Care Home: Victoria Cottage

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What the care home does well The Service User Guide included some pictorial examples to help people using the service to make a choice about the home and give them information about what to expect from living at Victoria Cottage. Any new resident considering Victoria Cottage as a place to live and receive care had a thorough pre-admission assessment. Communication between staff and residents was mutually respectful, upbeat and positive. Staff made sure that residents were encouraged to be as independent as possible and to have, and keep, regular health care appointments. Medication records were fully completed by the staff administering the medication. Regular management checks of medication were undertaken to monitor compliance. There was a complaints procedure in place and residents were supported to make complaints. Staff were trained in safeguarding and other training relating to managing violence and aggression. Those complaints made directly to the home had been appropriately dealt with. There were enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activities or to cover a resident requiring one to one support. the manager had the skills needed to successfully manager the service. What has improved since the last inspection? Since the last inspection information provided to people was accurate and reflective of the facilities available. Those residents who require assistance with moving had effective Manual Handling assessments in place. The home had effective guidelines available to staff administering homely remedies and medication given PRN (as required). Furniture and carpets that had become old and not suitable for purpose had been replaced Suitable locks had been fitted to all bathroom and toilet doors. Robust recruitment policies had been implemented. The manager believed that introducing person centred planning had led to more individualised activities for the residents over the last year. What the care home could do better: The service had made a number of improvements over the last year. There were some areas that needed further improvement, and these resulted in a requirement or recommendation in the report. They included the need for information provided for residents to be in a format that they can use and understand easily. The need to ensure that records are accurate, and that any changes or deviations are appropriately recorded and reported. The need to ensure that maintenance within the home is kept on track and that the home retains a homely atmosphere. Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria Cottage Victoria Cottage 37 St Andrews Road Bedford Beds MK40 2LW     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: Sally Snelson     Date: 3 0 1 2 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 29 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 29 Information about the care home Name of care home: Address: Victoria Cottage Victoria Cottage 37 St Andrews Road Bedford Beds MK40 2LW 01234271225 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Victoria Cottage Limited care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Any service users who have physical disabilities in addition to their learning disabilities must be provided with a bedroom on the ground floor. The home is permitted to accommodate one named service user over the age of 65 years. The home may also admit up to 2 service users who have a physical disability in addition to their learning disability. The home shall only admit service users between the ages of 18 and 65 years. Date of last inspection Brief description of the care home Victoria Cottage is located in a pleasant residential area of Bedford within walking distance of the local park and the town centre. The home is registered to provide for fourteen younger people who have a learning disability, two of whom may also have physical disabilities. The accommodation is arranged over two floors with single bedrooms on each floor and a double room on the ground floor. Each bedroom has a Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 14 14 1 7 0 3 2 0 0 9 Brief description of the care home washbasin facility and a call bell. Eight of the bedrooms have ensuite shower facilities. Two of the bedrooms share the ensuite facility. A combined shower toilet room is located on the lower floor and a separate toilet is located on the upper floor. The communal facilities of a large lounge, an all weather conservatory and a dining room are all located on the ground floor. To the rear of the property is a well-maintained garden with an enclosed pond. The manager advised us that on 30/12/09 the fees for this home varied from £405.00 to £1100.00 per week depending on the needs of the resident. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was a key inspection, was unannounced and took place from 10:00hrs on 30th December 2009. The manager Jill Garner was present throughout and assisted with the inspection process. During the inspection the care of two people who used the service (residents) was case tracked. This involved reading their records and comparing what was documented to what was provided. We also looked at recruitment, training health and safety documentation, medication records and food planning as well as touring the building. Any comments received about the home, plus all the information gathered on the day was used to form a judgement about the service. The manager had completed an AQAA in advavce of the inspection. We would like to thank all those involved in the inspection for their input and support. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Adults (18-65 years) Page 7 of 29 The service had made a number of improvements over the last year. There were some areas that needed further improvement, and these resulted in a requirement or recommendation in the report. They included the need for information provided for residents to be in a format that they can use and understand easily. The need to ensure that records are accurate, and that any changes or deviations are appropriately recorded and reported. The need to ensure that maintenance within the home is kept on track and that the home retains a homely atmosphere. 