Care Home: St Helen`s Down

Similar services:

• Insight - Eastchurch
• Southfields
• Thorndene
• Magenta
• Seabourne House
• 33 St John`s Church Road
• Dovedale Court
• Lyncol House

What the care home does well The home has an up to date Statement of Purpose and Service User Guide. The Service User Guide is produced in written and audio format to enable prospective residents to make an informed choice about moving into the home. Residents are supported by the registered manager and the staff to follow interests and hobbies of their own choosing. Residents are encouraged to participate in meetings, and are able to make choices in regard to annual holidays, meals, outings and how their home is managed. Each resident has a weekly planner outlining their activities for the week, what household tasks they will be involved in as well as days they will attend their day centres and outings they wish to participate in. The residents in the home are supported by both the manager and staff to maintain contact with friends and relatives. Residents are able to invited relatives and friends into the home for a short visit or to spend a day with them in the home, and are also supported in visiting family and friends. Residents are able to follow their own religious choices and are supported in this by the staff. From discussion with a residents and viewing care plans there was good evidence that all the residents personal and health care issues are met. Residents have regular annual health checks, and are supported by staff to visit health care professionals. The receipt, administration, recording, storage and return of medicines is well managed, and staff who administer medication have received appropriate medication training. Residents are given the information they need should they wish to make a complaint and staff are appropriately vetted prior to being employed by the home to help keep residents protected from abuse. Internally St Helens Down provides residents with a comfortable, well maintained and homely environment. Residents are able to make choices in regard to the decoration and furnishing of their bedrooms. Staffing levels in the home at present are sufficient to meet the health and social care needs of the residents. Extra staff are rostered on duty as and when required to meet the residents social care needs. the recruitment system used in the home is robust and all prospective staff are appropriately vetted prior to being employed, which helps to ensure residents are not placed at risk from abuse. Where residents have requested that the registered manager looks after their personal allowances there is good evidence that all residents monies are properly managed and kept safely. Health and safety in the home is good with regular checks being carried out to ensure that all equipment is in good working order. What has improved since the last inspection? The registered manager is fully aware of the need to carry out pre-admission assessments prior to a new resident moving into the home, to ensure that the staff and the building can meet the residents needs and to ensure the compatibility of the prospective resident with the residents already residing in the home. Care plans and risk assessments are detailed and describe the care needs of each individual resident. On the day of the inspection the home was hygienically clean and there was good evidence that procedures are in place to help protect residents from cross infection. The majority of staff in the home have received or updated mandatory training in all health and safety related subjects, to ensure that residents are not placed at risk. Half of the staff have now gained a NVQ qualification and there is evidence that some staff have participated in work related training, to ensure that they have the knowledge to meet the needs of the residents in the home. Since the last key inspection the manager has registered with CQC. The registered manager sent out quality assurance questionnaires to residents in 2009, but needs to further develop the quality assurance system used in the home, to incorporate the views of family, friends and external professionals. Once this quality assurance system has been developed fully an annual summary of the quality of care offered in the home should be published. What the care home could do better: While care plans are detailed they are not user friendly and residents themselves would find it difficult to understand their plan of care. There is evidence that each resident chooses a goal that they wish to achieve and this is clearly documented, with good information for staff as to how they should assist the resident in achieving their goal, but there is no record of how the resident is progressing with the goals they have chosen. It was noted that up until July 2009 a regular monthly review meetings took place between the individual residents and their key workers, a record of these meetings were then put into the care plan, since July the recording of these meetings has stopped. These review meetings should take place to ensure that the care needs of the residents are fully met, and any changes in their health and social care needs recorded. The grounds of the home are not maintained in a condition that is safe for residents to use. Resident do have access to a decked patio area from the communal lounge in the home, but the rest of the large garden is overgrown and uneven, the landscaping of this area, might lead to residents forming new interests and hobbies. Key inspection report Care homes for adults (18-65 years) Name: Address: St Helen`s Down 46 St Helen`s Down Hastings East Sussex TN34 2BQ     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: June Davies     Date: 1 5 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 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 27 Information about the care home Name of care home: Address: St Helen`s Down 46 St Helen`s Down Hastings East Sussex TN34 2BQ 00000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Evesleigh (East Sussex) Ltd Name of registered manager (if applicable) Mr Nicholas Harmer 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 maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home The registered providers of the service are Evesleigh (East Sussex) Ltd. The property is registered to accommodate six people with