Care Home: The Manor House

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What the care home does well The assessment of people living in the home is generally robust to ensure the service can meet their needs and information is provided to help those thinking about moving into the home know what it is like. People living in the home continue to be involved in their support and making decisions about their lives and who are regularly consulted by staff about these. The concerns of people living in the home are taken seriously by staff who listen to them well to ensure their individual wishes and choices can be met. People living in the home are supported by a friendly and supportive staff team who generally know them well and who receive regular training to help them do their jobs. The home is generally well organised and well managed to ensure staff can promote and protect the health and welfare of people using the service. What has improved since the last inspection? A substantial amount of work has been carried out to improve the environment and ensure people using the service have a comfortable and pleasant place to live. A more person centred approach to providing support has been provided to ensure the individual needs of people living in the home can be better supported. Recruitment checks have been improved and more staff training provided to ensure the welfare of people living in the home is safeguarded from harm. What the care home could do better: Significant events that occur in the home must be reported to the Care Quality Commission to ensure the welfare of people using the service can be safeguarded from harm. Support plans belonging to people living in the home should be further developed to ensure their current needs are reflected and they are kept up to date. Staffing levels should be reviewed to make sure their are sufficient numbers of staff on duty to meet the needs of people using the service and consideration given to creating a staff rota with pictures and words, to help people living in the home know who is coming on duty. The supervision of staff should be further developed to ensure the needs of people living in the home can be properly met and their dignity respected and staff provided with clear direction and leadership. The staff training programme should be further developed to ensure staff can support people living in the home better and ensure their human rights are protected. The choice of activities should continue to be developed to ensure the individual needs of people using the service can be better met and regular checks of medication should be carried out to ensure they are kept safe from potential harm. The quality assurance systems should be further developed to ensure the service can be better at monitoring its aims and objectives. Key inspection report Care homes for adults (18-65 years) Name: Address: The Manor House Whitton Road Alkborough Scunthorpe North Lincolnshire DN15 9JG     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: Rob Padwick     Date: 0 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Manor House Whitton Road Alkborough Scunthorpe North Lincolnshire DN15 9JG 01724720742 F/P01724720742 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only Code PC Date of last inspection Brief description of the care home The Manor House is a large property in its own grounds in the village of Alkborough, providing care and accommodation to up to 17 adults with learning disability. There are 11 singles bedrooms in the main home plus bungalow accommodation providing 3 additional singles units and one three bedded bungalow. There is plenty of space within communal areas for people using the service to use. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home. A copy of the latest inspection report for the home is available in the office. The home has a mini bus, gardens with roaming fowl, and a courtyard for service users to use at will. A local village shop is within walking distance, and the town of Scunthorpe is a short bus ride away. 18 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: This inspection report is based on information received by us since its last key inspection, which took place on 14th August 2007 and includes information gathered during a site visit to the home. As part of the inspection process, we send out a self assessment document that the Registered Person must complete and return to us. This helps us know how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was not returned to us until after we visited the service and this therefore limited the amount of work we could do to prepare for it. Other information used, included feedback from people living in the home, Professional people who know them well and official notifications sent to us by the home. This information helps us to reach judgments about the service provided. The site visit took place on 5th August 2009 and lasted for 6 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to her, we talked staff who were on duty and people living in the home. We Care Homes for Adults (18-65 years) Page 5 of 27 looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. In order to improve the way the Care Quality Commission involves and engages with people who use services, someone with experience of receiving similar services, known as an Expert by Experience assisted us with this inspection visit. This person spoke to people living in the home and helped us to look round the building as well as talking to staff. Information collected by the Expert by Experience is included within this report. The manager told us fees for the service are individually based and we were told these currently range from £351.05 to £2,038 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: Significant events that occur in the home must be reported to the Care Quality Commission to ensure the welfare of people using the service can be safeguarded from harm. Support plans belonging to people living in the home should be further developed to ensure their current needs are reflected and they are kept up