Care Home: Tamar House

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What the care home does well People live in a house, which is clean and comfortable.They are able to make their bedrooms homely with their own personal belongings such as ornaments and photos if they wish. One person said they could arrange their room as they wished.People can take part in a range of social and leisure activities if they wish. For example some people went out in the evening to a local club. They also attend centres during the day. People said they looked forward to going out.People told us they liked the meals and we saw that they have a choice.There have been few changes to the staff team. This means that people who live in the home get to know staff well. What has improved since the last inspection? We saw that some new lounge furniture has been provided. The manager also told us that they have replaced some of the bathroom floors.There is a programme in place to train staff, which is ongoing. This helps to ensure that staff have up to date knowledge and skills to care for people properly.There has been another review carried out about the quality of the service. What the care home could do better: Staff need to ensure that people who live in the home are clear about the full range of choices they have.Care plans need to show more clearly that people’s capacity to make choices and decisions have been considered appropriately in order that peoples rights are well protected.Staff must ensure that they follow some procedures more thoroughly for example when handling peoples finances to ensure people are well protected.Some staff expressed concerns about the night "on-call" system and feel that staffing levels need to be increased. Although some work has already taken place to address these concerns there needs to be better systems in place to show that staffing levels are regularly reviewed to ensure that there is no risk of residents needs not being met. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tamar House 5 Riseholme Road Lincoln Lincs. LN1 3SU 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: Sue Hayward Date: 2 8 0 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 37 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: Tamar House 5 Riseholme Road Lincoln Lincs. LN1 3SU 01522524093 info@prime-life.co.uk www.prime-life.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Sarah Martin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 13 2 Care home 13 Learning disability Additional conditions: The registered person may provide the following categories 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 disability - Code LD. Learning disability - Code LD(E) 2. The maximum number of service users who can be accommodated is 13. Date of last inspection 2 1 0 1 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home Tamar House is one of a number of homes run by Prime Life a privately owned company. It is in a residential area toward the outskirts of the city of Lincoln. They have a mini bus. This means that the people who live at the home can get around easily. Care Homes for Adults (18-65 years) Page 5 of 37 Thirteen men and women live at the home. Everybody who lives at the home has his or her own bedroom. Nobody has to share a room. Everyone is given information telling him or her what they can expect if they live there. Some information is on display in the dining room. Care Homes for Adults (18-65 years) Page 6 of 37 The manager told us that the current cost per week for someone to live there is £411.00 per week. Hairdressing, chiropody and transport costs are extra. Care Homes for Adults (18-65 years) Page 7 of 37 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 Care Homes for Adults (18-65 years) Page 8 of 37 How we did our inspection: This is what the inspector did when they were at the care home We talked to four people who live at the home. Everyone who lives at the home had been helped to complete a survey telling us their views about the care and support they receive. This information was sent to us before we visited the home and it helped us to plan the visit. Care Homes for Adults (18-65 years) Page 9 of 37 Two people showed us their bedrooms. We also talked to 3 staff that work in the home. We saw some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. Care Homes for Adults (18-65 years) Page 10 of 37 We looked at two care plans of people who live at the home as well. What the care home does well People live in a house, which is clean and comfortable. They are able to make their bedrooms homely with their own personal belongings such as ornaments and photos if they wish. One person said they could arrange their room as they wished. Care Homes for Adults (18-65 years) Page 11 of 37 People can take part in a range of social and leisure activities if they wish. For example some people went out in the evening to a local club. They also attend centres during the day. People said they looked forward to going out. People told us they liked the meals and we saw that they have a choice. There have been few changes to the staff team. This means that people who live in the home get to know staff well. Care Homes for Adults (18-65 years) Page 12 of 37 What has got better from the last inspection We saw that some new lounge furniture has been provided. The manager also told us that they have replaced some of the bathroom floors. There is a programme in place to train staff, which is ongoing. This helps to ensure that staff have up to date knowledge and skills to care for people properly. There has been another review carried out about the quality of the service. Care Homes for Adults (18-65 years) Page 13 of 37 What the care home could do better Staff need to ensure that people who live in the home are clear about the full range of choices they have. Care plans need to show more clearly that people’s capacity to make choices and decisions have been considered appropriately in order that peoples rights are well protected. Care Homes for Adults (18-65 years) Page 14 of 37 Staff must ensure that they follow some procedures more thoroughly for example when handling peoples finances to ensure people are well protected. Some staff expressed concerns about the night on-call system and feel that staffing levels need to be increased. Although some work has already taken place to address these concerns there needs to be better systems in place to show that staffing levels are regularly reviewed to ensure that there is no risk