is monitored with regard to their bowel movements at the request of medical professionals and has a document to record the information needed now has a document that is now being used to document the information needed which is being effectively used. The medication was appropriately stored and the medication administration records for the people living in the home were inspected. These records were found to be in order. This promotes the good health of the people living in the home. Care Homes for Adults (18-65 years) Page 16 of 28 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. People who are living in the home can be confident that their views are listened to and acted upon since the recording and action taken in relation to complaints was found to be in order. People are protected by clear adult protection procedures. This protects the people living in the home from abuse neglect and self-harm. Evidence: The complaints book was inspected and no complaints had been made since the previous inspection. The home has an up to date complaints procedure that had been reviewed in 2009. This ensures that clear up to date procedures are available to the people living and working in the home. This promotes their rights and ensures that complaints are taken seriously. The people living in the home are provided with a pictorial complaints procedure to ensure that the document is as accessible as possible for them. The organisations whistle blowing policy was seen and found to be in order. The home had a copy of the organisations adult protection guidelines and the procedures in relation to the relevant placing authorities at the time of the inspection. Staff had also undertaken adult protection training This ensures staff have the information they need to protect people from potential abuse. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: The finances for a number of people living in the home were inspected and found to be in order. two safeguarding issues had been brought to the attention of the comission since the last inspection. These have now been resolved by the home and relevant professionals concerned. Care Homes for Adults (18-65 years) Page 18 of 28 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 living at Rosneath Avenue enjoy a comfortable, homely, safe environment which benefits their health and wellbeing. However there is one identified area needing action promptly and two other minor areas of redecoration to ensure the home continues to be well maintained. Evidence: Roseneath Avenue is located in a residential street in Winchmore Hill near to local shops and public transport. This assists people living in the home to have an active role in the local community. The home is converted into three flats. A tour of the home was undertaken with the manager of the service. People living in the home have their own bedrooms. Peoples bedrooms were inspected having sought their permission. On the day of the inspection the bedrooms were found to be appropriately furnished. The rooms were personalised with peoples own individual items, such as a television, music centre, pictures and soft toys. This makes the people living in the home feel secure in their chosen environment. The seperate lounge areas are comfortable and well furnished. Currently the manager is in the process of obtaining a new sofa for one identified lounge which had also Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: recently been repainted. This ensures that people are provided with a suitable place for them to relax. This makes the people living in the home feel valued. The kitchens were clean and tidy. The kitchen ceiling for one identified kitchen had been repaired and painted. The kitchen on the middle floor is being included on the maintenance schedule to be painted as part of the planned decoration process. The kitchen was appropriately equipped to enable staff to meet peoples needs and assist the people living in the home to prepare meals to promote their independence were possible. The bathrooms were found to be clean and equipment was functioning effectively. One of the identified toilets needs the toilet seat replaced. There is an odour in this toilet which may be coming from the flooring, as the toilet and surrounding area was clean. There was a supply of soap and paper towels. The replacement of the flooring was discussed with the manager who has agreed to replace the flooring and treat as urgent. This will promote the health and wellbeing of the people living in the home. The middle and top floor hall-way would benefit from being painted. To ensure the home continues to be well maintained. This has been noted on the maintenance schedule for action and discussed with the area manager after the inspection. Therefore a requirement has not been made. There is a garden at the back of the home. This provides people with suitable area to sit and relax in the summer. Care Homes for Adults (18-65 years) Page 20 of 28 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. The registered manager cannot consistently manage the home until a deputy manager is appointed. The staff team need to update identified areas of training. This will ensure have the knowledge and skills to meet the needs of the people living in the home. The staff are not working effectively as a team as they could to fulfil their full potential therefore action needs to be taken to taken to promote effective team work. Evidence: The home is managed by an experienced registered manager. The staff rota was inspected and there were adequate staff on shift to meet the needs of the people living in the home. At the time of this inspection the deputy manager had resigned. The organisation is currently in the process of recruiting to the post and is currently at the second stage of interviews. This will ensure that the manager has the necessary support to manage the home effectively. A number of staff have completed their National Vocational Qualification (NVQ) level 2 and information is available on peoples files to evidence this. This expands their knowledge and skills and promotes their personal development. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: Staff training records indicated that staff had undertaken training in health and safety, Manual handling, Adult protection, infection control, equality and diversity, medication and epilepsy. However on the day of the inspection two staff had not attended their planned training in relation to protection of vulnerable adults due to being off sick on the identified training day. The manager has confirmed at the time of completing the report that this training has now been undertaken by the identified staff members. A number of staff undertook their epilepsy, medication, health and safety training some time ago and it now needs updating. Due to the needs of the people living in the home it is suggested that staff undertake specific training in relation to choking. It has been agreed that this will take place and manager has confirmed at the time of comleting the report that the training has been requested as a matter of urgency. This will ensure that the staff have the knowledge and skills to meet the needs of the people living in the home. The staff team is not functioning as effectively as it could and this was evidenced by discussions with staff, observation and recording methods.Work needs to be undertaken to ensure the staff members work more effectively as a team. A discussion has taken place with the manager and area manager of the home and it has been agreed that if the situation does not improve through the normal channels including staff supervision then an external team building exercise will be undertaken using an external body. This is an essential area to ensure that both the staff working in the home and the functioning of the home reaches its full potential. The supervision records indicated that not all staff are receiving regular supervision. This means staff are not being fully supported to work with the people living in the home in a consistent way. This matter has been brought to the attention of the area manager and is further discussed in the management section of the report. Care Homes for Adults (18-65 years) Page 22 of 28 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. An experienced Registered Manager manages the home. The manager has passed their registered Managers Award. The manager is going to continue the monitoring review and assessment process that takes place within the home. This needs to be used in conjunction with supervision and staff achievements records. As consistant sustained progress needs to be evidenced in these areas for the home to further improve. The health and safety of people living in the home is promoted and protected. However the one vacant post must be filled to ensure the home can be effectively managed. Evidence: An experienced Registered Manager manages the home. The manager has passed their Registered Managers award. This means the manager has the skills and knowledge to run the home. The manager is knowledgeable with regard to the people living in the home and their specific needs, which assists to ensure that peoples individual needs, can be met. However the manager has no deputy manager in post and the organisation is currently undertaking interviews to recruit a person to this Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: position. This is essential to ensure the manager has the support they require to run the home effectively. There is an established Quality assurance system in place. This is a document which is used to improve the quality of care provided to the people living in the home. The inspector is sent regulation 37 notifications of incident forms. This is a legal requirement and ensures that professional practice is followed. The current supervision of staff is has not been effectively used and the reasons for this were discussed with both the manager and area manager. The supervision system must be fully effective to ensure that staff receive full support to enable them to work with those people both living and working in the home in a consistant professional manner. Action has been undertaken to ensure regular staff supervision takes place. The manager has provided a schedule confirming the supervision dates that have been booked and those that have been completed. The area manager has confirmed that supervision sessions are now up-to date. The area manager has also confirmed that they will strictly monitor the supervision process and ensure support is offered to the manager to assist with this identified area of work during the the short time that it will take to appoint the deputy manager. In relation to the staff team functioning effectively as a team and reaching their full potential. Regular supervision and suggested team building exercises may then ensure that consistant sustained improvements can be made. This will build on the achievements the home has already made. These are further refered to in the staffing section of the report. A range of health and safety documentation was seen and included a gas certificate, electrical installation certificate, portable appliance testing certificate, fire evacuation procedures and servicing and testing of the homes fire fighting equipment. The home has an up to date fire risk assessment. The home has a current public liability insurance certificate. All of the records were found to be in order. This safeguards the health and wellbeing of the people living in the home. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 19 12 The Registered Manager must ensure that all chiropody appointments are clarly recorded. This will ensure that clear recording procedures are in place. 10/05/2009 2 35 18 The Registered Person must 15/05/2009 ensure that staff undertake training in relation to epilepsy, fire safety, medication, manual handling, risk and responses to choking, health and safety and the protection of vulnerable adults. This will ensure that staff have all the updated knowledge and skills to meet the needs of the people living in the home. 3 36 18 The Registered Person must 01/05/2009 ensure that staff receive supervision at least six times per year. Care Homes for Adults (18-65 years) Page 26 of 28 This will assist to ensure the staff work effectively as a staff team. 4 37 18 The Registered Person must ensure that a deputy manager is appointed. This will ensure that the home is effectively managed and the needs of the people living in the home are met. 10/06/2009 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 35 It is strongly recommended that the staff team undertake a team building exercise to improve the effectiveness of the staff team. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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