learning disabilities. St Helens Down is situated in a quiet residential area of Hastings. All resident accommodation is on the ground floor. Three of the six bedrooms on the ground floor have en-suite facilities. Communal areas are generous in terms of space and a large secure decking area has been created in the garden area for use during summer Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 3 0 0 1 2 0 0 9 Brief description of the care home months. A copy of the latest inspection report is on display at the entrance to the home. The fees charged can be obtained on application to the registered manager including the charges that are made over and above the fees. Care Homes for Adults (18-65 years) Page 5 of 27 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 unannounced inspection was carried out on the 15th December 2009 over a period of five hours. During the inspection the inspector spoke with the registered manager, a resident, a member of staff and looked at documentation relevant to the standards assessed. A short audit of medication was carried out. The inspector was also invited to look at a residents bedroom. Observations were made in regard to the garden around the home, health and safety, infection control, and the communal areas of the home. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? The registered manager is fully aware of the need to carry out pre-admission assessments prior to a new resident moving into the home, to ensure that the staff and Care Homes for Adults (18-65 years) Page 7 of 27 the building can meet the residents needs and to ensure the compatibility of the prospective resident with the residents already residing in the home. Care plans and risk assessments are detailed and describe the care needs of each individual resident. On the day of the inspection the home was hygienically clean and there was good evidence that procedures are in place to help protect residents from cross infection. The majority of staff in the home have received or updated mandatory training in all health and safety related subjects, to ensure that residents are not placed at risk. Half of the staff have now gained a NVQ qualification and there is evidence that some staff have participated in work related training, to ensure that they have the knowledge to meet the needs of the residents in the home. Since the last key inspection the manager has registered with CQC. The registered manager sent out quality assurance questionnaires to residents in 2009, but needs to further develop the quality assurance system used in the home, to incorporate the views of family, friends and external professionals. Once this quality assurance system has been developed fully an annual summary of the quality of care offered in the home should be published. What they could do better: 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 8 of 27 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 9 of 27 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. Prospective residents and their families are given sufficient information about the services offered, so that they are able to make an informed choice about moving into the home. Evidence: The statement of purpose and service user guide provides detailed information about the services that are offered by the home and enables prospective residents to make an informed choice about moving into the home. Prospective residents are also offered an audio version of the Service User Guide. At the present time there are 5 residents residing in the home, and the one vacancy is due to be filled early in the new year. A requirement was made at the previous key inspection that prospective residents should be fully assessed prior to moving into the home but there have been no new residents admitted into the home since the last key inspection. The registered manager informed the inspector that in future all prospective residents will be fully assessed prior to moving into the home, and that information will also be obtained from external professionals to ensure that the home Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: and the staff can meet the prospective residents needs. The prospective residents will also be invited to visit the home, to meet with present residents and staff, to ensure compatibility with the present residents. Care Homes for Adults (18-65 years) Page 11 of 27 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. While care plans are detailed and included pre-admission information, there was evidence that they are not always kept up to date, to truly reflect the needs and wishes of the residents. Evidence: The inspector viewed three care plans, and noted that while there was detailed information for each resident, the care plans themselves were not well ordered and are therefore not particularly user friendly. It was also noted that up until July 2009 there were detailed individual monthly meeting reports these have not been continued. Each care plan stated goals that the residents wished to achieve these are clearly written, but there is no written feedback on how the residents were progressing with their chosen goals. There was evidence that residents had been involved with the care planning process, and that likes and dislikes and preferences for activities and interests had been recorded. Each care plan had risk assessments in place and while some risk assessment were found to be generic, there was evidence that risk assessments had been drawn up for individuals in accordance with residents Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: needs and differing activities and interests. Risk assessments give staff information as to how the level of risk can be reduced for the resident. There was evidence that when required an advocate is available for residents should they wish to use this service. Discussion took place with the registered manager who understands that there are shortfalls in the care plans, in regard to continuing to seek resident views in the form of the monthly meetings, keeping information in order and ensuring that care plans can be used as good working tools for care staff. He assured the inspector that these issues would be addressed to ensure that care plans are user friendly and contain up to date information in relation to the residents. Care Homes for Adults (18-65 years) Page 13 of 27 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. Residents are able to participate in education, activities, outings, holidays and hobbies of their choice. Staff help and support residents to maintain contact with relatives and friends. The residents rights to privacy and dignity are observed by staff at all times. Evidence: None of the residents have paid employment but all five attend day centres of their choice during the week. There is evidence that residents are able to choose if they wish to further their learning through courses held in the day centres. Each residents has their own weekly routine chart, that includes day centre attendance, pursuit of activities that interest them, housekeeping tasks and following hobbies of interest to their individual choice. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: At the beginning of the inspection two residents were in the home waiting to attend individual appointments. The inspector noted that staff talked to the residents individually, and collectively and that residents were able to take part in staff conversations. From observation the inspector found that staff respect the resident rights to privacy and dignity, by knocking on doors prior to entering the residents bedroom. From evidence in care plans the inspector found that residents are able to follow their religious beliefs and attend the church of the choice on a regular basis. All the residents have regular access to the local community, either to follow hobbies and interests, to go shopping or visit places of local interest. One resident told the inspector how she likes to go on holiday each year and how the staff support her. She said that all residents have a choice of where they wish to go on holiday. In recent years residents have gone to Great Yarmouth, Butlins at Bognor Regis and Devon on holiday. One resident competes each year for inclusion in the Para Olympics and spends weekends attending training sessions. One resident told the inspector how she was able to maintain long standing friendships, and that she was assisted to do this with help of the staff. This resident also told the inspector that both friends had recently visited her, and how much she had enjoyed the day. There is evidence on daily records that residents are helped and assisted to maintain contact with relatives and friends. Each residents care plan outlines their food likes and dislikes. Residents take part in regular residents meetings where menus are discussed and changed in accordance with residents wishes. Mealtimes are arranged to fit in with each residents daily routines. All residents are given choices at breakfast, what sandwiches they would like to take to day centre for lunch, and usually residents are together in the home for their choice of evening meal. Each residents nutrition levels are monitored on a monthly basis, and recorded in individual care plans. The home is able to cater for specialised diets as and when required. None of the residents at the present time require assistance with eating. Care Homes for Adults (18-65 years) Page 15 of 27 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. The health of residents and their prescribed medication is well managed by the staff in the home. Evidence: From talking to one resident and viewing care plans the inspector found that residents are given assistance when needed to carry out personal hygiene tasks, but are encouraged to maintain the own personal hygiene as much as possible. Care plans showed that residents have access to all external health care specialists as and when required. On the day of the inspection one resident was being escorted by a member of staff to the optician for an eye test. There is also evidence that residents have annual health care checks with their General Practitioners. Medication in the home is well managed, with up to date policies and procedures for the administration of medication. Staff who administer medication have received regular medication training. The supplying pharmacist carries out regular checks on the receipt, administration, storage and return of medication in the home. At the present time there are no controlled drugs prescribed for residents. Eye drops are Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: dated on the bottle on the day of opening. Regular recorded temperatures are taken of the medication fridge and cupboard. Care Homes for Adults (18-65 years) Page 17 of 27 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. Resident have information about how to make complaint in a format that is suitable for them. The residents are protect from abuse by well trained and vetted staff. Evidence: The complaints policy and procedure is up to date and included in the Service User guide which is also produced in audio tape. There have been no complaints to the home since the last inspection. The home does have a complaints book where any complaint made will be logged, along with the investigation and reply to the complainant. On the day of the inspection one resident said that she was able to discuss any issue that was making her unhappy with a member of staff and that it was usually resolved there and then. There is an up to date Safeguarding Vulnerable Adults policy and procedure in the home. There have been no safeguarding referrals since the last key inspection. All but one member of staff has received Safeguarding Vulnerable Adults training. Residents are protected from abuse by stringent recruitment procedures Care Homes for Adults (18-65 years) Page 18 of 27 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. The home provides excellent living accommodation for its residents which is unfortunately spoilt by the rather overgrown and unkempt garden areas. Evidence: St Helens Down provides residents with a safe, homely, well maintained pleasing environment in which to live. Communal rooms are open plan and have access to a patio area at the rear of the property. All bedrooms are decorated and furnished to the residents choice and three bedrooms have en-suite facilities which include wet room showers. The remaining three bedrooms have a communal bathroom. All showers and bathrooms have aids to assist with mobility. The inspector did note that while residents have access to the outdoor patio area which is safe, the remaining garden area around the