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions would not be made to the home until a full needs assessment had been undertaken. New residents were provided with a contract. This set out in detail what was included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Evidence: All of the information in the Statement of Purpose and Service User Guide had now been updated. The Service User Guide included some pictorial examples to help people using the service to make a choice about the home and give them information about what to expect from living at Victoria Cottage. The manager told us that she intended to look at providing this document in more formats, such as audio or photograph, to ensure it was available to everyone. The home had not had an admission for a period, of approximately two and a half years. The service had a well structured and planned referrals and admission process Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: which was discussed with the manager on the day of inspection. The last perspective resident was assessed prior to admission, and given every opportunity to try the service. This was not only to see if they liked the home environment, but also the other service users who were living there. Residents contractual arrangements were reviewed. Contracts contained sufficient information to ensure service users rights were protected and empowered. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were working documents that were reviewed regularly involving the person and their representatives. Each care plan included risk assessments, which were also reviewed regularly. They addressed safety issues while aiming for improved outcomes and independence for people. Evidence: Since the last inspection staff had been trained to write person centred support plans and to provide care and support in this way. The two care plans that we looked at were clear and precise. It was apparent that they were active working documents and were regularly updated, as even plans that had been recently re-typed had hand written amendments to them. All plans had been reviewed at least six monthly. They were signed by the key worker and the resident, or someone on behalf of a resident. Staff members spoken to were able to talk about the information written in the care plans, which told us that staff were familiar with how they needed to ensure residents Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: health, personal care and social needs were met. Communication between staff and residents was mutually respectful, upbeat and positive. On several occasions during the inspection residents were observed receiving individual support, one resident could not decide what he wanted for his lunch staff reassured the person, and assisted him in a clear, but caring manner. People living in the home were being supported by staff to take risks. Appropriate risk assessments were in place. There were risk assessments for areas such as showering, crossing the road, making a drink, anxiety and using stairs. Untoward incidents were rare as staff were skilled at defusing situations. Few incidents (reg 37s) had been recorded since the last inspection and these were well documented. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service had the opportunity to develop and maintain important personal and family relationships as they wanted. Where appropriate, education and occupational opportunities were encouraged, supported and promoted by the staff team. Evidence: On the day of the inspection, which was during the period between Christmas and the New Year, two of the residents were staying away from the home for the holiday period, and others were out and about but there was no planned activities, although we did see staff working one to one with particular residents. Residents were making plans for their New Years Eve party and some were able to talk about the variety of Christmas celebrations they had been part of. For example one resident was in a theatre group that produced a pantomime which staff and other residents had Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: attended. Talking to service users and staff and reading the AQAA provided evidence of residents participating in appropriate activities within the local community, for example theatrical groups, local choirs and church events. Those who wanted to attended college courses and some attended vocational work groups. Risk assessments for individual activities where there were concerns had been completed. People using the service had worked with their key worker to document there likes and dislikes for activities, interests and food. The manager believed that introducing person centred planning had led to more individualised activities for the residents over the last year. Over the past year small groups of residents had been on holiday to various destinations at home and abroad. We saw photographic evidence of these holidays throughout the home. Residents family and friends details were included in all the files seen. Also included were friends and families birthdays and whether it was appropriate for them to receive a greetings card or gift for birthdays and Christmas from the resident. Some residents were involved in the planning of menus, and daily food preparation together with staff members. Much of the food was freshly cooked and the home had ample storage facilities for food. A large shop was undertaken by the company each week, but staff would take residents for smaller shops for perishable foods. Snacks and drinks were available throughout the day, and there appeared to be no restrictions. The routines in the home were flexible, and varied according to individual choices, and needs. One service user was observed cleaning the kitchen with support from a staff member; there was a list of weekly service user tasks. Residents were aware of their tasks and why they needed to do these. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff made sure that residents were encouraged to be as independent as possible and to have, and keep, regular health care appointments. Medication records were fully completed by the staff administering the medication. Regular management checks of medication were undertaken to monitor compliance. Evidence: Service users were supported wherever necessary with all aspects of their physical and emotional health. Adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dietitians was provided both within the community, and also at the home. Assistance required was clearly detailed in the care plans seen. One residents whose needs had altered had been assessed for a shower seat which had been provided and the care plan updated to allow for the changing needs. Care plans for another resident informed staff that they needed training before assisting this resident with eating. Drama therapy had been suggested to help a certain resident with his behaviours, and this had been rolled out to all the residents to help them understand and to improve Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: the atmosphere within the home. The monthly weight record of one of the residents we were case tracking showed there had been a dramatic weight loss and it appeared that nothing had been done. The manager immediately investigated this and staff told her that on the day the particular resident had not wanted to let go of the wall when standing on the scales so staff were aware the result was not accurate. We would have expected the person to have not recoded this weight or to have put a note, as to why there was such a deviation. The home had a robust policy and procedure in place to safeguard the administration, storage and receipt of medication. No concerns were found with regard to the administration of medication on the day of inspection. Three service users medication was looked at in detail. The medication sheets were signed accurately and were checked with the remaining amount of medication. Training records indicated that staff undertaking the administration of medication had had recent training about the administering medication. The home had its own medication audit process which had been in operation since a medication error had required a safeguarding meeting. This process was now well established within the home and was identifying any problems in a timely fashion. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a complaints procedure in place and residents were supported to make complaints. Staff were trained in safeguarding and other training relating to managing violence and aggression. Evidence: The home had a complaints policy which gave information about how to make a complaint. This information was also included in the homes statement of purpose and service user guide. The complaints procedure was available in makaton signs for those who would benefit from it. Given that many of the service users had complex needs, and therefore limited verbal communication skills we were told that staff members regularly informed residents how to raise concerns. The manager told us that they usually tried to sort out any grumbles raised by the service users informally, though the one to one key worker sessions but a record was kept of this concerns and how they were dealt with. Relatives and significant others were made aware of the policy, and knew how to complain if needed. The AQAA told us that the service was aware of the need to continually listen to people and support them to make complaints. Complaint records examined indicated that all concerns and complaints were appropriately dealt with. There had been no complaints made to us about the service since the last inspection. Those complaints made directly to the home had been appropriately dealt with. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: All staff at this home had attended training in safeguarding. The manager has a clear understanding of safeguarding and has used the reporting process appropriately over recent months where necessary to protect those using the service. Deprivation of Liberty (DOLS) and the Mental Capacity Act (MCA) was also planned into the training programme. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a physical environment that in the main met the needs of the people using the service. The home was comfortable and had a programme to improve the decoration, fixtures and fittings. Occasionally there was slippage of timescales and maintenance could be reactive rather than proactive. Evidence: We were given a tour of the home by one of the residents who also showed us his bedroom. The home was generally clean and tidy and free from offencive odours in the communal areas. Furniture that had been described as old and uncomfortable in the last report, such as the sofa, had been replaced and this made the home more homely and comfortable. In addition the home had been re-painted throughout and new carpets and flooring had been laid in communal areas and in four of the bedrooms. The manager told us that residents were encouraged to personalise their bedrooms and we saw evidence of this. During the tour some areas of the home appeared cooler than others. We were told that there had been some problems with the boiler that had failed at times and been repaired. Concerns had been raised at the last inspection about the curtains in the home and we were told that there were plans to replace them during this year; they had however been re-hung. The last report also made reference to the two people who shared a Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: bedroom and how this had been agreed. The complex needs of the residents made it difficult to provide this evidence but in both cases the parents had been consulted and were happy with the arrangements. There were also no records of any negative behaviours which may have been associated with two people sharing a room who were not happy with the arrangement. The manager was aware of the need to document this and to offer these residents an alternative room as one became available. Curtains in the room ensured that each of the residents had privacy when personal care was provided and the en-suite bathroom had two different types of baths that suited the individual needs of the individual residents. Also, since the last inspection the area that was used for food storage had been upgraded and locks had been put on all of the bathroom and toilet doors. There were laundry facilities which could be used by some of the residents but not be those who used a wheelchair. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activities or to cover a resident requiring one to one support. Evidence: On the day of the inspection there were four staff on duty. The manager and the duty rotas told us that this was normal and that additional staff could be used to facilitate activities for the residents when needed. The manager was in the process of devising the training plan for the new year and was able to show how the plan was developed. A range of training was offered to staff to develop knowledge within the staff team. This included the mandatory training as well as specialist training such as epilepsy awareness. There was a stable staff team in place and the manager told us that staff vacancies were rare and that on the whole staff had good attendance records. The AQAA told us that eight of the 14 staff team already had an NVQ qualification to level 2 or 3 and that all but one of the remaining staff were in the process of completing this training. Staff received regular supervision and a mentor scheme was in place for all new staff. New staff had a comprehensive induction and were not expected to work alone until Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: they were confident to do so. We looked at the personal files for three staff members who we chose at random. The recruitment process for each employee was very clearly documented, and files contained all the necessary documentation, which included; fully completed application forms, at least two references, including one from their most recent employer prior to coming to this service, Criminal Record Bureau (CRB) and POVA first checks, Home Office documentation where required, various forms of identification, including passports, birth certificates and driving licences. There was also photographic ID present in the files. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager had the required qualifications and experience and was competent to run the home. She promoted equal opportunities, had good people skills and understood the importance of person centred care. Evidence: The manager at this home had been in post for approximately four years. She was very passionate about the residents. She told us that she felt well supported by her line manager and the staff team. Discussions with some staff and residents indicated that she was well respected. One resident told us, I like Jill she is good at her job. All of the staff that we spoke to indicated they were very happy in their jobs and felt well supported by the manager. The manager told us that she enjoyed learning and had recently completed a communication course and was looking for the next thing to do. Throughout this inspection the manager demonstrated a clear understanding of the needs of the residents in the home, and the importance of encouraging their independence. There were clear policies in place in this home and the Annual Quality Assurance Assessment (AQAA) we received prior to this inspection was adequate. It Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: could have included more detail about plans for the future of the service. The manager regularly audited different areas of the service and ensured that residents and other stakeholders were asked for their opinions. We did not however see how these results were evaluated and used to influence the running of the home. Staff attended regular meetings and residents met together to discuss aspects of the service. Records that we looked at in this home were well organised and reflected individuals progress. Risk assessments were in place for each individual, and were being reviewed as individuals abilities and needs altered. We looked at Health and Safety records relating to fire evacuations, smoke detector testing, call point testing, water temperature testing, food temperature probing and general environmental checks. All of which are carried out on a daily or weekly basis and recorded on file. We were disappointed that a higher than expected freezer temperature had not been reported to the manager for attention as soon as it had been discovered. This suggested that the staff taking the readings were not completely aware of what they were recording and what was considered normal. The manager was able to demonstrate her understanding of reporting both regulation 37 notifications when necessary and referring to the safeguarding team. Over the past year CQC had been kept informed of any incidents that had occurred in the home, and we discussed and looked at information relating to these incidents in personal files, to see how different incidents had been concluded. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 17 Staff must ensure that any records made about the residents are followed up appropriately. This ensures that residents are kept safe and well. 01/02/2010 2 24 23 The premises must be kept fit for purpose and the maintenance programme must be maintained. This is to keep the home homely. 01/03/2010 3 39 24 Feedback received from stakeholders must be published and used to influence the running of the . This ensures that peoples views are taken into account. 01/03/2010 Care Homes for Adults (18-65 years) Page 27 of 29 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 service should ensure that information provided for residents is in a format that they can use and understand easily. Staff should ensure that they report any deviations of health and safety checks so that they can be investigated. 2 42 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!