Care Home: Together Working for Wellbeing (Southbury Road)

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What the care home does well Staff are committed to the rehabilitative model of enabling people to develop so that they can live in their own homes and support residents well. The home is a homely and supportive environment for the residents to live in. Recent refurbishment has improved the living space. What has improved since the last inspection? All requirements from the last inspection have been met. The hall and office carpet has been replaced, bathrooms have been refurbished, and the front gate removed to improve the appearance of the property. The heating system and radiators have been completely renewed. Staff supervision and quality assurance system are in place. Regulation 26 reports are completed monthly. What the care home could do better: The Statement of Purpose and Service User Guide needs updating. Mandatory staff training should be updated, including food hygiene. Staffing levels should be reviewed and the home should make sure that there is a system in place to cover staff absences. Fire drill recording needs to improve. It is recommended that the Registered Manager undertake a safeguarding adults Train the Trainer. Key inspection report Care homes for adults (18-65 years) Name: Address: Together Working for Wellbeing (Southbury Road) 87 Southbury Road Enfield Middlesex EN1 1PJ     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: Margaret Flaws     Date: 1 4 0 5 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: Together Working for Wellbeing (Southbury Road) 87 Southbury Road Enfield Middlesex EN1 1PJ 02083421593 02083629004 southburyroad@together-uk.org www.together-uk.org Together Working for Wellbeing care home 9 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) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 87 Southbury Road is managed by Together: Working for Wellbeing (formerly MACA), which provides services throughout the country for people with mental health problems. The home accommodates nine residents. There are three bedrooms on the ground floor and six bedrooms on the first floor. The home is wheelchair accessible. There is an adapted bathroom and toilet on the ground floor. The building has a lounge, dining room and kitchen. There is a separate laundry and a spacious garden to the rear of the building. The home is within walking distance of the local shops. There are good public transport links. The home aims to provide a supportive and rehabilitative environment where residents can improve their skills and confidence and move onto more independent accommodation. Fees at the time of the inspection were #892/week approx. Together makes inspection reports and information detailing the service provided by 87 Southbury Road available to residents and families. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 9 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 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 key unannounced inspection took place over one day with the Registered Manager present and assisting throughout. This inspection consisted of interviews with the Registered Manager, two staff members and discussions with several residents. We saw care, staff and general home records and toured the premises. An Annual Quality Assurance Assessment was provided to the Care Quality Commission and gave us good information for this inspection. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking 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 7 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 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to live in the home can be confident that their needs will be properly assessed, so that the home can work to meet these needs. Evidence: Three residents have come to live in the home since the last inspection. We saw their files, which were in good order. These included multidisciplinary assessments, discharge summaries and evidence of pre-admission and ongoing meetings and plans. Cultural and religeous needs were assessed. All residents are funded by the Enfield PCT and the home works closely with local mental health services. The home is supporting one resident who comes to stay overnight four nights a week and during one day. This is part of a gradual rehabilitation plan to build this residents confidence and wellbeing. We spoke to three residents who had lived in the home for less than one year. They told us that they liked living in the home and that they were able to visit before moving in. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: Since the last inspection, there have been some changes in the way the home works and the Registered Manager told us that there may be further changes as the organisation, Working together for Wellbeing, restructures its service delivery. The Statement of Purpose and Service User Guide should be updated to reflect any changes in the homes philosophy, the nature of its rehabilitative work, the expected duration of residents stay and description of how these goals will be achieved. A requirement is given. 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 living in the home are supported to develop as individuals and live independant lives. They are involved in planning their development and how they are supported. Residents are protected by the homes risk assessment policies and procedures. Evidence: We saw the care plans, case notes and files for three people living in the home. Their needs had been regularly assessed and were outlined in good quality care plans. Residents preferences and choices were recorded. The organisation has introduced a new model of care planning called Recovery Star and residents key workers are gradually introducing this tool into care and rehabilitation sessions with each resident. Key working is a well integrated part of care planning and staff gave good descriptions of how they put this into practice. They were knowledgeable about the residents needs and goals and their meetings with residents were documented. Residents confirmed that they valued these one to one sessions and said that they had regular opportunities to review their progress. