Care Home: The Haven

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What the care home does well The registered manager was receptive to advice given and demonstrated a commitment to put right any matters needed addressing to improve the service. Staff spoke enthusiastically about their roles and enjoy working at the home. Service users like living at the home and feel comfortable and safe. Indeed most of the service users have lived at the home for many years. The provider is committed to ensuring staff are appropriately equipped to do their job and 75% of support workers are now trained to NVQ 2 or above in care. There is a nice family atmosphere and staff listen to service users while carrying out their duties in an unhurried way. All service users have been re assessed and it is possible that a number of them will move out of the home into independent living facilities. The registered manager and support workers are supporting service users during this very difficult time, trying to limit any anxieties some of them have. Compliments about the service included "I like living here and don`t want to move"; "Jenny always listens to me"; "I go to Jenny if I`m unhappy about anything"; "I`m very happy living at the Haven"; "I enjoy chatting to all of the staff"; "I like to go out with staff at weekends and I like the market and local High Street". "The service is very caring; staff know the residents well; help residents access medical care and provide someone to accompany residents to the surgery whenever this is needed" and "Clients appear to be happy in their environment". What has improved since the last inspection? The refurbishment programme has commenced and should provide a better environment for current and future residents to live in. The registered manager is striving to introduce person centred care and there was some evidence of this in service users care records. Indeed there was more personalised information about individual service users on this visit. And some staff have received training in person centred care. What the care home could do better: It was difficult to obtain a coherent picture of service users` current condition, due to the volume of out of date documents contained in the current care files. Support workers should continue with improvements seen in the care records with particular regard to person centred care. A survey respondent commented "Both management and staff would benefit from additional training in person centred approaches to support the care they deliver" and "The service needs lots of encouragement to develop person centred care plans". As part of the home`s quality assurance programme, records of the provider`s regulation 26 visits must be completed monthly and made available for inspection, as Care Home Regulations require. For service users` protection the home must obtain a copy of the county`s multi agencysafeguarding policies and procedures. These should then be interlinked with the providers` version. Formal supervision of support workers should be carried at least six times a year and not on an ad hoc basis as it is now. For auditing purposes the supervision should be recorded. No requirements have been made, but a number of good practice recommendations have been made throughout the body of the report. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Haven 89 Rock Avenue Gillingham Kent ME7 5PX     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: Elizabeth Baker     Date: 0 7 0 4 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 03000 616161 (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: The Haven 89 Rock Avenue Gillingham Kent ME7 5PX 01634570239 01634570239 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dartford, Gravesham & Swanley Mencap Limited care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is 8 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability (LD) Date of last inspection Brief description of the care home The Haven provides care and support for seven adults with mild to severe learning disability. Twenty four hour support is provided. The premises are an older terraced style property and set over four floors. The home does not have a lift. The home is close to good local transport networks and is approximately one and a half miles from Gillingham town centre. The home does not have a car park. Parking is on the road and this is limited to either short term parking or permit holders. The home will provide day parking permits for visitors. Current fees range from £770 to £1,054 per week, depending on the assessed level of support required. Social outings, club admissions and holidays are not included in the core fees. Current activities include Adult Education courses, coastal and shopping trips, discos, social clubs, library, TV and board games. Care Homes for Adults (18-65 years) Page 4 of 29 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: Link Inspector Elizabeth Baker carried out the key unannounced visit to the service on 7 April 2009. The visit last seven hours. As well as briefly walking around the home, the visit consisted of talking and or communicating with all the service users. Three service users were spoken with in private. Two support workers were interviewed and others were spoken with. Verbal feedback of the visit was provided to the registered manager during and again at the end of the visit. At the time of compiling the report, in support of the visit, we the Commission received survey forms about the service from all the service users, two health professionals, one care manager and four support workers. Care Homes for Adults (18-65 years) Page 6 of 29 At our request the home was required to complete and return an Annual Quality Assurance Assessment (AQAA). Some of the information gathered from these sources has been incorporated into the report. Since the last visit there have been no safeguarding investigations. There have been no referrals to the Protection of Vulnerable Adults list. We have not received any complaints about the service. The last inspection to the home was carried out on 9 April 2008. What the care home does well: What has improved since the last inspection? What they could do better: It was difficult to obtain a coherent picture of service users current condition, due to the volume of out of date