Care homes for adults (18-65 years)...Care Homes for Adults (18-65 years) Page 2 of 30 This is a review of quality of outcomes that people experience in this care home. We believe

Key inspection report

Care homes for adults (18-65 years)

Name: Westleigh House

Address: 20 Chip Lane TauntonSomersetTA1 1BZ

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: Date:

Alison Philpott 2 1 1 0 2 0 0 9

Care Homes for Adults (18-65 years) Page 2 of 30

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 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.


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 Inspection report

Author Care Quality Commission

Audience General public

Further copies from 0870 240 7535 (telephone order line)

Copyright 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.

Internet address www.cqc.org.uk

http://www.tso.co.uk/bookshop


Information about the care home

Name of care home: Westleigh House

Address: 20 Chip Lane TauntonSomersetTA1 1BZ

Telephone number: 01823284198

Fax number: 01823350814

Email address:

Provider web address: Voyagecare.com

Name of registered provider(s): Voyage Ltd

Type of registration: care home

Number of places registered: 12

Conditions of registration:

Category(ies) : Number of places (if applicable):

Under 65 Over 65

learning disability 12 0

physical disability 12 0

Additional conditions:

One named person may be admitted in the LD(E) category.

Date of last inspection

Brief description of the care home

Westleigh House is a large two-storey property sited next to another Voyage home. The home is located in a residential area and is a reasonable walking distance from Taunton town centre. There is adequate parking and pleasant garden with patio to the rear of the property. The home is registered with the Care Quality Commission to provide personal care for up to twelve people between the age of 18 and 65 years who require care due to a learning disability and/ or physical disability. Westleigh's condition of registration permits one named person aged over 65 in the learning disability (elderly) category. The registered manager is Peter Kidson.


SummaryThis is an overview of what we found during the inspection.

The quality rating for this care home is: two star good service

Our judgement for each outcome:

Choice of home

Individual needs and choices

Lifestyle

Personal and healthcare support

Concerns, complaints and protection

Environment

Staffing

Conduct and management of the home

peterchart

Poor Adequate Good Excellent

How we did our inspection:

This was an unannounced inspection which took place over 7.25 hours on 21st October 2009. Throughout the report the term 'we' will be used as it is written on behalf of the Commission. As part of this inspection we received one completed survey from a person who lives at the home, two completed surveys from relatives, five completed surveys from staff and two completed surveys from health professionals. The home sent us their Annual Quality Assurance Assessment (AQAA) prior to the inspection in October 2009. During the inspection we observed care practice, and spoke with people who live at the home, management and staff. We viewed the accommodation and facilities at the home. We looked at three individual support plans, and looked at records relating to medication, finance and health & safety. On the day of the inspection, ten people were living at the home. Westleigh House provides support to people with complex and diverse needs. The age range on the day


of inspection was 42 to 84 years old. The focus of this inspection visit was to inspect the relevant key standards under the CQC Inspecting for Better Lives 2 framework. This focusses on outcomes for people living at the home. The quality of the service is measured under four ratings. These are excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report.


What the care home does well:

The home provides individualised care and support to people with diverse and complex needs. We spoke with staff who had a good knowledge of how to support the people who live at the home. The home accesses guidance and advice from health professionals to ensure that peoples needs are met appropriately. Health professionals commented 'I can't fault the staff, they are very good', 'they carry out exercises as instructed' and 'very good communication'. The environment is well maintained, comfortable and homely. Bedrooms are nicely personalised to reflect peoples' individual tastes and preferences. The home told us that there are ongoing maintenance and refurbishment plans in place. The garden is pleasant and provides a patio, water feature and seating areas for people.

What has improved since the last inspection?

The home has carried out work to meet the requirements made at the last key inspection. The home now has a registered manager. Some areas of the home have been redecorated.

What they could do better:

The home should ensure that all staff complete training in Total Communication so that they are able to communicate effectively with people who live at the home. We looked at individuals' support plans. We found that some information in previous support plans has not yet been transferred. The home must ensure that information stored in previous support plans is transferred into the new format support plans. This is so that the information is clear and staff know how to support individuals and meet their needs. We found some information about people who live at the home accessible to anyone. Personal information about individuals should be stored confidentially. We observed that one member of staff did not knock on a person's bedroom door before entering. This does not respect the person's privacy. The manager should ensure that all staff respect peoples' privacy. We received mixed views on the availability of food for people who live at the home. The registered manager needs to monitor the quality and quantity of food provided for people who live at the home to ensure people enjoy their food and their nutritional needs are met consistently. The home should ensure that people are offered drinks at regular intervals so that they have sufficient fluids throughout the day. The home should ensure that prescribed creams are dated on opening and discarded appropriately so they are used when at their best.


