Inspection on 08/05/09 for Benham Lodge

This is the latest available inspection report for this service, carried out on 8th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Benham Lodge 14/02/06

Benham Lodge 19/08/05

Benham Lodge 14/10/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Benham Lodge 42 Pelham Road Gravesend Kent DA11 0HZ     The quality rating for this care home is:   three star excellent 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: Helen Martin     Date: 0 8 0 5 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Benham Lodge 42 Pelham Road Gravesend Kent DA11 0HZ 01474533108 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) : benhamlodge42@talktalk.net DGSM Ltd care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 1. The registered person may provide the following category/ies of service only: Care home - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disabilities (LD) 2. The maximum number of service users to be accommodated is 9. Date of last inspection Brief description of the care home Benham lodge provides accommodation and residential care for up to 9 people with learning disabilities. The home is staffed twenty-four hours a day. Two of the service users are over 65 years of age. The premises are close to local facilities and public transport. The house is owned by Hyde Housing and leased to DGSM Your Choice, it was purpose built and all the service users have their own bedrooms on the ground or first floor. At the rear is a conservatory and well kept garden. There is car parking space at the front of the home. The house is best suited to people with few mobility difficulties, as there is no lift. Service users are provided with opportunities and support to attend a variety of day, Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home employment and leisure activities and to gain independence skills. The home has a high number of staff that have gained a National Vocational Qualification. The current basic fee for the home is 663.48 per week, although residents requiring more specialist needs to be met are charged more. Full information about the fees payable and the service the home provides are available from the manager. Care Homes for Adults (18-65 years) Page 5 of 29 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Benham Lodge provides care and accommodation for up to nine adults with a learning disability. The home is best suited for people with few mobility problems. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This Key Unannounced Inspection included a visit to the home in Gravesend on 8th May 2009, where the Registered Manager, two Support Workers and all the Service Users were spoken with. Some judgements about the quality of the service provided were taken from observation and conversation. Some records and documents were looked at together with the premises and facilities of the home. Care Homes for Adults (18-65 years) Page 6 of 29 The last Key Inspection was undertaken on 16th May 2007 and an Annual Service Review was completed on 27th May 2008. An Annual Quality Assurance Assessment, AQAA, has been received from the home. Any other information received since the previous Key Inspection has been reviewed. All of the above have been included within this inspection process and some of the gathered evidence is mentioned in this report where appropriate. What the care home does well: What has improved since the last inspection? People have benefited from being supported by staff to learn more things. All residents now do their own laundry, help with the cooking and are learning more about money. People enjoy being supported to be independent. Residents benefit because their care plans are easier to understand and the needs of older people are looked at more often. The house is looked after better by the owners, and repairs are done quickly and properly. Two rooms have been redecorated and there have been some new carpets and beds. Staff are able to do their jobs well because they are given more training and support. The manager now has a qualification and is planning another, which will help them in running the home well. Although residents still have to pay for their holidays, this is now written down in a way that is easier to understand. People are safer because when they agree to pay for their Care Homes for Adults (18-65 years) Page 8 of 29 holiday, this is talked about with their families and written down. What they could do better: 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 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 benefit from an assessment by the home before they decide to move in. This gives a good opportunity to see whether the home is suitable to meet their needs. Evidence: Residents benefited from an assessment before they moved in to make sure that their needs could be met by the home. People have been living at the home for some years and the need for any pre admission assessments in the near future is unlikely. The Registered Manager stated that there is a format for that could be used to record this, should there be the opportunity for any new potential residents in the future. A plan of care is developed from this assessment. Care Homes for Adults (18-65 years) Page 11 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy making choices and taking decisions about their lives. They are able to participate in all aspects of life in the home. Residents benefit from being involved in their care planning. Their changing wishes and needs are reflected in care plans, which they can easily understand. Residents benefit from being supported to take risks and to be independent. Evidence: Individual plans of care for each resident are developed which identify the support required from staff to meet residents personal, social and health care needs. Care plans are holistic and reflect changing wishes, needs and goals. Information is clear and easy to follow, detailed, individual and up to date. Residents benefit from being involved in their care planning. One resident spoken with confirmed this and explained that they also knew all about the reviews of their care Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: plan which happened every six months. Subsequent information received from the Registered Manager includes a pictorial care plan developed by staff and residents. This means that residents