Care Home: Rose Park

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What the care home does well People are assessed before they move into the home to make sure that the home are fully aware of all of their needs and how these are to be met before they move in. This helps to make sure that people only move into a home that can meet their needs. People receive good support in maintaining activities of their choice that they undertook before they moved into the home. This helps people with their choices and in living their lives as they would wish to. People receive good support in maintaining relationships of their choice: this helps them to have positive relationships in their lives and to live their life as they choose. People receive good support in maintaining their health and personal care needs. People live in a home that is kept clean, warm, comfortable and homely, helping them live in an environment that they value and that they find comfortable. People feel that they receive good support to raise concerns and are listened to. People live in a home that is well managed by an experienced manager, helping them to live their lives as they choose with the appropriate support. What has improved since the last inspection? People now have contracts with the home that reflect the majority of the required details. This helps to make sure that people are aware of the terms and conditions for living in the home. There are risk assessments in place to support people to undertake different activities of their choices, this helps them to live their life as they choose. There are records of the medication received, administered and disposed of in the home. This helps to provide a clear audit trail and to ensure that peoples medication needs are met. Staff have now received training on the safeguarding of adults. This will assist them in supporting a service user should an allegation of harm occur. What the care home could do better: Peoples files could be clearer and more concise with out of date documents being removed to make access and understanding easier for the staff to support people in the meeting of their needs. Staff should receive medication training to ensure that peoples medication needs continue to be fully met. There should be a training and development plan in the home; this will help to make sure that all staff are trained in the necessary courses to meet peoples needs. Staff recruitment practices must include that the home request references directly and that references are verified to ensure their authenticity, this will help to make sure that only people suitable for the role are employed in the home. Records of electrical maintenance checks should be up to date to help to ensure that systems do not pose a risk to the health and safety of the people who live in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Rose Park 4 Park Avenue Bridlington N Humberside YO15 2HL     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: Sarah Rodmell     Date: 1 1 1 2 2 0 0 9 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 31 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 31 Information about the care home Name of care home: Address: Rose Park 4 Park Avenue Bridlington N Humberside YO15 2HL 01262672720 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): fillingham9@hotmail.com Mrs Paula Rosina Fillingham and Mr Roger Frank Fillingham Name of registered manager (if applicable) Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1. 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. 2. The maximum number of service users that can be accommodated is: 10. Date of last inspection Brief description of the care home Rose Park is situated in a residential area of Bridlington; it is close to local amenities including shops and public transport. It is only a short journey into the town centre where more facilities, including shops, are found. The home is a detached property and offers a small courtyard area to the rear. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home Accommodation is over two floors with the the communal areas and two bedrooms being on the ground floor, and further bedrooms and bathrooms being on the first floor. All of the bedrooms are single and have en-suite facilities. Communal areas inlcude two lounges a dining area and kitchen. Care Homes for Adults (18-65 years) Page 5 of 31 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: The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. The inspection report is based on information gathered by the Care Quality Commission (CQC) since the last inspection of the home on 3rd March 2009, including information gathered during a site visit to the home. It began at 9.30 am and finished at 5 pm. On the day of the visit the inspector spoke with the owners of the home, one of whom is also the manager, and chatted to people living at the home and some of the staff. Inspection of the premises and close examination of a range of documentation including three care plans were also undertaken. The manager completed an Annual Quality Assurance Assessment (AQAA) and returned this to us within the given timescale.The AQAA is a self assessment document that provides information about the home. Care Homes for Adults (18-65 years) Page 6 of 31 The manager told us that the current fees for living in the home are £372.53 per week. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: Peoples files could be clearer and more concise with out of date documents being removed to make access and understanding easier for the staff to support people in the meeting of their needs. Staff should receive medication training to ensure that peoples medication needs continue to be fully met. There should be a training and development plan in the home; this will help to make sure that all staff are trained in the necessary courses to meet peoples needs. Staff recruitment practices must include that the home request references directly and Care Homes for Adults (18-65 years) Page 8 of 31 that references are verified to ensure their authenticity, this will help to make sure that only people suitable for the role are employed in the home. Records of electrical maintenance checks should be up to date to help to ensure that systems do not pose a risk to the health and safety of the people who live in the home. 