Care Home: St Christopher`s House

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What the care home does well The service is very good at supporting people with mental health issues, addressing those issues and helping people develop independent skills. The service has been successful in helping people to move on into more independent living. A number of the residents have Mental Health Act restrictions and the home has been good at working with other mental health professionals to support and care for residents. There are good relations between the home and external agencies. The service has set out it`s aims clearly and is good at following these through. There is consistency amongst the staff team in working with residents and encouraging them to follow agreed care plans. A pleasant, relaxed and friendly atmosphere has been created at the home. Residents value the service. One resident said, "I love it here. I never want to leave." Another said that, "since I`ve been here I`ve been able to change and get on with my life". Others referred to staff as being, "very helpful". There is good all round organisation and management of the service. For example, attention has been given to providing staff with training and there are good examples of work having been carried out to assist residents take up work and training opportunities. What has improved since the last inspection? There have been many improvements to the physical standards as well as an increase in the resources available for residents. The home has been decorated and new furniture provided. New beds have been provided for residents. A new wall mounted TV has been installed which receives satellite TV programmes. There has been progress with meeting previous requirements such as staff recruitment and training. The good standards evident at the last inspection have been sustained and this inspection has seen an improvement in the areas of healthcare support and staffing. What the care home could do better: Improving the recording of risk assessments is a key area. There is a need to demonstrate that risk assessments are regularly reviewed and updated and complete for all residents. Adding more equality and diversity information to care plans will also demonstrate the work that the service is doing in this area. There is a need to make sure that staff are monitored when they administer and record medication. This is an important area with a gap found at this inspection as well as gaps noted in the home`s records. The medication cabinet also needs a reorganisation and tidy up. Staff supervision needs to be provided more frequently. Staff were receiving supervision but over recent months the frequency had dropped. The recruitment of additional staff will provide a larger staff team and therefore more flexibility for staff cover arrangements. Weekend cover is quite light at the moment and needs to bereviewed to make sure any identified risks are addressed. The safeguarding procedure needs additional detail about the arrangements for reporting incidents or allegations of abuse to the local authority. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: St Christopher`s House 6 Mays Lane Barnet Hertfordshire EN5 2EE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Duncan Paterson     Date: 1 5 0 5 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 29 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 29 Information about the care home Name of care home: Address: St Christopher`s House 6 Mays Lane Barnet Hertfordshire EN5 2EE 02083648085 F/P02083648085 platinumltd@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Platinum Health Resources Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 6 6 St Christophers House is a care home registered to provide personal care for a maximum of six adults who may have either a mental disorder or learning disabilities. The home was opened in June 2005. It is owned by Platinum Health Resources Limited, a private company based in London. This is the only home owned by the company. The aim of the home is to provide individualised care by working in partnership with people and other relevant agencies and to encourage residents to lead as independent a life as possible and attain their full potential. The home is an end of terrace two-storey house with a loft conversion. There are a total of six single bedrooms, a large lounge on the ground floor and a smaller one on the first floor. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home On the ground floor there is one bedroom, a kitchen/diner, a lounge, a bathroom with a toilet, a small toilet and an office. The first floor has a bathroom and three bedrooms. The attic is converted into a further two bedrooms. There is a small parking area at the front of the house and a garden at the back. The home is set in a residential area and overlooks a primary school. It is within walking distance of the shops and amenities of Barnet and close to High Barnet tube station. The fees range from £850.00 - £950.00 per week. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place on 15 May 2009. The inspection involved a whole day of speaking with the owner, staff and residents as well as checking records. A range of the homes policies and procedures, staffing records and care plans were inspected. A tour of the premises also took place. A standard form, the Annual Quality Assurance Assessment (AQAA), was returned to us and this was taken into consideration. Unfortunately, the homes registered manager was on leave on the day of the inspection. The owner took the lead for the inspection in the managers absence. A brief telephone conversation was held with the manager after the inspection visit. Care Homes for Adults (18-65 years) Page 6 of 29 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: Improving the recording of risk assessments is a key area. There is a need to demonstrate that risk assessments are regularly reviewed and updated and complete for all residents. Adding more equality and diversity information to care plans will also demonstrate the work that the service is doing in this area. There is a need to make sure that staff are monitored when they administer and record medication. This is an important area with a gap found at this inspection as well as gaps noted in the homes records. The medication cabinet also needs a reorganisation and tidy up. Staff supervision needs to be provided more frequently. Staff were receiving supervision but over recent months the frequency had dropped. The recruitment of additional staff will provide a larger staff team and therefore more flexibility for staff cover arrangements. Weekend cover is quite light at the moment and needs to be Care Homes for Adults (18-65 years) Page 8 of 29 reviewed to make sure any identified risks are addressed. The safeguarding procedure needs additional detail about the arrangements for reporting incidents or allegations of abuse to the local authority. 