Care Home: St Domingo House

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What the care home does well People who live at the home told us good things about their support. They told us that they are making choices about what they do through the day, that staff are good and listen to what they say, and that they are going out and using the community. Each person who lives at the home has a care plan. These have information in which tells the staff what they need to do to support the person. People meet with staff on a regular basis to talk about their care plan and their support. People are supported to use their skills and to learn new skills. People are supported to shop, and to prepare their meals on a daily basis, to do household tasks and to manage their own money and mediaction where this is appropaite. Staff support people to look into attending vocational courses to develop their skills. People are supported to have an active social life and to go out for a meal, go to the pub, go to the gym, dance classes, go shopping, and follow other interests they have. Staff support people living at the home to visit their doctor, dentist, nurse, optician and other important appointments on a regular basis. Other professionals are linked to the home to support the people living there. Other professional people visit the home to provide support to the people who live there. The home is comfortable and clean. Each person has their own bedroom and these include their own belongings. Staff support the aims of the home in terms of promoting independence, enabling people to take risks and make choices and listening to the people who live there. People gave us good feedback about the staff team. What has improved since the last inspection? St Domingos is a newly registered service and this was the first key inspection of the home. As a result we are not able to comment on improvements on this occasion. What the care home could do better: St Domingos is a newly registered service and a number of systems and practices need to be developed further. These include systems and practices for assessing people`s needs, care planning for health related needs and quality assurance. When a new person is referred to the home for a service the manager should get a copy of their assessment of needs from the relevant professional. This is to make sure that the manager of the home is fully aware of the needs of the person before deciding if they can offer them a place. Care plans need more information on how to support the person with their physical health care needs and records relating to health need to be kept up to date.How the home checks on medication should be improved. The manager should look at what training staff have had and plan for what training they need for the future. The way in which the quality of the service is checked needs to be improved. The home does not have a manager who is registered with the Commission. Therefore an application for manager needs to be made to the Commission as soon as possible. Key inspection report Care homes for adults (18-65 years) Name: Address: St Domingo House 31 St. Domingo Grove Liverpool Merseyside L5 6RP     The quality rating for this care home is:   two star good 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: Debbie Corcoran     Date: 2 0 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 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 30 Information about the care home Name of care home: Address: St Domingo House 31 St. Domingo Grove Liverpool Merseyside L5 6RP 01512601984 01512930295 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Gracefield Health Care Limited (GHC) Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 disabilties - code LD The maximum number of service users who can be accommodated is: 6. Date of last inspection Brief description of the care home St Domingos is registered to provide care and support for up to six adults with a learning disability. The home is located in Anfield, Liverpool. The home is close to local shops and other amenities such as churches, parks and GP surgeries. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home Bus services run from close by to other parts of the city including the city centre. The current fees for residing at St Domingos start from £2,092 per week and will vary beyond this depending on the individaul needs of the person. 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: 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The visit to the home was not announced beforehand. We were accompanied on the inspection by an expert by experience. This is a person who has experience and or knowledge about using services. The expert spent time talking with the people living at the home and finding out their views on the service. We also talked to staff including the manager and one member of care staff. We looked at records such as care plans, medication records, staff files, staff training records and health and safety records. These help to show us how people are being supported and whether staff have the skills and training needed to do their job. Care Homes for Adults (18-65 years) Page 6 of 30 We sent surveys to people living at the home and to members of staff and we have used some of the things they told us in these to decide how the home is doing. We had a look around the home. We looked at the lounge, kitchen and some of the bedrooms. The manager returned a self assessment of the service to us before we visited. This is a way in which the manager tells us what they do well, where they have improved and where they can improve in the future. We have used some of the information in this to help us decide how the home is doing. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: St Domingos is a newly registered service and a number of systems and practices need to be developed further. These include systems and practices for assessing peoples needs, care planning for health related needs and quality assurance. When a new person is referred to the home for a service the manager should get a copy of their assessment of needs from the relevant professional. This is to make sure that the manager of the home is fully aware of the needs of the person before deciding if they can offer them a place. Care plans need more information on how to support the person with their physical health care needs and records relating to health need to be kept up to date. Care Homes for Adults (18-65 years) Page 8 of 30 How the home checks on medication should be improved. The manager should look at what training staff have had and plan for what training they need for the future. The way in which the quality of the service is checked needs to be improved. The home does not have a manager who is registered with the Commission. Therefore an application for manager needs to be made to the Commission as soon as possible. 