Care Home: Viola House

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What the care home does well The home provides a suitable stimulating environment for people with learning disabilities and challenging behaviour. A range of interesting planned and stimulating activities is provided. People using the service can choose if they want to take part in activities and are involved in the planning of new activities. The home provides person centred care focusing on people`s abilities and support people using the service to achieve their aspirations and dreams. People using the service live in a nicely decorated, clean, stimulating and well maintained environment. The home is keen to improve outcomes for people using the service and is pro-active and forward thinking in coming up with new ideas. People using the service were observed to be very relaxed within their home environment. The home has 21 staff epmloyed 18 of the staff hold or work towards National Voccational Qualifications in Care, this ensures that people using the service are supported by a skilled and qualified workforce. What has improved since the last inspection? This was the home`s first key inspection since re-registering with the Care Quality Commission in July 2009. What the care home could do better: We have made three requirements during this inspection. The home must support and encourage people using the service to be involved and take part in the planning of menus. All staff must receive at least six planned supervisions and one appraisal per calendar year, this ensures people using the service can be confident that staff are supported appropriately. Key inspection report Care homes for adults (18-65 years) Name: Address: Sunrise Care Ltd 57 Castleton Avenue Middx HA9 7QE 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: Andreas Schwarz Date: 1 5 1 2 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 30 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 © (2010) 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 30 Information about the care home Name of care home: Address: Sunrise Care Ltd 57 Castleton Avenue Middx HA9 7QE 02089036212 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): alison.simmonds@sunrisecare.co.uk Sunrise Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 10 Number of places (if applicable): Under 65 Over 65 10 0 learning disability Additional conditions: From Individual to Limited company - Responsible Individual now Mrs Alison Simmonds. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home 57 and 59 Castleton Avenue (Marteen House) is run and managed by Sunrise Care Ltd. The registered provider is Mrs Allison Simmonds. The home has reregistered with the Care Quality Commission on 28/07/2009, increasing the number of people using the service from 5 to 10. The home was previously registered with the Commission for Social Care Inspection. The home comprises of two newly refurbished buildings. Accomodation is available on the ground and first floor of both buildings. A large well maintained garden is available. There is off street parking for four vehicles in front of the home and no parking restrictions are in force on Castleton Avenue. One registered manager is responsible for the overall management of the home and the home is planning to employ two Team Leader who will support and report to the registered manager. The statement of purpose states that weekly fees start from £1100.00. 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 health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home This inspection is the annual Key inspection and the aim is to look at how well the service is meeting the key National Minimum Standards for Younger Adults. The unannounced inspection consisted of one day and lasted 9 hours. The manager and responsible person were interviewed and assisted with the inspection. The responsible person showed us around the home. During the day of this inspection there were five people using the service in the home. We spoke to three people using the service during this inspection. Throughout the inspection the way in which staff communicated with and supported people was observed, as well as how people got on with staff. We also interviewed staff to get their views and comments on the home. A wide range of records, including care plans, staff files and health & safety documents, were also looked at. We would like to thank the staff and management team and people living at Marteen House for their assistance with the inspection. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well What has got better from the last inspection This was the homes first key inspection since re-registering with the Care Quality Commission in July 2009. Care Homes for Adults (18-65 years) Page 8 of 30 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Andreas Schwarz 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 02072390330 Care Homes for Adults (18-65 years) Page 9 of 30 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 10 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 health care 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 11 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. Detailed information about the home is available so that residents and families know what they can expect from Viola House. People moving into the home can be confident that their needs and wishes will be fully assessed and an appropriate plan for meeting these needs will be drawn up. As a result their needs are met. Evidence: We viewed the homes service users guide, which was judged to be of a good standard and the use of pictures and symbols enables people who are unable to read to access the document. The service users guide provides detailed information about the home and support provided to people using the service. The homes statement of purpose was viewed and judged as detailed providing prospective people using the service with information about fees, how to complain and what to expect from the home. We viewed assessments of two people recently admitted to Viola House. Both assessments were of good standard and provide detailed information about peoples needs. It