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 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is clear printed information available about the service and what is provided. The small size of the home allows information to be communicated in person to residents. The owner, manager and staff are clear about the aims of the service and their arrangements for meeting residents needs. Evidence: There is a detailed statement of purpose which was last updated in June 2008. This provides clear information about the service and what it aims to do. This is a small service, providing care to six residents. The owner is involved on a day-to-day basis and there are good relations between staff and residents. The owner and staff were able to describe clearly the aims of the service and how they were assisting residents. And residents were able to describe how staff were assisting them. The service also has six flats in the community providing a Supporting People service. Some residents have moved to these flats and many of the current residents have the ambition to move on to this type of independent living. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: The owner described the aims of the service which included giving people independent skills, supporting people to have insight into their mental health issues and helping people lead full lives. The majority of residents were spoken with during the inspection. They confirmed that these aims were in progress. Residents confirmed that they received help with developing independent skills. One resident, who was attending college three days a week, was very appreciative of the help provided. They have really helped me, he said. A number of the residents are subject to Mental Health Act restrictions which requires careful oversight and liaison with health professionals. A visiting Community Psychiatric Nurse was spoken with. He confirmed that he visited every two weeks and felt the manager and staff were good and that communication was effective. He thought the service had reacted quickly to review the needs of a resident when needed. A sample of residents case files were inspected. These provided evidence that residents needs had been assessed before they moved in. There was detailed information on file from the referring agency. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed and provide clear actions for staff to follow to assist residents. They are based on information about residents needs and choices. Some development work is needed to make sure risk assessments are reviewed and updated regularly and more recorded detail about equality and diversity matters will assist with person centred planning. Evidence: A sample of three residents care plans were inspected. Overall, there are good care plans in place which provide a great deal of relevant information about each resident. These are well ordered with information accessible. Staff were clear about what they were providing for each resident and residents confirmed that the plans in place were happening. For example, assistance with medication or with the facilitation of work experience and attendance at college. Residents were happy that their interests were acknowledged and encouraged. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: From the review of care plans three areas were identified that will need to be addressed by the service. The linking between risk assessments and other sections of care plans needs to be clearer. There were risk assessments on residents files but they had not been marked as having been reviewed and updated since they were first drawn up. For example, one was dated 26 September 2007. There is some cross reference to other parts of the care plans but it will be useful if risk assessments clearly show that they have been reviewed at regular intervals. A risk assessment for a newly admitted resident had only been partially completed. The owner said that they were waiting for more information from the referring social worker. In addition, there was relevant information about risk on file which had been supplied by the referring agency. However, there should have been a complete risk assessment in place even if more details were to be added afterwards. None of the care plans had photographs of residents. These must be included now to comply with The Care Homes Regulations 2001. There is also a need to record more detail about the equality and diversity work completed at this service. This was discussed with the owner, staff and residents. It was clear that staff are knowledgeable about residents race, culture and religion and have provided the service taking this into consideration. However, more could be recorded on care plans about residents choices and how issues of equality and diversity have been responded to. Residents are involved in the day-to-day running of the home. Staff were observed to work closely with residents. For example, sharing meals and spending time together in the lounge. There are regular meetings as well as regular keyworker sessions. The small size of the home means that staff get to know residents well. There was a harmonious feel to the home with staff and residents getting on well with each other and welcoming of the inspection process. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are very good standards reached in this area. Residents are encouraged to take up employment and training opportunities as well as lead active and healthy lives and retain contact with friends and family. There are well thought out plans to boost residents domestic and cooking skills. Evidence: This area is one of the strengths of the service. There are plans, programmes and resources in place to assist residents to develop. There is clarity about what the service is trying to do. The owner, for example, explained that there are links with employers, such as the British Heart Foundation, where some residents go to work. Others go to college and are currently following intensive skill learning courses. The organisation also has six flats in the community where people have moved on to. Dayto-day programmes are in place at the home to assist residents develop their Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: independence skills. For example, in developing their cooking skills. Each residents takes it in turn to prepare the evening meal. And one resident cooks all his meals himself. There are good links with the community and with families. During the inspection a number of residents spoke about relatives and how they saw relatives often. They were being encouraged to maintain links with relatives. Others spoke about activities and interests they had and how they maintained these. For example, one residents spoke about going to the gym regularly and another about trips out with friends and holiday plans. The serving of lunch and the evening meal was observed. Lunch was a light meal. Not many of the residents were in for lunch. The evening meal is the main meal of the day and residents take it in turns to cook. Residents all ate together in the dining room with staff joining them. There was a pleasant and friendly atmosphere with residents helping each other out and discussing who the best cook was. The menus reflect residents choices and are varied and healthy. There was fresh fruit available. 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. Residents benefit from the home having effective links with health care professionals and other agencies. Staff can, as a result, plan carefully how to meet residents personal and health care needs. Greater oversight is needed of the medication system. Evidence: The main needs of residents in this home spring from the need to encourage them to address their mental health needs and develop independent ways of working. The staff have an important role in making sure that medication is taken regularly, that residents are assisted to take up health care appointments and make decisions about their day-to-day lives. There are good arrangements in place to meet all these areas. The visiting CPN confirmed that the service works well to meet residents needs and is good at communicating with him. A sample of health care records were seen. Overall, the records were clear and well structured. However, there was a need to update the records as the records for 2009 were not always complete. In addition, the fact that one resident, who had been refusing some dental treatment, was not recorded. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Medication arrangements were inspected. Overall, the arrangements made are sound. However, some improvements are needed in the following areas. The medication cupboard needs a clear out and to be made more orderly. One persons medication was placed in a plastic bag which also contained a loose tablet. Other medication in the cupboard needed to be returned to the pharmacy. There was a gap in the medication administration records and the staff communication book also referred to gaps in medication recording. It is important to follow up on these matters and a route is for there to be regularly monitoring of medication administration and recording by the manager. A requirement is given to do this. 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. There are varied opportunities for residents to raise concerns and complaints including the formal complaints procedure. The safeguarding arrangements are generally good but will be improved with a review of the homes safeguarding procedure. Evidence: The complaints records were inspected. There had been two complaints in the last 18 months. These provided details of the complaint as appropriate and the actions taken as a result. The safeguarding arrangements need some development to make sure there is clarity about the arrangements for reporting matters to the local authority. The safeguarding policy and procedure needs a review and updating so that the reporting arrangements are clearly set out for staff to follow. A recent referral to Barnet Council had been made in respect of a report of lost money from one of the residents. Some of the new staff at the home need safeguarding training and this has been arranged. The owner provided evidence that this training had been booked. 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. An attractive, welcoming, well equipped home is provided for residents. Evidence: The home is located in an extended end of terrace house. The owner said there had been a range of improvements since the last inspection. These included the redecoration of the home, installation of new carpets and sofas, an enlarged office, more computer equipment and a re-organisation of the smoking room arrangements. Satellite TV has also been made available for residents. A tour of the premises took place. The physical standards are good. The home is comfortably furnished and decorated with a range of communal space available for residents. The lounge is particularly comfortable with new sofas and a new wall mounted large screen television. This is a welcoming and inviting room for residents to spend their leisure time. The kitchen is also pleasant with space for all the residents to sit and have meal. This is what they were doing for their evening meal. The garden is also pleasant with an attractive outdoor space available for residents. None of the residents bedrooms were visited as none of the residents were happy to show off their bedrooms. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: None of the residents have difficulties with mobility and there are no specific adaptations at the home. Some minor cleaning work such as the windows, could be completed so that the appearance of the home is maintained to a good standard. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some very good, motivated staff. Overall arrangements for staff recruitment, training and supervision are sound and will be strengthen by the recruitment of a larger pool of staff and provision of more regular staff supervision. Evidence: The main issue facing the service at the moment is that of the need to recruit more staff. The owner reported that he had been working on this and that new staff have been appointed but they are waiting for Criminal Record Bureau (CRB) checks to be received. There is a need to increase the pool of staff available at the home. This will make the spread of staff shifts easier to manage. The home is small and the owner plays a part in providing care as well as out of hours cover. The staffing rota was inspected. Generally, there is one member of staff on duty during the day. This worker is supported by the owner and manager who are generally on duty during weekdays. However, at weekends the home is staffed by one member of staff working alone, although out-of-hours support is provided by the management team. Staff said that at weekends some of the residents go away to visit families but nonetheless having a staff member working alone may be a risk factor. The owner felt that increasing the pool of staff would go some way to addressing this issue. It is Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: recommended that weekend staff cover be reviewed so that any risk issues identified are addressed. The returned AQAA sated that of the five permanent staff two have completed NVQ qualifications. This was confirmed through discussions with staff during the inspection. Staff training and supervision was discussed with staff. Records were then inspected. Staff confirmed that they had received a range of relevant training. The owner was able to describe the training that had been arranged for staff such as the forthcoming safeguarding training. Where training is needed, such as medication, this is generally for new staff and will need to be arranged. A sample of staff files were examined in order to check recruitment. This had been carried out properly and there was evidence to confirm this. However, there is a need to make sure that evidence about peoples right to work in the UK is obtained. Staff supervision needs to be carried out more frequently. Staff confirmed that they had supervision but the records showed that there had been long gaps between supervision sessions. Six sessions a year is the recommended frequency. 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 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 well run and managed. The owner and manager work well together and have created a smoothly run, efficient service that strives to meet residents needs as well as develop their skills. Evidence: The registered manager is an experienced manager who has managed the home for a number of years. The owner said that he and the manager had worked together in a mental health setting in the past and as a result had a good and successful working relationship. The manager was spoken with in 2008 when the Annual Service Review was carried out as well as after the inspection. Together, the manager and owner have been able to create a service with a clear ethos and aims which are communicated clearly to staff and residents. Quality assurance initiatives were discussed with the owner. He said that a new formal quality assurance scheme was to be introduced. However, in the meantime there were a number of initiatives including surveys, meetings and regular reports from the Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: manager. This is a tightly knit service where the owner is in day-to-day contact and there are opportunities each day for monitoring and assessment of the service. A sample of policies and procures were inspected. Regular reviews of these are carried out and this provides opportunities to update and amend them. The owner reported that the service does not have involvement with residents money. Safe deposit boxes are provided in residents bedrooms and residents are encouraged to keep money and valuables in these boxes. A range of fire checks and certificates were seen. These provided evidence that the fire system was being regularly maintained and that checks such as fire drills were being carried out. Records of servicing and certificates for the homes systems such as gas and electricity were also seen. 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 6 17 There must be a photograph 01/07/2009 of each resident on their care plan. This will provide staff with full information about each resident and will assist with occasions when residents may enter hospital and with required notifications. 2 9 13 Each resident must have a regularly reviewed and updated risk assessment. This will enable staff to have uptodate information about risks associated with residents. 01/08/2009 3 20 13 Regular monitoring of medication administration and recording must be carried out by the manager. This will provide a useful means of checking that residents are receiving medication as prescribed and that any problems with 01/07/2009 Care Homes for Adults (18-65 years) Page 27 of 29 administration and recording are identified quickly. 4 23 13 The safeguarding policy 01/08/2009 must be updated so that the procedures for reporting incidents and allegations of abuse are clear. This will provide staff with clear details of the actions required when responding to incidents or allegations of abuse. 5 36 18 Staff must be provided with regular staff supervision sessions. These sessions must be recorded. Carrying out regular staff supervision will provide opportunities to offer staff development opportunities as well as provide opportunities for the manager to address practice matters. 01/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 More recorded detail should be provided on residents care plans about equality and diversity matters and how the service will address these. The weekend staff cover arrangements should be reviewed with additional staff provided as indicated. The recruitment arrangements should include assessment of staffs right to work in the UK. 2 3 33 34 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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