will be able to understand their care plans more easily. Residents are supported by staff with any risks involved in being as independent as possible. Risks are assessed and recorded for a range of activities. Residents are safer, because staff take action to reduce the risk of any harm occurring. Residents enjoy making their own individual choices. Considerable attention is given to support people to make decisions in all aspects of their life. Residents are able to choose how and where to spend their time. One person spoken with explained that they are looking forward to and being supported towards moving into the community. All residents enjoyed choosing the colours for their rooms. Residents benefit from making choices about how the home is run. This happens at weekly meetings, where a range of issues are discussed, such as meals, social events and domestic chores. All residents benefit from being involved in cooking and budgeting. The Registered Manager explained that all residents are now able to do their own laundry. Continuity of care is provided by individually named key workers. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy full individual lifestyles and are able to choose from a range of opportunities for leisure and personal development. They benefit from good support to further their skills and independence. Residents enjoy being part of the local community and they are able to see their family and friends when they wish. Residents enjoy choosing and helping to cook a variety of good quality food. Evidence: Residents are treated with respect and supported with their responsibilities. They enjoy being treated as individuals who have different interests and aspirations. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Residents enjoy a full lifestyle and are able to choose from a large variety of different activities and opportunities within the local community. The routines of the home and the number of staff on duty are flexible to accommodate this. Some people enjoy dancing at a nightclub, BBQs, church services and events, swimming and bowling. Others benefit from attending various day centres and groups, where they are able to participate in social events, activities that personally interest them or further develop their life skills. Residents spoken with had all been out during the day; one mentioned that they had been out to the shops and enjoyed it, while another said that they had not yet made up their mind about what to do on one day as they had three events to go to that clashed. All residents have the opportunity to go on holiday. Two residents are going abroad this year. Funding arrangements for this are mentioned under the Concerns, Complaints and Protection section of this report. Residents are able to socialise with their family and friends both inside and outside of the home when they wish. One resident described how they are going to have a birthday party for their family and everyone. Residents are able to relax in the home watching television or DVDs, cooking, gardening or playing games. One person said that they are a big Doctor Who fan and love to watch the DVDs and TV. Another looks after a pet rabbit. Residents benefit from support towards independent living skills. The Registered Manager explained that all residents now do their own laundry and are involved in cooking and budgeting. Residents enjoy choosing their own meals according to their own tastes and preferences. Menus are planned at weekly meetings. The Registered Manager described how staff are currently supporting some residents towards adult education courses. One resident has a job, whilst another two are undertaking employment training to prepare them for this. The Registered Manager explained that currently some residents are being supported towards more independent living within the community. One individual said I did not know I could get my own flat until my advocate told me about it; I am looking forward to it; people are helping me to get prepared for it with things like finance and shopping; I will get support in my flat when I go to live there. Care Homes for Adults (18-65 years) Page 15 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from receiving support in the way that they prefer. Their physical and emotional needs are met. Residents are protected by the systems in place for the administration of medication. Residents benefit from good support to come to terms with any potential challenges resulting from aging, illness or death. Evidence: Residents dignity and privacy are respected. People are asked about their wishes and needs, which are reflected in their care plans. Staff have an understanding of these and fit in with the preferred routines of each person. Residents are able to see social and health care professionals when they need to. Staff support residents to attend appointments with people, such as the GP, chiropodist, optician and dentist. If residents need more specialist health care, staff help them to Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: access this, such as hospital appointments, liaison with the Community Nurse or an Occupational Therapist. Staff monitor any ongoing medical conditions. Residents eat appropriately and their weight is checked regularly. The Registered Manager demonstrated a good understanding of the potential challenges faced by residents regarding aging, illness and death. If necessary, residents can be supported to come to terms with these issues by staff and appropriate health care professionals. Currently no residents manage their own medication and all benefit from support from staff to do so. Residents are protected by the systems in place within the home regarding the storage and administration of medication. All medication is stored securely and administration records are completed appropriately. There are written guidelines available for staff about the administration of drugs prescribed on a when required basis. All medication is prescribed with the exception of two basic homely remedies. The GP has confirmed in writing their agreement that these are suitable for all residents. Staff are trained to administer medication. Care Homes for Adults (18-65 years) Page 17 of 29 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. Residents views and concerns are listened to and acted upon. Procedures are in place that protect