of residents needs not being met. Care Homes for Adults (18-65 years) Page 15 of 37 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Sue Hayward Eastern Regional Office CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771300 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 16 of 37 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 17 of 37 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are good procedures in place to assess people’s needs and introduce them to the service before they are admitted to the home. Evidence: The care records of two people the service supports were checked, one who had been admitted since the last key inspection took place. Care records showed that there had been an assessment of need and care plans drawn up for both people, whose care was followed on this occasion. Records were available to show staff members had access to care plans and assessments and their comments confirmed this as well. They had a good knowledge of the needs of the people they were asked about and records showed that assessments had included obtaining information from other relevant professionals such as social services. Information telling people about the service is made available to people who use the service. For example a copy of the last key inspection report was on display in the home. Care records checked of the most recently admitted person to the home contained a record indicating what information they had received and when it had been given. It was noticed that personal records also contained information to show Care Homes for Adults (18-65 years) Page 18 of 37 Evidence: that they had been given information about their terms and conditions of residency at the home. This included information about trial stays. Details about how to contact us had not been updated although it was acknowledged in the information they provided us with prior to the visit that it is planned to be reviewed this year. Care Homes for Adults (18-65 years) Page 19 of 37 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 . Staff have a good knowledge of peoples needs and how to meet them, however care plans do not contain sufficient detail to show whether peoples capacity to make decisions has been taken into consideration. Evidence: We saw that care plans and risk assessments were in place for both of the people whose care we followed on this occasion. Care plans covered areas such as physical health, specialist care, mobility, behaviour and financial management. Risk assessments covered matters such as nutrition, road safety and using household equipment for example. Records were in some instances unclear about all aspects of the care needed, for example a record contained conflicting information about a person’s ability to manage their finances independently. Another did not contain clear information to demonstrate whether a risk assessment had taken place with regard to a person who has responsibility for her own room key. Care Homes for Adults (18-65 years) Page 20 of 37 Evidence: Staff spoken to had a good knowledge of the needs of the people the service supports and a record was in place to show that they had read the content of care plans. People made comments showing that they were aware of the records kept about them and they knew who their key worker was. This is a staff member who has specific responsibilities for specific people who use the service. However, there were comments from a staff member and people who use the service to show that they were not clear that they had a choice of key worker. We have since the visit, had confirmation in writing and through a telephone discussion with the manager that a “house” meeting has been held. It was made clear to people who live in the home they do have a choice about this and as a result two people have changed their key worker. Although staff said they had had some information about the Mental Capacity Act 2005 (legislation which is designed to protect peoples rights and choices) and there is information on display in the home about it, the care plans seen did not show whether or not this had been considered. There was information contained in one person’s records, which indicated there may be a need for an assessment to take place in relation to the management of finances. Discussion with the manager after the key inspection indicated that a specific format for recording assessments of people’s capacity had now been obtained and she would ensure they were completed. People who we spoke to made comments which indicated that they have choices as to the life they lead, for example one person said they chose when they got up and went to bed. It was observed that people had a choice as to whether they went out in the evening or stayed in. Care Homes for Adults (18-65 years) Page 21 of 37 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 who use the service have the opportunity to participate in a range of activities to meet their social and leisure needs, which promotes their independence and enables them to maintain relationships. Meals are well balanced and take into account people’s personal choice and specific dietary needs. Evidence: People who live in the home told us about the opportunities they have available for them to pursue their social interests. For example, people said they visited their family, attended day centres and went out in the evenings. During the visit some people returned from a day centre and in the evening a group of people went out to a club. Others stayed at home. Records are kept of activities that people participate in and these showed for example that day trips out, making decorations, going to the pub and bowling were activities that people could take part in. Comments from the surveys we received indicated that people made their own Care Homes for Adults (18-65 years) Page 22 of 37 Evidence: decisions about what they did each day. For example, I go home on Wednesday evening and all day Saturday and sometimes stay for the weekend. People said that they participated in housekeeping tasks and information we were provided with prior to the inspection showed that staff encourage people who live in the home to be involved in activities, which increases their independent living skills. One person made a comment indicating she was unhappy at times being involved in household tasks. The manager said people have opportunities to increase their independent living skills should they choose to however this is their choice. People made complimentary comments