to date. Staffing levels should be reviewed to make sure their are sufficient numbers of staff on duty to meet the needs of people using the service and consideration given to creating a staff rota with pictures and words, to help people living in the home know who is coming on duty. The supervision of staff should be further developed to ensure the needs of people living in the home can be properly met and their dignity respected and staff provided with clear direction and leadership. The staff training programme should be further developed to ensure staff can support people living in the home better and ensure their human rights are protected. The choice of activities should continue to be developed to ensure the individual needs of people using the service can be better met and regular checks of medication should Care Homes for Adults (18-65 years) Page 7 of 27 be carried out to ensure they are kept safe from potential harm. The quality assurance systems should be further developed to ensure the service can be better at monitoring its aims and objectives. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is available to help people thinking about using the home to make a decision about it and their needs are appropriately assessed to ensure the home will be able their needs. Evidence: Information about the service is available to help people thinking about moving into the home to make a decision about it. This information can be made available in pictures and words and other formats to help it to be easy to understand. The case files of people living in the home contained evidence their needs are carefully assessed before they move into the home, with Local authority assessments and other information compiled by the home manager, to ensure the service is appropriate for them. The manager told us she generally likes to visit people thinking about moving into the home and there was evidence admission to the service was generally a graded process that included a series of visits to ensure people can try it out and ensure it meets their needs and they are compatible with others living in the home. 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. People using the service are consulted and involved in decisions about the way support is provided to ensure their wishes and feelings for this can be met. Evidence: The case files belonging to people living in the home all contained a range of support plans developed from their assessments of need. The support plans covered a variety of health, personal and social care issues and there was evidence of regular keyworker involvement to ensure individual needs and choices could be met. The manager told us support plans were in the process of being further developed to enable a more person centred approach to be delivered, however people using the service confirmed they were consulted about them and we saw evidence of good staff involvement to ensure they are happy with the way support was provided. The case files inspected contained evidence of monitoring and evaluations of support plans to ensure they continued to reflect current needs, although there was evidence these could be further developed as some were in need of further updating and more information about action plans for staff to follow. The manager told us however, she was aware of this Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: shortfall, through regular audits that are carried out. A recommendation is made about this. People living in the home told us they were supported to be as independent as possible and involved in making decisions about their lives. Their case files contained assessments about the management of known risks to make sure they are kept safe from harm, whilst enabling them to be supported to maximise their ability to take responsibility for these. There was evidence in the homes records of a range of training to ensure staff are able to do their jobs, however a recommendation is made that this should include training on Deprivation of Liberty safeguards and Mental Capacity Act 2005 in order to ensure the human rights of people using the service are further protected. 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. Whilst people using the service are provided with opportunities to access a variety of leisure activities, further development of these would enable their individual needs to be better met Evidence: People living in the home told us they were able to make choices about their lives and a number were observed to go out on the day of our visit to the home. We were shown records and told about regular swimming and exercise sessions, together with pottery and art classes as well as trips to a local pub. Whilst the self assessment for the service told usWe are recognising the importance of moving away from rigid institutional care towards a more bespoke and individual format, there was evidence this aspect of the service needed to be further developed. The Expert by Experience said Two staff members told me they are going to try to get a computer. I think this would be a good idea because it provides more choice of activities. However, he noted Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: In the main living room a service user and a member of staff were playing Connect 4 and the others were just sat down. I think the staff should create more activities to do in the home. A recommendation is made about this. The home is situated in a small rural village which can make getting out in the community a difficulty for some people using the service, but we were told about plans to obtain wheelchair friendly transport for this. The case files inspected contained evidence people living in the home are supported to maintain links with friends and families who we were told are are encouraged to visit and take part in the life of the home. People using the service can participate and help choose the food that is served and some go out shopping with staff for this. There was evidence of a range of healthy home cooked meals using vegetables grown on the homes allotment are provided, however when Expert by Experience asked if people could help themselves to food in between meals was no, youve got to ask. 