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 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New people are admitted to the home without an appropriatley detailed assessment of needs having been attained or carried out and this may result in staff not being fully aware of the needs of the person. Evidence: We looked at the statement of purpose and service user guide for the service. These are documents which provide information on the services and facilities provided at St Domingos. We found the service user guide included the use of pictures and was written in plain language. We were told that a copy of this is given to all service users. The statement of purpose needs to be updated to reflect the change to manager of the home. We looked at how new people are admitted to the home and we found that some information about the person had been attained. However we could not see any evidence that the referring agency, for example Social Services, are asked to provide assessment information when a new person is referred to the home. It is important to attain this assessment information as it may contain significant information which may Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: otherwise be unknown to staff at the home. We could see that the home has a proforma for carrying out an assessment of needs with people using the service. However, this should be developed to ensure that a comprehensive assessment of needs is carried out and should be implemented as part of the procedures for admitting a new person into the home, particularly in the absence of an assessment from the referring agency. We were told that prospective service user are invited to visit the home and spend time there before deciding whether or not to move in and this was on a planned basis and recorded in a transition plan. The frequency and duration of visits is based on the individual needs of the person concerned. Each of the people living at the home has a statement of terms and conditions of their residency. These are signed by the person or their representative where appropriate. 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. Each of the people using the service has a support plan which provides staff with guidance on what the persons needs are and how these should be met. Evidence: Each of the people living at the home has a care plan / support plan. We looked at the care plans for both of the people living at the home. Care plans included information on how to meet the needs of the person in areas such as their needs with personal care, maintaining a healthy balance diet, activities, time away from the home, managing finances, managing medication, safety, relationships. The care plans we looked at had been signed by the person concerned. We also saw guidelines which included information on how to support people with specific issues such as their daily routine or supporting people with their behaviour. People living at the home have the opportunity to attend regular meetings with their key worker and core staff team. These provide a more formal basis for people to Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: comment on their support and their care / support plan. Risk assessments are carried out where a person living at the home is thought to be at risk of harm. The risk assessments looked at provided a good level of information about how to keep people safe. We found that people are supported to take risks as part of living a more independent lifestyle. During discussions with people who live at the home they were positive about their support and appeared confident that staff were meeting their needs and providing good care and support. People said that they are making their own decisions as to their daily support and their routines within the home and they confirmed that staff support them to use and develop their independent living skills. We noted examples of people being supported to manage their money, people choosing their own meals every mealtime and being supported by staff to prepare and cook these, people choosing to use local community resources independently, attending residents meetings and being actively involved in the recruitment and selection of new staff. 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. People living at the home are supported to develop their independent living skills, to be supported in a range of activities and to be involved in their local community. People choose their meals and are supported to use and develop their skills as appropriate. Evidence: During discussions with people living at the home they gave good feedback on their support with pursuing interests and activities. They reported going out and using community resources independently and with support from staff. Records and discussions indicated that people are being supported in activities such as going to the gym, swimming, sauna, local shops and market, cookery, going out on own, attending a dance class, keep fit, cinema, attending courses, going to the city centre, disco, football, craft and days out. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: We also noted that people are supported to take part in further educational courses. People living at the home are encouraged to make choices about the home and their care. People have the opportunity to attend meetings with staff on a regular basis. During discussions with one of the people living at the home they confirmed that they are making choices as to their daily routine and how to spend their day and people are supported to manage their own affairs when possible, for example one person manages their own money. People living at the home are encouraged and supported to prepare and cook their own meals. Each person chooses their own meal a member of staff supports the person in preparing and cooking this. The manager told us in the self assessment of the service (AQAA) what the home does well in relation to these standards Service users are encouraged to maintain their independence. This ranges from supporting service users to do their own laundry when it suits the service user and not when it suits the running of the home, and on a day and time when it is convenient to the service user. Service users are encouraged to plan their own menus, undertake activities which they like, find suitable jobs (paid or unpaid) in the community and attend training and vocational programs wherever possible. We support and enable service users to integrate into local community life, eg library, music and movement, dance class, cinema, post office, using the bus / train, taxi, attend college. Local shops / markets, use local barbers and hairdressing salon. 