Care Home: York House and Aldersmore

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What the care home does well Listens to people and helps them to do the things they want to do.Looks after people`s health and cares for them well.Helps people keep in touch with their families and friends.People have comfortable bedrooms with their own things in them. What has improved since the last inspection? Some of the paperwork has got better.There has been some redecorating in the home. What the care home could do better: Where medicine is stored could be better.Some of the care plans could have some more information.Some of the other paperwork could be a bit better. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: York House and Aldersmore 19 York Road Holland on Sea Essex CO15 5NS The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Finney Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: York House and Aldersmore 19 York Road Holland on Sea Essex CO15 5NS 01255814333 01255818179 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Doson Limited Name of registered manager (if applicable) Mrs Barbara Lynne Hinchcliffe Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 16 0 care home 16 learning disability Additional conditions: The provider may provide the following category of service only: Care Home only Code PC. To service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Learning disability - Code LD Physical disability - Code PD The maximum number of service users who can be accommodated is: 16 Date of last inspection 1 8 0 9 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home This is a purpose built care home. This means that wheelchair users and other disabled people can get around easily. The home has rooms for 16 people to live there. The home has a lift inside so that people can get upstairs easily. There is a train station a few miles from the home. There are also different bus routes. This means that the people who want to visit can get there in different ways. Care Homes for Adults (18-65 years) Page 5 of 36 The home has got cars that people can use. This means that the people who live there can get out and about easily. The home is very near the sea and the beach. Care Homes for Adults (18-65 years) Page 6 of 36 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 Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home We looked at lots of different evidence for this report. We looked at paperwork like care plans, staff files and menus. The manager sent us information called an Annual Quality Assurance Assessment or AQAA. This gave us information about how they run the home. Care Homes for Adults (18-65 years) Page 8 of 36 We visited the home on 5th January 2009. We looked around the home. We talked to people living in the home and staff. We looked to see if people were happy with what goes on in the home. Care Homes for Adults (18-65 years) Page 9 of 36 What the care home does well Listens to people and helps them to do the things they want to do. Looks after peoples health and cares for them well. Helps people keep in touch with their families and friends. Care Homes for Adults (18-65 years) Page 10 of 36 People have comfortable bedrooms with their own things in them. What has got better from the last inspection Some of the paperwork has got better. Care Homes for Adults (18-65 years) Page 11 of 36 There has been some redecorating in the home. What the care home could do better Where medicine is stored could be better. Care Homes for Adults (18-65 years) Page 12 of 36 Some of the care plans could have some more information. Some of the other paperwork could be a bit 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 Ray Finney CPC1 Capital Park Fulbourn Cambridge Care Homes for Adults (18-65 years) Page 13 of 36 CB21 5XE 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 14 of 36 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 15 of 36 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 . Through the comprehensive admission process people choosing to live at York House and Aldersmore can be confident that their needs will be met. Evidence: The manager stated in the AQAA, Each service user has an individual pre-admission assessment form which forms the basis for suitability for admission to the home. Although there have been no recent admissions to the home, there was evidence that people living there had had their needs assessed. A sample of three individual files were examined and all had comprehensive assessments in place. Through discussion the manager was able to demonstrate an awareness of the importance of carrying out a thorough assessment so that staff know what peoples needs are. The areas covered in the assessments examined included family involvement and relationships, communication, mobility and dexterity, personal safety, medical history, medication, mental health, diet, weight and food, dental care, foot care, religious observance, daily living and social activities. The manager also stated in the AQAA, All service users are offered trial visits prior to Care Homes for Adults (18-65 years) Page 16 of 36 Evidence: admission. One person living in the home who completed a survey with the support of their key worker stated, I got a letter for here. I came to look. I was happy with what I saw. Care Homes for Adults (18-65 years) Page 17 of 36 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in York House and Aldersmore receive good quality care based on their assessed and identified needs. Evidence: The manager stated in the AQAA, Details of Care Management Assessment records are used as a basis for developing care plans. On the day of the inspection a sample of three care plans were examined. The standard care plan format covered a range of areas of peoples individual identified needs. The manager stated in the AQAA, Care plans have full information and are reviewed twice in a month. Service users take part in care plan reviews and all related parties are invited. It was evident from discussions that the manager and staff have a good awareness of peoples identified needs, although the standard format of the care plans do not all reflect this knowledge and could contain more details. However, each person has a Self-directed Support Plan, which contains information about the persons daily care routine. These are written from the point of view of the individual and contain good details to guide staff. The kind of specific details in the Self-directed Care Plans includes information about how the person prefers to have