Care Home: Summerview

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What the care home does well There had been no new admissions to the home since the last inspection. Each person had a care plan which described what they like, dislike and how staff are to support and care for them. Residents are involved in making decisions about how they live their lives and how the home is run. They attend regular meetings to make decisions about the things that are important to them such as menus, meals, activities and holidays. Each resident has a health action plan and information about their health care needs is recorded. Staff ensure that people living in the home receive the medicines they need, attend routine appointments for health checks and that they see the doctor if they are unwell. Residents general health and wellbeing is monitored and they are encouraged to eat healthily and to participate in exercise as part of a healthy lifestyle. People living in the home can go out to local clubs, day centres, pubs, restaurants and places of interests. They have regular holidays away from the home and spend time with family, friends and other people who are important to them. Staff are trained to understand and support residents and to recognise and report any bad practice and so help to safeguard people who may be vulnerable. Any complaints or concerns are investigated and residents feel happy to discuss any issues with staff or the manager. Staff are recruited through a thorough process and all of the relevant checks are carried out to help ensure that only those who are suited are employed in the home. Residents are involved in how people are recruited and see people before they are employed. The home is clean, safe and comfortable. The home is well managed and residents are asked to make comment and suggest changes to help make things better where there are any areas for improvement. What has improved since the last inspection? A new manager had been employed and some new staff. This has improved the way that the home is managed and residents and their families were happier. Staff were recruited more thoroughly and all the necessary checks including references from previous employers and Criminal Records Bureau disclosures were carried out to help ensure that only people who were suitable worked at the home. Residents felt that their concerns were dealt with more promptly. There have been improvements made to the home, including new flooring and carpets and redecoration and the garden had been improved so that residents could enjoy spending time there. What the care home could do better: Care plans should be reviewed so that they accurately reflect changes to a person`s needs and how this impacts on how they live their lives. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Summerview 35 Pembury Road Westcliff On Sea Essex SS0 8DU     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: Carolyn Delaney     Date: 2 8 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: Summerview 35 Pembury Road Westcliff On Sea Essex SS0 8DU 01702348310 01702348310 cathy.sutton@summercare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): SummerCare Homes Ltd Name of registered manager (if applicable) Maria Dean Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Maximum number to be cared for 6 (six). Personal care to be provided to 6 residents with a learning disability. The age of the service users will be between 18 and 65 years. Date of last inspection Brief description of the care home Summerview is a care home, which provides accommodation for 6 adults with learning disabilities. The home is situated close to the seafront and within close proximity to the town centre and local community amenities. Service users resident at the home are provided with single bedroom accommodation and access to communal areas including a large lounge area, dining room and garden to the rear of the property. There is limited off road parking but adjacent streets can also be used for this. The fees for a place at the home range from £708.00 - £1929.97 (one to one support) 6 Over 65 0 care home 6 Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home 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 was a routine unannounced inspection, which included a visit made to the home between the hours of 10.00 and 19.00 on 28th May 2009. The last inspection was carried out on 4th April 2008. As part of the inspection process we reviewed information we had received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they do well, how they evidence this and the improvements made Care Homes for Adults (18-65 years) Page 6 of 29 within the previous twelve months. We sent surveys to the home to distribute to residents and staff and to complete and tell us what they think about the home. At the time of writing this report we had not received any returned surveys. During the inspection we spoke with three residents and three members of staff. The views and comments expressed by these people were reflected in the report. We looked at how the manager dealt with the issues identified at the last inspection. We checked how they had made the changes as identified in the improvement plan they sent us following the last inspection. When we visited the home we looked at residents care plans and information available to staff to help them support residents. We looked at how staff were recruited to work in the home and how they were trained to support residents. We looked at how the home was managed and how residents were involved in this. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the care home does well: What has improved since the last inspection? What they could do better: Care plans should be reviewed so that they accurately reflect changes to a persons needs and how this impacts on how they live their lives. Care Homes for Adults (18-65 years) Page 8 of 29 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. People looking for a home can be assured that their assessed needs will be met. Evidence: The manager told us in the Annual Quality Assurance Assessment that anyone considering moving into the home would be invited to stay and spend some quality time to help them decide if it was the right place for them. They also told us that the person would be given a brochure to tell them what it is like to live in the home and that an assessment of their needs would be carried out to ensure that the home would be suitable. There had been no admissions to the home for a number of years. When we visited the home we looked at the information available about the home. This information was detailed and described the home and the services provided. There was a pictorial summary available for people who may not be able to understand the written version. We looked at the arrangements for assessing a persons needs before they would be Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: offered a place in the home. We saw that a comprehensive assessment would be completed with the involvement of the person, people who were important to them and the care management team involved in finding a suitable care home. During the inspection we spoke with three residents and they told us that they were happy living in the home. 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. People living in the home make decisions about how they live their lives and spend their time. Evidence: The manager told us in the Annual Quality Assurance Assessment that staff support residents to make decisions about the things they do and how they are supported. At the time of the inspection there were five residents living in the home. We looked at the care plans for two residents. Both care plans had been written from the residents perspective. Each care plan had an About Me section, which described what both people liked and disliked. Information was recorded about how residents how might react if they experienced something they did not like and how staff could manage this behaviour. Each resident had a plan for how they spent their days. We saw that one person did not regularly participate in the activities as described in their plan. The manager told Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: us that this was due to the persons illness, which impacted on how they spent their days. This was not reflected in the residents care plan. The manager told us that care plans were due for review. We looked at how people living in the home were supported and enabled to take risks as part of living an independent life. Risks to each personbs health and safety were assessed. Residents were supported to take part in activities which posed some risks, such as going out in the community, handling money and carrying out domestic chores. There were detailed risk management plans in place to minimise the risks to residents. Extra staff were employed where needed to support people to go out to college and to access activities in the community. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home enjoy a lifestyle which suits their needs and wishes. Evidence: The manager told us in the Annual Quality Assurance Assessment that they continued to offer residents opportunities to develop social, emotional, communication and living skills. They told us that they helped residents to find paid or voluntary employment if they wanted this. Staff told us that residents choose the types of activities they wished to participate in. When we visited the home we saw that each resident had a plan, which included a section called Places I go to on a daily basis. This described what the person liked to do during the day.We saw that some residents attended local day care facilities on weekdays. Here they participated in leisure activities and developed life skills such as Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: cooking. One resident had been refusing to attend and staff told us that they try to find things for this person to do during the day, dependent on their mood. Some residents also attended courses at a local adult education college. At the time of the inspection none of the residents were employed in paid or voluntary work. One person said that they would like to but that their medical condition prevented this. Residents had regular holidays away from the home and they chose where they would like to go. Shortly before this inspection residents had been on holiday with staff for four days. Both staff and residents told us that they had enjoyed this immensely. The manager told us It was good to spend time with residents away from the home and to see them enjoying themselves so much. Residents planned menus with staff and chose the meals that they wanted for the coming week. Staff usually cook meals with some assistance from residents according to their capabilities. We looked at how residents were supported to access activities and maintain relationships with people who were important to them. Residents told us that they attended clubs and discos each week, They told us that they had planned activities during the week and that on weekends they had free time and some people spent time with family. One resident told us that they had a partner and that they could spend time with them and invite them to their home. 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 are well cared for and supported to meet their health and personal care needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that each resident had a full assessment undertaken of their health and personal care needs and a care plan, which described how staff were to support the person. They also told us that staff received training people specific to the needs of residents including training in supporting people who have diabetes and epilepsy. When we visited the home we looked at how staff support residents for their personal and health care needs. We looked at the care plans for two people. There was information recorded in both plans about how and when they like to perform personal care and hygiene. Residents preferences for bathing and showering and the times they like to do this were recorded. Residents were encouraged to be as independent as possible and were prompted and encouraged to maintain good levels of personal hygiene. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Each resident had a health action plan. These plans included details of any medical conditions such as diabetes or epilepsy and how staff supported residents to manage these. We saw that staff had received training to help them support residents health care needs. We looked at the care plan for one person who had more complex medical needs. The affect of these needs on their daily lives, ability to make decisions and exercise choices was not recorded to reflect the residents individual needs. When we spoke with staff they could demonstrate that they supported the resident in a flexible way depending on how the resident was feeling each day. We saw that staff supported residents to attend routine health appointments and that they acted promptly to ensure that residents saw a doctor if they felt unwell. Staff monitored residents general health and weight regularly. Residents were encouraged to eat a balanced diet and to take exercise as part of a healthy lifestyle. Two residents we spoke with told us that staff looked after them well. One person said they care for me. Another person said staff here are very good. We looked at the arrangements in place for ensuring that residents receive the medicines, which have been prescribed for them. We saw that staff received training and information in policies and procedures to help them handle and administer medicines safely. Residents were assessed to see if they were capable of retaining control of their medicines as part of maintaining independence. At the time of the inspection none of the people living in the home were capable of managing their medicines and were dependent on staff to do this for them. We saw that residents received medicines as prescribed as part of their treatment plan. 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. Residents are treated well and their complaints and concerns are dealt with appropriately. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is a complaints policy and procedure available, which residents, their families and other people who are important to them can access. They told us that this procedure is available in a user friendly pictorial format. When we last visited the home residents told us that they did not always feel that their complaints were dealt with. We asked the manager to tell us in an improvement plan how they were going to address these issues. When we carried out this inspection we looked at whether the issues had been dealt with. We looked at the complaints policy and found that it was accessible and available in a pictorial format to help people who may find it difficult to understand the written version. There was also a suggestion box in the hall way where people could make suggestions or raise concerns anonymously should they wish. We looked at records and there had been no complaints made since the last inspection. We spoke with two residents and they told us that staff treated them well and that they were happy living in the the home. One person told us I have no Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: complaints but if I did they (staff) would sort it out. Another person said I would tell the manager, they listen to me. We looked at the arrangements for safeguarding people from abuse. We saw that staff received training and information in policies and procedures to help them to recognise signs of abuse and to report any bad practice. There was a whistle blowing policy in place. This helped to assure staff that they would be protected from harassment should they need to raise concerns. There had been one safeguarding alert raised since the last inspection. A resident alleged that a member of staff had been verbally abusive to them. This was referred to the local safeguarding team and investigated appropriately. We looked at how staff were recruited to work in the home. We saw that people were recruited thoroughly and all of the necessary checks including references from previous employers and Criminal Records Bureau disclosures were carried out before they started work. These checks help to ensure that only people who are suitable are employed in the home. Care Homes for Adults (18-65 years) Page 20 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. Residents enjoy a safe, comfortable and well maintained home environment which suits their needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents had all of the equipment that they needed and that bedrooms reflected each persons individual personality through their choice of furniture, decor and personal belongings. They told us that there had been improvements to the environment with the redecoration and refurbishment of some areas of the house. When we last visited the home we identified a number of areas where improvements were needed. Repairs had not been carried out promptly and some equipment such as the tumble dryer were not working and there were problems with lighting. Following the inspection we asked the manager to tell us in an improvement plan how these issues were to be addressed. They told us that refurbishment of the home was planned and that the time it took for repairs to be carried out would be monitored. When we visited the home we looked at how these had been dealt with. We saw that there had been improvements to the homes environment. New laminate Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: flooring and carpet had been laid throughout some communal areas such as lounge area and corridors. The lounge area had been redecorated and new furniture had been purchased. Improvements had been made to the garden area and there was a place where residents could plant shrubs etc. New garden furniture had been purchased and residents could enjoy this space more during the summer months. We spoke with two residents and they told us they liked the changes made to the home. One person said we have new sofas. Another resident said I really like the garden now. We looked at records and saw that repairs were carried out more promptly. Staff and residents we spoke with confirmed this. Staff support residents to keep the home clean and tidy. We saw that there were procedures in place and that staff had training to promote good hand washing practices and to reduce the risk of infection. We saw that the home was well maintained, that checks were carried out regularly to ensure that equipment was in good working order. Care Homes for Adults (18-65 years) Page 22 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. Residents are well cared for and supported by a team of competent and skilled staff. Evidence: The manager told us in the Annual Quality Assurance Assessment that all staff had a detailed job description in relation to their jobs, that they had an induction to the home when they started work and that they received both mandatory and specialist training to best support residents. When we last visited the home we found that staff were not always recruited thoroughly and that the home relied heavily on the use of temporary agency staff, which had an impact on how residents were supported particularly in accessing amenities in the local community. We asked the manager to tell us in an improvement plan how they were to address these issues. They told us in the plan that staff would be recruited in line with the homes policy and procedure. When we visited the home we looked at how the issues identified at the last inspection had been addressed. We looked at staffing levels and how staff were recruited, trained and supported to meet the needs of residents. We looked at the recruitment files for three members of staff who had been employed at the home since the last inspection. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: We saw that before they commenced work that satisfactory employment references, Criminal Records Bureau disclosures and PoVA First checks had been obtained and a full ten year employment history was checked for each person. Staff had undertaken a two staged interview process with the second interview carried out in the presence of residents at the home. This helped to involve residents in the process and to ensure that only people who were suitable were employed in the home. We saw that once people started work in the home that they undertook a detailed induction, which introduced them to the home, the needs of residents and the homes policies and procedures. In addition we saw that staff had detailed job descriptions and information about their roles, responsibilities and the conduct expected of them. We saw that there was an ongoing programme for staff training and development. Staff undertook training in a wide range of topics including communication, assessing risks, managing epilepsy and diabetes and safe handling of medicines. Staff were also trained to recognise and report abuse or poor practices and they had specific training in understanding the needs of people who have a learning disability. The home employed three members of staff during the day and this is increased to four two days each week to support one resident to attend college and additional staff were employed some evenings to support residents to go out or stay in depending on their choices. The organisation has a team of temporary bank staff to support the home should regular staff be unavailable due to sickness etc. As new staff had been employed the home depended less on the use of agency staff. We saw that on the occasions where it was necessary the manager employed the services of a local agency for temporary support staff and that detailed information and a photograph was obtained from the agency before the person commenced work in the home. This helped to ensure that the person would be suitable to work in the home and to confirm identity of the person when they arrived at the premises. During the inspection we observed how staff enaged with and supported residents. We saw that staff treated residents well and enaged with them in conversations and residents were comfortable in their company. Residents told us that they were well cared for by staff. Care Homes for Adults (18-65 years) Page 24 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 managed in the interests of the people who live there. Evidence: When we last visited the home we identified some issues with the way in which the service was managed. The manager at that time did not spend enough time at the home to ensure that it was run in the interests of the people who live there and residents told us that they did not feel that things were always dealt with promptly. We asked the owner to tell us in an improvement plan how they were to address these issues. They told us that following the inspection a new manager had been employed. The manager told us in the Annual Quality Assurance Assessment that they had many years experience in working with people who have a learning disability. They also told us that the home was managed in an open way, which promoted a positive and inclusive atmosphere where residents could feel comfortable. They told us that there was a detailed set of policies and procedures, which were kept up to date and reflected how the home was managed. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: At the time of the inspection the manager had recently completed their interview as part of their application to register with the Care Quality Commission. We spoke with her about the improvements that had been made since the last inspection. She told us that she worked as part of the staff rota for two days per week and the rest of the time she carried out her management duties. She told us that she worked on alternate Saturdays to provide extra support at weekends. We looked at how residents and their families were engaged and involved in airing their views about the home . We saw that there were regular meetings for both residents and their families. We looked at the minutes from the most recent meetings. We saw that residents and relatives were involved in making suggestions and decisions about the things, which were important to them such as repairs and the environment, holidays and activities. We saw that where suggestions were made a number of improvements had been made. Staff had held some fund raising events and monies raised were used to improve the garden at the request of residents. Some money was also used for meals out during residents recent holiday. We looked at the arrangements for ensuring that the home was maintained safely. We saw that regular checks were carried out on equipment such as hot water and heating systems, fire alarms and fire fighting equipment, gas and electrical installations and equipment. All equipment was well maintained and repaired as required. Care Homes for Adults (18-65 years) Page 26 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 27 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 15 Care plans must be kept under review so that they accurately reflect the needs of each person living in the home. This will help to ensure that staff have up to date information about people so that they can support them accordingly. 24/07/2009 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 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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