Care Home: Willowbanks Specialist Nursing

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What the care home does well People who use the service stated that the staff and manager treat them well. They reported that they are happy with how they spend their time, the meals provided and the environment in which they live. The home has recently been awarded three stars (the highest rating possible) in a inspection of food hygiene arrangements undertaken by the local council. Three options were available for lunch on the day of the visit, all of which were served with fresh vegetables. Staff members have access to the information they require to meet individual needs. Support plans contain references to the research & evidence on which guidance is based. Qualified staff (both general & mental nurses) and care staff are on duty, ensuring that people`s needs are met. When asked what the home does well, people who use the service stated: `Bingo & activities; giving cigarettes; pocket money; being taken on holiday`; `It`s a warm & friendly environment in which to live. I feel happy & content here. Family & friends are welcomed at any time. It`s nice to know they can have a meal with you as it`s made to feel like it is our home. A few months ago (a close family member) died suddenly. The care & love we received from all the staff at all levels was heartfelt. They could not have cared & supported me & my family any better`. When staff members were asked the same question, they made the following comments: `I think the home offers a variety of activities for each service user that is appropriate. I think they offer good opportunities for training. I like that I can ask anyone for help`; `Comprehensive training. Indepth clinical supervisions. Excellent resident care. Excellent choice of activities`. Health & social care professionals stated that the home: `provides for the spiritual, emotional and physical needs of the individual. Also enables individuals to use facilities in local community and maintain connections with family`; `Staff work well at managing disturbed behaviour without resorting to unnecessary sedation. They also work hard at allowing residents access to normalising activities e.g. pub meals, shopping trips, social trips & activities`. What has improved since the last inspection? A number of communal areas have been refurbished. A log cabin has been built in the grounds, which is in the process of being converted into a sensory room. The manager has completed a level 4 National Vocational Qualification in management. What the care home could do better: An incident which took place during April 2009 in which a person who uses the service sustained a minor injury as a result of the actions of another should have been reported to ourselves & the local authority. Incidents which affect the wellbeing and safety of people who use the service must be reported to the appropriate agencies. This is to ensure appropriate action is taken to protect people from harm. Work on a new path leading to the log cabin has left a change of levels, which could potentially pose a risk to people who use the service. The risks associated with the change of levels must be assessed & appropriate action taken. This is to ensure that the grounds are safe for use by people who use the service. Whilst the efforts of staff in dealing with problems of incontinence are acknowledged, an offensive odour was noted in several places on the ground floor. The premises must be kept odour free. This is to ensure that all the people who use the service live in pleasant surroundings. It was noted at the time of the last visit that whilst our records show that the registered provider is an individual, records at the home indicate that it is owned by a limited company. A requirement was made that the registered provider must ensure that the home is appropriately registered.This requirement has not been met. The arrangements relating to the administration of medication to a person identified at the time of the visit should be reviewed to ensure that they do not put other people at risk. When people who use the service, staff and health & social care professionals were asked what the home could do better, the issues they raised included more activities at weekends, better administrative support and improved communication both between staff and between the home & other agencies. Several people reported that the management of the home were aware of these issues and were seeking to address them. Key inspection report Care homes for adults (18-65 years) Name: Address: Willowbanks Nursing Ashby Lane Bitteswell Lutterworth Leicestershire LE17 4LS     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: Martin Hefferman     Date: 1 8 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 30 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 30 Information about the care home Name of care home: Address: Willowbanks Nursing Ashby Lane Bitteswell Lutterworth Leicestershire LE17 4LS 01455558355 01455559565 surraynor@goldcareltd.com www.goldcareltd.com Mr Soharaj Sooriah care home 56 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 dementia mental disorder, excluding learning disability or dementia Additional conditions: Ashby 1 (ground floor), No persons may be admitted to the ground floor of the home (known as Ashby 1) who fall within categories DE and DE (E), when 30 persons of these categories/combined categories are already accommodated. Ashby 2 (first floor), no persons may be admitted to the first floor of the home (known as Ashby 2) who fall within the category MD when 26 persons are already accommodated. For the 15 existing service users within the category of MD (E) to remain within Ashby 1, no further admissions within this category will be made. No-one under 25 years of age who falls into category of DE may be admitted to the home when 26 persons of this category are allready accommodated. No-one under 40 years of age who falls within the category of DE may be admitted to the home when 30 persons of this category are already accommodated . To be able to admit the named person of category PD (under 55 years) as identified in variation application form dated 6/9/02. Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 30 30 30 56 To be able to admit the named person under 25 years of age named in Variation Application No V000019833 dated 27/04/2005. This agreed placement is not to exceed 1 year from date admission. To be able to admit the named person under 50 years of age named in variation Application No V000047173 dated 21.04.03 When 20 or more service users are accommodated on Ashby 1 there must be at least two qualified nurses on duty, one of which must be a Registered Menta l Nurse (RMN) during day time hours (7:30 - 21:30) and one RMN qualified nurse at night. When 20 or more service users are accommodated on Ashby 2 there must be at least two qualified nurses on duty, one of which must be a Registered Menta l Nurse (RMN) during day time hours (7:30 - 21:30) and one RMN qualified nurse at night. Date of last inspection Brief description of the care home Willowbanks Nursing Home is situated in a rural area on the outskirts of Bitteswell, near Lutterworth. The home is set within its own grounds, which people who live there are able to access and enjoy. The home has its own transport including a minibus, which is accessible by wheelchair, to support access to local facilities and amenities. There is car parking space to the front of the building. The home has 56 beds and provides nursing care for people within the mental disorder and dementia categories. It is run as two separate units known as Ashby One (ground floor), which provides dementia care for people aged 40 & above and currently caters for people in the over 65 years mental disorder category. Ashby Two (first floor) provides care for people aged between 25 and 65 years within the mental disorder category. A passenger lift and a staircase provide access to the first floor. All of the rooms are single with en suite facilities. There is a range of communal areas on both floors including lounges, dining rooms, smoke room and activity areas. The registered manager stated that fees start at £269 per day and will be dependent on assessed needs. Information about the services provided at the home was available at the time of the visit. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A visit to the home took place on 18th May 2009, lasting approximately seven hours. The main method of inspection used on that day was case tracking which involved selecting two people who use the service and tracking the care they receive through review of their records, discussion with them & staff and observation of care practices. We were not able to speak to one of the people who were chosen for the purposes of case tracking. We did speak to six people who use the service, a relative, four members of staff, the registered manager and the area manager during the course of the visit. This inspection has also taken into account all of the information received since the date of the last visit, including the providers annual quality assurance assessment. Comment cards were received from five people who use the service, three members of staff and two health & social care professionals. Care Homes for Adults (18-65 years) Page 6 of 30 Willowbanks Nursing Home was last inspected on 4th June 2008. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: An incident which took place during April 2009 in which a person who uses the service sustained a minor injury as a result of the actions of another should have been reported to ourselves & the local authority. Incidents which affect the wellbeing and safety of people who use the service must be reported to the appropriate agencies. This is to ensure appropriate action is taken to protect people from harm. Work on a new path leading to the log cabin has left a change of levels, which could potentially pose a risk to people who use the service. The risks associated with the Care Homes for Adults (18-65 years) Page 8 of 30 change of levels must be assessed & appropriate action taken. This is to ensure that the grounds are safe for use by people who use the service. Whilst the efforts of staff in dealing with problems of incontinence are acknowledged, an offensive odour was noted in several places on the ground floor. The premises must be kept odour free. This is to ensure that all the people who use the service live in pleasant surroundings. It was noted at the time of the last visit that whilst our records show that the registered provider is an individual, records at the home indicate that it is owned by a limited company. A requirement was made that the registered provider must ensure that the home is appropriately registered.This requirement has not been met. The arrangements relating to the administration of medication to a person identified at the time of the visit should be reviewed to ensure that they do not put other people at risk. When people who use the service, staff and health & social care professionals were asked what the home could do better, the issues they raised included more activities at weekends, better administrative support and improved communication both between staff and between the home & other agencies. Several people reported that the management of the home were aware of these issues and were seeking to address them. 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 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. Assessment practices are effective, ensuring that individual needs are identified before people move in. Evidence: Willowbanks Nursing Home is divided into two units (Ashby 1 & 2), each providing a service to a specific client group. Information has been produced about both units. Documents set out their respective aims & objectives, the facilities & services that are available, their admission criteria, staffing arrangements & complaints procedure. The registered manager agreed to update information about the home to reflect the change in registration from the Commission for Social Care Inspection to the Care Quality Commission. People who use the service indicated that they received enough information about the home before they moved in to enable them to decide it was the right place for them. The registered manager agreed to look at whether information about the home could be made more accessible, particularly for people with dementia. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: Detailed assessments were available for both of the people who were chosen for the purposes of case tracking. They covered a range of issues including mental & physical health, family & personal history, everyday tasks and social activities. Assessments had also been completed of the risks associated with providing care to both people. Staff members confirmed that they have access to the information they require to meet peoples individual needs (see Individual Needs & Choices). Care Homes for Adults (18-65 years) Page 12 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. Staff members have access to the information they require to meet individual needs. People who use the service are treated as individuals and their right to make choices respected. Evidence: Individual plans were available for the people who use chosen for the purposes of case tracking. The plans that were inspected covered a range of issues including mental & physical health, nutrition & diet, personal care, welfare & safety in the community and smoking. They contained references to the research & evidence on which the plans had been based. Records indicate that peoples needs are kept under review. Risk assessment & management plans were available for the people whose records were inspected. Staff members confirmed that they have access to the information they require to meet peoples needs. People who use the service indicated that they make decisions about what they do each day and reported that they can do what they want during the day and in the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: evening. One person stated that he had enjoyed a meal out in Lutterworth that morning. A second person reported that she was looking forward to a forthcoming holiday at Butlins. People were able to access communal areas & their rooms throughout the visit. They have access to a kitchenette on the first floor to make their own drinks. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service enjoy a lifestyle, which meets their individual expectations. Evidence: The people we spoke to stated that they enjoy the activities that are provided and find there is enough to do. They reported that they enjoy playing bingo, shopping, going out for meals & to nightclubs. One person stated that he is looking forward to watching Leicester City play next season, having recently bought a season ticket. Activities were undertaken on a one-to-one basis during the course of the morning whilst a game of bingo took place in the afternoon. A programme of day trips is planned for later in the year. One person stated that she would like to be able to do more activities at the weekends. This issue was brought to the attention of the registered manager. Records indicate that both of the people who were chosen for the purposes of case Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: tracking are in contact with their families. A relative stated that she visits the home every day and is always made to feel welcome. A support group for the relatives of people with dementia continues to meet at the home. People stated that they enjoy the food provided.They reported that they are always offered a choice. Three options were available for the main meal on the day of the visit, all served with fresh vegetables. The home was awarded three stars (the best possible rating) in a recent inspection of food hygiene arrangements undertaken by the local council. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive personal & healthcare support based on their individual needs. Evidence: People who use the service stated that they are happy with the care they receive. Individual plans set out details of the personal support each person requires. They also contain information about the mental & physical healthcare needs that have been identified and the action required as a result. Assessments have been completed of the risks associated with challenging behaviour, moving & handling, malnutrition and pressure areas. Care is provided by both general & mental nurses, ensuring that all nursing needs are met. Records indicate that people are in contact with their GPs & other healthcare professionals. Two health & social care professionals who completed comment cards indicated that the home always seeks advice and acts on it to meet peoples health & social care needs & improve their well-being. The registered manager stated that no one managed their own medication at the time of the visit. Records of the medication administered to the people who were chosen for the purposes of case tracking met relevant requirements. Records of controlled drugs Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: are signed by two members of staff. The balance of one such medication was checked and found to be correct. The registered manager stated that a local pharmacist provides training. This was confirmed by the staff members we spoke to. It was noted that a person identified at the time of the visit left the dining table briefly after being given his tablets but before taking them. A staff member returned on several occasions to check he had taken his medication. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an effective complaints procedure, which ensures that peoples views are listened to and acted upon. Action is being taken to ensure people are protected from abuse. Evidence: The homes complaints procedure is set out in the information provided to people who use the service and displayed within the building. The registered manager agreed to amend the procedure to reflect the change in registration from the Commission for Social Care Inspection to the Care Quality Commission. People who use the service indicated that they know how to make a complaint and reported that care staff & the manager listen and act on what they say. Health & social care professionals also indicated that the home responds appropriately if people raise any concerns. This finding was confirmed by the records we inspected relating to one of the complaints that had been received. Information provided prior to the visit indicates that the home has received six complaints in the past twelve months, all of which were upheld. Prior to the visit, there had been one safeguarding adult alert and investigation which had been been dealt with appropriately by the home. A staff member has been suspended pending the outcome of a police investigation into an allegation of physical assault and has been referred to the Protection Of Vulnerable Adults register. The registered manager was in the process of making a safeguarding alert to both the Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: police and social services at the time of our visit. Whilst investigations were still ongoing, action had been taken to prevent further problems from occurring in the future. Records indicate that an incident took place during April 2009 in which a person who uses the service sustained a minor injury as a result of the actions of another. This incident was not reported to either ourselves or Leicestershire County Council. A staff member stated that she has received training on the protection of vulnerable adults and confirmed that she was aware of the action she should take if she suspects someone is being abused. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 live in a generally clean and comfortable environment. Action is however required to ensure that all areas are odour free, safe and in a good state of repair. Evidence: People who use the service stated that they are happy with the environment in which they live. Four of the five people who completed comment cards indicated that the home is always fresh & clean (the fifth ticked usually). A number of communal areas have been refurbished since the date of the last inspection. The registered manager stated that work would now start on peoples bedrooms. The home has also built a log cabin in the grounds since the date of the last visit, which is in the process of being converted into a sensory room. It was noted that work on a new path leading to the log cabin had left a change of levels, which could potentially pose a risk to people who use the service. Whilst the efforts of staff in dealing with problems of incontinence are acknowledged, an offensive odour was noted in several places on the ground floor. The registered manager stated that flooring in a downstairs toilet would be replaced & a wall on the first floor repaired. She agreed to investigate why a corridor on the ground floor felt sticky. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Information provided prior to the visit indicates that the home continues to work with environmental health and a pest control company to eradicate a fly problem which has plagued Willowbanks for many years. The registered manager stated that the company spray the carpets every four weeks. Fly catchers have also been placed in rooms. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by sufficient numbers and an appropriate mix of nursing & care staff. Evidence: People who use the service indicated that care staff and managers treat them well. The staff we spoke to stated that they felt that there were sufficient numbers of staff on duty to meet peoples needs. There was an appropriate mix of qualified staff (both general & mental nurses) and care staff on duty on the day of the visit. Information provided prior to the visit indicates that all of the staff who have worked in the home in the past twelve months have had satisfactory pre-employment checks. This was confirmed by the records we inspected relating to two staff members & by the staff who completed comment cards. Staff members indicated that their induction had covered everything they needed to know to do the job when they started. They reported that they are given training that is relevant to their role, helps them to understand & meet the individual needs of people and keeps them up to date with new ways of working. All reported that they usually have enough support, experience & knowledge to meet the different needs of people who live at the home. This was confirmed by health & social care professionals Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: who indicated that the home always responds to the diverse needs of individual people. The records that were inspected indicated that staff have received training on issues such as first aid, fire safety & breakaway techniques since the start of 2009. A staff member stated that she was due to attend a course on dealing with challenging behaviour the following day. Other staff confirmed that they had received training on issues such as medication & the Protection of Vulnerable Adults in the past. The registered manager stated that the training records for 2008 had been archived. She agreed to ensure that they are available at the home in future. Information provided prior to the visit indicates that thirteen members of staff have obtained National Vocational Qualification level 2 or above. 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. Action is being taken to ensure that Willowbanks is managed in the best interests of the people who live there. Evidence: The manager is a registered nurse. Since the date of the last inspection, she has completed a level 4 National Vocational Qualification in management. It was noted at the time of the last visit that whilst our records show that the registered provider is an individual, records at the home indicate that it is owned by a limited company. A requirement was made that the registered provider must ensure that the home is appropriately registered. This requirement has not been met. An internal audit has identified discrepancies relating to the management of peoples finances. This issue has been reported to both the police & social services. The registered manager reported that action had already been taken to prevent similar incidents from occurring in the future. Survey forms have been sent to people who use the service, their relatives & visiting Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: professionals. The registered manager stated that she intends to complete audits on a range of issues including care plans & medication. Information provided prior to the visit indicates that equipment has been serviced or tested as recommended by the manufacturer or other regulatory body. Records indicate that fire alarms are tested regularly and that staff have received fire training. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R 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 1 37 7 The registered provider must 31/08/2008 ensure that the home is appropriately registered. Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 37 Incidents affecting the wellbeing and safety of people who use the service must be reported to the appropriate agencies. This is to ensure appropriate action is taken to protect people from harm. 22/05/2009 2 24 23 The risks associated with the 30/06/2009 change of levels in the garden must be assessed & appropriate action taken. This is to ensure that the grounds are safe for use by people who use the service. 3 30 16 The premises must be kept odour free. This is to ensure that people who use the service live in pleasant surroundings. 30/06/2009 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 20 The arrangements relating to the administration of medication to a person identified at the time of the visit should be reviewed to ensure that they do not put other people at risk. Care Homes for Adults (18-65 years) Page 29 of 30 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. 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