about the meals provided. There was a choice of main meal available on the day of the visit and it was noticed that staff asked people which meal they wanted. Good size portions were served to people and staff were aware of peoples specific dietary needs. The records of the people whose care was being followed was noted to contain information about their dietary needs and preferences. Care Homes for Adults (18-65 years) Page 23 of 37 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 people the service supports is promoted however records of medication must be consistently completed in order to demonstrate that people are sufficiently well protected by the policies and procedures in place. Evidence: Records showed that people are registered with different doctors surgeries. They also showed when people had had visits to or from health professionals. People who live at the home told us they were able to visit the doctor when they needed. Staff were aware of peoples individual health needs. Staff told us that some of the people who live in the home need minimal support with their personal care needs however the gender of staff that provide this support is taken into consideration, for example male staff do not support females with their personal hygiene needs. Records were in place informing staff about the medication that people who live in the home have been prescribed. Storage arrangements for medication were satisfactory. Records are kept to show when staff have administered medicines. It was noticed that there were occasional gaps in the recording of these when a person was away from the Care Homes for Adults (18-65 years) Page 24 of 37 Evidence: home on leave. The service does have a contract with a local pharmacist who visits periodically, checks the systems in place and produces a report. We were shown the most recent report of 08/12/08 and it raised some issues in relation to the recording of medications and the need for a protocol to be followed when people are prescribed medication on an as required basis. Whilst there was a format in place for recording the latter it had not been completed. Staff also confirmed that they received training before they were able to administer medication. The manager has confirmed since the visit that a protocol has now been completed. Care Homes for Adults (18-65 years) Page 25 of 37 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are satisfactory policies and procedures in place to ensure that any concerns, complaints and allegations are appropriately responded to, but financial records are not sufficiently robust enough. Evidence: There are satisfactory policies and procedures in place about complaints and safeguarding adults. The people we asked who live in the home said they knew to tell staff if they had a problem or concern. A staff member and information from the surveys we received indicated that some service users would be unable to understand how to make a complaint in which case a staff member said they would rely on observations of peoples behaviour to determine their satisfaction with the service. The complaints procedure was on display on the notice board and it is also included in the terms and conditions of residency information given to people. A copy of the local authority safeguarding adult’s procedure was also seen in the home. Those staff spoken to knew the procedure for reporting complaints and safeguarding adult’s matters and said they received training about this. There have been a number of matters referred and looked into by the safeguarding adults team since the last key inspection. One is currently being looked into to decide whether or not it comes within the safeguarding remit. A staff member told us that their recruitment process had included completing an Care Homes for Adults (18-65 years) Page 26 of 37 Evidence: application form on the day of her interview with the manager and a senior member of staff. We were also told that they had started work whilst awaiting for a criminal record bureau check being received however was never left alone during that time. Whilst there are satisfactory arrangements in place to ensure any money or valuables held in safe keeping on behalf of people who use the service are being stored properly the record keeping systems did not always show that two people had witnessed transactions, which had occurred. Furthermore, discussion indicated records were sometimes second signed at a later date. We have been provided with written confirmation since the service visit that this matter is to be discussed with staff and records will be double signed in future. People we spoke to made varied comments about their satisfaction with the service. Care Homes for Adults (18-65 years) Page 27 of 37 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 . People live in a home which is well maintained, clean and tidy and which is suitable for their needs. Evidence: We saw the bedrooms of two people the service supports with their permission. They were clean and tidy and had been made more homely with some of their own personal possessions. People who use the service told us they found their rooms to be comfortable. Bedrooms are lockable and one person spoken with said she had been given a key. Both lounges were seen as was the dining room, kitchen, laundry and bathrooms. Generally areas were clean and tidy. New settees and chairs were seen in one lounge. Records of meetings held with people who live in the home showed that there was discussion with them about the decor of the home. A staff member is employed by the organisation that has responsibilities for some of the maintenance of the building and was visiting on the day of the inspection. Staff made comments, which demonstrated that any maintenance issues reported are generally dealt with, promptly as the maintenance person calls in every other day. Maintenance records showed that matters such as boxing in pipes and covering the radiator in the hallway had been raised. Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: People who live in the home and had been assisted to complete surveys said that the home was always fresh and clean. Discussion with staff confirmed that equipment is available for them to use such as gloves and aprons to ensure good hygiene practises are followed. They have provided us with information to show that they have procedures in place relating to infection control. Care Homes for Adults (18-65 years) Page 29 of 37 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 are supported by a consistent team of staff who have training opportunities to ensure they have the knowledge and skills to provide appropriate care. Evidence: Information we were provided with prior to the visit showed that there are both male and female staff employed to work in the home, providing a service to the people who are currently living there. Discussion with staff and the sample of staff rotas checked showed that there are two people on duty throughout the day and one person on wakeful duty at night. At the weekends there are some additional hours when three people are on duty during the day. The manager is included on the staff rota. Care staff also have cleaning, catering and laundry duties. Staff made comments, which raised some concerns about the staffing levels at the home. These related to the range of duties they have, night staffing levels and the staff on-call system, although their comments indicated they were committed to the work they do. We were told that two staff members are currently on leave. A staff member from another home within the organisation is currently working in the capacity of an acting senior staff member at Tamar House. Other comments showed that staff work additional hours to cover any shortfalls if needed. Comments indicated Care Homes for Adults (18-65 years) Page 30 of 37 Evidence: that the manager was always on-call. However, she has previously confirmed that it would take her 25 minutes to get to the home if called out. We have since had written confirmation that the on-call arrangements are to be shared with the acting senior staff member who lives nearer the home. In addition to this we were told there is always a member of the wider management team of the organisation on-call who can be contacted and staff are aware of these arrangements. We were provided with information, which showed that there have been few changes to the staff team. Staff follow an induction-training programme and have other regular training. Comments from staff spoken to on the day of the visit confirmed they had participated in training. We were told five staff have also achieved a nationally recognised award in care at level two or above and one is working toward achieving it. The manager provided us with information, which demonstrated that the recruitment procedure for staff had included obtaining checks such as criminal records bureau (CRB), protection of vulnerable adults (POVA) and references in respect of the three most recent people employed. It was noted in two instances people had commenced employment after a POVA check had been received but before receipt of a CRB check. One person whose employment had commenced prior to receipt of the CRB check told us she was never left alone during that time. Staff told us that they were supported through the team meetings and individual supervision meetings, which take place with the manager. People who use the service and the staff on duty were noticed to have a good rapport. Comments from the surveys we received indicated that staff always treated them well. Care Homes for Adults (18-65 years) Page 31 of 37 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 management systems in place help to ensure the health and welfare of people who live at the home. Evidence: There has been no change to the management arrangements since the previous key inspection. Comments from people who live at the home confirmed that they knew who was in charge. People’s comments and records confirmed that there are systems in place to monitor the quality of the service. For example, house meetings are held and one person who lives at the home told us we talk at meetings about what we want to do. However, some other comments indicated people might not fully understand the choices they have. It was confirmed that the last quality review of the service by the organisation had taken place in July 2008 and the outcomes of this are displayed in the home. Reports are available which show there are visits from representatives of the organisation to discuss aspects of the service and any actions needed. Care Homes for Adults (18-65 years) Page 32 of 37 Evidence: There are a range of policies and procedures to guide and instruct staff. We were told prior to the visit that all procedures were reviewed in February 2008. We have also been given information, which demonstrates that equipment is serviced and tested at recommended intervals. Fire extinguishers were randomly checked during the visit and showed they had been tested in 2008. The report of the most recent fire safety officers visit on 22/01/09 raised an issue relating to recording checks of the emergency lighting system on a monthly basis. The fire records made available did not show whether this matter had been addressed although showed that regular tests of the fire alarm system were carried out. The manager has confirmed since the inspection that monthly checks are made of the emergency lighting however records are stored separately from other fire records. Staff need to be clear of where records are located in order that good practice can be demonstrated. Care Homes for Adults (18-65 years) Page 33 of 37 Are there any outstanding requirements from the last inspection? Yes No X 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 34 of 37 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 Description 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 Description Timescale for action 1 23 17 Accurate and up to date records of all financial transactions of money held in safe keeping on behalf of people who live in the home must be kept. 06/04/2009 This will ensure people are well protected. 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 It is recommended that care plans are reviewed to ensure they are consistently in sufficient detail to ensure the needs of people who use the service and how they are to be met are fully identified. Care plans need to demonstrate that consideration has been given to people’s capacity and ability to make choices and decisions and any significant outcomes recorded. This will ensure peoples welfare and safety is promoted. 2 7 Care Homes for Adults (18-65 years) Page 35 of 37 3 20 It is good practise to ensure that staff always completes codes to show the reason why medication has not been given. Care Homes for Adults (18-65 years) Page 36 of 37 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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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