Please wait

Inspection on 24/09/08 for Littleover Lane Residential Care Home

Also see our care home review for Littleover Lane Residential Care Home for more information

This is the latest available inspection report for this service, carried out on 24th September 2008.

CSCI found this care home to be providing an Excellent 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Littleover Lane Residential Care Home 44 & 44a Littleover Lane Littleover Derby DE23 6JG 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: Angela Kennedy Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 35 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Littleover Lane Residential Care Home 44 & 44a Littleover Lane Littleover Derby DE23 6JG 01332270154 F/P01332270154 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Mr Martin Coe Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 0 care home 9 learning disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Mencap lease Littleover Lane. The accommodation comprises of two houses, which provide personal care for up to 9 service users with a learning disability, aged between 18 and 65 years of age. Five service users occupy house number 44, and four service users live at house number 44a. Both houses have been furbished to reflect the style of a family home. Both houses have an accessible garden, which is segregated with a garden fence and a gate separating the patio areas. Each house is run independently, in accordance with service user needs. Care Homes for Adults (18-65 years) Page 5 of 35 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 Care Homes for Adults (18-65 years) Page 6 of 35 How we did our inspection: This is what the inspector did when they were at the care home This key inspection was unannounced and took place over one day. The last Key Inspection undertaken at this service was on the 18th October 2007. The inspection was focused on assessing compliance with defined key National Minimum Standards. The commission had requested the service to complete an Annual Quality Assurance Assessment and the information provided within this Page 7 of 35 Care Homes for Adults (18-65 years) document is included within this report. Three people that lived at Littleover Lane were spoken with.All of the people spoken with confirmed they were happy with the support and care they received at Littleover Lane and said they liked living there. The manager was on duty on the day of this inspection visit and provided all of the required information. The weekly fees at the time of this inspection visit ranged from 586 to 941 Pounds. It was confirmed that the fees payable Care Homes for Adults (18-65 years) Page 8 of 35 were based on each individual’s assessed needs. Items not included in this fee were: Personal items and clothing purchased Toiletries Social and community activities A contribution of 111.00 Pounds was given to each individual towards their annual holiday. What the care home does well The support plans and risks assessments seen were detailed and provided the staff with all of the relevant information they needed to Care Homes for Adults (18-65 years) Page 9 of 35 support individuals in their personal, health care and social needs. Staff spoken with felt they had sufficient information to be able to meet individual’s support needs. The staff demonstrated a good understanding of individuals needs and appeared confident and competent in their work. They encouraged and supported individual’s to retain as much independence as possible. Care Homes for Adults (18-65 years) Page 10 of 35 Individuals were encouraged to make decisions about their daily lives, such as the activities they preferred, the decor of their rooms, their preferred choice of holidays and the meals they preferred. What has got better from the last inspection A conservatory is now in place that provides a comfortable smoking area for the people using the service that smoke. This does not impact on the health of people using the service that do not smoke. All of the requirements left at the last inspection have been Care Homes for Adults (18-65 years) Page 11 of 35 met. The medication practices have improved to ensure safe working practices around medication administration are followed at all times. What the care home could do better The manager has demonstrated that the service continues to develop to improve the outcomes for the people that live there. Care Homes for Adults (18-65 years) Page 12 of 35 Some areas seen would benefit from redecoration, however in general this was being addressed. 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 Angela Kennedy 33 Greycoat Street London SW1P 2QF 02079792000 Care Homes for Adults (18-65 years) Page 13 of 35 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 14 of 35 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 15 of 35 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 . Individuals needs are fully assessed and met prior to admission. This ensures the service is confident that they can meet each persons needs, before admission is agreed. Evidence: Four people were living at 44a Littleover Road and four at 44 Littleover Road. At this inspection visit two people were case tracked, but only one persons records were looked at as the second person chosen to case track was not happy for their written records to be seen. However this person was spoken to at length and was able to provide detailed information regarding their care and the support they received. Staff that supported this person were also spoken to at length regarding the support provided to this person The majority of individuals using the service had their needs assessed by social workers or through the care management system. The assessments then form part of the individuals plan compiled by the home. Seven of the eight people were admitted to the home prior to 1999, and their initial needs assessment have been archived. Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: There was evidence that the placing Authority reviews the care needs assessments on a regular basis. One person had moved into 44 Littleover Lane since 1999 and there needs assessment was seen at the last inspection visit in 2007. There was sufficient evidence seen at that time to demonstrate that a needs assessment had been undertaken prior to their admission. Care Homes for Adults (18-65 years) Page 17 of 35 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 . The support plans in place enabled individuals needs and goal to be met and their independence to be promoted. Evidence: The records seen demonstrated that plans of care were in place that the individual or someone close to them had been involved in making. This ensured that the individuals needs and goals were met. Information was provide about individuals such as their personal details, including a photograph for identification purposes, other people involved in their life including professionals that supported them such as doctors and other health care professionals, their health care needs, information about their ethnicity and religion, their methods of communication, their diet and food preferences. The support plans in place were detailed and pictorial descriptions were used to enable individuals to understand the areas of support that were being addressed. The support plans seen covered all areas of personal, health, leisure, activities of daily living, Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: community access and travel arrangements. The support plans were personalised and had been complied with the individual together with friends and /or the Advocacy Service. The Support plans seen had been were written from the individuals point of view and included the individual’s lifestyle preferences and choices. The person whose support plans were looked at was unable to sign their support plans, this had been recorded within their records and signed by a member of staff. Evidence was in place within the support plans seen to demonstrate that they had been reviewed on a regular basis. Daily records were completed to ensure good communication between the staff regarding each person was maintained. The daily records seen included easy read summaries to enable individuals to understand the areas of support that were being addressed. Care plans and risk assessments seen clearly linked with each other and provided the staff team with the information required to ensure individuals were supported in a safe way. This enabled the staff to support and promote individuals independence as much as possible. One person using the service spoke in detail about the support they received and confirmed that they had been and continued to be involved in the development and reviews of their support plans. This person confirmed that the staff team provided them with the level of support they required. They talked about their decision to grow vegetables and talked about what they had grown and how the staff had supported them. Care Homes for Adults (18-65 years) Page 19 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People were supported to follow their personal interests and be part of their local community. The meals provided were well balanced and in accordance with individuals preferences and dietary requirements. Evidence: The support plans seen indicated that individuals recreational, social, educational and leisure interests and hobbies were generally well met. The records seen identified the personal goals, choices and preferences of the individual and risk assessments were in place in relation to these activities. This enabled the staff to support and promote individuals independence within their chosen activity/ interest as much as possible. From discussions with the staff team it was confirmed that the staffing levels were adapted when possible to ensure sufficient staff were in post to support people in community based activities and events. For example during the daytime in the week some people attended their local day opportunity placements either full time or on a Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: part time basis. Therefore the staffing levels at this time reflected this and were then increased at other times to allow for community activities to be undertaken. One person using the service stated that they enjoyed playing bingo during the week and said that the staff supported them in attending this within their local community. They did say that they had missed a few weeks and stated that this was due to another person using the service being unwell and therefore staff had not been available to support them. Discussions with the manager confirmed that this had happened but confirmed that alternative arrangements had now been put in place to ensure this person was able to attend bingo with staff support. It was confirmed by the manager that at the time of this inspection visit no annual holidays had been undertaken by anyone using the service this year. However it was stated that members of staff were consulting with individuals regarding their preferred holiday destinations, and that these were still in the planning stage at the present time. It was stated that some people would not be going on holiday this year due to their present health care needs. Individuals were supported to follow their preferred daily routines. As stated above some people accessed their local day services or other daytime opportunities. One person using the service however did not wish to access these services and although the staff had tried to encourage this person to consider these opportunities they had respected this persons wishes not to join in. During this inspection visit individuals were observed spending time alone if they wished to and spending time with members of staff, either undertaking an activity or sitting chatting to them. One person was seen reading a book; another went out for a walk to the local park. As stated earlier in this report one person talked about the vegetable garden they had grown with the staff support. It was confirmed that these vegetables had been used in the daily meals provided. Other people using the service confirmed that these vegetables were enjoyed and said they were really tasty, better than ones from the shop Information on records seen and from discussions held with the manager and staff demonstrated that a positive relationship and good communication was maintained with individual’s families. This supported individuals to maintain relationships with their family. Records of the meals provided were seen and demonstrated that the meals provided were well balanced. Special diets such as soft diets and diabetic diets were catered for. Individuals went food shopping with staff support and the meals prepared were based on individual preferences. Pictorial formats were used to enable people to identify the various meals to choose from. All of the people spoken with stated that they enjoyed the meals and enjoyed shopping for them. Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: Care Homes for Adults (18-65 years) Page 22 of 35 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People receive personal support from staff in a way that they prefer. The practices in place ensure that health care needs are met and individuals are supported to take their medicines in a safe way. Evidence: Individual’s personal care needs and how they were to be met were recorded in their support plans. One person spoken with was able to confirm that they were supported in their personal care needs in a way that they preferred. Support plans and records held demonstrated that individual’s health care needs were met. People were supported to access health care services, such as G.P appointments and hospital visits and attended services within the community including opticians, podiatrists and dentists. Records were in place to demonstrate that annual health checks were undertaken. Since the last inspection each person using the service now has a health file in place that is used to support them in understanding their health care needs and allows them to take ownership of their own healthcare. This file was used to record appointments Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: in, and was taken to healthcare appointments to enable individuals with staff support, to record any advice or treatment given. The records in place included pictorial formats to assist individuals understanding. These files were a useful tool for staff and health care professionals also, as personal information that may be required at healthcare appointments was recorded. Such as other health care professional contacts, the communication methods used by the individual, medications prescribed, dietary requirements and the person’s healthcare history. None of the people using the service were able to administer their own medication. The medication administration records were looked at and had been completed correctly, there were no gaps noted within these records, which indicated that medications had been administered as prescribed. A controlled drugs cabinet was now in place that meets with the legal requirements for storing controlled drugs within a residential care home setting. At the time of the inspection no controlled drugs were in use or being stored at the service. A controlled drugs register had been purchased for the recording of controlled drugs stored and administered at the service. This demonstrates that that the service has ensured that they will be able to comply with the new requirements now in place regarding the storage and administration of controlled drugs. Records were seen to confirm that the staff had received training on medication administration. The arrangements for receipt, storage and disposal of medication were also examined and found to be satisfactory. Care Homes for Adults (18-65 years) Page 24 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Concerns are addressed promptly and efficiently and actions are taken to put things right and people are safeguarded from abuse and neglect. Evidence: The service has a complaints procedure with a summary and a complaints form included in the service users guide, which all of the people using the service have a copy of. Mencap have developed a format, which is accessible to individual’s as several people are not able to fully communicate their concerns. Derbyshire Advocacy Service is used by the service, and they support individuals in making complaints as required. We have received no complaints about this service since the last inspection. The service continues to demonstrate their proactive and positive approach in addressing any concerns or complaints. Since the last inspection one complaint had been received. This was from one of the people using the service regarding documentation about their support needs. This was thoroughly addressed and the correct procedure followed to ensure this persons complaint was listened to and acted upon appropriately. Some of the people using the service were able to confirm that if they did have any concerns they would discuss these with a member of staff or the manager. Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: No reported incidents or allegations under the safeguarding adults procedure have been made since the last inspection. Records demonstrated that all staff had completed training on Safeguarding Adults. The Safeguarding Adults policy was not looked at during this inspection, as it was seen at the last visit and was in line with the Local Authority procedure and protocol. As the Local Authority are the lead investigators in Safeguarding referrals and investigations this indicates that the correct procedures would be followed in any safeguarding issues. Care Homes for Adults (18-65 years) Page 26 of 35 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 accommodation provided had sufficient facilities and space to enable individual’s to lead the life they chose and meet their needs. Evidence: A partial tour of both of the houses was undertaken and all communal areas and some bedrooms were seen. The staff are required to do sleep in duty in one of the houses, the other house has a waking night staff. In general the decor within both houses was satisfactory, it was noted that some areas such as the banister at the bottom of the staircase at number 44 would benefit from re- painting to enhance its appearance. Both houses appeared clean and this indicates that satisfactory levels of hygiene are maintained. Individuals were supported to choose the decor and furnishings for their bedrooms and on the day of this visit one person was in discussion with a local painter and decorator regarding their requirements in the redecoration of their bedroom. This person did point out some small repairs that required work in their room such as small holes that had been drilled for shelving and they stated that the decorator would be sorting these out. As stated in the pre- inspection self assessment information, new flooring has been Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: laid in two individuals rooms that reflected their needs and preferences. One person’s room had been structurally redesigned to allow for more space and this room had been redecorated. All of the people spoken with confirmed they were happy with