The home should keep a copy of the outcome of complaints on file so that it is clear that they have been followed up. We found that some floor tiles were cracked. This is not hygienic and may pose a risk of infection. The home should consider replacing these floor tiles. People have not been able to take part in their timetabled activities due to staff shortages. The manager told us the home is recruiting new staff. The registered manager needs to ensure there are sufficient staff on duty so that people who live at the home are able to consistently benefit from activities. The home should ensure that staff undertake training and updates in intervention techniques. This is so that staff know what to do and to protect people from risk of harm. One accident report did not contain any detail of what had happened or how the person was when they were found. The home should ensure that accident records include the nature of the accident and whether medical treatment was required.

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 [email protected] or by telephoning our

order line 0870 240 7535.


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


Choice of home


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.


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 processes in place to ensure that any person who wishes to move to the home will have their needs assessed appropriately.

Evidence:

The home has not had any new admissions since the last inspection. The home told us on their AQAA that they will carry out a full personal assessment prior to admission to ensure they can meet the needs of people who may move into the home. People will be offered introductory visits to the home so that they have the opportunity to get to know other people who live at the home and staff. One person had moved to the home for a short term placement. The home had obtained the person's support plan. This appeared to have been reviewed as risk assessments had been put in place. A staff member who usually supports the person and knows them was able to continue this support within the home. We looked at a care plan of one of the people who lives at the home that stated they use Total Communication and signing to communicate. The manager told us that some


Evidence:

of the staff who work at the home have completed training in Total Communication. This information was not included in the staff training matrix. The home should ensure that all staff complete training in Total Communication so that they are able to communicate effectively with people who live at the home. The home is registered with the Commission as a care home for younger adults. Some of the people have lived at the home for many years. Therefore, the current age range of the people who live at the home is 42 to 84 years old. As people age, the home should keep peoples' changing needs under review and ensure that staff know how to continue to meet those needs.


Individual needs and choices


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.


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.

Peoples' individual support plans are being developed. Existing information has not yet been transferred into some of the new style support plans. People are encouraged to make their own decisions and choices.

Evidence:

The home told us on the AQAA 'Introduced new format Individual Support Plans which give detailed guidance and information regarding individual's needs and choices'. We looked at the new support plans. We found that some information is still in the previous support plan and has not yet been transferred. Some of the support plan sheets are blank. This means that staff may find it difficult to read and follow the plans. We asked staff if they are given up-to-date information about the needs of the people they support. Two staff said 'usually'; two staff said 'sometimes' and one member of


Evidence:

staff said 'never'. Staff spoken with at the inspection had a good knowledge of the people they support. We looked at three support plans. These contained person centred information about the support needed, peoples' preferences and what people can do independently. Some support plans had not been dated or signed so it was not clear when they were completed or who was involved in their development. The home should ensure that plans are signed and dated so that it is clear when they were written and that they are up to date. We saw a number of entries that had been crossed out or tippex had been used which means the original entry was not legible. The home should ensure that records are legible for audit purposes. The new support plans have not yet been produced in accessible formats for people who would benefit from this. The home told us on the AQAA that they have plans to 'provide every service user with a copy of their individual plan in a format appropriate to their understanding'. Key workers carry out monthly reviews to identify changing needs. These reviews are recorded and placed in the support plan. During the inspection, it was evident that people were offered choices and able to make decisions. The home told us on the AQAA that they plan to increase peoples' participation in the day to day running of the home, through involvement in staff recruitment and introductory visits for people who may move to the home. We viewed detailed individual risk assessments relating to areas that had been identified as a risk in support plans. Support plans and records are stored in the office. We found a book in the dining room which contained minutes of staff meetings. Personal information relating to individuals' health was recorded in the book. This was accessible to anyone and does not promoteconfidentiality.


Lifestyle


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.


