Care Home: Tavistock Square (17)

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What the care home does well Detailed information is gathered and shared to ensure that potential service users can be sure this home will be able to meet their needs. Staff are fully committed to supporting the people who live here to lead purposeful and fulfilling lives. They engage with service users very well and understand their individualised communication styles. The service users have complex needs and the work is very intensive and challenging but the staff team are enthusiastic, skilled and work well as a team. They work hard to help service users access fulfilling social and recreational activities that interest and suit them. One relative said in a survey, "my relative has a lot more interests such as swimming, holidays and social life". Another said, "Up til now, we are quite happy. Since our relative moved to Tavistock they are a much happier person and this is reflected on home visits". People are encouraged to raise any concerns. Staff have also had good training in how to respond to challenging behaviour and this helps to safeguard service users. The home is clean and well maintained and provides spacious, homely accommodation. Service users were able to spend time where they wished. What has improved since the last inspection? A new manager has now commenced following several months where the home was without a manager due to the retirement of the previous postholder. The home has also experienced more staff turnover since the last inspection but this has now stabilised and a full staff team are now in place. More male staff are now employed, which is good as there are more male than female service users. What the care home could do better: Staff have not received supervision at the frequency they should have. Now that a new manager is in post, staff should be given the opportunity to meet with their manager or other senior member of staff privately every two months. This process is known as "supervision" and helps ensure staff are given the advice and support they need to do their job well. Senior management within the organisation who run this home have not made the required number of unannounced visits required by regulation. Such visits are important as this is how the organisation can ensure the home is being run properly. It is disappointing that such visits do not appear to have taken place during the period after the last manager retired and when there were a number of staff changes taking place. Staff should sign the guidance provided on when individual service users are given specific medications. This shows that they had read and understood the guidance and helps to ensure that service users are only given the medication when they need it. Key inspection report Care homes for adults (18-65 years) Name: Address: Tavistock Square (17) Tavistock Square (17) Silksworth Sunderland SR3 1DZ     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: Janine Smith     Date: 2 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 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: Tavistock Square (17) Tavistock Square (17) Silksworth Sunderland SR3 1DZ 01915238250 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): carol.ruddick@nhs.net Northumberland, Tyne & Wear NHS Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The home at 17 Tavistock Square provides accommodation for 6 people with a learning disability. It is a modern, purpose-built bungalow with level access at the two front entrances and good access around all areas for people with physical disabilities. It is sited in a cul-de-sac of similar modern housing and is set back with a large driveway and large back garden. The home provides personal care and is owned and operated by Northumberland, Tyne Wear NHS Trust. The bungalow provides 6 good-sized bedrooms, 2 lounges, 2 dining rooms, 2 bathrooms and an activities room. The home is within easy walking distance of various local shops, clubs, health centre and a church. It is also a short drive from main supermarkets and leisure clubs. Information about the service is readily available. The manager is to confirm the fees charged. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: Before this visit we looked at information we have received since the last visit on 18th November 2008; how the service dealt with any complaints and concerns since the last visit; any changes to how the home is run; the providers view of how well they care for people; the views of people who use the service and the staff. We received surveys from service users, who were helped by their relatives to complete these. An unannounced visit was made on 12th January 2010. During the visit we talked with people who use the service, staff and the manager. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept and checked that the staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We also checked what improvements had been made since the last visit. Care Homes for Adults (18-65 years) Page 5 of 27 We told the manager what we found. At the time of the inspection, the manager was new in post and had only been on duty for three shifts. As she was not wholly familiar with the systems in the home, a further visit was made on 21st January 2010 to discuss some issues with her and an assistant team leader. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at signficant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 7 of 27 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. People who may use the service have the information needed to make sure the home will meet their needs. Evidence: The Statement of Purpose and Service Users Guide were readily available in the home, which means potential service users can easily be given information about the services provided. Three surveys were received from service users who all said they got enough information about the home before they made a decision to move here. There was written evidence to show that the needs of potential service users are assessed before they are offered a place here, so that the staff team can be sure they will be able to meet their needs. During this process detailed information is gathered about the potential service users needs. Minutes of a meeting held to review the placement of one service user, showed they had settled in extremely well. Care Homes for Adults (18-65 years) Page 10 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. The people living in the home are given the support they need to help them make decisions about their day to day life in the home. Evidence: Three care records were looked at, including care plans and risk assessments. They detailed the individual needs of each service user and how these are met but some updating is required of both care plans and risk assessments. This has already been identified by management recently as requiring action. Care records contained assessment tools developed to comply with new Deprivation of Libery legislation but these have not been completed yet. Time was spent observing daily life in the home. Each service user has complex communication needs and observations indicated that staff understood peoples preferred communication methods and listened carefully to what they had to say. Care records contained documents known as communication passports which show in words, photographs and pictures how each person communicates their needs and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: wishes. These were