Care Home: The Poplars

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What the care home does well When we asked people about their Home, they told us "I like living here" "I want to stay here I don`t want to move" People are provided with a homely living environment so they are comfortable and safe in their surroundings. People are supported by staff who are enthusiastic about their work and understand people`s needs. People are supported to keep in touch with family and friends so they maintain relationships that are important to them. People are supported to do activities that they enjoy and take part in community based activities. People are provided with a healthy and nutritious menu so their well being is promoted. What has improved since the last inspection? Repair work has been completed so the Home is safe and comfortable for people. Some people have been supported to move onto new homes that meet their assessed needs. What the care home could do better: A system for analysing incidents and accidents should be developed so people`s health and safety is well managed. Plans must be in place for peoples health care needs so they receive the support they need to keep well. Staff should have updated medication training so they have the skills and knowledge to administer medication safely. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Poplars 889 Chester Road Erdington Birmingham B24 0BS     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: Donna Ahern     Date: 2 8 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: The Poplars 889 Chester Road Erdington Birmingham B24 0BS 01213730288 01213862460 Telephone number: Fax number: Email address: Provider web address: Katymeakin@Birmingham.gov.ukwww.birmingh am.gov.uk Name of registered provider(s): Type of registration: Number of places registered: Social Care and Health care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 12 Date of last inspection Brief description of the care home The Poplars is a Home owned by the Local Authority and is registered to provide personal care and support for up to 12 adults with a learning disability. Six people were living there at the time of the visit.Accommodation was originally provided in three houses and access between these is through a series of hallways and staircases, therefore is not considered to be ideal. In addition, the internal layout and a number of facilities provided at The Poplars are no longer deemed to be fit for purpose. For Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 12 Brief description of the care home example there is no passenger lift and this may have been required for people living there in the future, therefore there will be no further admissions to the Home prior to re provision plans being implemented. Accommodation is currently provided in two houses that are interlinked and run as one unit. The Poplars has its own large frontage, rear gardens and there is ample off road parking at the front of the houses. There are a number of local bus routes, local shops, and a railway station near by. The Home is well located to access Erdington and Sutton Coldfield. People have a choice of lounges and dining areas and the main dining room is large and decorated in a homely style. The bedrooms at the Home vary in size, are all for single occupancy and people are encouraged to personalise these. There are no call bell facilities provided at the Home. There are six bathrooms and seven toilets and staff are available to provide assistance in these areas as required. There is a designated smoking area provided for people who smoke. There is a notice board in the dining room displaying forthcoming events and other information of interest to people. Copies of our most recent inspection reports are available for people to read. The weekly accommodation fee to live at The Poplars is set by Birmingham City Council. Items not covered by this fee include clothing and toileteries. Care Homes for Adults (18-65 years) Page 5 of 30 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. One inspector carried out this inspection over one day; the home did not know we were going to visit. The focus of inspections we, the commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. Six people were living at the home. All people have a learning disability. We case tracked three peoples care this involves establishing individuals experience of living in the care home by meeting or observing them, discussing their care with staff, Care Homes for Adults (18-65 years) Page 6 of 30 looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. The registered manager had been absent from the Home for five months. Two assistant managers and senior care staff were overseeing the day to day running of the Home. The two assistant managers assisted us with the inspection. Time was spent observing care practices, interactions and support from staff. Five staff on duty were spoken to. We looked around some parts of the Home to make sure it was warm, clean and comfortable. We looked at a sample of care, staff and health and safety records. We were sent an Annual Quality Assurance Assessment (AQAA) by the home. This tells us about what the home think they are doing well and where they need to improve. It also gives us some numerical information about staff and people living at the home. We also looked at notifications received from the home. These are reports about things that have happened in the home that the Home must tell us about. 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 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 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 30 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 living in the Home have most of the information they need to know about the Home. Evidence: Due to the re provision of the services provided at The Poplars there had been no new admissions to the Home for a long period of time, therefore the pre admission process could not be assessed on this occasion. Registered numbers have reduced significantly over recent years as people have been supported to move to new Homes. There were six people living there at the time of the visit. There is no date yet confirmed for the closure of the Home. We were told that the consultation process with people living there, their representatives and staff should commence soon. A service user guide had been produced for the people currently living at the Home and this was available in an easy read format so that it was accessible to all people. The statement of purpose had not been updated for a few years and should be updated to confirm the current arrangements for people living there. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: People told us I like it here I want to stay here I dont want to move. Care Homes for Adults (18-65 years) Page 11 of 30 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. Care plans and risk assessments have most of the information that staff need to meet peoples assessed needs and protect them from the risk of harm. Evidence: We looked at three care plans. Care plans explain what each person needs are and the care and support they required to make sure these needs are met. We found that the files looked at gave general information about how staff should support the person in order to meet their individual needs in relation to personal care, communication, health care and social activities. We spoke to five members of staff and we also observed people being supported by staff. Staff demonstrated knowledge of peoples individual needs which was consistent with the information on peoples files. This indicates that staff know how to provide care and support to people so their needs are understood. We saw by reading peoples files, talking to staff and observing practice that risk Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: assessments required implementing in some areas where people are engaging in activities where there are known risks. This includes accessing the community independently, smoking and mobility issues in the Home. The risk assessment will support the good practice already in place and ensure people are encouraged and supported to maintain their independence whilst minimising any risks. We saw people receiving good support from staff. People were seen making different choices about how they spent their time. Some people went out to the shop, some choose to relax in their room or the lounge. People were seen freely accessing their bedrooms and different areas of the Home. We saw from care records and talking to people and staff that people are encouraged to make choices and decisions about their daily lives. People had been supported to take part in house meetings. One took place on the evening of our visit and we read the minutes of other meetings and trips out and menu planning had been discussed. The assistant manager said that meetings would now take place monthly so that people have an opportunity to talk about how the Home is run. Care Homes for Adults (18-65 years) Page 13 of 30 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 in the Home experience a meaningful lifestyle that promotes their independence and is reflective of their individual needs and interests. Evidence: We looked at care plans and daily records to establish that people are leading meaningful lifestyles and taking part in activities that they enjoy. We also spoke to three staff members and observed care and support on the day Care plans gave some information about what people like to do. We saw that activity plans on peoples files did not always reflect what people were doing now so need updating. We saw that people are supported to gain and develop life skills in order to lead fulfilling lives in which their independence is promoted. People are supported to do light household tasks and the laundry of their personal clothing with the support of staff. One person chooses to distribute the post, bring the milk and bread in and Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: empty the bins as his contribution to being involved in life at the Home. People are supported to make their own hot beverages and snack meals. We saw people make hot drinks as and when they wanted. Most people attend day centres and work placements and people met stated that they enjoyed going to these. On the day of the visit one of the people who does not attend a day centre had been out for a pub lunch and then relaxed in the lounge and said she was knitting a blanket for a relatives baby. People moved freely around their home accessing their bedroom or communal lounge, kitchen or dining room. We saw that bedroom doors are lockable and people told us they look after their own key. There are lots of different communal areas for people to relax in and small quiet lounges have been developed in rooms that were originally bedrooms. A games room with table tennis facilities and a gym facility had also been created on the first floor. Individualised fitness programmes had been developed by health care professionals in order to promote peoples well being. On the evening of our visit one of the people was being supported to attend an exercise class at a local leisure centre and they said, I like going . We saw that through a house meeting people had been asked about trips they would like to go on and several trips are scheduled to take place from May through to December to places including Wells Bourne market, Cheshire Oaks Southport, Weston, and Upton on Severn. People told us about family and friends who are important to them. There are facilities for people to meet with their relatives in private. Some people chose to visit their families and friends outside of the Home. There was a payphone available for people to use located in the visitors room so people could use this facility in private if they wish. On the day of our visit a house meeting was held with people living there and this included discussing the new summer menus. Healthy eating is encouraged and for some people the advice and support of a dietician had been sought. Meal times are flexible, the main meals being predominantly in the evenings after college/work as this suits the lifestyles of the majority of people living there. Snacks are available at all times so that people are not hungry. Special diets could be arranged for reasons of taste, health, culture,religious preferences and diabetic meals are being prepared at the current time. Menus were on display in the dining rooms for people to refer to in order to make their meal choices. Menus identified a variety of meals to meet any taste, for example traditional roast meals and spicy dishes. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Care Homes for Adults (18-65 years) Page 16 of 30 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 systems in place generally ensure that peoples health care needs are met. Evidence: Care plans that we looked at had some detail about how to meet peoples personal care needs. There was information about how much support people require from staff and also how people should be encouraged to do as much for themselves in order to maintain their independence. We saw that each person has a Health Action Plan in place that ensures individual health care needs are monitored and support needed provided. Referrals had been made to different professionals such as speech and language, psychology and chiropody so that specific health care needs are met. We looked at the log of health care appointments and saw medical appointments and interventions are recorded so peoples well being can be monitored. We spoke to staff about the management of peoples epilepsy. We saw that general epilepsy advice was on the files of people who have epilepsy. These were not specific to the individual and gave no specific information about the persons epilepsy. Staff informed us that people had not had a seizure for many years and guidance on peoples care plan said call the emergency services if concerned. Staff agreed to Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: support people to get their epilepsy reviewed by health professionals and ensure that individual protocols specific to the person are in place. Care plans looked at had details of peoples preferences regarding the gender of staff member assisting with personal care this should ensure that people receive support in a way that they prefer. We saw that peoples weight is monitored which can be an important indicator of other health care concerns. We saw that advice had been sought from dieticians about how people can be supported with healthy eating to promote good health and well-being. For some people detailed dietary records were being maintained to ensure an adequate diet is maintained. We looked at the arrangements in place for medication management. Medication is stored in a locked cabinet in the office. The cupboard was found to be clean, tidy and well ordered. The medication administration Records (MARS) looked at was signed indicating medication had been given as required. We recommended that medication records that are handwritten should be signed and checked by a second person to ensure accuracy. Copies of prescriptions are retained so that staff can check the right medication has been received from the chemist. Separate storage and recording procedures were in place for controlled drugs. None of the people self-administered their medication. Peoples consent to medication had been obtained and recorded on their care plan. Systems were in place for medication audits however these had not taken place seen the absence of the manager. These should be reinstated so that staff competence in this area is monitored. Staff training records seen indicated that staff responsible for medication management had completed training over four years ago. Updated training should be provided so staff continue to have the skills and knowledge to administer medication safely. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to listen to and respond to complaints and to protect people from the risk of harm. Evidence: The complaints procedure is available in an easy read format so it is more meaningful for the people who live at The Poplars. The commission had received no complaints about this Home and no complaints have been made directly to the service since our last visit. One safeguarding referral made to Birmingham Social Services by the commission was still under investigation. We saw that the Home had referred two recent incidents onto Social Services for their attention. People told us I can talk to staff staff are good. Staff we spoke to demonstrated a general understanding of their duty to safeguard people and how to report concerns on to senior managers. We spoke to staff and looked at training records to determine that training in safeguarding vulnerable adults had been provided. Safeguarding procedures, including an easy read format, and a whistle blowing policy was available for staff to refer to. The assistant managers informed us that these procedures are discussed with staff through their one- one sessions. This ensures that staff know what to do in the event of an allegation being made. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: Behaviour management plans were on peoples care plans so people get consistent support from staff. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, safe and comfortable home, which promotes their well being and meets their individual needs. Evidence: Although no final date has been agreed decisions have been made to close the Home, as some areas are no longer fit for purpose with regard to layout and facilities provided. For example there is no passenger lift and this may have been required for people living there in the future. Accommadation is provided over three linked properties with different levels and steps and is not suitable for people who may experience mobility difficulties. Since our last visit a number of people have been supported to move onto new homes that meet their assessed needs. We looked around some parts of the home including communal areas, bathrooms and bedrooms of the people case tracked. The internal environment of the Home was found to be clean and fresh and of a comfortable temperature for the time of year. Communal areas were homely and comfortable for people to relax in. The hallway, stairs and lounge had recently been painted so it is clean, fresh and comfortable for people. People said they had helped to choose the colour of the paint. There is a good choice of bathroom and toilet facilities for the six people who now live there. Some bathrooms had been fully refitted to a good standard with domestic style Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: baths and a walk in shower. Other aids and adaptations provided included grab rails near to toilets and baths and handrails in the corridors and on the stairs. The building is not designed to accommodate wheel chair users or people requiring a hoist. We were told that the current people living there have no difficulty accessing all areas of the Home. People showed us their bedrooms. These were seen to be spacious, very comfortable and contained personal items and were decorated in appropriate styles that reflected the age, gender, interests and culture of individuals. People told us. My room is lovely. I like my room its big. There is a spacious pleasant and secure rear garden for all people living at the home to use. There is a separate laundry room, which was clean and organised and is kept locked for safety purposes. We saw substances such as cleaning products that could cause harm to people had been locked safely away. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who have a good understanding of peoples individual needs. The recruitment procedures in place protect people from the risk of harm. Evidence: We watched the way that people interacted with staff on duty, which indicated that good relationships exist between people living there and the staff supporting them. We looked at the staffing rota for the week of the visit and the previous two weeks. These showed that there is generally three staff on duty to care for the people living there during the day. At night two staff members are on duty and one senior member sleeps in and is available to give support if needed. We could see from the rota that there is a senior person on all shifts this should ensure that staff are supported in their role each day. We were told that staffing levels were recently increased to three to meet peoples needs. We spoke to five staff during this visit they demonstrated that they had a good understanding of peoples individual needs and were enthusiastic about their work and keen to learn and develop their skills. Staff told us they had an induction to the work place when they first started. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: We spoke to staff about the training they had received and they said that they had completed training in mandatory areas including safeguarding, health and safety, fire and first aid. We looked at the staff training matrix, which confirmed mandatory training had taken place. Some training refreshers are due and the matrix required some updating. Training specific to meeting peoples individual needs had also taken place including autism, epilepsy, mental capacity and deprivation of liberty. This should ensure that staff have the up to date knowledge and skills required to meet peoples individual needs. Only a few staff had been recruited since our last visit. We looked at staff recruitment records for two staff members. Systems in place should ensure that people are protected from the risk of having unsuitable staff work in the Home. Staff told us that they receive regular supervision and they can talk about practice issues and training needs. The assistant manager told us that they discuss policy and procedures such as safeguarding and whistleblowing in these sessions. We looked at the supersion scheduled which indicated that regular supervision takes place. Regular staff meetings take place, which provide an opportunity for staff to discuss good practice and development issues. Regular managers meetings take place and this should ensure good communication between senior staff who rarely have the opportunity to work on shift together but hand over from one shift to the next. Care Homes for Adults (18-65 years) Page 24 of 30 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. Arrangements in place generally promote the health, safety and well being of people. Evidence: We were told in the absence of the registered manager two senior assistants and two senior carers have been overseeing the running of the Home. A manager from another local authority home has also provided support. Staff said that the current senior staff and assistant managers are supportive. We found that well-organised systems are in place to promote the well-being and safety of people and staff receive the support to do their job. The additional staffing has provided people with the support they need during a difficult time with many changes taking place in peoples lives. The report has highlighted some areas for attention. Some further work to risk assessments is needed and peoples health care needs in respect of epilepsy requires clarification and clear guidelines in place so people are supported to be safe. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We looked at the record of visits by the registered provider and saw that regular visits took place up until March 2009 and reports of these visits were available in the Home. There are quality assurance systems in place including auditing systems for health and safety. Service satisfaction questionnaires have not been sent out for a few years. These should be distributed to people in order to obtain their views about the service provided at The Poplars. A comprehensive quality assurance programme had not been implemented. We looked at some health and safety records including fire records and water temperatures checks all are checked and serviced regularly and records are very well maintained. The work place fire risk assessment was just due for review and this was dealt with at the time of our visit. Good systems are in place for the recording and monitoring of fire drills and staff training in fire safety. This ensures that all staff including night staff takes part in practice drills so they are competent in the homes fire procedure and know how to support people should the alarm be activated. It was noted that a fire drill was now due. There are systems in place for the recording and monitoring of accidents. We recommended that a system is implemented for the analysis of incidents and accidents to ensure that action has been taken to look at any trends and ensure that any steps to minimize further occurrence is taken. Staff spoken with and records looked at confirmed that staff have completed training on health and safety, first aid, fire safety and food hygiene. This should ensure that a safe environment is provided for people. The AQAA had been completed to a satisfactory standard and returned to us within the required timescales. Care Homes for Adults (18-65 years) Page 26 of 30 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 30 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 19 12 Individual epilepsy protocols must be in place for people. So their health and well being is protected. 30/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 The statement of purpose should be updated so people have the information they need about who the Home is for and what will be provided. Risk assessments should be in place so people receive the support they need to promote their independance. Peoples activity planners should be updated to reflect their current activities and interest so they are supported consistently. Medication records that are handwritten should be signed and checked by a second person to ensure safe practice. Staff who administer medication require refresher training so they continue to have the skills and knowledge to manage peoples medication competently. 2 3 9 12 4 5 19 19 Care Homes for Adults (18-65 years) Page 28 of 30 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 6 24 The Home has been previously assessed as not fit for purpose the provider should keep CQC informed of its plans to close the home. Service satisfaction questionnaires should be distributed to people in order to obtain their views about the service provided Arrangements should be in place so that incidents and accidents are analysed and steps taken to prevent further occurrence so people are protected. A fire drill was due so that staff know how to act in the event of a fire and support people safely. 7 39 8 42 9 42 Care Homes for Adults (18-65 years) Page 29 of 30 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. 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