documents contained in the current care files. Support workers should continue with improvements seen in the care records with particular regard to person centred care. A survey respondent commented Both management and staff would benefit from additional training in person centred approaches to support the care they deliver and The service needs lots of encouragement to develop person centred care plans. As part of the homes quality assurance programme, records of the providers regulation 26 visits must be completed monthly and made available for inspection, as Care Home Regulations require. For service users protection the home must obtain a copy of the countys multi agency Care Homes for Adults (18-65 years) Page 8 of 29 safeguarding policies and procedures. These should then be interlinked with the providers version. Formal supervision of support workers should be carried at least six times a year and not on an ad hoc basis as it is now. For auditing purposes the supervision should be recorded. No requirements have been made, but a number of good practice recommendations have been made throughout the body of the report. 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 –03000 616161. 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. The homes service user guide is good and provides prospective service users with the information they need to make a decision about moving into the home or not. Evidence: The home has a statement of purpose and service user guide which provide information about the home to prospective service users. As is good practice the service user guide has been produced in an easy to read pictorial format. Five of the six people living at the home have done so for a long time. We looked at the assessment process of the most recently admitted resident. This included information provided by the sponsoring authority and information the home had acquired during their assessment process, including a visit to the prospective service user in their current accommodation. The information gathered was used to inform the respective care plan. The service user made various visits to the home prior to a decision of permanent Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: residency being made. The service users records included a contract of long term residency. 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. Service users are enabled and supported in living an independent life as is possible. Evidence: Three care files were inspected. Service users living in the home looked happy and relaxed. Support workers spoke to them in a respectful manner and supported them in making choices. This included making decisions about what to make for lunch. Three care files were inspected. They included various records including care plans and risk assessments. Since the last visit some support workers have received training in person centred care and some improvements to the records were seen. Good pen pictures are now available and reflected what service users had said during our talks with them. Daily records are maintained and provided a mix of daily experiences. Support workers sign and date the entries. However including the actual times would Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: enhance the records as they would provide a better audit trail if an investigation was needed to be carried out. The manager is aware that further improvements to the care records with regard to person centred care is needed and is seeking support from another manager within the group. Risk assessments have been completed for daily activities. The assessments are reviewed annually or more often if a change in a service users condition is noted. However for a service user with an unsteady gait the risk assessment did not include potential hazards of the way up to and into his bedroom. For another resident with a hearing impediment, the environmental risk assessment of his bedroom made no mention of this with regards to fire safety. The manager said both assessments would be reviewed. All the service users are encouraged to lead as independent a life as possible. Some of the service users attend Adult Education and some have part time voluntary jobs. Interviews with service users indicated they enjoy going to their clubs and discos. And one service user is now a member of a local advocacy group. All service users have their own bank accounts and apart from one, manage their own transactions. The home does not act as an appointee for any service user. Where service users ask the home to keep small amounts of monies on their behalf, these are kept in an individual and secure way. Individual records of transactions are maintained and are subject to auditing by the organisation as well as the local authority. 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. Links with the community are good and support and enrich service users social, occupation and development opportunities. Service users benefit from a variety of lifestyle choices with support from support workers where this is needed. Evidence: To promote diversity and equality the home supports service users in developing their skills and abilities, including continued learning if that is their wish. A number of service users work part time in charity shops and enjoy meeting people in this environment. A number of service users like to attend church and church clubs. Service users go to pubs and discos and one service user is now a DJ at a particular club. Since the home has been taken over, activities have increased. This includes attending group functions, buffets and other social events. The home has its own mini bus enabling service users to take trips out to the coast and places of interest. Service Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: users spoken with described how much they had enjoyed their last years holiday in the New Forrest. Indeed they liked it so much they have chosen to return there this year. Each person has a weekly activity planner. The activities are a mixture of educational activities, daily routine activities and leisure, including swimming. Service users are supported in making home visits and arrangements were in hand for some of them to stay with their relatives over the Easter period. To promote privacy service users have keys to their bedrooms