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: We saw the residents daily notes. Copies of the residents care plans are kept with the daily notes so that the staff can refer to these when planning each day with the residents and evaluate progress in meeting agreed goals. The daily notes were generally clear, personalised notes that gave a good picture of how each person spent their day and how staff worked with them. The notes included an account of their interactions with others, moods, general wellbeing and activities. We sat in on the afternoon handover session between staff. Staff had a rounded discussion about the residents and clearly communicated issues to be addressed. It was evident from this meeting that the staff knew the residents very well and demonstrated a committment to supporting them to meet their goals and work towards more independant living. Residents told us that they choose how they spent their time and pursue their relationships with each other. During the inspection, residents chose when they got up, had their meals and went out. Staff said that they could see how the rehabilitative model, with a view to residents moving into their own flats within two years, had improved the residentss wellbeing and abilities. Residents also told us that the home had helped to increase their confidence, expand their independance and opened up the possibility of living in the community. They believed that the home was helping them to move on. Residents agreed that this was the case even though they sometimes had to do more for themselves than had been used to in the past. Staff told us that they were not always popular with the residents when they encouraged them to do things for themselves, rather than having them done for them. There were clear risk assessments for each person completed by both the home and the mental health teams involved in supporting them. These covered a range of risks and had been regularly reviewed. The home works on a daily and weekly basis with the local mental health teams. These regular meetings help to minimise risks and staff told us that this support is valuable and can reduce the need for hospital readmissions. Regular case meetings are documented, with specific actions outlined and taken. 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. Residents are supported to develop as individuals so that they can live full lives in the local community. They are supported to maintain contact with their families, pursue friendships and personal relationships as they choose. Residents benefit from having staff who respect their rights and encourage them to act responsibily. They are provided with healthy, nutritious meals. Evidence: Most residents have close and regular contact with family. One resident had just returned from a visit to aother part of England with his family. He said he had a great time and went to football games and on outings. During the day, some residents spent time at home and out going to the swimming pool together,two others spent time listening to music, one resident did her washing and tidied her room and others went out on visits and to the shops. Residents were able to undertake individual activities as they wished. One person went out for a visit with a St John of God worker (St John Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: of God support workers, who have known the residents in hospital, are provided through the Enfield Mental Health Rehabilitation Team). Staff told us that it can be difficult to support the residents to go out as much as they wish because the staffing level is reduced. There used to be an additional staff member on duty between 10am 6pm but this position has been cut. A requirement to review the staffing level to ensure it matches the homes philosophy and goals is made under the Staffing section of this report. In the house, there are televisions, DVD players, games, a karaoke machine, music, and other in house activities available. Residents play football in the garden and snooker in the lounge. Staff told us that the residents use the office computer if they need to use the internet. Residents go out to local commmunity facilities such as the gym, library, cinema and some residents are working towards employment. Residents told us they have regular contact with their families. One resident stays at the home for part of the week and spends the rest of the time with family. Other residents spend varying amounts of time at their family homes and family members visit. Staff interactions with residents that we saw during the inspection appeared respectful and professional but also warm and supportive. Residents have keys to their rooms to protect their privacy. Each resident has a contract, kept on file, which outlines both rights and responsibilities. We saw the menu displayed in the kitchen. Residents have a weekly house meeting on a Monday night and at that meeting, decide what they would like to eat that week. They then create the menu. The home is close to a large supermarket. Residents can go and buy food and other shopping for the house and help with the routine weekly shop. They also cook for themselves or help the staff cook. Food storage was appropriate for a home of this size and food was safely kept. The home has provided a seperate fridge and cupboard for two residents who are close to moving into supported living to help them plan their shopping and budgeting. 