residents from potential abuse. Residents financial interests are protected, although this could be improved by additional funding for holidays. Evidence: Residents are at ease and confident talking with the Registered Manager and staff who listen to their views and concerns. There is a regular weekly meeting where any issues can be discussed. The home provides a written complaints procedure. Residents benefit from access to this in a format they can more easily understand. The Registered Manager said that the home has received no complaints since the last key inspection. Written policies regarding the protection of vulnerable adults are available for staff. These include the procedures from the local authority. Staff receive training in the protection of vulnerable adults. The home has a system in place, which aims to protect the financial interests of residents. Small amounts of cash are held on the behalf of some residents. This is kept Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: securely. All money is stored individually and transaction records are maintained. Cash checked tallied with accounts seen. Receipts are kept for purchases made. Staff make regular checks and the organisation audits the system. Residents possessions are recorded in their care plans, although one such record seen was not signed or dated. The Registered Manager assured the inspector that they would undertake a review as soon as possible to ensure that all records of residents possessions are signed and dated. Residents have the opportunity to go on holiday if they wish. Currently the organisation does not pay for the cost of this. The Registered Manager explained that the organisation continues to be in discussion with the local authority regarding the funding needed for this. Residents agree to pay for the cost of their holiday together with the costs of the necessary staff to support them. This agreement is confirmed in writing by the resident and their representative. The Service Users Guide is presented in a way that residents can more easily understand. Part of this includes information about how holidays are paid for. Care Homes for Adults (18-65 years) Page 19 of 29 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. Residents enjoy living in a clean, tidy, comfortable, homely and well maintained environment. The premises are best suited for people with few mobility difficulties. Evidence: The building fits in with the local community and has a style and atmosphere suitable for people who live there. Residents benefit from living in clean, tidy, comfortable and homely accommodation. The premises are generally suitable for their current needs. Residents have unrestricted access in the house and garden. The garden is attractive, well kept and has patio furniture. Residents benefit from using the garden and one enjoys keeping a pet rabbit there. The house is maintained and decorated by a Housing Association, which owns the property. The Registered Manager explained that since the last key inspection, all outstanding repairs and maintenance had been completed satisfactorily. It was said that there are now regular meetings about the upkeep of the house and all work is undertaken appropriately and promptly. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The home has a lounge, kitchen.dining room and conservatory, which are all pleasant areas. There are bathrooms both upstairs and downstairs. All residents have their own rooms. Residents spoken with all said that they like their rooms, which are all individual and highly personalised. People are able to choose the colour of their room, how it is decorated and how their furniture is arranged. Residents have lots of items in their rooms, which reflect their personal interests. Some people explained that they were big Dr Who fans and clearly enjoyed their posters and DVD collection. Bedrooms meet service users needs and are well furnished. There are no lifts, specific environmental adaptations or disability equipment within the home. Current residents have few mobility problems. The Registered Manager said that there is a staff call system in place throughout the whole house, for residents to use in case of an emergency. The premises are clean and hygienic. Residents use the laundry and the kitchen with support from staff, both of which are domestic in nature. The Registered Manager explained that all residents now do their own laundry and all are involved in cooking. The laundry room contained pictorial signs about how to use the machines available. Care Homes for Adults (18-65 years) Page 21 of 29 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. Residents benefit from a sufficient number of appropriately recruited, qualified, trained and supervised staff who have a good understanding of their needs. Evidence: A good rapport was observed between residents and staff. Residents spoken with indicated that staff are very good and look after them well. There were enough staff on duty at the time of this visit to meet residents needs. There are a minimum of two staff on duty in the mornings, three in the afternoons with one awake at night. There are additional daytime shifts at the weekends and more staff are available depending on residents needs. There are no auxiliary staff employed in the home, as staff support residents with all domestic tasks. There is an on call system for emergencies. The home has a procedure in place which aims to recruit suitable staff who can meet the needs of residents. Records seen showed that residents are protected by appropriate pre employment checks, such as references, identification and a criminal records bureau check. The Registered Manager explained that the home has a low staff turnover as people enjoy working there; there have been no new employees recently Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: and the home is fully staffed. Induction training is undertaken by any new staff. In the past although this has been written down, records do not show detailed information. The Registered Manager assured the inspector that this would be included in the new training for learning disabilities shortly to commence for all staff; that any new staff in future would undertake this. The home provides an ongoing programme of training for all staff, which is designed to further develop and update their skills. Records show that