as they prefer to keep them locked. Post is given to service users unopened although support workers will provide assistance with the correspondence if this is requested. A service user described how they all get together with the manager and discuss their meal choices. The menu is planned from this. Service users generally do their own shopping and two service users assist the home with the main weekly home shop. Service users were seen preparing their own lunch during the visit. Fresh fruit was available. Some of the residents may be transferring to independent living. Although they are able to make sandwiches and drinks they cannot actually cook a meal. Indeed a support worker was seen preparing the main evening meal. The kitchen and dining area are about to be totally refurbished. The new layout and facilities may encourage service users to participate more in meal preparation, as part of their life skills programme. Service users are regularly weighed and the information is recorded. However it was difficult to establish the current situation for one service user whose assessed needs requires his weight be kept under review. This was because weights are maintained separately and did not cross reference to his current care plan. 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. Service users receive personal support in accordance with their needs, wishes and preferences and can feel confident they are fully supported with their healthcare needs. Evidence: The three care files inspected contained care plans, health action plans, risk assessments and evidence of medical appointments and support from health care professionals. All service users are registered with a GP and service users have access to dentists, opticians, chiropodists and other allied health care professionals. The care files evidenced service users recently attending well person clinics. This enables their health be regularly checked and monitored. Service users were seen appropriately dressed and groomed for the time of day and season, with attention to detail where this is important to them. A hairdresser visits the home and some service users use this service. Other service users prefer to use hairdressers in the town and make their own arrangements. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Some service users take prescribed medicines. Records are kept of medicines administered as is required. The manager said she is registered on our professional website and has accessed our professional guidance on medicine management and administration. Some service users take as and when required (PRN) medicines. However the corresponding care records do not actually specify when this should be administered, as good practice requires. Patient information sheets are maintained. This is good practice as these contain information and warnings on possible side effects. Medicines are currently kept in a locked cupboard in a locked room on the second floor. Arrangements are in hand to move them to another room. The Royal Pharmaceutical Society of Great Britain has issued medicine guidance for care homes including information about storage facilities. The guidance document The Handling of Medicines in Social Care is available from their website. The manager may find this document useful. 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. Service users can be sure their concerns are listened to and acted upon. Evidence: Service users are provided with information on how to make a complaint. The document is a combination of pictures, captions and easy to read words. The document includes contact details of the organisation and us. Service users spoken with knew what to do and who to speak to if they are unhappy about anything. The returned AQAA records the home has not received any complaints and there have been no safeguarding vulnerable adult investigations. We have not received any complaints about the service. A more formal complaints procedure attached the homes Statement of Purpose also includes contact details of the organisation and us. However it does not include contact details of the sponsoring authority. It is good practice to include this. The organisation has provided the home with policies and procedures in respect of safeguarding vulnerable adults. However a review of the documents identified that they do not sufficiently interlink with the countys multi agency policies and procedures on safeguarding. This could result in a delay in referring a safeguarding matter. Support workers interviewed described appropriately the action they would take if they Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: suspected abuse had taken place. Training details evidence some support workers have received appropriate training. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The planned improvements to the home will make The Haven a more homely, comfortable and brighter place for current and future service users to live in. Evidence: The home is a converted private house, situated near to Gillingham town centre, is typical of the surrounding area and there is nothing to determine this is anything other than a family home. The premises have not always been kept in a good decorative state both internally and externally. However the manager has plans and a budget to start improving the situation. Since the last visit the attached garage has been converted into an office and the manager will shortly be moving into this. A new ground floor shower room is nearing completion. The kitchen dining room is to be totally refurbished and the laundry will be expanded and upgraded. An additional shower room will be installed on the first floor. Kent Health Protection Unit has produced Guidelines for Infection Prevention and Control in the Community. These include good information on equipping laundries. The guidelines may assist the home in ensuring its facilities maximise good infection control practices whilst minimising potential cross infection risks to service users. The guidelines can be obtained direct from the Unit. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The main through lounge offers a comfortable, warm and homely environment and many service users were seen using this at different times throughout the visit. Three service users showed us their bedrooms and we talked to them there. All the bedrooms had been individualised with service users personal affects and preferences. Generally, service users are responsible for keeping their rooms clean and tidy and those visited were just so. The bedrooms visited were in a good decorative state. We would like to thank service users for the opportunity of visiting their bedrooms. With the passage of time and continuous wear and tear, corridor and stair carpets, are looking tired. The decorative state of this area is not good either. The registered manager anticipates the carpets will be replaced and the area redecorated as part of the next stage of the homes ongoing improvement plans. 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. Service users care, social and emotional needs are promoted by a stable workforce in such numbers that meet current service users needs. Evidence: The home is staffed 24 hours a day and currently runs on two support workers on duty throughout the day and evening and one asleep at night. The home is currently recruiting more support workers. When staffing levels increase, this will allow for more one to one care being provided to service users who have an assessed need for this. Support workers were seen going about their duties in an unhurried manner. Ancillary staff are not employed and domestic duties are carried out by support workers and or with input from service users. Although supervision and appraisal of support workers does take place, it does not occur as regularly as it should. The manager is available most times and there is an open door policy for support workers to talk to her about anything. However this practice does not guarantee that important matters are recorded for auditing purposes. It is recommended that formal supervision takes place at least six times a year. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: In the last year, support workers have received training in various subjects including manual handling, first aid, food hygiene, fire awareness, protection of vulnerable adults, medication, autism spectrum disorder, diabetes, managing challenging behaviours, epilepsy, communication, person centred care, Mental Capacity Act and bereavement. However support workers have not yet received training in respect of Deprivation of Liberty Safeguards. As the safeguards came into affect on 1 April 2009 and could have implications on the homes current and future service users, it is the providers responsibility to ensure this training is sourced and provided. The AQAA records that 75 of support workers are now trained to NVQ level 2 or above in care. This is good practice. Good systems are in place for the recruitment and appointment of support workers. Applicants are required to attend an interview and complete an application form. References are sought and obtained. Applicants are subject to Protection of Vulnerable Adults and Criminal Record Bureau checks. Job descriptions were seen in the records. The records are kept in good order and allow for easy auditing. A new system of induction has just commenced. New support workers are now required to undertake an initial course. This is followed by an in depth Learning Disability Qualification induction course, which when completed leads into a NVQ care course. Support workers spoke enthusiastically about their roles and one commented that she cannot wait to start her NVQ training. 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. Although service users benefit from a well run home, the registered manager is aware of further improvements that need to be made and planning is in place to acheive this. Evidence: The home manager has worked at the home for about 13 years and been the registered manager for six. She attained the Registered Managers Award in May 2004 and NVQ level 3 in Social and Health Care in March 2002. Since that time she has attended training relevant to her role including Appraisal and Supervision. Meetings are held so service users and support workers can voice their opinions and make suggestions about how the service is run. Our latest inspection report is kept near to the front door, providing easy access to anybody wishing to read it. The home now uses the organisations quality assurance programme and the registered manager has received training on how to implement this. Surveys are not currently used to obtain the views of the service users or indeed feedback from other Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: professionals involved in service users care. However a trustee visits the home to speak to service users. Providers are required to demonstrate that homes are appropriately monitored. To achieve this, organisations can nominate a person to visit the service and complete a report of their findings. Where we require this, this must be undertaken monthly. Although the home receives regular visits from the organisations representative, reports are not always completed as regulation requires. The new organisation has provided the home with policies and procedures. However the AQAA records that some of them have not been reviewed since April 2006. In order that support workers and service users have ready access to current good practice and regulation, policies and procedures should be reviewed more frequently. Records for service users and support workers are kept with due regard to confidentiality. As stated previously personnel files are maintained to a good standard and allow for easy auditing. However the same could not be said for care files. Over time the home has accumulated a lot of information on service users and has tended to keep this in the individual files of each service user. However, the volume of information seen at this visit made it difficult to establish the current situation, with particular regard to service users health. The home keeps records of fire safety checks. Although most in house checks are carried out as regularly as good practice requires, the in house emergency lighting checks were not being carried out monthly. The AQAA records that the homes equipment is serviced or tested as recommended by the manufacturer or other regulatory body. 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 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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