Inspection on 06/11/09 for 83 Burgh Road

This is the latest available inspection report for this service, carried out on 6th November 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

83 Burgh Road 01/02/06

83 Burgh Road 29/09/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: 83 Burgh Road 83 Burgh Road Skegness Lincolnshire PE25 2RW 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: Wendy Taylor Date: 1 2 1 1 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 36 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 36 Information about the care home Name of care home: Address: 83 Burgh Road 83 Burgh Road Skegness Lincolnshire PE25 2RW 01754610777 01754899873 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) : Thera Trust care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection A bit about the care home 83 Burgh Road is a detached bungalow located on a main road leading to the Skegness sea front area. Care Homes for Adults (18-65 years) Page 4 of 36 It is in easy reach of the town centre and sea front amenities, including shops, pubs, banks and leisure establishments. There are good local transport links. x3 The bungalow is situated on a good-sized plot, with ample parking and garden space. There are 3 single occupancy bedrooms. The home is registered to provide a short break service for up to 3 adults with learning disabilities Care Homes for Adults (18-65 years) Page 5 of 36 at any one time. Thera Trust maintains the home. The current cost of the block contract is £17, 108.09 per month, however this is to be reviewed in the near future as the Local Authority will be amending their contract to purchase only two of the three beds. 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 The quality rating for this 2** service is 2 stars. This means that people get good quality outcomes. We already had things like surveys that people had sent us, so we looked at what they said. An inspector then visited the home to see how things are done. Care Homes for Adults (18-65 years) Page 8 of 36 We spoke to people who were staying there , and some staff, and we watched how staff did their jobs. We looked at things like care plans, staff records, and some policies. What the care home does well Care Homes for Adults (18-65 years) Page 9 of 36 People have care plans that they help to write, and they say what they want to happen when they stay at the home. People can make the choices and decisions that they want to. People can carry on going to their usual day activities. People can do the things they enjoy doing at home, like going Care Homes for Adults (18-65 years) Page 10 of 36 to church or to the pub. People can have the food and drink that they like and need. What has got better from the last inspection The lounge had been decorated and had a new carpet. There are photographs of staff Care Homes for Adults (18-65 years) Page 11 of 36 on the wall to show people who will be working with them. There are menus with pictures to show what people have chosen to eat. There are better risk assessments and a new file about helping people to stay safe. Care Homes for Adults (18-65 years) Page 12 of 36 What the care home could do better We suggested that assessments and care plans say how people make their own decisions and what support they need if they cannot. This is so that peoples rights are protected. We said that it would be better to record all of the reviews that take place so that information is up to date. We said that they need to look at different ways for people who use wheelchairs to get out and about. Care Homes for Adults (18-65 years) Page 13 of 36 We think that that they should look at the ways that they record what people spend, and how they store peoples money. This is so that people know their money is managed properly. We suggested that the manager looks at the staff supervision records to make sure that everyone is getting at least six sessions a year. This is so that staff are well supported. Care Homes for Adults (18-65 years) Page 14 of 36 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 Wendy Taylor CQC East Midlands Citygate Gallowgate Newcastle upon Tyne NE1 4PA 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 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 16 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. People are sure that their needs will be met because there are clear and detailed assessments in place. Evidence: When we visited the home, we looked at three peoples files. We saw that the files contained an assessment of all the things that the person needs help with, and what they like to do when they stay at the home. For example, there was information about how people move around, how they like to relax, what they like to eat and drink, and how they tell staff what they want. There are also clear instructions about how people like to carry out their usual daily routines, such as bathing or going to daytime support, and there is information about their health needs. In questionnaires that people sent us before we visited, comments were made such as assessments are thorough and help people get the right service. During the visits we watched how people were supported by staff. We saw that the staff were using the information in the assessments, to help people be as independent as they can be, and enjoy their stay. For example, staff made sure that the right cutlery and crockery were available for people to use, and people were able to enjoy their usual leisure time Care Homes for Adults (18-65 years) Page 17 of 36 Evidence: activities. Although the assessments contain information about how people make daily choices and how they communicate with other people, there is no clear information about how they make lifestyle decisions. Care Homes for Adults (18-65 years) Page 18 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 have choice and control over the things that are important to them, and their needs are met in the way they want them to be. Evidence: Care plans are in place for things like communication, personal care, religious needs, and daily routines. They show the way to support people with needs and wishes that are recorded in assessments. They say how people prefer their care to be given such as having a bath instead of a shower, or having a lady or a man to help them. The plans do not show how people make wider lifestyle decisions, or how to support them and record when they are not able to do this. The records show who is involved in developing the care plans and reviewing them. We saw that this is usually done with the person, their families, social workers, and any other professional who provides the person with support. In the files that we looked at there is also a care plan from the placing authority to show what they expect the home to provide when the person is staying there. Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: The manager told us that staff review peoples needs each time they come to stay at the home, but there are no clear records to show this. There is a yearly recorded review carried out by the placing authority, and notes of these reviews are in peoples files. Records also show us that peoples personal files are looked at by the manager at least four times a year to make sure that any changes are recorded properly. We saw that if a risk is identified, a risk assessment is carried out. Risk assessments are in place for things like medication, diet, making hot drinks, and personal care. We saw that key workers are currently reviewing and updating all of the risk assessments, and there is a training session booked to help them do this. People told us that they are treated well when they stay at the home. One person said I love it, and I like all the staff. Other people made comments like staff look after me very well, I can choose what I want to do, and they take me out. We saw that staff have a very good understanding of what people like and what their needs are. We saw that they knew how to offer people choices in the right way, and help them to be as independent as they are able to be. Care Homes for Adults (18-65 years) Page 20 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. Peoples individual lifestyle needs and choices are respected and maintained, and they can enjoy the social opportunities available in the local community. Evidence: We saw that people are supported to carry on going to their usual day activity when they come to stay at the home. People told us that they can still go to centres and meet their friends, they can still go to their own church, and friends and family can come to see them at the home if they wish. During the visit we saw that people were supported to do the leisure activity of their choice, such as drawing or watching TV, and people told us they also do things like go bowling or go to the local pub. There is an activity board in the main hallway of the house, which people can use to choose the activity they want to do. There are pictures of different activities available for them to stick on the board to remind them of their choices. There is also a another board in the hallway, which has lots of photos of people enjoying outings and other activities when they come to stay at the home. Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: We were told that it is difficult for people who use wheelchairs to use wider community facilities when they are staying at the home. Information tells us that people can use a specialist taxi service but this is expensive and not consistently available. There are a wide range of books, games, and puzzles for people to use, and there is also a TV that people can have in their bedroom if they wish. We received information from people before we visited, and this shows that people can do whatever activities they want, and the staff support them to meet all of their differing needs. Staff also told us about garden parties that they hold in the summer so that people can meet neighbours, and we saw some photos of these parties. As well as being able to continue with their social and leisure activities, we saw that people are supported to continue with their usual daily routines such as getting up and going to bed at the same time as at home, and joining in with household chores such as washing dishes. We also saw that they are able to use the type of cutlery and crockery they would normally use, and have their preferred cups or mugs to drink from. Menus are made up of the things people like or need to eat. This matches with the information in peoples assessments, and people also told us that they can choose whatever they want to eat. We saw lots of very clear information in peoples files such as how they take their drinks, what they like in packed lunches, and whether they need a special diet such as low salt or soft foods. There is a menu board in the kitchen with pictures of the planned meals, so that everyone can see what is going to be cooked. We saw people enjoying a well balanced evening meal, and saw that staff had checked what people wanted on their plates before serving. 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. Satisfactory systems are in place to ensure that peoples health and personal care needs are met. Evidence: People told us that health care needs are always met, and staff seek out information and advice about those needs to make sure that people are supported in the right way. We saw that care plans show clearly how to meet assessed needs including things like how best to move people and what equipment to use, and how and when to administer special medication. A comment was made to us that some gentlemen might not always have a shave, and the manager told us that this is the choice of the person. The manager said that she will make sure that care plans show this choice more clearly. We saw that if they need to, people can see their own GP when they are staying at the home. Records show that staff can also help them to see a range of other professionals such as community nurses or Consultants if they need to. Equipment such as hoists, a specialist