very detailed and helped staff understand the words, symbols or signals, etc people will use. One relative thought that staff changes and lack of continuity over the past year had caused some difficulties, with some staff not fully understanding their relatives needs or how and what they are trying to communicate but that this had improved as the staff team have returned to full strength. Service users are encouraged and supported to undertake worthwhile, exciting activities that they enjoy, such as swimming and canoeing, following an assessment to minimise any potential hazards. They all go out on planned outings every day. They also participated in housekeeping tasks, such as assisting with the laundry. All three service users who completed a survey said they could usually make decisions about what they wanted to do each day, some by making their feelings known to staff if they cannot speak verbally. They also said the staff always or usually treated them well and usually acted on what they said, although one qualified this by saying, they try to do what they think I want. Staff were seen providing individualised support to service users to find out what they needed and wanted or answering their questions. Service users spent time where they wanted and alone doing an activity or with staff. Care Homes for Adults (18-65 years) Page 12 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. People who live here are able to make choices about their lifestyle and are supported to develop their life skills. The staff work hard to help service users access social and recreational facilities that interest and suit them. Evidence: At the last inspection, not as many individual activities were taking place due to staffing contraints. That has now improved. Records, surveys, discussion with staff and observations made showed that service users are supported to enjoy a wide range of activities, which are both enjoyable and stimulating. For example, photographs showed some enjoying canoeing and swimming. One had tried horse riding but did not enjoy it. Another likes trains and has visited Tanfield, Alston and other places of interest. One has a seaon ticket to watch ice hockey games regularly. One relative said in a survey, my relative has a lot more interests such as swimming, holidays and social life. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: There was plenty of evidence to show service users are encouraged and supported to keep in touch with their family and friends. One relative said in a survey, I can call anytime and am always welcomed and I never feel awkward about asking anything. Structured routines have been developed, as this is what service users prefer so that they know what they are going to do and when. Service users were heard asking when they would be going out or doing certain things. A relative said in a survey, they treat my relative as an individual. They are always well dressed and groomed. Their care is consistent and they know what their routine is, which is good because of their autism. My relative responds well to all the staff. A meal was taken with some service users and staff in one of the dining rooms. This was a pleasant occasion, where service users were seen to enjoy their meal of chicken nuggetts and spaghetti. Staff supported those service users who needed help to eat their meal. Care Homes for Adults (18-65 years) Page 14 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 and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Staff spoken to were well informed about the needs of the people they care for and how they communicate if they cannot verbally say what they want. One service user said in a survey that the home does day to day things, like personal care needs, cleaning and meals well. Relatives who completed surveys said that their relatives always or usually received the care and support needed and staff usually had the right skills and experience. One said, I am very happy about the care my relative receives and another said, Up till now we are quite happy. Since our relative moved to Tavistock, we feel they are a much happier person and this reflects on home visits. One relative thought that staff changes and lack of continuity had caused some difficulties, but this had improved as staff turnover has settled. Care records showed that GPs were contacted if service users were unwell and they saw consultants and other specialists when necessary. Advice was sought from specialists if there were any concerns. Records showed routine checks up by opticians, Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: dentists, and chiropodists. Their weight was monitored regularly. Written protocols are in place to guide staff about when to give specific medications that are only to be given in certain circumstances, but the protocol for one service user had only been signed by three staff to show they had read it. The protocol was also available in the medication records file. Photographs of service users are also kept with each persons administration record to help ensure medication is given to the right person. Medication was discussed with a carer who described appropriate systems for ordering, administration and disposal of medication. A sample of the records indicated these were being kept properly. Medication is stored within a cupboard located in the centre corridor in the home. This cupboard is not ideal, as it is used for other items but also because its location makes it difficult for staff to concentrate, as service users constantly interrupted them. This has already been identified as a concern by the management team and a new medication cupboard had been supplied which is to be installed in the office. The manager has instructed staff to dispense medication in the office, not the kitchen to avoid the potential for errors occurring. Since the last inspection, an error occurred when a service user was given the wrong medication. Steps have been taken to reduce the chances of this happening again and the relocation of the medication storage will help with this. Staff are trained to administer medication and undergo an annual competency test to ensure that they continue to follow good practice. Care Homes for Adults (18-65 years) Page 16 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. People who live here are able to express their concerns and have access to a robust, effective complaints procedure and are protected from abuse. Evidence: Two service users said in survey that they knew how to make a complaint, or knew someone who did. Three relatives said that any issues they had raised had been responded to appropriately, but another thought that whilst the staff team always behaved properly when issues were raised, doing this created tensions between relatives and staff. Staff knew about the complaints and safeguarding procedures, and would be prepared to report any concerns. They had had safeguarding training. Staff have been trained about how to respond to behaviours which they may find challenging and each attends a five day training course about control and restraint. They then complete three days of refresher training annually. This covers behaviours, breakaway techniques and how to safeguard people from harm. The organisation has established a system, known as Point of Contact, where experienced staff are contactable on a rota system if support staff need advice about dealing with any situation. This generally works well though members of the staff team had had concerns about the advice given in one instance. Following this incident, staff had had debriefing meetings with a senior member of staff to talk about how Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: they felt about the situation that occurred and the issues it raised. This was good practice and helped to support the staff concerned. As a consequence of this, further advice and guidance has been sought from health professionals and in the meantime, staff have been advised how to access 24 hour advice and guidance from health personnel if they need to deal with a similar situation in future. The staff team help service users manage their money and bank accounts. There is a thorough system in place so that all transactions are recorded and checked every day. 