appropriate courses and qualifications have been undertaken, including first aid, food hygiene, moving and handling, fire, medication, the protection of vulnerable adults, health and safety, challenging behaviour, infection control and risk assessment. Additional courses can be undertaken which are more specific to the needs of residents such as learning disabilities, diabetes, mental health, autism and aspergers. All staff, with the exception of one, have obtained a National Vocational Qualification. The Registered Manager explained that staff supervision consisted of a combination of informal and formal recorded one to one sessions. This is now undertaken by the Registered Manager and senior staff. Records seen showed most recent formal supervision in April 2009. Care Homes for Adults (18-65 years) Page 23 of 29 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. Residents enjoy living in a relaxed atmosphere and benefit from a qualified and experienced Registered Manager. The home is well run, although this could be enhanced if the organisation increased the hours allowed for management and administration. The home aims to run in the best interests of residents. They benefit from being asked for their opinions about the service they receive, although this would be enhanced by more frequent visits from representatives of the organisation. Residents are safeguarded by up to date policies and procedures available for staff. Residents are protected by the testing and maintenance of systems and equipment within the home. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: The Registered Manager is experienced in caring for people with learning disabilities and has been working in the home for some time. Since the last key inspection, they have completed a National Vocational Qualification at level 4 and intend to commence the Registered Managers Award. During this visit the Registered Manager explained that it was the organisations continued policy that they worked two days a week with the direct care of residents, leaving three days a week for the management and administration of the home. Although, recently this policy has been superseded as, in addition to managing Benham Lodge, the Registered Manager is temporarily covering the management of another home. The Registered Manager explained that this was not a problem as they had additional support from the Service Manager. These arrangements have not impacted on the management or improvement of the home since the last key inspection. However it is evident that time is restricted for the Registered Manager, which could limit the homes ability to progress further improvements and implement plans. The Provider is strongly recommended to review the Registered Managers work pattern to ensure that an appropriate amount of time is allowed for all aspects of the management and administration of Benham Lodge. This should include the organisations policy of allowing three days per week for the management and administration of the home and a plan regarding the temporary management cover of another home. There is an open and inclusive atmosphere in the home. At the time of this visit residents were confident and relaxed chatting and spending time with staff. Both staff and the Registered Manager responded promptly and appropriately in a friendly and polite manner. There is a regular weekly residents meeting where any issues can be discussed. Residents benefit from being asked about their wishes and needs. The organisation uses a recognised quality assurance system and regular meetings are held throughout the year. There is a system of audits using National Minimum Standards. The home uses questionnaires to gain opinions of the service from residents, their families, staff and health and social care professionals. Visits from a representative of the organisation as the Provider were discussed. These take place, although not on a regular monthly basis. Although one such visit was undertaken by the Service Manager on the day of this inspection, the previous most recent visit was in September 2008. A statutory requirement has been made. The home has a range of recorded policies and procedures that are available for staff. These include complaints, safeguarding vulnerable adults and medication. The Registered Manager explained that the organisation had recently reviewed and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: updated all policies and procedures and had provided additional guidelines where needed. A number of records have been looked at as part of this inspection. These have been mentioned within this report where appropriate. Records and certificates seen generally indicated the regular testing and maintenance of systems and equipment within the home. The Registered Manager explained that following a fire inspection in September 2008, the homes fire risk assessment had been reviewed and updated. The Registered Manager assured the inspector that, although no further recommendations regarding the frequency of fire alarm and emergency lights tests were made, they would confirm these arrangements with the Fire and Rescue Authority. Accidents and incidents are recorded appropriately. The Registered Manager monitors the premises and the accommodation. This is done so that potential hazards to the health and safety of residents can be identified and addressed. The home has procedures in place for the maintenance of food hygiene. In order to reduce the risks of scalding, all hot water outlets have mixer valves fitted and temperatures checked. Hot water temperatures were last checked three months ago. The Registered Manager assured the inspector that this was in the process of being undertaken and would be completed shortly. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 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 39 26 Where the registered provider is an organisation, the home shall receive an unannounced visit from an appropriate representative of the organisation at least once a month. In order to fully ensure that the home is run in the best interests of residents, the Provider must visit the home at least once a month. 30/06/2009 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: 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) 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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