bath, and a specialist bed are available for people who may need them. There are also things like special cutlery and crockery, and equipment to raise the height of tables for people who use wheelchairs. Records show that staff are trained in how to move people safely and use equipment, and staff Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: confirmed this when we spoke to them. There is a keyworker system in place and we saw that it has recently been reviewed. A person told us who their keyworker is, and the manager said that people can choose who they want. She also said that people can have a change of keyworker whenever they want. Information we already had told us that there is a policy about how to manage medication in the right way, and an audit of medication practice is carried out once every year. We saw that there are clear guidelines for booking medication into the home, and that people who use the service and their representatives are given clear information about how the medication should be packaged. We saw that medication administration was signed for in the right way, and the medication was stored in a locked cabinet. Medication administration sheets are hand written by staff and we noticed one spelling mistake. We also saw that staff do not sign to say who has written out the administration sheet. On the first day of the site visit, the manager and staff made changes to the way they write out administration sheets so that these things do not happen again. On our second visit to the home we saw that these changes were now being used. 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 are protected by clear policies and procedures, and staff who know how to put them into practice. Evidence: Records show us that no complaints have been made about the service since we last visited. We saw that the complaints policy is available in the entrance hall and is written in easy read and picture formats. People told us that they know how to make a complaint, and who to speak to if they are not happy. We were also told that the home responds in the right way if any concerns are raised. We saw that there are leaflets about how people can contact independent advocacy services if they want help to express their views, including financial advocacy. Some people who stay at the home keep and manage their own money, and the staff record how much they have brought with them. Some people need more help and staff keep records and receipts of how much money they have brought and what they have spent. Their money is kept in a locked cabinet but the cabinet also has other things in it like medication. One person told us that they do not see the receipts for the money that is spent. Since we last visited there has been one referral made to the Local Authority Safeguarding Team. We know that the home co-operated well with the investigation, and it showed that they were doing things in the right way. Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: We saw that the home has their own policy about how to keep people safe which is available in the entrance hall. It also has a copy of the Local Authority guidelines, but they were not freely available to people who use the service or staff, and the manager said that she would keep a copy in the entrance hall as well. Staff were able to tell us how they would manage and report any situation where people were at risk of abuse, and records showed us that they are regularly trained about how to keep people safe. 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 have a homely and comfortable environment to stay in, which can meet their assessed needs. Evidence: People told us that the home is kept fresh and clean, and one person said that they are very comfortable in their chosen bedroom, and they can keep it how they like. We saw that the home was very clean and tidy when we visited. It is furnished and decorated in a comfortable and homely way, and we know that the lounge has been recently re decorated. We saw that a recent quality assurance report highlighted the need for some improvements to the home such as a new patio in the rear garden. The manager said that action is now in progress to complete this work. Corridors, doorways and rooms are spacious enough for people who use wheelchairs, and there is a range of equipment available to help people move around. Records show us that all of the equipment is regularly serviced and maintained. We know that the home has a range of policies to help keep the home safe and comfortable for people to use, including one about controlling the spread of infection. We saw information leaflets and notices around the home about things like washing hands, and using tissues when you sneeze. We also saw that there were gloves and aprons Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: around the home for people to use when they needed to. 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 benefit from being supported by well trained and safely recruited staff. Evidence: Staff told us that there are usually enough of them on duty to meet the needs of the people who come to stay at the home. Staff rotas show which people are using the service at any one time so that the right number of staff are allocated. We saw that the rotas are flexible, for example sometimes there is a sleep-in staff at night and sometimes there is an awake staff depending upon who is staying. We also saw that there are a number of staff employed to work only when they are needed, which means that extra staff can be called upon who people know. There is a board in the entrance hall with photos of the staff who are on duty for each shift so that people know who will be working with them. Staff files contain things like criminal record bureau checks, written references, application forms, and identification. Staff told us that they had thorough recruitment checks before they started work, including an interview. The manager told us that they are currently looking for ways to include people more in the interview