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 9 of 31 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 31 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. We looked at standard 2. People are assessed before they move into the home to help to make sure that the home can meet their needs. Evidence: The manager recorded in the AQAA, We promote independence and encourage the service users to pursue their interests in the community and within the home. We encourage service users to approach the manager or staff if they have any concerns. They also recorded that there had been one new service user admitted to the home since the last inspection. The manager told us that the new service user visited the home on a weekly basis until the process for them moving in was completed and that their care plan and risk assessment were completed. We looked at the files of three of the people who live in the home. The files included an assessment of the person detailing their needs and how these are to be met. The Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: areas of need covered were varied and included, for example, maintaining independence, personal care, communication, continence, mobility and nutrition. These assessments had then been used to develop an individual plan of care for the service user, including any necessary risk assessments. One person has been supported through re-assessment with a view to moving to another service. This person told us how they were looking forward to this and chatted to the staff about this. We saw that people have contracts that detail the terms and conditions for living in the home. This includes the majority of the areas required, although it does not include the details of the room to be occupied and does not refer to the service user plan. The previous requirement for people to have a contract has been met. Care Homes for Adults (18-65 years) Page 12 of 31 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. We looked at standards 6, 7 & 9. People receive support through the care planning process to have their needs met and to live their lives as they choose. Evidence: The manager recorded in the AQAA that, We include all service users in their care planning to ensure their needs are met. We train all staff to listen to the service users and to help them with their communication. They also recorded, I feel the service users have all their needs met and are able to make their own decisions or choices this is reflected in each individual care plan. We looked at the care files for three of the people who live in the home. These contained a large amount of information, which due to the volume made it at times difficult to determine the latest information regarding the service users. However the Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: information provided covered a variety of areas that included: a persons basic details, a personal profile and history, their care plan, and activity sheets. Care plans included a tick box that identified the area of need to be covered, for example, self care, continence, communication, mobility, social and nutritional needs. It then described the individual areas of need as potential building areas and went on to describe the prescribed care, which is the necessary support people need to have their needs met. They also included a care plan action sheet, with the actions and objectives, a person specification, qualifications, and details of their general interests, team style, an assessment overview, and risk assessments. Risk assessments included, for example, nutritional risks, the risk of slipping, a Waterlow risk assessment, and a moving and handling risk assessment. Additionally there were individual risk assessments regarding the risks if a fire occurred in the home. When we spoke to staff they told us that they refer to peoples care plans for information about people and to keep up to date with the latest information on how to meet peoples needs. We saw that people were able to make choices throughout the day, deciding what to do, to stay in or go out, and what to have to eat and whether to be alone or with others. Peoples daily notes included diary sheets that recorded, for example, the times that people got up or went to bed, their personal care needs and how these were met, their mood, and how they participated in the daily routines of the home and their own leisure choices. There were some records of review in peoples files , however these need to be improved upon and should include the details of regular reviews within the home. Care Homes for Adults (18-65 years) Page 14 of 31 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. We looked at standards, 12, 13 14, 15, 16 & 17. People are supported to have their work, education , leisure and dietary needs met. Evidence: The manager recorded in the AQAA, All service users attends activities, and work in the community as well as at home. This is recorded in their individual care plans. We created a garden for the service users, where they grew their own flowers, and we introduced some games for them. The majority of the people who live in the home were out during the day , attending adult education and a work placement. One person had been supported by the home to maintain their employment after moving into the home. When we spoke to staff they told us that people do different things each day and that this includes: attending Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: adult education, attending a farm activity, a drama group and a place of work. They also told us that leisure activities include:shopping, going out for a drink or a meal, attending social evenings, trips out and parties. People who live in the home told us that they can do as they wish,and that there is plenty to do including baking and bowling. People also told us about the support they receive to maintain relationships. One person has received specific 1:1 support from staff to maintain an important relationship. They talked to us about this and how they value this. Other people told us how they maintain contact with people who are important to them. We observed that staff and people who live in the home talked easily with each other and that these conversations were respectful. We saw that people could access different areas of the home as they chose and that they could decide when to be with others or alone. Staff told us how one person holds a key to their room and how they support people to open their own post. There were some records of peoples likes and dislikes, although at times records were duplicated and confusing, one form stating a persons like or dislike and another form stating differently. Although meals are thought out and planned the menus did not include details of the different choices that are available to people, including fruit. The manager told us that fresh fruit and vegetables are available each a day and it is recommended that the menus reflect these. People