home is overgrown and unlevel. Last summer the home purchased a garden shed and residents took great delight in painting this shed with a seaside theme. This shows that residents have an interest in their outdoor space and this could be further improved for them with landscaping and the removal of rubbish. On the day of the inspection the home was hygienically clean and there were no offensive odours in the home. The separate laundry room was found to be well Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: ordered with appropriate laundering facilities, which some of the residents are able to use themselves under supervision from staff. All cleaning materials are locked in a COSHH cupboard. Staff are provided with disposable clothing that helps to prevent cross infection. Communal bathrooms/toilets and the laundry room have hand washing facilities and are supplied with liquid soap and paper hand towels. Care Homes for Adults (18-65 years) Page 20 of 27 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 management of staff in the home ensure that there are sufficient staff rostered onto each shift and that staff have the skills and knowledge to meet the residents care and social needs. Staff recruitment within the home is robust ensuring that prospective staff are appropriately vetted prior to being employed in the home therefore helping to protect the residents from abuse. Evidence: Staff rotas showed that sufficient staff are rostered on duty at the present time to meet the care and social needs of the residents. There is always one member of waking night staff on duty between the hours of 9.00 p.m. and 8.00 or 9.00 a.m. One resident present in the home at the time of this inspection said that there was always staff available to meet the residents care and social needs, with extra staff being rostered on duty when required. At least 50 per cent of staff have achieved the NVQ level 2 or above qualification, with some staff having obtained a NVQ in Learning Disabilities. There was evidence through the training matrix and discussion with a member of staff on duty that staff have the opportunity to receive work related training in relation to the care and social needs of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the residents. Through conversation with the member of staff on duty and by looking at two staff personnel files evidence was available to show that staff are appropriately vetted prior to taking up employment in the home which helps to ensure that residents are protected from risk of abuse. The number of staff who have completed and updated their mandatory training is good, and the only shortfalls found were for staff who have been newly recruited and are awaiting acceptance on the relevant training courses. This level of training helps to ensure that residents are not placed at risk. Care Homes for Adults (18-65 years) Page 22 of 27 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 managed by the registered manager is is well liked by the staff and residents. The quality assurance system in the home needs further development. Health and safety within the home plays an important role ensuring the residents live and staff work in a safe and risk free environment. Evidence: New manager has now been registered with CQC and has completed his NVQ in Social Care and is in the process of working towards his management award. He has experience at senior level in another home owned by Evesleigh Limited, the same company that owns St Helens Down. The registered manager ensures that he works hands on alongside the staff and also escorts residents to appointments or outings into the community. The registered manager also ensures that there is a good handover between shift with a handover Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: sheet being completed. Regulation 26 visits take place and it is evident that monitoring of documentation and observations take place to ensure that the home is meeting the National Minimum Standards. It was recognised within the latest Regulation 26 report that further work needs to be done to improve the care planning process within the home, and to ensure that all aspects of the residents needs are recorded, and in a format that is appropriate to the residents level of understanding. The manager was also able to show the inspector evidence of quality monitoring of the service from residents questionnaires, but further work needs to be done, to seek the views of the service from relatives, friends, and all professionals who have contact with the residents. There was evidence that Health and Safety and Fire Risk Assessments take place on a regular basis, but this obviously does not include the external area of the home. There was no evidence that a summary of the quality assurance questionnaires and quality monitoring is produced annually which is made available to residents and other interested parties. Through discussion with the registered manager, he is now aware of how to proceed with producing a complete overview of the quality of care in the home, and has stated that he will work towards getting this completed in 2010. All residents have requested that the home looks after the personal allowances. The registered manager has ensured that each resident has their own finance sheet, and money pouch with numbered tag. At the end of each shift the personal allowances are checked to ensure they are in order. At the present time the registered manager has dealing with four residents cheque books, but any monies put into the account or taken out of the account requires a double signature and these are audited during Regulation 26 visits. There is recorded evidence to show that the security of the premises, maintenance issues, hot water delivery, fire point checks, car, first aid boxes, fridge freezer temperatures, medication fridge, magnetic door closures, self closing fire doors are all checks either on a daily or weekly basis. Incidences of accidents or falls are all recorded in the Accident book and acted upon appropriately. The registered manager stated that any resident who falls on a regular basis would be referred to their General Practitioner for further action. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 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 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!