was evident in the assessments viewed, that people using the service or their representatives have been involved in the assessment of needs. Assessment information are included in peoples care plans to ensure peoples needs are met. We spoke to one of Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: the people who has been assessed by the home, the person informed us that she likes the home. Care Homes for Adults (18-65 years) Page 13 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 provide detailed information so that in general the needs of people using the service are met. The staff team at Viola House are good at finding ways for people using the service to make as many decisions for themselves as possible. People using the service are protected by risk assessments that are comprehensive and indicate clearly how risks to the safety of residents are reduced, whilst still promoting independence. Evidence: We assessed three care plans, all care plans were detailed and person centred. Needs are addressed individually and guidelines are put into place in how to meet the needs best. One of the care plans we viewed was from a person living in the home for a number of years, the care plan has been reviewed every six months and updated if needs have changed. People using the service were not able to discuss their care plans with us due to their communication difficulties. The home is documenting cultural needs and preferences of the person in the care plan. The registered manager informed us that six people living at Viola House have close links with their family. One relative informed us that he is consulted by the home about any changes to the care of his relative. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Peoples independence is being promoted by staff at Viola House offering them choice in choosing activities they enjoy and assisting them to develop in all aspects of their daily living skills. Throughout the inspection people using the service made choices about when they got up in the morning or went to bed, when they had their meals, what they ate, and whether they went out or not. We observed one person refusing the lunch provided, following encouragement by staff, the person was offered an alternative. As a result people using the service feel they have more control over their lives and this is contributing to their life at Viola House being a positive experience for them. We assessed financial records for two people using the service. Peoples finances are kept in a safe, which can be accessed by the manager. Records viewed were transparent, detailed and of a good standard. People using the service hold their own personal bank account, which they manage with the assistance of staff and management. Peoples files contain a variety of detailed risk assessments in order to ensure their safety, whilst promoting independence wherever possible. These included guidelines for staff when supporting people in the community so that people using the service can get out and about to local shops, whilst identifying ways of reducing any possible dangers to their safety, or the safety of others. Other risk assessments looked at peoples behaviours, risk of falls, risk of using transport, etc. Risk assessments are reviewed during person centred planning meetings or if peoples needs have changed. All staff have read the risk assessments, and demonstrated understanding when interviewed during this inspection. Observations made during this inspection, showed that staff follow risk management guidance to support people using the service safely. Care Homes for Adults (18-65 years) Page 15 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. The home is very good at enabling people using the service to get out and about so that they lead a ordinary life as possible. Staff supports people using the service to keep in close contact with friends and family, as well as respecting their rights and encouraging them to act responsibly. People using the service enjoy their meals and benefit from being offered a diet that is healthy and reflects their cultural preferences. Evidence: People using the service are offered a wide range of activities. Apart from planned activities people go shopping in Wembley, walks in local parks, discos and restaurants. We observed staff interacting with people using the service and offering choices of inhouse or community based activities. One person takes part in art therapy sessions, which are currently funded by the person. The manager told us that she is in the process of applying for additional funding, which would enable the person to take part more regularly in these sessions. One person told us that she likes to go for walks and daily activity records confirmed this. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People using the service regularly access the local and wider community. Planned activities are walks, visits to the library, visits to church, pubs and restaurants. In addition to this people using the service go to discos, regular annual holidays and day trips. One of the residents goes regularly to church; staff told us that on occasions the person chooses to stay at home. Observation throughout the inspection indicated that staff treat residents with respect and are patient when encouraging residents to do something. The manager and staff told us that relatives are involved in peoples care and visit the home regularly to spend time with their relative. People using the service access the community regularly enabling them to maintain and make friendships and relationships with disabled and non-disabled people. We observed people using the service move around freely in their home and spend time with peers or on their own if they wish. People using the service have some restrictions, due to their disability. These environmental restrictions are clearly recorded and assessed. In the light of new legislation and amendments in the form of the Mental Capacity Act and the Deprivation of Liberty Safeguards, people using the service have been assessed. The home has a cook employed for four days per week. The cook is responsible for the menu planning and ordering of ingredients. People using the service told us that they enjoy the food provided. The home has a four week rolling menu. When discussing the menu with the cook, she explained that the menu will be changed if she gets bored with it. It was not clear how people using the service are involved in the planning of the menu. People are offered alternatives if they are not happy with the meal offered or are not able to eat certain foods due to religious beliefs. Food eaten by people using the service are recorded individually and meals provided are nutritious, healthy and culturally appropriate. We noted that people using the service planned a Christmas party in luxurious hotel in Wembley. Food is currently prepared in 59 Castleton Avenue and people living in 57 Castleton Avenue join in for the meal. The manager told us that she is planning to change this and meals will be prepared on each premise. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and health care 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 are good at meeting the physical and emotional health needs of residents. As a result residents feel more at home and relaxed at Viola House. The residents are protected by arrangements regarding medication in the home. Evidence: People using the service indicated by their actions and behaviour that they felt relaxed and comfortable in their home. A key worker system is in place to ensure that people get the support they need that is appropriate to their individual situation. Staff spoken to knew about the individual needs of each person. The care plans are detailed and set out clearly how staff should respond to the individual needs and wishes of residents, with guidelines about areas of risk. As a result people using the service have felt supported in their home and have become more independent than previously. For example residents take a greater part in the daily running of the home including tidying up and helping to maintain the garden. The home has good links with Brent Learning Disabilities Team and can access health care professionals such as Speech and Language therapy, psychologist and psychiatrist. The psychiatrist meets regularly to review peoples medication. Staff spoken to told us that they regularly support people using the service to outpatient appointments. Health records showed that people are seen by dentists and opticians to check their teeth and Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: eye sight. The home has a medication procedure in place and medication is safely stored in a lockable cabinet. All staff have recently taken part in medication training and have undertaken a competency assessment. Medication Administration Records are of a good standard and individual guidelines are in place. Medication has been monitored by the dispensing pharmacist in September and November 2009. Care Homes for Adults (18-65 years) Page 19 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. People using the service and their representatives can be confident in the complaints procedures in the home that make sure their concerns are responded to whilst at Marteen House. People using the service benefit from safeguarding adults procedures that make sure that they are safe and secure whilst at Viola House. Evidence: The homes complaints procedure is available in the service users guide and displayed on the noticeboard in 57 and 59 Castleton Avenue. The complaints procedure is available in pictorial form. Complaints records viewed confirmed that people using the service and relatives are confident in raising dissatisfaction about the home. The home has received three complaints since re-registering with the Care Quality Commission (CQC). Complaints have been recorded in detail; actions and outcomes of complaints were well documented. One person told us that she would go to the manager or her key worker if she is not happy about anything. We viewed the homes adult protection policy, which was judged of good standard. The home had one safeguarding referral since registering with the CQC, the allegations were not substantiated and relevant authorities have been informed of the outcomes. All staff have received adult protection training and records show that recently employed staff will Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: attend adult protection training within the next two months. Staff spoken to demonstrated good understanding of organisational and local adult protection procedures. We noted in all three residents files viewed, that the home has undertaken Deprivation of Liberty assessments on people using the service. Care Homes for Adults (18-65 years) Page 21 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 using the service at Viola House live in an attractive and comfortable environment that add to their quality of life, with a good standard of cleanliness and hygiene maintained in the home. Evidence: The home has changed their registration with the CQC on 28/07/2009 and has increased the number of spaces to ten. During the day of the key inspection the home had two vacancies. The environment was assessed during the registration in July 2009 and was judged as compliant with National Minimum Standards. The environment was fully updated and the service consists now of 57 and 59 Castleton Avenue. Each building is self-contained, but is joined via a passage, which requires access via a key pad system. The manager informed us that both homes will be managed by one registered manager, and each building would have a deputy manager, which we felt is a good solution to manage the service safely. The home was free of any offensive odours. Facilities to launder clothes are located in a solid built shed in the garden of 57 Castleton Avenue, which can be accessed via a gate by people living in 59 Castleton Avenue. Training records viewed demonstrate that staff have attended infection control training and Food hygiene training. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by a committed, competent and experienced team of staff at the home. People using the service are protected by the homes rigorous recruitment procedures for new staff. People enjoy a good quality of life because staff in general have the training and support they need to provide a good standard of care. However the frequency of supervisions and appraisals need to be improved so that residents can be confident that staff are appropriately supported. Evidence: The home has sufficient staff in place. In 57 Castleton Avenue two staff work early, two staff work late and one staff does the sleep-in. In 59 Castleton Avenue one staff works early, two staff work late and one staff covers both home during the night (waking night). The home has currently one rota for both homes, we found the rota very difficult to read and recommend one rota for each home. A manager is on-call during the evenings and on weekends for emergencies. Staff spoken to showed that they are very knowledgeable about the needs, likes and dislikes of people using the service. We randomly selected four staffing files and noted that two employees have qualifications in care. Training records viewed showed us that the home has 21 staff employed, 18 of the 21 staff have or work towards National Vocational Qualifications in Care. Staff files were looked at and contained the information needed to make sure that all new staff in the home have had the appropriate checks made, including obtaining written Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: references and satisfactory CRB (Criminal Records Bureau) disclosures. As a result people using the service are protected by the procedures Viola House has in place when recruiting staff. The manager told us that recruitment has been ongoing and a director has been employed who is responsible in dealing with recruitment and vetting of new staff. We sampled four training records of individual carers, evidence showed us that carers have a wide range of training, which was provided by the home or undertaken during previous employment. The manager provided us with a training plan for all staff and it was evident that staff have attended a range of training. On occasions we noted that training certificates have expired and recommend to provide regular refresher sessions for staff. The home has renewed their Investors in People award in 2009. We noted that staff did not receive a minimum of six planed supervision sessions per calendar year. One person starting in December 2008 had no supervisions, another member of staff starting in February 2009 had two supervisions and another member of staff working for the organisation a number of years had one supervision in 2009. Similarly to supervisions, appraisals do not happen in annual intervals. We discussed with the responsible person, who informed us that one member of staff is responsible for supervising all carers and due to the refurbishment work staff supervisions did not happen as regularly as required. 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. People using the service benefit from living in a home which is managed effectively. Sunrise Care Ltd has good systems in place to ensure that the home responds to and acts on comments and suggestions from all key parties about how the home is run so that there is a process of continuous improvement at Viola House. The home has good procedures in place in relation to health and safety. Evidence: The home is managed by Mrs Alma Simmonds. Mrs Simmonds is a Registered Nurse and Registered Mental Health Nurse with over twenty years experience. The home is mentoring Social Work Students and Student Nurses. Staff spoke extremely positively about the manager and the atmosphere in the home was observed as relaxed. The new registered person is Mrs Alison Simmonds, who has been working in the home on an operational level for a number of years. The registered manager informed us that she is planning to take a step back in the near future and is currently in the process of training up and handing information over to a new suitable person. The home has a quality assurance policy in place, which has been reviewed. The homes annual development plan has been done together with people using the service and Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: service users surveys have been analysed. The home tried to arrange residents meetings, but people using the service choose not to have them. Due to the refurbishment and transition there was no regular staff meeting, but the manager informed us that they are planning to re-introduce staff meetings on a fortnightly basis and senior meetings on a weekly basis. We viewed fire records which were found to be up to date and fire drills and checks are undertaken in regular intervals. All safety certificates such as Portable Appliance Test, gas safety tests, have been updated and renewed as part of the registration process. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes  No  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 Description 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 Description Timescale for action 1 17 14 The responsible person must 01/02/2010 ensure that people using the service are involved in the the planning of the menu. This ensures peoples involvement in the provision of food provided by the service. 2 36 18 The responsible person must 01/02/2010 ensure that all staff receive a minimum of six planned supervisions and one appraisal per calendar year. This ensures people using the service can feel confident that staff are supported appropriately. 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 1 32 We recommend to provide individual staffing rotas for 57 and 59 Castleton Avenue to make them more accessible and easier to understand for people using the service. It is recored to provide regular training refreshers for carers, to ensure people using the service can be assured that staff supporting them are skilled and experienced. We recommend that the home is delegating responsibilities of staff supervisions and appraisals to ensure that supervisions and appraisals can happen more frequently. 2 35 3 36 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 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 © (2010) 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. 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