the decor of their home and standards of hygiene in place. A conservatory has been built to the rear of one of the houses to accommodate the smokers that lived there. This is the designated smoking area and did not impact on those that did not smoke. A smoking policy was in place at the home and this was seen at the last inspection visit. One person that smoked stated that it was much better now they had the conservatory, as before they had to smoke outside in the sheltered area provided. In one of the houses two people were unable to access the stairs due to mobility needs, therefore their bedrooms were situated on the ground floor and a living room and dining area were provided on the ground floor, along with a kitchen and shower area and toilet. For the other two people living at this house a living room with drinks facilities was situated on the first floor. As stated in the pre- inspection self assessment information in the other house a new bath had been installed to enable one person living there to access the bath, as they had some difficulty with the previous bath installed. It was confirmed that this persons physical support needs were more appropriately supported with the new bath in place. Care Homes for Adults (18-65 years) Page 28 of 35 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 have safe and appropriate support by a competent and qualified staff team that receive the right training, support and supervision from their manager. Evidence: The service operated a key worker system and staff spoken with had a good understanding of their roles and responsibilities as a key worker. People that was spoken with new who their key worker was. The people using the service were provided with safe and appropriate support from a competent staff team as they received the relevant training and supervision and support from their manager. The manager had provided information within their pre inspection self assessment document that confirmed that out of eleven members of staff, five had achieved a National Vocational Qualification (NVQ) at level 2 or above and two staff were working towards this qualification. The training records seen demonstrated that staff were kept up to date with all relevant mandatory training, such as fire safety, moving and handling, recognising and Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: alerting others to suspected abuse and medication administration. Training was also provided that was relevant to the needs of the people using the service, such as basic sign and symbol training. The staff spoken confirmed that the training they received was good and relevant to the needs of the people using the service. One person said, if you find a course that you think would be useful to you or relevant the manager is supportive in this and will agree to you attending if you can. The recruitment records for two members of staff were looked at. All of the documents required by law were in place to demonstrate that checks had been done prior to these staff commencing in post. This ensured that they were suitable to work with the people using the service. It was confirmed in the pre-inspection self-assessment information that all interview panels for new staff include someone that uses the service. This enables the people using the service to have their say in the people employed to support them. Records were seen in staff files that demonstrated that the staff received formal supervision from the manager on a regular basis. Staff spoken with said supervision is very useful, the manager always makes time to talk to staff if we need to speak to him Care Homes for Adults (18-65 years) Page 30 of 35 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is run and managed appropriately and the opinions of those that use the service are central to its development. The health and safety practices in place ensure the environment is safe for the people living there. Evidence: The manager is now registered with the commission and has obtained the registered managers award. As stated earlier in this report the staff spoken with confirmed that the manager provided them with the support and guidance they required. This enabled them to work effectively in supporting the needs of the people using the service. As stated in the pre inspection self assessment information the service had defined process for gaining feedback from the people using the service and stakeholders. This included monthly meetings for the people using the service and surveys sent out to the people using the service and their families. Monthly monitoring visits and annual Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: reviews of the service also took place. From these visits a comprehensive report with recommendations was sent to the home. The service demonstrated many ways in which they involve the people using the service in decision making, some of these have already been included within this report, such as decisions regarding staff recruitment, the colour schemes / decorating of bedrooms, the new conservatory and colour scheme, the decision to change the flower bed to a vegetable plot, discussions and decisions regarding annual holidays and day to day decisions such as the meals that are purchased and prepared and the activities that are undertaken. All of the people spoken with confirmed that the staff involved them in decisions about their life at the home. Information within the pre inspection self-assessment document stated that all the required health and safety practices at the service were satisfactory. A sample of service certificates for equipment was looked at and all seen were satisfactory. Fire safety practices were undertaken as required and this ensured the environment was kept safe for the people using the service, staff team and visitors. As stated earlier in this report records were seen to demonstrate that staff were kept up to date in health and safety practices through mandatory training such as first aid, moving and handling, fire safety and food hygiene. Care Homes for Adults (18-65 years) Page 32 of 35 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 35 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 24 The bottom of the staircase banister at number 44 should be re- painted to enhance its appearance. Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. Care Homes for Adults (18-65 years) Page 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!