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. Residents receive appropriate personal care support, if they need it. Their physical and mental health needs are monitored and met. Residents are protected by the homes medication policies and procedures. Evidence: Some residents need some support with their personal care needs from time to time and others need prompting to undertake personal hygiene. These needs were outlined in their care plans. The Registered Manager and staff told us how these needs were addressed. Quality assurance surveys we saw indicated that the residents were satisfied with this support. Healthcare records are kept in each persons file. Healthcare appointments and visits by professionals were documented. The home has intensive back up from the Enfield Mental Health Rehabilitation service, with weekly input from a Clinical Psychologist, Psychiatrist, occupational therapist and other community mental health staff. Full three hour care plan review meetings are held monthly with this team, who are pleased with the homes success in rehabilitation. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The home has regular visits from Enfield Rehabilitation Team and regular visits by mental health professionals, including psychiatrists. Staff from the St John of God project take residents out. A staff member showed us the medication arrangements. None of the residents self medicate. The medications are stored in a locked cupboard in the office.The Medication Administration Records we saw were in order and there were no gaps. We also saw the process for returning excess medication. The Registered Manager showed examples of how residents came from hospital with a high number of medications and how unused medications were returned to the pharmacy. In line with the homes rehabilitative philosophy, people close to moving into supported living do not use a dossett box medication system. Staff support them to take their medication and help them learn how to manage their own medication. The home uses a dual system with some medication supplied by Boots in dossett boxes and some supplied by the local pharmacy. 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. Residents are supported to express their concerns and they understand that these concerns will be followed up. They are also protected by the homes safeguarding policy and procedure. Evidence: We saw the complaints records for the home. Two minor complaints had been recorded since the last inspection. We saw a clear paper trail of follow-up actions taken and outcomes recorded.Residents we spoke to told us that they felt safe in the home and would raise concerns with if they needed to. The home has a copy of the local authoritys safeguarding adults policy and procedure in the office. During the inspection, the Registered Manager located a new version of this policy on the local authoritys website and made a copy for the home. The staff were able to describe what they would do in response to an allegation or disclosure of abuse. The Registered Manager told us that there had been no safeguarding concerns since the last inspection. Some staff need to have safeguarding training updates and requirement is made under the Staffing section of this report. It is also recommended that the Registered Manager undertake a Safeguarding Adults Train the Trainer course so that she can keep her staff updated in safeguarding. 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. Residents live safely in a homely, comfortable environment that meets their needs. Evidence: We toured the building with the Registered Manager. Considerable physical improvements have been made to the home since the last inspection. Several bedrooms and the lounge have been refurbished. The Registered Manager and staff have repainted the hallways and the bathrooms.These spaces are now very homely and welcoming. One bathroom is set aside for women only to reflect cultural gender preferences.The lounge and refurbished bedrooms have new curtains and televisions. We visited several residents bedrooms and these were highly personalised. The residents said they liked them. At the last inspection, several requirements were made to improve the environment. These have been met. The hall and office carpet have been replaced. The upstairs bathrooms have been refurbished. The front gate has been removed. The heating system has been replaced, with new radiators and an improved gas supply. It has not been possible to provide a quiet room, as recommended, because of insufficient space. The home was clean and hygienic on the day of the inspection. Residents clean and Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: tidy their own rooms and take part in a rota of chores around the house. A part time cleaner comes three days per week. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes recruitment policies and procedures. There are sufficient staff in the home to meet the residents needs. The residents would benefit from improvements in staff training. Evidence: Under the current staffing structure, the home employs a Registered Manager, a Deputy Manager alongside the care staff. Working together for Wellbeing is currently restructuring its management positions and this structure will change. We saw the staff rota. There are two members of care staff on duty at all times, supported by the Registered Manager during the week. Staff told us that one additional staff position, from Monday to Friday 10am to 6pm had been cut since the last inspection. They said this made it harder to build on the rehabilitation model and take residents out into the community unless the Registered Manager was on site. A requirement is given that the staffing level be reviewed. We checked five staff files, some for staff who had started work after the last inspection. All staff had had pre-employment checks, including Criminal Records Bureau checks with POVA clearances and written reference checks. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: We saw the training records for staff. Over the past two years, staff have been trained in dual diagnosis and alcohol and drugs, care planning, wellbeing and stress management,non violent crisis intervention, rehabilitation models, team leadership, forensic mental health, risk assessment and health and safety. Some staff have received update training in mandatory areas of practice such as first aid, medication, safeguarding adults (POVA) and fire training. However, staff need more regular refresher training in these areas. Some staff also do not have valid food hygiene certificates. There must be a clear staff training programme in place to ensure that staff receive mandatory and refresher training in these areas. A requirement is given. Staff must receive outstanding refresher training as soon as possible. It is also recommended that the Registered Manager undertakes a Train the Trainer course in the safeguarding adults to keep staff updated. Several staff have achieved NVQ3. The staff told us that they are a tight knit team who work well together. Residents were also positive about how the staff supported them. Staff meetings are held regularly and staff said that they could meet on a one to one basis with the Registered Manager as and when needed. Formal supervision has improved sufficiently to meet a requirement from the last inspection but there has been some recent slippage due to the sickness absence of a supervising staff member. A requirement is given that the home ensures there are good systems in place to provide cover for staff absences. 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. Residents benefit from a well run and managed home. Their views are constantly sought to improve the service offered. Their health and safety is protected. Evidence: The Registered Manager is now registered with CQC. She demonstrated a good understanding of how to run the home well for the residents benefit. Staff and residents were positive about her management style, approachability and proactive stance. Staff said they felt that she provided them with good support, respect and leadership. Regulation Twenty Six management visits take place monthly and the report on file higlighted any areas for action. This meets a previous requirement. The home has several ways of measuring quality assurance. They undertake a regular, small scale survey to obtain feedback (with positive results), holds residents meetings and contact relatives and professionals for formal feedback. We saw sufficient evidence on file and in our conversations with the residents to show that the home is good at consulting and involving the people who live there and others. This meets a previous requirement. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: We saw the incident records. These were well recorded, with actions arising documented and changes to risk assessments noted. The incidents were generally minor. Staff told us that the residents were relatively calm and stable and presented few challenges that could lead to potential incidents. They also said that the close relationship with mental health services was helpful. We saw the homes health and safety certificates. These were in order and up to date. They included gas safety, electrical installation and portable appliance testing. The Registered Manager said that a fire officer visited the home two months ago. He did not make any specific recommmendations. The homes fire safety records were reasonable but the recording of four full fire drills per year, with residents participation, could improve. A requirement is given. The fire equipment regularly monitored and tested. The home has a fire risk assessment. Fire training also needs updating and a requirement is given under the Staffing section of this report. 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 1 4 The Registered Person must ensure that the homes Statement of Purpose and Service User Guide are updated to reflect changes in the homes philosophy and nature of work. Prospective residents should have all the information they need before moving into the home. 14/08/2009 2 33 18 The Registered Person must ensure that there is a good system in place to cover staff absences. Staffing should be matched to the residents needs. 14/08/2009 3 33 18 The Registered Person must 14/08/2009 ensure that the staffing level is reviewed. There must be sufficient staff on duty. Care Homes for Adults (18-65 years) Page 25 of 27 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 4 35 18 The Registered Person should ensure that staff are updated in food hygiene. Staff training should be kept up to date. 14/08/2009 5 35 18 The Registered Persons should ensure that staff training in mandatory areas of pracitice is kept up to date. Staff should be kept up to date with good practice. 14/08/2009 6 42 12 The Registered Person must ensure that fire drill be correctly recorded Fire records should be kept up to date 14/08/2009 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 35 That the Registered Manager should undertake a Train the Trainer course in Safeguarding Adults. 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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