their personal care needs met. One stated, I will sit Care Homes for Adults (18-65 years) Page 18 of 36 Evidence: on the shower chair to be washed. Staff wash my hair and apply conditioner. I will cover my eyes with the flannel. Throughout the inspection staff were observed to interact well with people living in the home. People were being asked what they like to do and one person came in and out of the office on a number of occasions to talk to the manager about what they like and want. Routines are flexible and people choose what time they get up or go to bed. As previously reported, mealtimes fit in with what people are doing during the day. Records examined confirm that risk assessments in place. Like the standard format of the care plans, these would benefit from containing the level of information detailed in the Self-directed Support Plans. The manager said that updating the care plans is an ongoing process and further improvements are planned, including plans for Person Centred Plans to be produced in a pictorial format so that they may be more easily understood by people living in the home. Care Homes for Adults (18-65 years) Page 19 of 36 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 living in York House and Aldersmore can expect to enjoy a lifestyle that meets their wishes and needs. Evidence: The manager stated in the AQAA, We operate a day care centre in-house which is attended by a number of service users. This provides extensive facilities to learn and use practical skills and provides opportunities for service users to socialise and increase their circle of friends. There have been improvements to the activity centre since the last inspection with an improved kitchen area. On the day of the inspection some people were observed to be enjoying one-to-one activities in the day centre. Records examined show that people living in the home are supported to access College courses including Work Preparation, Computer Skills and Local History. The manager stated in the AQAA, Most of our service users attend classes of their choice at local colleges, eg art, craft, flower arranging, assertiveness, music and dance, drama. Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: There is a disco in the daycare centre twice a week. The manager discussed peoples one-to-one activity time where people do individual activities of their choice such as going personal shopping or to the pub. The manager plans to introduce All About Me books and showed us the format she is going to use. Some staff have had training provided by EICA (Essex Independent Care Homes Association) around social activities. The manager explained that this has helped staff have a better understanding of how involvement in day-to-day daily routines can enhance peoples lifestyle. It was evident from observations of what was going on, talking to people and daily records that there are a variety of activities that people take part in. These range from organised group activities such as the disco to individual pastimes like colouring and drawing. A relative who completed a survey stated, Encouragement to go out and do activities during the day seems to be good. Surveys received from people living in the home, completed with the support of their key workers, also contained positive comments about the activities in the home. One person stated, I am happy most of the time. I enjoy my activities and classes and getting out as much as I can. I like going shopping and someone else said, I do things at the weekend with my key worker when I write thank you cards and do birthday cards. On the day of the inspection individual records examined contained activity plans, although these did not contain a level of detail that reflected what people actually do. The activity planners would benefit from being individualised with a similar amount of detail as there is in the Self directed Support Plans. The managers plans for developing the All About Me books would improve recording of activities. People spoken with said they keep in touch with family and friends and records examined confirm that family input is welcomed and relatives are invited to care reviews. A relative who completed a survey stated that what the home does well is, listens to me or my family, works with us to agreed goals for my relative, keeps me informed as and when necessary, is welcoming when I visit. Another relative stated, I can always ring or discuss any information I need. The manager stated in the AQAA, Service users choose their own one week holidays. Some prefer to go to a holiday cottage in Devon, Norfolk or other picturesque and interesting locations. Others go to a time share in Portugal. The manager explained that the time share is owned by the proprietors and some of the people living in the home have enjoyed holidays there, although it is not suitable for anyone with mobility difficulties. A relative who completed a survey was positive about how people are supported around holidays. They said, Holidays have been a great move letting my relative have a break from the norm. As previously reported, people continue to enjoy the food provided in the home. Kitchens in both houses are domestic and the dining rooms are pleasant, giving a homely feel to mealtimes. People enjoy a varied menu that includes fresh fruit and vegetables. The manager stated in the AQAA that they have Plans to introduce Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: pictorial representation of food menu. Care Homes for Adults (18-65 years) Page 22 of 36 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 using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. Evidence: The manager stated in the AQAA, Personal support is provided in private and only in situations where service users cannot manage themselves. On the day of the inspection observations of interactions between staff and people living in the home indicate that people are treated with respect and their dignity is maintained when being supported with personal care. Self Directed Care Plans document how people want to have their personal care needs met and the level of support that they need staff to provide. Completed surveys received by us contained positive comments about how people are supported with personal care. A healthcare professional who completed a survey stated, Each time I visit there is always a good atmosphere and all service users are well presented. A social care professional who completed a survey stated that what the home does well is, Knocking on doors, covering service users when supporting