Inspection on 01/04/10 for Kingstone House

This is the latest available inspection report for this service, carried out on 1st April 2010.

CQC found this care home to be providing an Adequate 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

Kingstone House 29/11/07

Kingstone House 31/05/06

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Extracts from inspection reports are licensed from CQC, this page was updated on 03/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Kingstone House 121 - 123 London Road Burgess Hill West Sussex RH15 8LU     The quality rating for this care home is:   one star adequate 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: Annie Taggart     Date: 0 1 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Kingstone House 121 - 123 London Road Burgess Hill West Sussex RH15 8LU 01444245063 01444258534 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): springmeadow@ilg.co.uk Evesleigh Care Homes Ltd (ILIACE Group) Name of registered manager (if applicable) Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 20. The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability - (LD). Date of last inspection Brief description of the care home Kingstone House is a care home registered to accommodate up to twenty Service Users with learning disabilities. The Registered Provider is Independent Living Group (ILG) and there is no registered manager in post. The home is made up of three detached properties located next door to each other. Kingstone has the capacity to accommodate twelve people and Clevelands comprises of three 2-bed independent apartments, each with their own kitchen, sitting/dining room and bathroom. To the rear of these properties is The Lodge, which houses two self-contained flats. All of the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 20 2 1 1 0 2 0 0 9 Brief description of the care home accommodation is situated a short walk from Burgess Hill town centre, and therefore is accessible to all community facilities, including rail and bus stations. Each service user has their own bedroom complete with en suite toilet facilities, some with showers. In addition there is also a large walk-in shower on the ground floor of Kingstone. Kitchens, dining rooms and lounge areas are well maintained and decorated to a high standard. The home is also in the process of developing an activity room at Kingstone. External grounds are enclosed for security purposes and consist of a tarmac area and a small lawn with seating. Information about the service, including the Statement of Purpose, Service Users Guide and CQC reports is made available to prospective service users or their relatives, on request, as part of the admission process. Care Homes for Adults (18-65 years) Page 5 of 28 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: one star adequate 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: In order to plan for this inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home for completion and surveys were sent to service users and the staff working in the home. We also looked at information that we have received during safeguarding meetings with West Sussex Safeguarding team and information from the last report. The home has provided an improvement plan following the last key inspection visit and this formed part of the inspection plan. The AQAA was returned in the given timescales and gave us clear information about the services being provided in the home. Six service user and four staff surveys were returned and comments from these have been used in this report. The unannounced visit was carried out at 9.30am on Thursday 1st April and lasted for five and a half hours. Care Homes for Adults (18-65 years) Page 6 of 28 During the visit we were able to meet with service users in communal areas and in their private bedrooms and we spoke with the staff on duty and observed staff practice. The assessments, care plans and supporting documentation for five service users was tracked and we looked at the system for administering and recording medication. We saw the recruitment file for one newly appointed member of staff and looked at evidence of staff training and supervision. Records for the running of the business were seen and this included risk assessments, health and safety records, incidents and accidents reporting, fire safety and staff fire training and we looked at the system for managing service users monies. Feedback following the visit was given to the interim acting manager. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? 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 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 8 of 28 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 9 of 28 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. In order to ensure that the staff team have the information they need to effectively support people, assessments of need have been reviewed and iodated. Evidence: At the last key inspection a Requirement was made for people to have their needs and wishes assessed in order for the home to provide and effective service. At this visit we saw that people had received a detailed re-assessment that recorded their individual needs and wishes. No new service users have been admitted since the last inspection visit and the acting manager told us that the compatibility of people would be a priority when introducing new people to the home. The homes Statement of Purpose is in need of updating to reflect the changes in management and the acting manager told us that this would be completed when the new manager is in place. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Records showed us that contracts of terms and conditions of residency are agreed and the five that we looked at had been signed by the service user of their representative. Care Homes for Adults (18-65 years) Page 11 of 28 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. There are clear and detailed care plans in place in order to guide the staff team to the needs of the people they are supporting. Risks are assessed and recorded and monthly reviews and daily records are kept up to date. Evidence: At the last key inspection visit a Requirement was made for the home to ensure that care plans were kept up to date and clearly guided the staff team to the needs and wishes of the people they are supporting. At this visit we tracked the care plans for five of the people living in the home and this showed us that that care plans had been updated and contained clear and current information. For each person there is an Essential Lifestyles Plan in place that details background information, personal preferences, physical,emotional and mental healthcare needs and risks both personal and environmental were recorded. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Records show that the people living in the home have complex needs and often display difficult and challenging behaviour. Care plans contained updated behaviour management plans that had been completed with input from behavioural specialists and the plans identified triggers for behaviours and how the staff team were to deal with this. Monthly key worker reports and daily records are completed and each person has a daily diary. When looking at the daily records we saw that they clearly recorded all of the events in the persons day but some said, appears to be happy or appears irritable and out of sorts. We spoke to the acting manager about the need for daily records to be more specific and she said that she would address this at the next staff meeting. From looking at records we saw that formal care plan reviews are held and service users, their families or representatives and care managers are involved in the process. Care Homes for Adults (18-65 years) Page 13 of 28 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. The people living in the home have access to a variety of day care and social activities and these are flexible to suit their individual needs. Improvements have been made to menus and food records and advice is being sought from a nutritionist. Evidence: Daily records and individual activity plans showed us that people are supported to take part in educational and day service resources and they are supported to access their local community. For each service user there is an individual programme of activities in place and for some people this also has been completed using pictures and symbols in order for the person to better understand their day. Activities included attending colleges and day services, visiting family and friends, Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: holidays and days out and going out for meals and coffee. For some people most of their activities are based around the home and when talking to service users we were told I dont like colleges and I like to do my own thing. Some of the service users living in the Kingstone part of the home are of a retired age group and expressed that they did not want structured activities and we saw two of the people go out independently to the local shops and for a coffee. Another person had an activity booked for the morning but became distressed and angry because they wanted to go to the shops to buy an item of clothing, the staff on duty dealt with this in a calm and supportive way and changed the activity to suit the persons wishes. In the Clevelands part of the home there are three seperate flats and service users have their own designated staff teams. On the day of the visit all of the service users were out for the day at planned activities, one person came back during the visit and said that they had enjoyed their day. Activities recorded for people included, attending colleges, going to the gym, swimming, working on an animal farm and attending day service facilities. The manager told us that because of the complexity of needs of service users, the staff team has to be flexible to meet their individual needs. There are four vehicles on site for people to use to access the community. In returned service user surveys comments included, I like going out with my key worker and to swimming and I like the food at Kingstone, I like the people I live with and I like the freedom to get to do what I like. At the last key inspection requirements were made regarding the home accessing guidance from a nutritional expert to ensure that peoples nutritional needs were met. At this visit we saw that menus had been reviewed and updated to reflect service user choice and the menus were in words and symbols for people who used this form of communication. Some people had agreed to working to a healthy eating plan and we saw that this was being successful by weight loss and by people being more active. Food records were up to date and recorded what people ate each day and in records we saw that a referral had been made via the Doctor for input from a dietician. There were bowls of fresh fruit in the dining room and we saw that people were involved in preparing and cooking meals. Care Homes for Adults (18-65 years) Page 15 of 28 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. There are updated plans in place to ensure that the staff team are aware of the physical, emotional and mental health needs of the people they are supporting. The home is working with other professionals and medication is being well managed. Evidence: Requirements were made at the last inspection for the home to ensure that peoples changing healthcare needs were kept under review and that medication records were kept current and in good order. At this visit we saw that people have an updated Health Action Plan in place that clearly informs the staff team of the physical, emotional and mental healthcare needs of each person they are supporting. The plans showed that input had been gained from other professionals and records showed us that people had recently seen opticians, dentists and their doctor. The home works with specialists such as the local learning disability community teams and challenging behaviour teams and records show that the local district nurse also has input into the home. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: At the last visit there were also concerns regarding the system for recording and monitoring peoples weight in relation to their health, at this visit we found that people are weighed monthly and this is added to the key workers monthly update. Records showed us that professional advice had been sought regarding people who were staying in bed all day and not eating and plans were in place to address this. The manager told us that as the staff team received more training and guidance in dealing with Autism and also difficult behaviours, the incidents of this had decreased and service users were much more active. We looked at the system for recording and administering medication and saw that this was being well managed. The MAR sheets were complete with no gaps in signing, medication was safely stored and audits were carried out and recorded. From looking at records we saw that there is still a high level of some people regularly refusing their medications. Daily records showed us that this had been referred to their doctor who had agreed guidelines and had spoken to service users about their refusal. In the Clevelands house, medication records were in good order. There were clear Epilepsy guidelines in place for one person that had been agreed and signed by their doctor and the staff team. Care Homes for Adults (18-65 years) Page 17 of 28 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. There is a system in place for recording and investigating complaints and concern and the staff team are trained and aware of their responsibilities to protect people from risk of abuse or harm. Evidence: The home has a complaints procedure a copy of which is displayed in the home and there is also an accessible format in pictures and symbols for service users. We looked at the records of complaints and saw that no formal complaints had been recorded since the last inspection visit. Service users told us that if they were not happy they would talk to a member of staff or their family. At the last visit Requirements were made for the staff to receive training in safeguarding people from risk of abuse or harm, for managing challenging behaviour and for restraint only to be used following an agreed plan with professionals. At this visit we saw that the staff team had received updated safeguarding training and the staff on duty were aware of their responsibilities and said that they would report any suspected abuse. A new staff member who was shadowing experienced staff was asked what they would do if they heard another member of staff shouting at a service user, they replied, I have been told that you must never shout at people as this only makes things worse and I would report it. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Where restraint is used for the safety of people, there is a detailed agreed plan in place that has been implemented with guidance from a behavioural team, the staff have received the relevant training and have signed the plan to say that they will comply. The acting manager has expertise in training staff in challenging behaviour and Autism awareness and was able to show us evidence such as graphs and accident and incident forms that showed that as the staff team have become more competent and confident in dealing with difficult behaviours, incidences of these have dramatically decreased. We discussed with the acting manager how this support would be continued as her contract is due to finish and she told us that she would be staying on to work alongside the new manager to ensure the plans continued to be implemented. There are a number of outstanding safeguarding issues currently under investigation by the West Sussex Safeguarding team that have not yet been finally resolved. Care Homes for Adults (18-65 years) Page 19 of 28 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. The home provides a comfortable and homely environment for the people who live there. Maintenance issues are addressed and there is a programme of redecoration and refurbishment under way. Evidence: The service is divided into three seperate buildings, Kingstone House and Clevelands are large detached houses situated next to each other on a main road and the Lodge is a small single dwelling to the rear. The Lodge is currently not occupied but is being considered as single accommodation for one of the service users living in Clevelands. Kingstone House has accommodation over two floors with a lounge, kitchen and dining area on each floor. Two service users live upstairs with two staff on duty. Clevelands is divided into three flats, each with their own seperate entrance and each service user living there has their own designated staff team. Throughout the buildings, service users private rooms were bright and homely and personalised with their own belongings and evidence of hobbies and interests and service users told us that they were happy with their private space. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: A programme of updating and refurbishing the environment has been started and we saw that a fire place had been taken out of the downstairs lounge to make more room and ready the room for redecoration. The acting manager told us that new carpets and some new furniture had been agreed with the providers and was to be ordered. A maintenance person has been recruited and records show that regular health and safety checks and hot water checks are undertaken and recorded and there are environmental and fire risk assessments in place. In a returned service user survey we are told, the staff try their hardest for us, the home is close to town and not so far to walk and I am not lonely. Care Homes for Adults (18-65 years) Page 21 of 28 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. In order to protect the people living in the home, there is a robust recruitment process in place and staff receive training and supervision. Evidence: At the last key inspection Requirements were made regarding staff training and supervision and we found that the staff were not working in a consistent and competent manner. The home is run as two distinct houses, the three people in Clevelands each having their own designated staff team, some people have two to one staffing when out in the community. In Kingstone staffing rotas and shift plans showed us that there are now two staff designated each day to work in the second floor of the home where service users require a higher level of emotional support. The acting manager told us that there were sufficient staff to meet the individual needs of service users. In four returned staff surveys, three said that higher staffing levels would make them more effective. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Staff training records and individual staff files showed us that here is a programme of training and staff development in place. All staff receive mandatory training such as manual handling and first aid and a centrally managed training matrix identifies when updates are due and arranges training dates. In the AQAA we are told that of twenty two staff, eleven have the NVQ award in care at level two or above and others are working towards the award. We looked at the staffing records of one member of staff who has recently been recruited and saw that all of the required documentation was in place including a current Criminal Bureau Check and two references. The staff member was working in the home under supervision during their induction period and showed us that she was booked on all mandatory training. Records showed us that the staff team are now receiving regular supervision and support and this includes discussion on work practice. Staff meetings are also regularly held and recorded. During the day the staff on duty were kind and respectful to service users and were aware of the individual needs of the people they are supporting. In Clevelands we were only able to meet with one service user and one staff member as the others were out for the day. In returned staff surveys we are told, the home supports service users very well. We have a good staff team and it is a friendly place to work. The staff have help where needed and go on lots of training to benefit themselves and the people they support. Another staff member said, Kingstone House is well organised, things are always happening for people and service users are happy. Care Homes for Adults (18-65 years) Page 23 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In order to ensure that the improvements made to the running of the home are sustained, a registered manager must be in place and Regulation 26,providers visits must be carried out in order to monitor the service being provided. Evidence: There is no registered manager in the home but an interim manager/consultant who has expertise in training staff teams in working with people with Autism and people with difficult behaviours has been in post since November 2009. The managers contract is about to end and we were told that an experienced manager had been recruited and would take up post on 19th April 2010. During the day we observed the manager guiding and supporting staff to a high level when instances of difficult behaviour occurred. We spoke to the manager about how the ways of working and staff confidence would be continued once she was no longer leading the staff team. We were told that systems and procedures were now in place and the acting manager would continue to work alongside the new manager for an induction period of two weeks. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: There has been no formal quality assurance process carried out by the organisation since 2008. The manager told us that surveys had recently been sent to families and other people involved with he home and these would be collated by the head office when returned. This will be assessed at the next inspection. From looking at records we saw that Regulation 26, registered providers visits have not been carried out on a regular monthly basis and none were recorded for September, October and December 2009. There was a visit in January 2010 and a full compliance audit was carried out on 22nd to 24th February 2010 by the organisations compliance team. We checked the system for managing service users monies and saw that this was well managed. Each service users has a money wallet with a numbered security tag that is replaced and recorded each time the wallet is opened and written records and receipts are kept for any expenditure. The system for recording incidents and accidents was checked and this showed us that the home addresses concerns and reports to the Commission as appropriate. Health and safety issues are addressed and we saw records of checks such as fire checks, staff fire training and electrical appliance checks and these were current. We spoke to the acting manager about how the home had followed and completed their improvement plan and made positive changes to the care being provided to people. We discussed how the home would need to continue to evidence that these improvements were enshrined in practice over time and would be sustained once the acting manager had left. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 1 42 26 26 (1) The registered 30/05/2010 provider must ensure that monthly Regulation 26 registered providers visits are carried out and recorded. This is to ensure that the management and running of the home is monitored and supported. 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 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 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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