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 are well supported with their personal, emotional and physical healthcare needs. Evidence: Care plans describe the personal care needs of the people living at the home. During discussions with a member of staff we asked them how they ensure the privacy and dignity of people is maintained and the member of staff gave appropriate answers to this. Care plans make reference to specific aspects of health but they did not include a sufficient level of information to direct staff appropriately and demonstrate all of the things which are needed to maintain the persons health. The details of this were discussed with the manager at the time of the inspection visit. People living at the home are well supported to remain healthy and to attend health related appointments. For example they are supported to see a GP, dentist, etc on a regular basis. People are also supported to see other health professionals as appropriate to their needs. We did note that some of this information hadnt been Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: recorded clearly and this was discussed with the manager at the time of the inspection visit. We were told that mental professionals are linked to the home and will provide support to people if this is appropriate to the needs of the person and we did see some evidence of this in records. The provider has told us in the self assessment of the service (AQAA) that The Psychiatrist plans to act as a link with the community GP to review service users mental health and wellbeing and medication. The Psychologist provides assessment and counseling to service users and provides psychologically based intervention training for support workers to ensure consistency of care and intervention across the whole staff team. We looked at how medication is being managed. As part of this we looked at a sample of medication administration records and medication in stock. This showed that medication is recorded and administered appropriately on the whole. We did however note a small number of practices which need to be improved and these could be resolved by extending the auditing of medication. The details of these were discussed with the manager at the time of the inspection visit. Medication is administered by members of staff who have been provided with training in administering medication. People living at the home are supported to take their own medication when possible and in line with care planning risk assessment. 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. Policies, procedures and practices are in place for dealing with complaints and for aiming to protect service users against abuse or neglect. Evidence: The home has a complaints policy and procedure which is time scaled appropriately and includes contact details for the Commission. Information on how to make a complaint is provided to people in the service user guide. We were told that there have been no complaints made directly to the home since it has been registered. We therefore could not assess how complaints are dealt with on this occasion. An adult protection policy and procedure was in place. This outlines responsibilities for responding to an allegation of abuse and any subsequent investigations. Staff are provided with adult protection training in their induction. During discussions with the manager and a member of staff they were able to explain what they would do in the event of witnessing an abusive situation and the manager knows the protocols for reporting allegations. There have been no safeguarding concerns raised to date. Staff recruitment procedures include a check against the Protection of Vulnerable Adults register and attaining a criminal records bureau check for new members off staff. Accidents and incidents are appropriately recorded. A sample of accident records were Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: looked at and these showed no particular areas of concern. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a clean and comfortable home environment which is presented to a suitable standard. Evidence: St Domingos is situated in a residential area of Liverpool. The home is situated with good links to local shops, public transport and the city centre. A tour of the home was carried out and this included all communal areas and a sample of bedrooms. Accommodation is provided over 4 floors. The furnishings and fittings across the home are modern and of a good standard and the house was refurbished prior to the service opening. However, the house lacks a homely feeling as there are no carpets, no pictures or other pieces of furniture except for large items of furniture in communal areas. This was picked up by the expert who accompanied us on the inspection who thought that the house was nice but felt like it was waiting for more people to move in. Bedrooms for people living at the home had been furnished and presented to a good standard. Every bedroom had en suite facilities. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The home was presented as appropriately maintained and clean. We saw that health and safety practices are adopted and health and safety related checks are carried out on a regular basis. 