with personal hygiene needs. All communication with service users is in a dignified Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: manner. A relative who completed a survey stated that what the home does well is provides a high level of personal care. The manager and staff spoken with were able to demonstrate a good awareness of peoples healthcare needs. The manager stated in the AQAA, Regular visits are made by dentist, podiatrist etc. Care plans examined contained a range of charts for recording healthcare needs including GP visits, hospital appointments, chiropody and dentist appointments. Records examined contained minutes of review meetings where peoples changing needs around care were recorded. There were positive responses in surveys received from relatives about how people are supported with their healthcare needs. One person stated, I am informed of GP visits etc and their outcomes. On the day of the inspection, the homes medication system was examined. Medicine Administration Record (MAR) sheets examined were all completed appropriately and the manager was able to demonstrate an awareness of following robust procedures around the administration and recording of medication. Staff records contained evidence that people administering medication have received training. Medication is stored in locked cupboards but these are not used solely for the storage of medication. Although the parts of the cupboards used for medication were tidy and well organised, overall the storage needs to be improved in line with guidelines from the Royal Pharmaceutical Society of Great Britain (RPSGB). The home does not have a controlled drugs cabinet, although there were no controlled drugs in use at the time of the inspection. The current storage facilities would not meet current requirements around the storage of controlled drugs should anyone living in the home be prescribed medication that requires the level of secure storage necessary for this type of medication. Care Homes for Adults (18-65 years) Page 24 of 36 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 can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: As previously reported, the home continues to have an appropriate complaints procedure in place. No formal complaints have been recorded by the home although the manager discussed a recent anonymous complaint that was received by the local authority and dealt with under their safeguarding procedures. Observations on the day of the inspection showed that people were confident in talking to staff about their concerns. One person living in the home who completed a survey stated, I go the the team leader or my key worker. If I am not happy with that I go to the manager. There are a range of policies and procedures in place to guide staff in keeping people safe. These include policies around Adult Protection and Prevention of Abuse, Reporting Bad Practice and Whistleblowing. Through discussion the manager was able to demonstrate a good awareness of her responsibilities around keeping people safe. Records examined indicate that staff have had updated safeguarding training in the past year (previously called Protection of Vulnerable Adults or POVA). The manager said that they do not manage peoples finances and stated in the AQAA, Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: Where the care home manages pocket money, individual expense accounts together with back up invoices are maintained. Peoples weekly allowance of spending money is kept securely in individual locked boxes. Records examined confirm that all personal spending is appropriately receipted and recorded in cash books. People have individual bank accounts with the manager as the named signatory. We had discussions with the manager about whether this is the most appropriate and robust system for ensuring peoples finances are safeguarded. Care Homes for Adults (18-65 years) Page 26 of 36 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 can enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: A tour of the premises showed that York House and Aldersmore provides a domestic and comfortable environment and the people living there benefit from the homely surroundings. The furnishings are in keeping with the style and age of the property and are well maintained. The Manager stated in the AQAA, The home employs a maintenance person who undertakes and implements any maintenance required. Peoples individual rooms reflect their personal tastes with ample personal possessions, ornaments, games and television sets. On the day of the inspection a tour of the premises confirmed that there was a good standard of cleanliness throughout the home including in the bathrooms and toilets. There are two bathrooms, one with an assisted bath, one with an older style bath and walk in wet-room. Bathrooms contained appropriate equipment to meet peoples needs and had wheelchair access for those whose mobility was impaired. All areas were seen to be clean and well maintained. A survey completed by a healthcare professional stated, The home never has any unpleasant odours. Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: There was evidence of redecoration throughout many areas of the home. The manager stated in the AQAA that there are, Plans to replace carpets in Aldersmore corridor and lounge and purchase new dining tables for Aldersmore. As previously reported the gardens are well maintained with mature plantings and are easily accessible by ramps so that people living in the home can enjoy the gardens when the weather allows. Care Homes for Adults (18-65 years) Page 28 of 36 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home can be confident they are cared for by a competent staff team who can meet their needs and who have been employed following thorough recruitment checks to ensure people are safeguarded. Evidence: The dataset that is part of the homes AQAA, states that 17 out of a total of 23 care staff have a National Vocational Qualification (NVQ) at level 2 or above and a further 4 are working towards the award. On the day of the inspection we had a discussion with the manager around NVQ and she was able to demonstrate a commitment to continuing to support staff to achieve the award. The manager holds the A1 NVQ Assessors award, which will assist in supporting staff who are working on NVQ. The manager stated in the AQAA, Staff meetings take place once a week. This is used as a forum for discussion on care management, staff issues and training on in-house procedures and practices. A social care professional