Judgement:


There is a lack of activities due to staff shortages. People appeared to be enjoying their food. There are times when the home doesn't manage and monitor its food stock levels.

Evidence:

Some people who live at the home go to local day centres. People are encouraged to pursue their individual interests. These include music; going to the pub; shopping; art; ten pin bowling; horse riding and sailing. On the day of the inspection, three people went out on a sailing trip to Wimbleball Lake with staff. Another person went to a cafe in town. Two people were observed to be doing artwork in the afternoon.


Evidence:

We looked at peoples' activity timetables. Daily records showed that people were not following the timetable but spending time around the home. Two staff who completed surveys told us they felt that people do not get enough opportunities to go out and do activities. We observed that people at the home did not appear to be occupied with activities. During the inspection we spoke with staff who told us there had been staff shortages recently and this has meant people haven't been out as much as usual. They told us that they have done their best to try and arrange support for people to go out and hope that this will improve. The home told us on the AQAA that they support people to access an annual holiday of the individuals choice. Some of the people who live at the home had chosen to go to Newquay. Care plans viewed contained contact information for peoples' family. A relative told us they are usually kept up to date with important issues. They also said that they would like to be able to contact the home by e-mail. We observed some good interactions between staff and people who live at the home. We observed that one member of staff did not knock on a person's bedroom door before entering. This does not respect the person's privacy. The manager should ensure that all staff respect peoples' privacy. People are supported to take part in daily living skills such as shopping, cooking, and cleaning. The menu on the day of the inspection stated lunch was 'scrambled egg' or 'poached egg' 'on toast'. Tea was 'liver and bacon casserole and vegetables' or 'pasty and chips'. We observed lunch being served in the dining room. People were eating casserole. Staff told us that they had swopped the meals over as there were more staff on duty at lunchtime. Some people had gone out on the trip. We observed that staff had kept a meal back for these people. A relative commented that the food at the home is good. Two staff who completed surveys told us they felt that people do not get enough food. We observed that the size of portions at lunch were satisfactory. The food smelt


Evidence:

appetising and people appeared to be enjoying their meal. Staff cut up food and supported people as required. We looked at the food stock at the home on the day of the inspection. Food was available in the fridge, dry store and a small amount in the freezer. A selection of fresh fruit was available in the kitchen. We spoke with staff during the inspection who told us that there is usually enough food and there is a delivery of meat every Friday. Staff told us they make a list of the food needed for the week and then go to do the shopping. Staff told us that sometimes staff don't follow the menu which means there are times when food stocks run down by the weekend. The home's operations manager carried out a visit to the home in August and said 'ensure food available at all times'. The registered manager needs to monitor the quality and quantity of food provided for people who live at the home to ensure people enjoy their food and their nutritional needs are met consistently. During the morning, we observed that staff who were making drinks for people did not appear to know who had already been given drinks. One person who lives at the home asked the inspector for a drink. We looked at a care plan that stated 'likes to drink lots throughout the day - can make own drinks but needs to be supervised'. People are not able to access the kitchen without support and we did not observe the person making a drink. Staff told us that they weren't enough staff on duty for the person to be able to make a drink. The home should ensure that people are offered drinks at regular intervals so that they have sufficient fluids throughout the day. We observed one person drinking from a mug. They appeared to be having difficulty in holding the mug and a different type of cup may be more appropriate for the person.


Personal and healthcare support


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.


Judgement:


People are supported to access health professionals. Medication records are up-to-date.

Evidence:

Each person who lives at the home has a designated key worker. People's support plans contained information about how people preferred to be supported. Staff photos are displayed on the noticeboard so that people know who is on duty each day. We viewed records that showed that people have access to GP, physiotherapist, chiropodist, dentist, optician and psychiatrist. The home is currently introducing a separate file for each person that contains information relating to their health. Health professionals commented 'I can't fault the staff, they are very good', 'they carry out exercises as instructed' and 'very good communication'. We viewed the home's medication records. The home uses a monitored dosage system. Photographs of each person were available for identification purposes. The


Evidence:

medication administration record sheets were fully completed. The home has written guidelines stating how to support people in adminstration. We observed that some prescribed creams were not dated on opening. The home should ensure that creams are dated on opening and discarded appropriately so they are used when at their best. We looked at guidance relating to one person's diabetes. This provided detailed information for staff to follow. Staff at the home have been trained by the district nurse to administer insulin.


