Care Home: Shirebrook Manor Nursing Home

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What the care home does well The home provides care for younger adults with very challenging behaviour some of which are now very frail having been at the home for a number of years. All of the people living at the home have a care plan and the majority of the people stated they are aware and have signed them to show they agree. The atmosphere within the home generally was warm and friendly, good relationships were observed between the care staff and people living there. People living there have stated they like and enjoy living at Shirebrook Manor. The home provides good levels of staffing. The home offers an activities programme, which includes trips out into the community as well as activities within the home. Several of the people living at the home now assess activities outside the home. The home has now started to develop person centred care planning, and life history work. All of the people who live at the home have a named nurse and key worker. What has improved since the last inspection? The majority of the requirements from the previous inspection have been fully complied with by the time of this inspection. The home has a new registered manager and people living there spoke very warmly and positively about her. People spoken with stated they could discuss what they were unhappy about with her. Staff indicated they liked the changes she had implemented with the home. We have received no complaints about this service compared to previous inspection years. Work has begun on the rebuild and refurbishment of the Shirebrook Manor and this is estimated to take about eight months. The recording of the Regulation 26 visits, has improved and at this present time we no longer require copies of these reports. Shirebrook Care Group Ltd is providing good training opportunities for the staff and this includes all the mandatory and specialist training course. What the care home could do better: The general sate of the building continues to be of concern. Although the rebuild is underway the registered provider must ensure that the home is maintained to an adequate standard in the intervening period.Also the registered provider should consider the effects of any future admissions to the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Shirebrook Manor Nursing Home Central Drive Shirebrook Nottinghamshire NG20 8BA     The quality rating for this care home is:   one star adequate 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: Nancy Bradley     Date: 0 8 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Shirebrook Manor Nursing Home Central Drive Shirebrook Nottinghamshire NG20 8BA 01623744414 01623748882 shirebrookmanor@shirebrookcaregroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Shirebrook Nursing Home Limited Name of registered manager (if applicable) Karen Lonsdale Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Shirebrook Manor Nursing Home is registered to provide personal care with nursing, to male and female service users who fall within the following categories:- Learning Disability (LD) 33 The maximum number of persons to be accommodated at Shirebrook Manor Nursing Home at any one time is 33 To accommodate the service user named in variation application V33834 who is over the age of 65 and has a learning disability LD(E) Date of last inspection Brief description of the care home The Care home is situated in the village of Shirebrook, which lies on the Derbyshire and Mansfield boundaries. The home is purpose built for the provision of nursing care to a maximum of 33 service users with a learning disability. The home comprises of two floors with each floor being divided into smaller units, one of which provides care to service users with a challenging nature. The home also provides a small day care Care Homes for Adults (18-65 years) Page 4 of 30 care home 33 Over 65 0 33 Brief description of the care home facility, for the residing service users. The current scale of charges is a basic #900.00 to #1783.79 per week. The information on additional charges was not available. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 the people who use this service experience good quality outcomes. This was an unannounced key inspection and took place over a total of six hours. We spoke with the registered manager, care staff and people living at the home. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. We looked at all the information that we received or asked for, since last key inspection. This included the following: The Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 30 (AQAA) that was sent to us by the home. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the home. Additionally, time was spent in preparation for the visit, looking at the service history and the previous inspection report. Records were examined relating to the people living there and the general running of the home. We sent out Have Your Say questionnaires and we received fourteen completed questionnaires from people living there who confirmed they were very happy at the home and were looked after by the staff and would not wish to live anywhere else. We received eight completed questionnaires from relatives and thirteen from care staff. All were satisfied about the care, and looking forward to seeing the new development. This is the best response we have had to questionnaires. The staff stated the support from homes management was good and the care staff are working well together. What the care home does well: What has improved since the last inspection? What they could do better: The general sate of the building continues to be of concern. Although the rebuild is underway the registered provider must ensure that the home is maintained to an adequate standard in the intervening period. Care Homes for Adults (18-65 years) Page 8 of 30 Also