process. Records show that there is a clear induction programme for new staff which follows a nationally recognised format. It includes information about things like record keeping, fire Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: safety, and confidentiality. There are also observation reports written about how the new staff members put their learning into practice. Staff told us that as well as their induction, they are given on-going training that helps them keep up to date with good practice. We saw that there is a set yearly plan for this training, and records show staff have done courses about things like epilepsy, oral hygiene, autism, communication, first aid, and risk assessment. Records also show that all of the staff have gained a nationally recognised care qualification at various levels. We know that one member of staff has an extra part to their job role, as a training representative. This means that they go to meetings about training that the provider holds, and can give the rest of the team up to date information about the providers plans. They also keep information about all of the training that staff have had, and what they need, so as to help plan the coming years programme. Staff told us that they get good support from the manager and their supervisors. Records show that staff are receiving supervision sessions, from supervisors who are trained to carry out this role. They also receive yearly appraisals of their work performance. The manager told us that she is going to audit the supervision records in the near future, to make sure that everyone has received at least six sessions before the end of their working year. 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. People benefit from a well managed home, and they are protected by the health, safety, and welfare arrangements. Evidence: The registered manager has worked at the home since it first opened in 2004. She has nationally recognised care and management qualifications. Since the last time we visited the home, records show that she has completed training in subjects such as moving and handling, new laws about peoples rights, recruitment, causes of learning disability, and keeping people safe. People told us that they think the manager has the right skills and experience to support people, and manage the service well. Staff told us that she is very supportive. We know that there is a quality assurance system in place, and we saw reports of visits that have been carried out recently by a company that employ assessors who have experience of using services for people with learning disabilities. Areas in need of improvement were highlighted by the assessors, such as decoration, and we saw that they have all been addressed. People are also able to say what they think of the service by using a comment card system. The system allows people to send their comments Care Homes for Adults (18-65 years) Page 31 of 36 Evidence: directly to the provider company through free post, and receive a personal reply. We saw that comment cards are in an easy read format, and are available in the entrance hall. Record show that the manager carries out an audit of a range of issues within the home every three months. She looks at things like safety issues, staffing issues, person centred planning arrangements, and health action planning. We also saw reports of monthly visits carried out by an area manager, which look at things like the environment, complaints and compliments, and the views of people staying at the home. We saw that there is a risk assessment in place for fire safety, and there are records to show that staff check fire alarm call points every week. These records show that the fire alarm system is regularly serviced and fire safety checks are carried out. Staff also check and record things like water temperatures, and fridge and freezer temperatures. They were able to tell us what the temperatures should be set at, and what to do if they were too high or too low. Any substances that could cause harm to people, such as cleaning fluids, are kept in a locked cupboard, and there is lots of information available about how to manage the substances safely. There are risk assessments in place for things like kitchen hazards, slips and falls, unwanted callers, and staff working on their own. 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 It is recommended that assessments contain information about how people make lifestyle decisions in accordance with the Mental Capacity Act, 2005. This is so that peoples rights and choices are protected. It is recommended that care plans contain information about how people make lifestyle decisions. This should include how to support them when they are not able to do this, in accordance with the Mental Capacity Act, 2005. This is so that peoples rights and decisions are protected. It is recommended that staff record all reviews of needs or care plans. This is so that they can demonstrate that all of the information is up to date. It is recommended that transport options, especially for those who use wheelchairs, are reviewed. This is so that people have the opportunity to access a greater range of community facilities. 2 6 3 6 4 13 Care Homes for Adults (18-65 years) Page 34 of 36 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 5 23 It is recommended that a system be developed to give people, and their representatives where appropriate, information about how the home has spent money on behalf of the person. This is so that people are assured that their money is appropriately managed. It is recommended that storage of peoples personal money is reviewed. This is so that it does not impact on the storage of any other items that need to be kept securely, such as medication. It is recommended that staff receive at least six supervision sessions each year. This so that they continue to be well supported. 6 23 7 36 Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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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