Concerns, complaints and protection


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.


Judgement:


The service has a complaints procedure. People know how to raise concerns. The home's policies and procedures relating to abuse protect people from the risk of harm.

Evidence:

The home has a complaints policy. We observed that people had 'I am worried' cards in their bedrooms. These can be used to raise any concerns. An accessible version of 'letting us know what you think' policy was displayed on the home's notice board. A relative confirmed that they knew how to make a complaint if necessary. The home told us on the AQAA they have received three complaints in the past twelve months. We looked at the complaints. One complaint on the file did not have a recorded outcome. The manager advised that this was because the operations manager had responded to the complaint. The home should keep a copy of the outcome of complaints on file so that it is clear that they have been followed up. We have received three complaints since the last inspection on 20th November 2007. These complaints were passed to the home. They were investigated by the operations manager and action points were passed to the manager. The home has whistleblowing and abuse policies in place. Staff spoken with knew what


Evidence:

to do if they suspected or witnessed abuse. The home ensures that new staff do not start work until the appropriate checks have been carried out. There has been a safeguarding incident at the home. The home followed the Somerset policy for safeguarding adults. The provider told us what they were doing and who they had contacted. The provider has been carrying out an investigation. Prior to the inspection, we received information about two other safeguarding incidents. We discussed these with the manager during the inspection. We are waiting to hear the outcome.


Environment


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.


Judgement:


The home is well decorated and maintained. It provides a comfortable and homely environment for the people who live there.

Evidence:

Westleigh House is a large, older property. The accommodation is provided over two floors. Both floors are accessible by stairs or a passenger lift. The home has two good sized lounges with televisions, a dining room, and a kitchen. Bedrooms are nicely personalised and reflected each persons' individual tastes and preferences. There is good use of colour, rooms are bright and cheerful. People have their personal belongings including photos and ornaments. A relative commented that the home is 'well decorated and frequently renewed' and 'provides good living conditions'. Some bedrooms have en-suite showers, other bedrooms have en-suite baths. There is a large bathroom with an assisted bath. Efforts have been made to make the bathroom feel more homely, with the use of a mirror and pictures. The bathroom door lock was broken. The manager was not aware of this and confirmed this would be


Evidence:

repaired as a matter of urgency. The home told us that there are ongoing maintenance and refurbishment plans in place. We observed that some areas of the home have been re-decorated since the last inspection. The home has fitted new carpets in the lounge and downstairs corridor. The lounge and some bedrooms have been redecorated. The garden is pleasant and provides a patio, water feature and seating areas for people. We viewed liquid soap and paper hand towels. This promotes good infection control practice. We observed that floor tiles in the medication treatment room and laundry room were cracked. This is not hygienic and may pose a risk of infection. The home should consider replacing the floor tiles. The home was smelt fresh in most areas. We found that two bedrooms and a communal toilet smelt of urine.


Staffing


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.


Judgement:


There are times when the home has been short staffed. The home's recruitment procedures protect people from the risk of harm. The home provides a comprehensive training programme. Some staff would benefit from training in Total Communication and intervention techniques.

Evidence:

On the day of the inspection, there were five support workers on duty. The registered manager was working on the floor. A senior member of staff came in at 12.30pm. We looked at the rotas for the last two weeks. One senior staff member is on duty each day, some shifts had been covered by the registered manager. Cover in the mornings ranged from 5 to 7 support staff. Cover in the afternoon ranged from 3 to 5 support staff. There are two waking staff and one sleeping staff at night. The home told us on the AQAA that staff absences and the time needed to recruit new staff has impacted on the home's ability to improve as much as they would have liked. We asked staff in surveys 'are there enough staff to meet the individual needs of all the people who use the service'. One person said 'usually' and four said 'sometimes'.