who completed a survey stated, From what I have observed the care staff are service user focused and a relative said, Some care staff are better than others. Some of the staff do not display the same high levels of care, patience and commitment. The manager is aware of these issues and is working to improve such standards. A member of staff who completed a survey stated, There is a staff meeting every week and the minutes posted on the notice board in every department as to how things are working, and open to Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: suggestions. Overall these responses support the judgement that people are being cared for by a competent staff team. As previously reported, the home continues to have a robust recruitment procedure in place. On the day of the inspection we observed interactions between the manager and a prospective member of staff who had been interviewed and offered a post subject to the relevant safeguarding checks. The manager demonstrated a commitment to ensuring all the relevant information was in place. A sample of three staff files examined contained all the relevant documentation required by regulation including relevant references, proof of identity, Criminal Record Bureau (CRB) and PovaFirst Checks. (A PovaFirst check is to ascertain that a prospective member of staff has not been placed on a register of people barred from working with vulnerable people.) We had a discussion with the manager around the records relating to some of the established staff team who had been in post for a number of years, where some of the records may now be missing. It would be good practice for a record to be made in any of these personnel files where not all information is available to document what checks were done at the time to ensure people were recruited appropriately and any subsequent additional checks that were undertaken. The manager stated in the AQAA, All staff training is up to date. Training typically includes manual handling, POVA, Infection Control, Health and Safety etc. Records examined contain evidence that new staff receive induction training and are given copies of the GSCC General Social Care Council Codes of Practice. Personnel records examined contained evidence that staff receive a range of training to enable them to support the needs of people living in the home. The manager stated in the AQAA, Due to change in needs of our service users, the staff are trained in the following clinical practices, diabetics awareness, blood sugar monitoring, Makaton, continence management, dementia. Training courses include both in-house training and external courses. Training records examined included Food Safety, Client Handling, an update on POVA Awareness, Fire Safety, Health and Safety and Continence Management. However, some personnel files contained a number of training certificates that were now out of date in addition to more up to date records. Overall staff files could be improved if obsolete data was removed. Care Homes for Adults (18-65 years) Page 30 of 36 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 home is appropriately managed in the best interests of people living there. Evidence: The manager has been in post for the past year and is now registered with us at the Commission. She has been working towards the Registered Managers Award (RMA) but the organisation she was registered with ceased to trade and she has been taken on by another company. Although this has held up completion of the award she was able to demonstrate a commitment to achieving a recognised managers qualification. A survey completed by a relative was positive about the management of the home. The relative stated, There was a change of manager about a year ago and there has been a gradual improvement since then. The culture is changing slowly and the staff issues relate to care staff from the previous regime who were allowed a much more laissez faire routine. The manager stated in the AQAA, The registered provider undertakes annual quality assurance audits to ensure that minimum standards requirements are complied with and documentary evidence is available. As reported at the last key inspection, the Care Homes for Adults (18-65 years) Page 31 of 36 Evidence: home continues to have a Quality Assurance process in place to seek the views of people using the service. Surveys are sent out and the information received is collated into a report. There are a range of meetings held to seek the views of staff and of people living in the home. Staff team meetings alternate with House meetings on a fortnightly basis. A sample of Health and Safety documentation was examined and all found to be in order, including Maintenance of the lift, hoists, Gas Safety and Landlords Gas Certificate. In the past year inspections have been carried out by Tendring District Council Environmental Services and a Water Regulations Act inspection by Tendring Water and no issues were raised. Maintenance personnel carry out weekly checks on water temperatures, fire alarms and emergency lighting and Portable Appliance Testing (PAT). Care Homes for Adults (18-65 years) Page 32 of 36 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 33 of 36 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 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 2 3 4 6 9 12 20 Recording in care plans should contain greater detail which would reflect the standard of care provided. Risk assessments should record in detail how risks are being managed. Peoples individual activity records should contain more details about what people do on a daily basis. Improvements to the storage of medication would ensure peoples prescribed medicines are stored safely. An appropriate facility for the storage of controlled drugs should be available in the event that someone living in the home may be prescribed medication that requires this level of secure storage. A review of systems in place for supporting people to maintain bank accounts would ensure that their finances are robustly safeguarded. Improved organisation of staff files would ensure that the recruitment process is robust and all relevant checks are in 5 23 6 34 Care Homes for Adults (18-65 years) Page 34 of 36 place for all staff, including those that have been post for a number of years. 7 35 Improved organisation of training records would ensure that all staff have up to date training certificates as proof of the training they have undertaken. Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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