Care Home: Rockville House

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What the care home does well Rockville has plenty of room and it is easy for people to move around. There is a lovely bath and a separate shower. Rockville has a very good manager and some lovely staff. There is plenty of information in care plans, so that staff may know how people like to be supported. Medicines are organised well, so that people are helped to keep well. There is plenty of food, and different sorts, so that people may have meals that they enjoy and that are good for them. People have been supported to go out, to the shops and the pub. What has improved since the last inspection? There is a whole new group of Trustees, to manage the service. They have held meetings to listen to the service users. They have started to organise the money better, so that it will be spent on things that make the service better for people. They are improving training and arrangements for staff, so that they can support people better. What the care home could do better: Staff still need more training, so they know the best way to support people. The Manager should introduce and effective system to ensure that information is shared promptly and reliably between the day centre and the respite unit, to ensure that knowledge is shared and therapies are continued. Information about the service should be produced in forms that prospective service users may understand. Person centred planning should be developed, in consultation with people who use the service. Activities outside Rockville House, and links with outside organisations, should be further developed, to promote service users` independence and enhance their lives. Staff levels should be sufficient to support individual activities both indoors and in the community. Key inspection report Care homes for adults (18-65 years) Name: Address: Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG     The quality rating for this care home is:   one star adequate 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: Stella Lindsay     Date: 0 2 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 29 Information about the care home Name of care home: Address: Rockville House 2a Rockville Park Plymstock Plymouth Devon PL9 7DG 01752407130 01752481624 sm.bailey@btopenworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Independence South West Name of registered manager (if applicable) Ms Josephine Louise May Whetton Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Age 18-65yrs One Service User named elsewhere, who is under 18 years of age can reside at the home Date of last inspection Brief description of the care home Rockville Respite Centre is owned and managed by the registered charity Independence South West. The respite facility is purpose built on one level, and is adjacent to a day centre that is owned and managed by the same organisation. The service is registered to provide respite accommodation to a maximum of three service users who have a physical disability and who may also have a learning disability. The centre is situated in a residential area in the town of Plymstock, and is close to shops and leisure amenities. The centre has the use of two minibuses. There is a standard Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 1 8 0 8 2 0 0 9 Brief description of the care home fee of 110 pounds per night. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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: We visited Rockville House on a Friday afternoon in January, to meet the people who were staying that night, and the people who were supporting them. We met the Manager, Jo Whetton, and the new Chairman of Trustees and Company Secretary. We looked round the respite unit. We saw how well medicines are organised, to help people keep well. We went back to Rockville House the next Tuesday to look at care plans and other paper work. We met some other staff. We did all this to see what it is like for people staying at Rockville House, and to see Care Homes for Adults (18-65 years) Page 6 of 29 how safe they are kept. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information about the service needs updating, to give new service users an accurate picture of what is offered, in a form they can understand. A system is in place to ensure careful assessment will be carried out, to ensure that the service is offered appropriately. Evidence: The service has a Statement of Purpose, which needs updating to describe the new management arrangements, staff and training. The Manager had plans to produce all information in various forms including audiotapes and photos, to help people understand. There have not been any new referrals to this service since the last inspection. The Manager has a new assessment format awaiting trial. It is very comprehensive, to make sure that all aspects of a persons care needs may be considered before a service is offered. As this is a respite service, the nine people who are current service users are Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: frequently admitted and discharged. We saw that the service had communicated with the informal carers at home, by phone and by use of communication books, to up-date staff on any changes since the persons last stay. The Manager told us that their regular service users sometimes need to be admitted unexpectedly, due to a crisis or emergency in their family. They had in all but one instance been able to accommodate these needs, by offering acceptable alternative dates to people who had been booked in. This is good practice, with respect to an ongoing service where staff have built up their understanding of vulnerable people. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were accurate and up to date, but needed to be developed in a person centred way. Risk assessments had been recorded, with advice for staff in helping service users to avoid harm. Evidence: All service users had care plans which were written with good detail to give staff the information they would need to provide care in a safe way, and in the way that suited each service user. We saw that they had been reviewed recently by the Manager, and any new professional advice included. The Manager was introducing the key worker role, and giving guidance to staff on developing their practice. This included work which had started, to develop Person centred plans with service users. We saw work in progress on communication and ideas about important people in their life which one service user had been working on with their key worker. Some service users can understand the written word, while others will benefit more from photos. The Manager was aware of a Person Centred Planning implementation workshop during the week following this inspection, and planned attend with staff and service users from Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: Rockville. Most work of this nature is carried on in the day centre, and passed through to the respite unit. All staff need to remain alert to this, and ensure that information is shared effectively. The Manager and staff recognised that there were no pen pictures of their service users. One Support worker told us that they would like to know about the service users earlier years, about their families, and how their condition developed. Some long established staff have knowledge of service users family connections, and this needs to be shared and built on, with contributions from families where they agree to participate, and all written with, and from the point of view of, the service user. Service users were being empowered to speak up. Some were unused to having their views considered, and needed encouragement. Staff had not yet had training in the Mental Capacity Act, which could help them understand support for service users when faced with a decision. There was a leaflet about an Advocacy service on display in the entrance hall. There was a record kept of cash held on behalf of service users for safe keeping, with receipts and full accountability. Some were able to look after their own money, and had a lockable storage facility in their room. We saw risk assessments in respect to community activities, including the need to model appropriate behaviours, and with respect to potential for self harm. The use of bed guards was considered, and though professional advice had not been recorded, the Manager had provided reasons for their use, and guidance as to when they should be used. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users could often benefit from individual attention, but should have more scope for outdoor activities and community engagement. Evidence: There was a small board in the kitchen with photos of the staff on duty when we arrived, and the residents who were to be staying that night. This is still work in progress, as the staff coming on duty were not shown, which could be reassuring for service users, and we found that their photos were not yet available. We saw from personal records and also from people telling us that during January, a small group had driven at a weekend across Dartmoor to Cadover Bridge, and people had walked to the local pub at lunchtime. During the period of this inspection, people had gone shopping, locally and into the town centre at the weekend. We were told that people also use the local library. Staff told us that evening outings had not been Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: possible recently. We recognise it is mid-winter. One resident told us they liked coming to Rockville, and they were looking forward to going shopping the following day. They knew who would be able to drive for them. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support is both flexible and reliable. Staff were keen to work well with health therapists, in order to promote service users well being and independence. Evidence: Relatives who spoke to us were very happy with the support their service users were receiving, and confident in the abilities of the staff to understand and respond to peoples needs. We found that staff had a good knowledge of service users care needs, but not all were aware of the most recent entries in service users care plans. Staff told us that they felt they could give good care and do everything properly, as there were only ever two or three people in residence, and they had plenty of time. Health professionals who completed our surveys said their main hope for the future was that information, for example about therapeutic activities, that they share with the Manager and some staff, should be shared with all staff, so that activities will be continued in their absence. Staff told us that they were finding that exercises are now being treated seriously, as a treatment that must be given regularly. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Professional training in moving and handling had been provided within the respite unit, using the homes equipment, to ensure that staff know how to use it correctly. Records showed that professional advice and support had been called for, including Speech and Language therapy, and an assessment of anxiety levels. Healthy eating was considered, and one person who we met had been supported while on a slightly restricted diet. Physiotherapists visit the service users while they are attending the adjoining day centre, but their advice may be continuously followed in the respite unit, as the records, management, and some staff work across both parts of the organisation. We were told that people use the sensory room at weekends, and also do exercises including playing ball in the treatment room. There was a suitable policy and procedure for the guidance of staff on the safe administration of medication. Service users bring their medication with them from home. It is clerked in, and we saw that administration had been carried out with care. The Manager audits the contents of the medication cupboard and the records frequently, to ensure that accuracy is maintained. No controlled drugs were being managed at this time, and no invasive procedures required. A District Nurse visited when an injection was necessary, and a Diabetic Nurse had provided staff training on on diet and the causes of diabetes, and training for staff to enable them to test for blood sugar levels. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected from potential harm by staffs good attitude, training, and understanding of their communication patterns. Evidence: There was a suitable complaints policy, and voices and opinions of service users were being increasingly heard. The complaints procedure, along with a leaflet about Citizen Advocacy was on display in the entrance hall. No complaints had been received by the service or by the CQC since the last inspection. Earlier in the year, staff training was delivered with respect to attitudes and understanding of safeguarding vulnerable people. The Manager has also provided booklets from the British Institute for Learning Disability (BILD) about abuse, and was in negotiation with a training provider for further training on safeguarding adults. The Alerters Guidance was in the services policy file, for staff to refer to if necessary. During the autumn staff had demonstrated their responsibility for whistle blowing, by alerting the Manager to abuse that had taken place, allegedly. Action was taken to protect service users from harm. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rockville House provides a clean, accessible and comfortable environment for the service users. Evidence: The respite unit at Rockville House comprises a suite of rooms alongside the main building which houses the day centre. Residents have access to all the facilities out of hours, including a sensory room and physiotherapy room. We found that these facilities were well equipped and in good order. The Chairman of Trustees has taken responsibility for managing repairs. He has also been elected Chair of the Health Safety and Buildings Sub Committee. A company is employed to advise on health and safety, and met with the Chairman during January. There are gardens and patios to the front and rear of the building. There is parking for several vehicles. There are three bedrooms for service users. All have hi-lo beds with removable bed guards. One had an alarm to alert staff if the occupant starts to have a seizure. The Sub Committee approved the replacement of pressure mats, which are to alert staff if service users get up in the night, and of the nurse call units. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: There is a choice in bathing facilities, with a Parker bath with shower attachment, and an accessible shower. Liquid soap and paper towels were provided, and all areas we saw were clean and hygienic. Relatives returning surveys also confirmed that the respite unit is always fresh and clean. The kitchen/diner had space for people to maneuver, and service users could sit to the table or a worktop to help with food preparation. All surfaces were sound and clean. The lounge had comfortable sofas and a large screen television. Service users have said they would like televisions in their bedrooms, to give choice of whether to be sociable or to choose a different programme. The Responsible Individual for the organisation, in her monthly report to the Trustees, has advised that her aim is to enhance the ambiance with soft furnishings. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team is being built up, to provide a strong and flexible workforce. Training needs are still outstanding. The service has a robust recruitment procedure, to ensure that suitable people are employed. Evidence: It has been possible to provide care for people in the respite unit during weekdays, but normally this service operates out of office hours, when people are not engaged in their day centre or other activities. There are two staff on duty including one Senior Carer, which is sufficient for meeting care needs, but not always to enable social activities. At night the staff are on sleeping in duty. They told us there have been few calls at night recently, so this provision remains sufficient. Of the two staff on duty during the day at weekends, one was often a driver, but not always. We were told that management were in the process of recruiting a driver/handyman. Staff were currently responsible for cleaning, but the Personnel Sub Committee were planning to replace the previous cleaner who had resigned. The committee is in the process of establishing a post of Deputy Manager. A new Acting Senior had been appointed for a six month period. These posts are based in the day centre, but an improved staff structure should improve support and supervision throughout the service. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: One relative who spoke to us said how welcoming the staff always were, and how important it was that they could be relied on for support over the years. health professionals completing surveys told us that they found that the morale and motivation of most of the staff (but not yet all) appeared to be much improved, since the new trustees have come into management. We looked at the documentation from recent appointments, and found that all checks that are required to protect service users from potential harm had been carried out. Staff confirmed that service users had been involved in the recruitment process. Training had been provided, in Moving and Handling, Health and Safety, and emergency first aid. The manager told us all staff were up to date with training in epilepsy care. She was working on a strategy to provide training for all staff in their outstanding training needs, including food hygiene, safe administration of medication, and safeguarding adults. Training in Total Communication and person centred planning would then follow. The Manager had provided individual supervision for staff in particular circumstances, but not yet provided this in a structured way for all. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The new management team are motivated and well organised to deliver a good service. As yet it is too early to see benefits for service users in terms of the organisations aims for promoting their well being and independence. Evidence: The Registered Manager, Mrs Josephine Whetton, is a qualified Learning Disability nurse, with extensive experience in community and residential nursing. We have found her to be a proactive and effective manager, upholding standards for the service through a difficult time of change. Staff told us they could rely on her for guidance. There had been problems over the past year, which had affected the ability of the Manager to run the service in the best interests of the service users. An entire new board of Trustees had taken on the management of the service only twelve weeks before this inspection. We met the new Chairman and the Company Secretary. They demonstrated their commitment to improving the service, and to running it in an entirely open and collaborative way. At the Service Users Forum, held the day before this inspection started, service users were invited to be representatives on the Board, Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: and there were many volunteers. Trustees have formed Sub Committees for Strategy and Finance, Personnel, and Health, Safety and Buildings, and have made a start on tackling the problems that they inherited. The trustees are seeking training for themselves with respect to good practice and values in services for people with learning disabilities. They were working on improving the staff structure and contractual arrangements, and were supporting the manager to provide the necessary training and supervision. The new Responsible Individual for the company is Mrs Janet Brooks. She has made her first visit to the respite unit, met with service users and staff and toured the premises. Her report to the Trustees included improvements she is recommending, with respect to making the unit more homely and attractive, and increasing the range of in-house entertainment. Staff told us that they had already found the new trustees to be approachable, and that they had listened to their views. They found them to be well focused on the service users, and improving the service for them. Some told us that communication between staff and management had needed so much improvement that it still had some way to go, and that efforts are focused on the day centre, with the respite unit following after. The Manager had plans for regular staff meetings for the staff who work in the residential unit, but this had not yet happened. There is not yet a system of self-monitoring and internal audit, or an established annual development plan, based on a cycle of planning, action, and review, reflecting aims for improved outcomes for service users. Independence South West employs a company to advise on health and safety matters. They had recently completed an audit, and the Trustees were awaiting their report. This service has a good record on safety, with fire training regularly provided, and the alarm system serviced professionally. Emergency first aid training had been provided for all staff, to ensure a first aider would be on duty at all times, and the Manager told us she would arrange enhanced first aid training for senior staff. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 Staff must all be up to date in the training essential for health and safety in the home, and also training in relation to meeting residents needs. This is to enable them to provide a service that meets the service users individual plans, and fulfills the aims of the service. 30/11/2010 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 1 6 13 Information about the service should be produced in forms that prospective service users may understand. Person centred planning should be developed in consultation with service users. Activities outside the home, and community engagement, should be further developed, to promote service users independence and enhance their lives. The Manager should introduce an effective system to Page 27 of 29 4 19 Care Homes for Adults (18-65 years) 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 ensure that information is shared promptly and reliably between the day centre and the respite unit, to ensure that knowledge is shared and therapies are continued. 5 6 33 36 Staff levels should be sufficient to support activities both indoors and in the community. The Manager should implement a system of supervision to ensure that all staff have an opportunity to receive feedback on their performance, guidance on policies and initiatives in the service, and consideration of their training needs. The management should introduce an appropriate system of self-monitoring and internal audit, and the establishment of an annual development plan, based on a cycle of planning, action, and review, reflecting aims for improved outcomes for service users. 7 39 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. 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