Evidence:

At the inspection, Staff and management told us that there have been staff shortages recently. Staff told us that this has impacted on how much time they can spend with people who live at the home (see Lifestyle section). We observed that staff appeared to be busy during the inspection. A relative commented 'I feel it is understaffed..need more one to one'. The manager told us that the home is currently recruiting further staff including a senior. The home has recently appointed a deputy manager. We looked at two staff recruitment files. These contained all of the required checks. Some information is stored at the company's head office. The staff training matrix includes training in the following areas; Health and safety; fire training; moving and handling; food hygiene; protection of vulnerable adults; infection control; first aid; intervention techniques; medication and induction. Staff told us that they were being given training that is relevant to their work. The matrix highlighted that 13 staff need to undertake or update training in intervention techniques. This training should be arranged as soon as possible so that staff know what to do and to protect people from risk of harm. The manager told us that some staff have completed training in diabetes and report writing. One member of staff has recently attended a oral health workshop at Wellington hospital. They will be cascading this information to the team. 10 of the 22 staff have completed a National Vocational Qualification (NVQ) at level 2 or above. Four staff are currently completing the Learning Disability Qualification (LDQ). Three people are registered to commence an NVQ.


Conduct and management of the home


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.


Judgement:


The manager has the required experience to run the home. The service has quality assurance systems in place. The health & safety procedures generally protect people from the risk of harm.

Evidence:

Peter Kidson has registered as manager with the Commission since the last key inspection on 20th November 2007. He has ten years experience of working and managing within the care industry. Peter is currently working towards the Registered Managers Award. The home has been without a deputy manager for the past six months. Staff told us that they haven't felt well supported recently. The manager has been working on the floor on occasions due to staff shortages. A deputy manager will be starting at the beginning of November 2009 and this will provide support to the manager. One member of staff told us that they feel things will improve once the new management


Evidence:

structure is in place. The home has quality assurance systems in place. The operations manager visits the home monthly to monitor quality and speak to people. We looked at health and safety records and checks including gas safety, electrical installation, fire extinguishers, portable appliance testing, and lifting equipment. These were all up to date. We looked at accident records. One accident report did not contain any detail of what had happened or how the person was when they were found. The home should ensure that accident records include the nature of the accident and whether medical treatment was required. We found that the plant room on the first floor was unlocked during the morning of the inspection. This placed people at risk of accessing electrics and pipework. The window was not restricted and may have placed people at the risk of falling. We discussed this with the manager who investigated and explained that a contractor had visited the day before and the key had been misplaced. The manager restricted the window during the inspection. Following the inspection the manager confirmed that the lock would be changed within 48 hours.


Are there any outstanding requirements from the last inspection?

Yes £ No R

Outstanding statutory requirementsThese 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


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 6 15 The home must ensure that information stored in previous support plans is transferred into the new format support plans. This is so that the information is clear and staff know how to support individuals and meet their needs.

21/01/2010

RecommendationsThese 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 3 The home should ensure that all staff complete training in Total Communication so that they are able to communicate effectively with people who live at the home.

2 6 -The home should ensure that support plans are signed and dated so that it is clear when they were written and that they are up to date.-The home should ensure that entries made in support plans are legible for audit purposes.- support plans should be written in suitable accesible formats for individuals living at the home.


RecommendationsThese 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

3 10 Personal information about individuals should be stored confidentially. This recommendation was also made at the previous key inspection on 20/11/07.

4 16 The registered manager should ensure that all staff knock on peoples' bedroom doors before entering to respect peoples' privacy.

5 17 -It is strongly recommended that the registered manager monitors the quality and quantity of food provided for people who live at the home to ensure people enjoy their food and their nutritional needs are met consistently.-The home should ensure that people are offered drinks at regular intervals so that they have sufficient fluids throughout the day.

6 19 The home should ensure that prescribed creams are dated on opening and discarded appropriately so they are used when at their best.

7 22 The home should keep a copy of the outcome of complaints on file so that it is clear that they have been followed up.

8 30 The home should consider replacing the identified cracked floor tiles as this is not hygienic and may pose a risk of infection.

9 33 It is strongly recommended that the registered manager ensures there are sufficient staff on duty so that people who live at the home are able to consistently benefit from activities.

10 35 The home should ensure that staff undertake training and updates in intervention techniques. This is so that staff know what to do andto protect people from risk of harm.

11 42 The home should ensure that all accident records include detailed information including the nature of the accident and whether medical treatment was required.


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Care homes for adults (18-65 years)...Care Homes for Adults (18-65 years) Page 2 of 30 This is a review of quality of outcomes that people experience in this care home. We believe