the registered provider should consider the effects of any future admissions to 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 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to ensure that peoples needs are fully assessed prior to admission. This is further enhanced by regular reviews of peoples care needs. Evidence: The care records of two people living at the home were viewed, one of which was the most resent admission to the home. The majority of the people who are admitted to the home have their needs assessed through the care management system, which highlights their additional needs, and the need for additional staffing hours. The home also undertakes its own individual comprehensive needs assessment and which is in accordance with Shirebrook Care Ltd assessment process and the National Minimum Standard 2.3. The assessment then forms part of the care plan compiled by the home. The registered manager undertakes the initial assessment with the head office then compiling the overall care package. The majority of people living at Shirebrook Manor have been there for a long time and the initial assessments provided very little information. The home is developing a system for recording significant events and life history of the people who live at the home. Although this is a big undertaking the Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: registered manger stated she is committed to doing this. All care needs assessments are reviewed by the referring authority. The Adult Social Services contracting departments are regularly reviewing the home and the contracts which they have with Shirebrook Care Group Ltd. The home currently has three vacancies and as discussed at the site visit it may be advisable not to undertake any further admissions until the refurbishment and rebuild of the home is complete. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a care planning and review system in place, which ensures that peoples individual needs are met. Evidence: During the visit care plans of two people who live at the home were seen. The registered manager had compiled the care plan and evidence was seen of care plans being reviewed on a monthly and six monthly basis. All of the people case-tracked had a comprehensive care plan, which was in accordance with their assessed need and formulated within a risk assessment framework. All care plans were very detailed and comprehensive including peoples individual lifestyle preferences and choices; the interventions prescribed by outside health care professionals were appropriate. Daily records are also maintained on each person. The home has moved into person centred planning and people living at the home were getting involved in compiling their care records. The person centred planning runs Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: along side the more formal care planning system in operation. People living at the home were compiling their care plan with help from their key worker. The care records include peoples goals, achievements and aspirations. As discussed with the registered manager person centred planning is an on going process and further development of person centred care is planned. During the visit care staff were observed discussing with people, choices and arrangements for daily living. There was evidence to show that people at the home had been consulted about their care plan. Although the people at the home have server learning disabilities and not always able to communicate their wishes, several of the key workers had taken time and effort to go through the care plan and they had signed to show they understood and agreed. Discussions with one person at the home and from the questionnaires received confirmed they had been made aware of the care plan and knew what was in it. During the tour of the home care staff were observed encouraging service users to make decisions, which affect their daily lives. People living at the home knew who their key worker was and told us how they help them on a daily basis. All service users have access to the Derbyshire Advocacy Service. Risk assessments were in place covering such issues as, peoples health and safety, physical health, nutrition, mobility, tissue viability, and risks associated with social activities. The registered manager has compiled individual fire risk assessments taking account of the refurbishment and rebuild of the home. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were arrangements in place, which enable people to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. Evidence: The care records of two people living at the home provided details of care planning and risk assessments of their social, recreational, educational and occupational activities both within the home and outside in the community. On the day of the visit people living in the home were involved in a number of activities such as playing snooker, basic computer skills, and music therapy. The daily activities are displayed on the home information board in an easy read format. The home has also developed a monthly newsletter and quiz. This is open to people from the home and their visiting relatives. People living at the home stated they like living there and liked the activities Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: on offer. Relatives are also encouraged to join in the activities. Currently the home is without a mini bus and this is preventing several people accessing activities in the community. Transport to outside activities is reliant on care staff using their own cars. The daily routines are flexible with people being able to make their own decisions about how they spend the day. The relationships observed between care staff and people living at the home appeared to be open, friendly and good humoured. The staff encouraged the people living at the home to take pride in their appearance and their individual dress sense is respected. One person spoken with stated that they liked to go out shopping and talked about the shops they go to. Information on peoples records indicated that contact with family and friends were appropriate. Any restrictions on contact are recorded in care plans. People at the home can speak with family and friends by telephone if they wish. The daily menus indicate that the people who live at the home are provided with a healthy well-balanced and nutritious diet. People at the home made positive comments about the meals and said their likes and dislikes are taken in to account. We joined people from the home for lunch. Information in the AQAA and discussions with the registered manager confirmed the home is changing the menu to give more options and variety. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and beliefs. Evidence: From records seen and from discussions with staff, peoples health and personal needs are being met. People living at the home are generally healthy and records showed that staff promptly contacted the appropriate medical services when necessary. People living at the home are registered and attended services within the community including doctor optician, podiatrist, dentist, and audiologist. All of the people at the home have their own My Health Care Passport which they can take with them to any medical appointments they have. The people at the home said they have a choice of a showering or bathing daily. A record is kept of people who are at risk of developing pressure sores and several of the people like to have their weight recorded. People at the home see this as part of maintaining a healthy life style. Most of the people at the home have some contact with learning difficulties service at Ashgreen. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: The home maintains records of all hospital and doctor visits. The home operates and monitors medication administered no one is able to self medicate unsupervised. All staff have received training on medication procedures. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to satisfactory. These included any controlled drugs administered by the home. The home has their medication supplied from the local pharmacy which carries out regular inspections. The registered manager is also carrying out monthly checks on all medication received and administered and her findings are recorded. Any issues arising from the audit are immediately addressed with the staff concerned. As discussed at the site visit the home needs to have any changes to how medication is administered agreed by the doctor, fully recorded and risk assessed. The home had instructions on a care review form that medication for one person could be given covertly. At present the home is caring for some very frail people and as part of meeting their care need the home has stated to compile end of life plans. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place to safeguard peoples welfare and ensure that their concerns are listened to and acted upon. Evidence: People living at the home are made aware of the homes complaints procedure through the service user guide and via their key worker. A copy is displayed on the homes notice board in an easy to read format. Any concerns and complaints made by people living at the home or their relatives are investigated within the agreed time scales. The manager maintains a record of all complaints made by service users, details of the investigation action and outcome. The complaints procedure contains the current contact details of the Care Quality Commission and informs the complainants that they are able to contact the Commission at any stage of the complaints process if they wish to do so. We have not received any formal complaints from people or their relatives about their care since the site visit. Information in the AQAA indicates the home has not received any complaints about its service. Discussions with the registered manager and records seen indicate that there has been several incidents under the safeguarding of adults procedure since the last site visit. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: These have now been concluded. The home has a safeguarding adult protection policy and procedures although the contact details for Social Services are recorded in the Statement of Purpose they are not fully recorded in the policy. This was raised as an issue in a resent Regulation 26 visit made by the Registered Provider. Information from the registered manager indicated several new staff still need to complete safeguarding vulnerable adults training. This training is undertaken in house, as Shirebrook Care Group have an approved trainer. The home policy on physical intervention has been reviewed and they now use the CPI method of intervention. This requires more de-escalation techniques with physical intervention as the last resort information from the registered manager indicated this has been very beneficial with no one having to be restrained. Peoples monies are checked regularly by the registered manager and provider. We viewed these procedures and found them to be satisfactory at the time of this site visit. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is poor for people living at the home, effecting their daily lives and independence. Evidence: We carried out a full tour of the home as a result of previous requirements and were, accompanied by the registered manager. All communal areas were viewed together with staff facilities. Peoples bedrooms were viewed with their agreement and all rooms had been decorated and furnished to their personal choice and were being personalised. The issues relating to the environment and the general condition of the building have been identified in the four previous reports. The refurbishment of the building is currently under way. The registered provider has written to families informing them it will take about eight months. On going repairs have been made to the home however the overall state of the home remains poor. People who live on the Phoenix unit live in an environment of control and containment with little comfort in their surroundings. Some soft furnishings have been purchased, however tables and chairs are secured to the floor and overall offers little or no Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: comfort to the people who live there. The generally the home was free of any unpleasant odours or smells. The registered manager undertakes daily checks to try and maintain a satisfactory hygiene standard. The home has satisfactory hygiene procedures in place. All staff are having refresher training on hygiene procedures. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has robust recruitment and selection procedures in place to ensure that the appropriate staff are employed to care for vulnerable people. Evidence: The home has nine qualified nurses with the remainder of the staff having a NVQ level 2/ 3 or working towards qualification. Several staff are approved trainers for safeguarding adult and physical intervention. The staff working on the Phoenix unit are registered nurses in mental health or learning disability and the care staff work along side them. The registered manager confirmed that the ancillary and kitchen staff are registered to attend a NVQ courses. The home has a robust recruitment procedure in place, which ensures that their staff are suitable to work with vulnerable people. Several staff personnel records were examined which confirmed that thorough employment checks were carried out. All new staff are required to provide two references, a full employment history, have a clear Criminal Records Bureau clearance to an enhanced level and complete a three months probationary period. We noted that applicants were not always providing a full employment history. In most cases they were only providing the year and month. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: The records contained all required information has detailed in Schedule 2 of the National Minimum Standard, Care Homes for Adults 2001. The staff personnel records were well presented and organised. As discussed with the registered manager where notes are taken during staff interviews these should be signed and dated. All staff receive induction training and commence comprehensive foundation training within three months of their appointment. From discussions with the registered manager and from examination of records the home is providing good training and development opportunities. Details of staff training together with training planned were provided by way of the AQAA. The training programme covered Mental Capacity Act, Deprivation of Liberty, fire training and person centred planning. Discussions with the registered manager and records seen confirmed that formal supervision has now been established. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well managed, with staff seeking the views from the people who live there. Evidence: The registered manager has a number of years experience in the care sector, and has a recognised managers award. Examination of her personnel records confirmed she had a contract and relevant job description detailing her role and responsibilities. She commenced her duties at the home eleven months ago and has developed structure and systems which has enhanced the overall management of the home. Completed questionnaires for staff and relatives indicated that they were satisfied with the changes and found the registered manager support. The registered manager has on open door policy and has established a surgery for relatives. The manager stated that a process for monitoring care and services provided has been established and this is in line with the policy operated within Shirebrook Care Ltd. The finding will be made public to people who live at the home, relatives and stakeholders. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Information in the AQAA indicates that the majority of the Shirebrook Care Groups polices and procedures have now been updated. The operations manager undertakes the Regulation 26 visits. The Care Quality Commission now long requires copies of these reports to be sent to us. The AQAA dataset indicated that all the necessary maintenance checks had been undertaken. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Procedures and risk assessments must be in place for managing medication being given covertly. Staff who administer medication must be made aware of these procedures. This is to ensure people receive the medication they are prescribed and to protect against errors in medication administered. 30/06/2009 2 20 13 The home must obtain full agreement and instructions from the appropriate doctor before people are given medication covertly. This is to ensure people are protected by the homes policy and procedures fro dealing with medication. 30/06/2009 3 34 18 All applicants must provide a 30/06/2009 full employment history. Care Homes for Adults (18-65 years) Page 28 of 30 To ensure staff are suitable to work with vulnerable people. 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 Until the homes refurbishment and rebuild is complete the registered provider should consider the occupancy numbers for the home and not admit to full numbers. To continue with the implementation of person centred care planning. All staff to receive training on person centred care planning. The contact details for the local Adult Social Services Department should be should be include in the homes safeguarding policy. The homes application form should show that the days date, month and year are required when providing a full employment history. 2 3 4 6 6 23 5 34 Care Homes for Adults (18-65 years) Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!