have nutritional risk assessments in place, although weight records and reviews of these assessments had not been carried out or were unclear in peoples files. One persons records stated that they required a specific diet to help them manage a health condition, records for this were unclear. In discussion with the manager it was explained that this condition was now managed through an ordinary diet. However records did not reflect this and these must be made clearer. Staff also told us how people make choices in their daily routines and that this includes: what to eat, what to drink, what to wear, when to go shopping and that people were able to express their own opinions about things. Care Homes for Adults (18-65 years) Page 16 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at standards 18, 19 & 20. People receive good support in the meeting of their health and medication needs. However the lack of staff training may compromise this. Evidence: The manager recorded in the AQAA , We liaise with GPs, nurses, continuance teams and centres some of the service users attend. All medical appointments are attended by staff to support the service users. All professional appointments are recorded in care plans. We spoke to one professional who supports people who live in the home. They were very positive about the support offered for people in the home and commented that there were good interactions and that the home had a family feel.Peoples records included details of appointments with health professionals and the reasons for these visits. This included accessing specialist professionals, for example, specialist learning disability nurses. When we spoke to the staff team they told us about the support that people receive in the meeting of their health needs. They were clear about peoples Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: individual needs and the actions that they should take to meet these.When we spoke to the people who live in the home, they also told us that they are supported to have their health needs met. Staff also told us how they make sure that peoples privacy is respected when they are completing personal care, this included: closing doors when completing personal care tasks, standing outside of the bathroom to encourage independence, supporting people to handle their own post and how some people hold their own key to their rooms. Medication is stored in a locked cabinet in the office of the home. We examined the records for receipt, administration and disposal of medicines and saw that these appeared to be correct. At times staff are having to copy information onto the Medication Administration Sheet (MAR), although only one person is completing this and it is best practice that there is also one person checking and countersigning these entries to help to reduce the risk of errors occurring. There is also a fridge for the storing of any medicines that are required to be kept cool. Monitoring of the fridge temperature with records of this is not taking place and the manager was advised as to this on the day of the visit. There was no evidence in the staff training records that staff have undertaken accredited medication training and this must be addressed. Care Homes for Adults (18-65 years) Page 18 of 31 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. We looked at standards 22 & 23. There are policies in place in the home to help people to raise concerns and to be protected from harm. Evidence: The manager recorded in the AQAA, Complaints procedures in place showing how complaints can be made. Whistle blowing policy in place, all staff sign to state they understand the meaning of policies in place. Complaints procedure is on service users notice board. For those that cannot understand due to communication problems or those that cannot read, the manager will explain to their understanding ability makaton. There is a complaints policy within the home and the information included in the AQAA that there have not been any complaints received by the home.When we spoke to the people who live in the home they told us that they would talk to the staff about any concerns that they may have, and that they were confidemt that the staff would deal with these. Staff have attended training on protecting vulnerable people and when we talked to staff about this, they were clear on the actions that they would take should an allegation of harm occur.There is a policy in the home that instructs the staff on the Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: actions to take should an allegation of harm occur, this includes how to report the allegation and the involvement of the Local Authority. The manager showed us the systems for handling peoples monies. These included that each person has a bank account held on their behalf by the organisation, additionally they each also have their own bank account. The manager told us how they have undertaken a lot of work to help people with their finances since, they moved into the home. She also told us how many of the people who live in the home receive the support of their family with the managing of their money. Care Homes for Adults (18-65 years) Page 20 of 31 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. We looked at standards 24 & 30. People live in a home that is clean, warm and comfortable, where on the whole their safety needs are met. Evidence: The home is located over 3 floors with a small courtyard and garden area to the rear of the property. The ground floor includes the kitchen, dining room, office, laundry and bathroom areas and two of bedrooms. Other bedrooms are over the two floors with access to adjacent bathrooms also available. People showed us around their bedrooms. All are en-suite and have been decorated individually. People told us that they are happy with their rooms and we saw that they have personalised them to make them individual.One of the owners told us about their plans for re-decoration of some of the bedrooms. The manager recorded in the AQAA, We have made the home bright and more welcoming. And safe and secure for the service users. Cleaning rota is in place with daily and weekly tasks. We found the home to be clean, warm and homely throughout. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: There is laundry area available on the ground floor and people are able to access this as necessary. There was a letter in place to confirm that the water systems in the home meet the requirements of the Water Supply Water (Fittings) Regulations. We looked at the records for fire safety in the home. A fire risk assessment was completed in April 2009 and records are kept of the fire drills, and emergency lighting and fire alarm tests. The maintenance check for the fire extinguishers was last completed in December 2008 and required updating.This work has now been completed with the certificate being forwarded to the Commission. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We looked at standards 32, 34 & 35. People are supported by a staff team that are correctly employed and who receive some training to help them meet peoples needs. Evidence: The manager recorded in the AQAA, Staff are recruited on CRB and POVA checks. At interviews I involve some of the service users. We looked at the staff files for three of the people who work in the home. The files included details of peoples recruitment and training. We saw that people had completed an application form, references and a Criminal Records Bureau check (CRB), helping to make sure that the person is suitable for the role and that they do not hold a criminal conviction that may prevent them from working with vulnerable people. One reference had been obtained that was entitled to whom it may concern, it is recommended best practice that if these references are only accepted after verification of the details. When we spoke to staff they told us that they had completed the necessary checks, including an application form, CRB and references before they started work in the Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: home. There was no evidence that the staff are employed within the General Social Care Council code of conduct (GSCC) and this must be addressed. After commencing their employment people had undertaken an in house induction into the home and supervision sessions.The manager told us that people are undertaking National Vocational Qualifications (NVQ). However there was no evidence that the induction meets the requirements of the Skills for Care council. Training records recorded that people had undertaken a variety of courses including, fire equipment, Mental Health Awareness, Deprivation of Liberty, Safeguarding, Food Safety and Infection Control. People had individual training needs assessments and details of the courses required and the dates by which these needed to be completed. When we spoke to staff they told us that they had completed different training that included: fire training, Deprivation of liberty training, Health and Safety, epilepsy and the safeguarding of vulnerable adults. There was no evidence that people have undertaken training in equality and again this is recommended. The manager told us that she does not have a training and development plan for the staff team as a whole as she completes individual training plans. Care Homes for Adults (18-65 years) Page 24 of 31 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. We looked at standards 37, 39 & 42. People live in a home that is well managed and that on the whole meets their safety needs. Evidence: The manager is also one of the owners of the home. They told us that they have previous experience of managing care services and that over the last year they have undertaken training in: Deprivation of Liberty, Fire and First Aid training. There is a quality assurance system that includes staff, service user and visitor questionnaires. This information is collected but has not been summarised into a report to be used as part of the development of the home. The manager recorded in the AQAA that, All service users enjoy participating in house meetings and always give their input. All recorded in care plans. A previous requirement for there to be a quality assurance system has been met. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: We looked at the maintenance records in the home. This included the Gas and electrical safety records. The records for the electrical installation maintenance were for 2004, showing that these were over due. The manager felt that this check had been completed and was to forward the up to date record to the CQC, however this has not been received. Other maintenance records included that the portable appliances had been maintained, that Control of substances Hazardous to health (COSHH) assessments had been undertaken, and checks that the hot water supply and fridge temperatures were correct.The previous requirement for checks of the hot water has been met. Care Homes for Adults (18-65 years) Page 26 of 31 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 27 of 31 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 17 17 Records of peoples dietary 26/02/2010 needs and how these are met must be clear and up to date. This will help to make sure that their current needs are met. 2 20 13 Information regarding peoples medication that is transcribed onto peoples records must be completed by two people. With both signing to confirm the details. This helps to prevent errors occurring and to make sure that peoples medication needs are met. 25/02/2010 3 20 13 Staff must receive appropriate training and be assessed as competent in handling of and administration of medicines in the home. 25/02/2010 Care Homes for Adults (18-65 years) Page 28 of 31 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 will help to ensure that peoples medication needs are met correctly. 4 42 13 The electrical systems in the 25/02/2010 home must be maintained to the current legal standards. This will help to prevent any risks to peoples health and safety. 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 6 Records should be kept and easily available that show how peoples care needs are met and that this is regularly reviewed in the home. Care plans should be clear and concise to enable peoples information to be easily accessible to them and the staff who support them. Nutritional risk assessments and records must be up to date and clear. Records of peoples likes and dislikes must be up to date, clear and accessible. All references should be verified to confirm the details of the reference and referee. Staff should be employed within the code of conduct of the GSCC. Staff induction should meet the requirements of the Skills for Care Council. Staff should receive training in equality, this will help them to support vulnerable people who live in the home. There should be a training and development plan held Page 29 of 31 2 6 3 4 5 6 7 8 9 17 17 32 34 34 34 35 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 within the home that will assist in the planning and development of the training required to continue to support people with the meeting of their needs. Care Homes for Adults (18-65 years) Page 30 of 31 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. 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