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. People who live at the home are supported by staff who are appropriately recruited, trained and well supported. Evidence: There is a manager and or senior staff on duty at all times throughout the day. Staff roles and lines of accountability are clear. This means that staff know their responsibilities and know when to refer to a senior person for advice or support. Discussions with people living at the home and staff indicated that staff are supporting the aims and objectives of the home in encouraging people to make choices, develop their independent living skills, and use their local community. At the time of the visit there were two people living at the home and two staff working. This means that people have the opportunity for a good level of one to one support. We looked at staff rosters to assess usual staffing levels and found these to be as found on the day of the visit. We looked at a sample of staff files to assess recruitment and selection practices and ensure these were in line with protecting people. These showed that relevant pre employment checks, for example, attaining references and criminal records Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: disclosures had been made prior to starting new members of staff. These practices aim to safeguard people living at the home. We looked at a sample of training records. These showed us that staff have been provided with training in topics such as health and safety, first aid, protection of vulnerable adults, food hygiene, fire safety, moving and handling, infection control, mental health awareness, administration of medication. Staff also sign for receipt of a health and safety handbook and staff handbook and also sign as being aware of key policies and procedures. We advise that the manager carries out a review of staff training and develops a training plan so as to ensure all members of the staff team have appropriate training to meet the specific needs of the people using the service. The manager reported that six out eight of the care staff have attained a relevant National Vocational Qualification (N.V.Q) in Health and Social Care. This exceeds the target for 50 of care staff to be qualified. The manager reported the use of an Induction workbook which new staff are required to work through and this has been matched to the required induction standards. Core training is provided as part of the induction process. The induction process has yet to be fully implemented for all new staff and this is an area of work which the manager told us that she was working on. 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. People live in a home which is managed and run in their best interests. Peoples health and welfare is safeguarded by appropriate procedures and practices. Evidence: The home did have a manager who was registered as such with the Commission. However, this person has recently left their employment. At the time of the inspection visit the home was being managed by a former senior member of staff. The registered provider must ensure an application for registration of a manager is made to the Commission. The current manager presents as committed to providing a good quality service. We found that there were some systems in place for checking on the quality of the service provided for example attaining feedback from people living at the home and regular visits from the registered provider but there was no evidence of a quality assurance system being used at the time of the inspection visit. Since the inspection the manager of the service has forwarded a copy of a quality assurance check which they intend to implement. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: The process for supporting people with managing their personal monies was looked at. This was presented as a straight forward and accountable process as the people using the service currently manager their own finances and staff only hold small amounts of money and valuables for people living at the home and these are signed in and out accordingly. Staff records showed us that staff are provided with regular supervision meetings. Staff team meetings also take place. Both of these forums give staff the opportunity to review their practice, share good practice, develop their skills and knowledge, develop as workers, contribute to decision making and shaping the service and to share important information on the needs of the people they support and on the service in general. The home has policies and procedures in relation to health and safety and staff are provided with training in core health and safety related skills. A sample of records of fire and health and safety checks were looked at and found to be up to date. The home has a tool for risk assessing for health and safety issues and for the development of a management plan but this hasnt been implemented to date. We recommend that this is implemented. 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 2 14 The registered person shall 09/03/2010 not provide accomodation to a service user without the needs of the service user having been assessed by a suitably qualified or suitably trained person. To ensure that accurate and sufficient information on the needs of the person has been attained and to determine whether or not the persons needs can be met effectively. 2 20 13 Medication practices must include an appropriately detailed audit of medication and practices. This is to safeguard the health and wellbeing of the people living at the home. 09/03/2010 3 39 35 A quality assurance sysytem 09/04/2010 must be implemented. Care Homes for Adults (18-65 years) Page 28 of 30 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 To check on the quality of the service provided and identify areas for improvement. 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 Care plans should include a greater level of detail as to the health care needs of the people living at the home. This is to ensure that the persons needs have been identified and planning is in place to meet their needs. People living at the home should be consulted with on how to make the home more homely. A staff training analysis and training plan should be carried out with regards to the training needs of the staff team and to include more specialised training in line with the needs of the service users. The process for the induction of new staff should be fully implemented to ensure it can be demonstrated that staff have completed their induction. A safe working practice risk assessment should be carried out and management plan put in place to control identified risks. 2 3 24 35 4 35 5 42 Care Homes for Adults (18-65 years) Page 29 of 30 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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