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 physical design and layout of the home enables people to live in a safe, well maintained and comfortable environment. Evidence: The home was toured. It has good bathing facilities equipped for people with physical disabilities and was clean and tidy. Staff are given training about infection control and have protective clothing available when needed. Each service user has their own bedroom. These were personalised with their belongings and items that interested them. The home has a conservatory, with some sensory equipment. There is a large garden area. One service user has his own shed in the garden where he likes to spend time in warmer weather. Three service users said in a survey that the home is always or usually fresh and clean. A relative commented in a survey, that the home is always clean and looked after and that their relatives bedroom is like a bedroom that she would have at home and it had a lovely homely feel. Another thought more homely type furniture could be purchased. Care Homes for Adults (18-65 years) Page 19 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. There is now a more settled, permanent staff team who are trained, skilled and in sufficient numbers to support the people who live here. Evidence: The management of the home have acknowledged there have been problems with stability of staff team over the past year due to delays in recruiting new staff because of length of time it takes to do vetting checks; long term sickness and temporary staff looking for other jobs because of uncertainty about future organisational change. In order to resolve some of these difficulties temporary staff were offered permanent posts and occupational health had been involved in trying to resolve long term sickness absence. The remaining vacancy had just been filled. As a result, there is now a full stable staff team and more staff on duty. More male staff have been employed to provide more gender balance in staff team as there are more male service users than female. The rota and discussion with the manager and staff showed that there are usually four support workers on duty between 8 am to 8 pm. There may also be one or two staff, known as enablers on duty depending on the number and type of social actitivies planned. Through the night one person is on waking night duty and another worker sleeps in on the premises in case further support is needed. Discussion with the Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: manager and staff showed that they felt the staffing numbers were appropriate to meet the needs of service users. Two fairly new staff confirmed that they had had induction training and other training since they took up their post. They both felt they had been well supported by the management team and colleagues which helped them understand their job role and what was required of them. They had also received training on control and restraint, safeguarding adults and children and infection control. Another member of staff confirmed they had had achieved a National Vocational Qualificiation at level 3 as well as essential health and safety training. They had also received training in control and restraint, autism and epilepsy and felt the training provided was marvellous. A supervision timetable was seen, which staff signed to show they had received supervision. A member of staff confirmed supervision took place, but less often than six times a year. This is no doubt due to the absence of a manager for a number of months. Care Homes for Adults (18-65 years) Page 21 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. Managerial oversight by the provider is not as robust as it should be to ensure the protection of service users and support for the staff team and this is a weakness in an otherwise good service. Evidence: The registered manager retired last year. A new manager has just been appointed and had worked three shifts at the time this inspection took place. Although off duty on the day of inspection, she came into work to assist the staff whilst the inspection took place. She has experience of working at a senior level in similar homes run by this organisation and said she was currently completing her application for registration with the Care Quality Commission. The new manager was unsure about the quality assurance methods used in the home but by the time of the second inspection visit, she had established a system for checking and auditing various systems in the home. The manager said that senior management were now carrying out unannounced Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: monthly visits as required by regulation. Copies were seen of two recent visits, but there was a gap in the file for August 2009 to December 2009, which was disappointing as this was the period when there was no manager in place and a number of staff changes took place. The organisation should have been carrying out uannounced monthly visits to make sure that the quality of care was being maintained and staff received the support they need. During this inspection, the Fire Brigade also carried out an inspection and the fire systems were also inspected by maintenance personnel. Fire records were therefore not looked at to avoid duplication. There was evidence a bath hoist had been serviced and maintained in July 2009. Hot water temperatures to baths are tested daily and staff were aware of the appropriate temperature for safety. Staff confirmed they had received essential health and safety training, such as moving and handling, food hygiene, first aid, fire safety, health and safety, handling medication and infection control. Care Homes for Adults (18-65 years) Page 23 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 24 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 1 43 26 The registered provider must ensure that an appropriate employee of the organisation makes at least one unannounced visit to the home each month and provide a written report of the visit. This helps to safeguard service users and ensure that the home is being well run. 28/02/2010 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 20 The manager should ensure that all staff have signed the written guidance provided on when to administer specific medications which are only to be given to individual service users in particular circumstances. This helps to show that they have read and understood it. The new manager should ensure that staff receive one to one supervision, whereby they are able to meet privately with the manager to discuss their work, at least six times a Page 25 of 27 2 36 Care Homes for Adults (18-65 years) 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 year. 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!