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. Whilst people living in the home are supported to ensure their health and personal care needs are met, further supervision and training for staff would enable their individual needs to be better respected. Evidence: People living in the home confirmed their health and personal care needs were met and the case files inspected contained support plans detailing how staff should assist them with these. There was evidence of daily monitoring of need and liaison with professionals in the community about any concerns that are highlighted. Staff indicated they had a good understanding of the people living in the home and knew them well and staff files inspected contained evidence of a range of training to ensure they can appropriately do their jobs. Whilst case files contained health action plans and evidence of recording of a range of associated issues, there was evidence these could be further developed with clearer guidelines for staff actions in regard to identified concerns as previously noted. Since the last time we visited the home there has been progress to develop the staff team and enable people using the service to experience an increased choice of who Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: supports them with personal care as previously recommended. However, whilst people told us staff generally respected their wishes and their dignity was respected, there was evidence this aspect of the home could be further improved with clearer management support, direction and leadership. The Expert by Experience asked about privacy and if staff knocked on bedroom doors and one told him theyre alright, theyre not too keen, but they respect our privacy whilst another one told him that some of them do. A recommendation is made about this (see Staffing). Policies and procedures were available to ensure medicines are safely administered to people living in the home. Only staff who have received appropriate training in the safe use and handling of medication are responsible for this we saw confirmation of this in the staff training records we inspected. A random check of the medication records indicated these were being appropriately kept, however an error had been reported to us during the past year, which we passed to the Local Authority to investigate as a safeguarding concern and a recommendation is made that the manager carries out regular audits of medication kept in the home to ensure people using the service are kept safe from harm. 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. The concerns of people living in the home are taken seriously and training provided for staff to ensure they know how to safeguard them from harm. Evidence: People living in the home told us they were generally happy with the service and would talk to the staff if they had any concerns. Information about how to make an official complaint is given to people using the service when they move in to the home and we were told this can be provided in an easy read format to make it easier for them to understand. We received an anonymous complaint during the past year which we passed to the Local Authority to investigate under its duties to safeguard vulnerable adults and were told this had been largely unsubstantiated, although some recommendations were made to improve the support plans for people living in the home. The service has policies in place to ensure people using the service are safeguarded from harm and there was evidence of training provided for staff on this. Discussion with staff indicated they were confident about what to do about this area of practice should they have a concern. The records of finances belonging to people living in the home we inspected were accurately kept with two staff signatures recorded for any entries made. Care Homes for Adults (18-65 years) Page 17 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. People using the service are provided with a homely environment that is well maintained and decorated to a good standard. Evidence: Since the last time we visited the home, four newly built self contained bungalows have been registered for people who are more independent to use, in order to give them opportunities to live in a more domestic style setting. All of the bungalows are built to a very good standard with ensuite bathing and kitchen facilities and single bedrooms, and one is built for two people to share. At the time of our visit one of the bungalows was used as a separate office for support staff as no one was yet living in it. A call system is provided to enable management checks to ensure people using the service are kept safe from harm. People living in the bungalows told us they liked their new living arrangements very much, however, we saw some evidence staff needed more training and supervision to help people take responsibility for themselves, as one of the bedrooms was in need of a clean and a bit untidy. A programme of refurbishment to the main house had been nearly completed and there was evidence of good improvements made, with new flooring laid and a general upgrade of the building. The house was clean and tidy with bedrooms comfortably furnished and the communal facilities bright and airy. The Expert by Experience however, noticed a downstairs shower room still needed a curtain and told us I think there should be one Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: for extra privacy. The main building is not suitable for wheelchair users due to the narrowness of its corridors and doorways and a kitchen in one of the bungalows needed further adapting to make it accessible for wheelchair users; however the manager told us plans were in place to complete this in the near future. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst staff have received training to ensure they are able to do their jobs, further direction and development of this would enable them to support the individual needs of people using the service better Evidence: Interactions between staff and people using the service were observed to be friendly with staff supporting them in a sensitive way. The self assessment told us the service has sufficient staff by number and skill to achieve our aims and objectives and whilst there was evidence this was generally the case, the Expert by Experience was told Quite a few staff come and go, we do need a few more. We were told the service has started working in a more individualised way to support the individual needs of people living in the home better, however there was some evidence this needed to be further developed. The Expert by Experience stated There seemed to be quite a few staff and some went out with people but added Not many were spending time with service users in the house. I think there should have been more staff working directly with the service users. The service users didnt know who was going to be working on a daily basis. I recommend a staff rota is available with pictures to show who is working. Recommendations about this are made. A training and induction programme was in place to help staff to do their jobs and Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: staff files contained evidence of a range of training provided. We were told about a mentoring programme for new staff and on going progress in them obtaining NVQ 2 qualifications. However, whilst training provided was generally appropriate for the service and we saw evidence of professional supervision to support them with this, some people living in the home have specialist conditions and it is recommended the training and supervision is further developed to include autism training and assistance with independence. Recruitment policies and procedures were available to ensure staff are safe to work with people living in the home. The files of support staff employed since we last visited continue to show this aspect of the service is carried out appropriately and that robust checks are carried out. 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. Whilst management arrangements are in place to ensure the home is effectively run, further development of more accurate recording systems and staff supervision would enable the needs of people living in the home to be better met. Evidence: The manager is appropriately qualified and has considerable experience of managing services for people with learning disabilities. The manager takes a hands on approach and staff records inspected confirmed regular monthly team meetings are held to ensure good staff communication. Quality assurance systems were in place to ensure the service can monitor its effectiveness and although surveys had not yet been sent out this year to people with an interest in the service, we were told plans were in place to do this in the near future. Whilst audits from senior management are carried out to ensure the service can be regularly monitored, it is recommended these are further developed to address requirements and recommendations in this report. The self assessment for the service was returned to us late which limited our preparation to plan for this site visit. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: However, because there was evidence management arrangements were generally satisfactory, we have decided on this occasion not to alter our judgement about the home, although it is possible we could have done so. Regular checks were being carried out to ensure the health safety and welfare of people living in the home can be effectively promoted and protected and maintenance certificates and equipment were up to date with training provided on these issues. The Accident records however, indicated an event had occurred which had not been reported to us and a requirement is made about this to make sure people using the service are safeguarded from potential harm 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 42 37 The Registered Person must 30/11/2009 ensure significant events are reported to the Care Quality Commission. This is to ensure the welfare of people using the service can be safeguarded from harm. 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 The Registered Person should ensure support plans of people living in the home are further developed to include staff actions to take and are monthly evaluated to ensure they reflect current needs and are kept up to date. The Registered Person should ensure staff training is provided about the Deprivation of Liberty safeguards and Mental Capacity Act 2005 in order to ensure the rights of people using the service are further protected. The Registered Person should continue to develop the choice of activities provided to ensure the individual needs of people using the service can be better met. 2 9 3 12 Care Homes for Adults (18-65 years) Page 25 of 27 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 4 20 The Registered Person should ensure medication audits are regularly carried out in order that people using the service are kept safe from potential harm. The Registered Person should review staffing levels in the home to ensure there are sufficient numbers available on duty to meet the needs of people using the service. The Registered Person should consider making available a staff rota with pictures and words to help people living in the home know who is coming on duty. The Registered Person should ensure autism training is provided to staff to ensure the individual needs of people living in the home can be better met. The Registered person should ensure staff are effectively supervised to ensure they can do their jobs. This is to ensure the needs of people living in the home can be properly met and their dignity respected met and staff provided with clear leadership and direction. The Registered Person should develop the quality assurance systems for the home to ensure the service can monitor its effectiveness better in meeting its aims and objectives. 5 32 6 32 7 35 8 36 9 39 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). 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