Inspection on 11/01/09 for Nicholas Court (1-5)

This is the latest available inspection report for this service, carried out on 11th January 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Nicholas Court (1-5) 1-5 Nicholas Court 2a Tunmarsh Lane Plaistow London E13 9NA     The quality rating for this care home is:   two star good 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: Robert Cole     Date: 1 1 0 1 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 30 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Nicholas Court (1-5) 2a Tunmarsh Lane 1-5 Nicholas Court Plaistow London E13 9NA 02085488825 02073504858 sue.crosby-dyas@heritagecare.co.uk 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) : Heritage Care care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home 1-5 Nicholas Court is a purpose built home for younger adults who have learning disabilities and challenging behavioural needs. The home consists of five individual flats. Service users benefit from residing in individual flats where their independence and choice is promoted. Newham Registration and Inspection Unit originally registered Nicholas Court in November 1995. Heritage Care is the care provider and they have recently taken over ownership of the building and now have registered provider responsibilities. The home is located in a residential area in Plaistow, close to shops, services and amenities. A range of bus routes along the Barking Road and Greengate Street serve the home. The nearest underground stations are Plaistow and Upton Park Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home on the District Line. The home has a small car park and unrestricted street parking is available in adjacent roads. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on the 11/01/09 and was unannounced. The inspector had the opportunity of speaking with service users and staff from the home. Most of the service users have limited verbal communication, and the inspector was able to observe staff interactions with service users to gain an insight in to their experiences of the home. The inspection also included an examination of records and other documents, along with a tour of the premises. Prior to this inspection, the home completed an Annual Quality Assurance Assessment (AQAA) at the request of the CSCI. This has contributed to the overall inspection process, and to judgements made within this report. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 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 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 8 of 30 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 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the judgement of the inspector that the home needs to do more to enable service users to make an informed choice as to move in or not. Documentation about the home must be up to date, and pre admission assessments must be carried out to ascertain if a placement is suitable. Evidence: The home has a Statement of Purpose in place. This includes the homes mission statement which is To provide care and support services for people to live valued lives. The Statement also includes details of the aims and objectives of the services and facilities provided. However, the Statement is dated from May 2005, and contains out of date information. For example, the inspector was informed by staff in duty that the current manager has been in place for approximately two years, yet there details were not included in the Statement, while the statement also refers to English Churches Housing Group as the registered provider, but Heritage Care is now the registered provider. To help ensure that any prospective service users have access to accurate and up to date information about the home, it is required that the Statement Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: is subject to regular review, and that it contains accurate and up to date information. The home also has a Service User Guide in place, and all service users are provided with their own copy. This has been produced in written and pictorial form, to help make it more accessible to service users, thus helping to meet their needs around equality and diversity issues. The Guide includes details of the fees payable, and also of the homes complaints procedure. The home has an admissions procedure in place. This states that any prospective service users will be given the opportunity of visiting the home before moving in. A service user moved in to the home on the 5/11/08, and there was evidence to support that they had indeed been able to visit the home on several occasions before moving in. The admissions policy also states that an assessment of any prospective service users needs will be carried out, to determine whether or not it would be a suitable placement, and if the home was able to meet their needs. For the service user who moved in to the home on the 5/11/08, there was no evidence that such an assessment was carried out. To help ensure that any placements are suitable, and that the home is able to meet the needs of prospective service users, it is required that comprehensive pre admission assessments are carried out for any prospective service users before they move in to the home. Care Homes for Adults (18-65 years) Page 11 of 30 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. It is the judgement of the inspector that service users have a large measure of control over their daily lives, and that they have the opportunity of being involved in the day to day running of the home. However, comprehensive risk assessments must be in place for all service users. Evidence: Individual care plans are in place for all service users. These are generally of a good standard, clear and comprehensive. Care plans are person centred, and set out what the needs of the service user are, and how the home is able to meet those needs. Plans cover needs around personal care, mobility, social and leisure activities and equality and diversity issues such as culture and religion. Plans are written in the first person, for example I like to look at photos of what I have been up to lately, this makes me happy. and I like to go to Temple. Each service user has their own circle of support, which they are members of along Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: with people of importance to them, including family members, keyworkers and the homes manager. These circles meet monthly, and are part of the care planning and review process. Where risk assessments are in place for individual service users, these are of a satisfactory standard, identifying risks and including strategies to manage and reduce those risks. Assessments make clear that service users are supported to take reasonable risks, such as going on holiday and accessing the community. Assessments are also in place around personal care, road safety and managing challenging behaviours that some service users present. However, for a service user that moved in to the home o the 5/11/08, risk assessments were not comprehensive. For example, staff informed the inspector that this service user has epilepsy, and this presents a risk when they are taking a bath and at other times. The staff member was able to discuss controls in place to reduce any risk, but there was no risk assessment in place around this. To help ensure that risks are managed in a consistent manner to promote the health, safety and welfare of service users and others, it is required that comprehensive risk assessments are in place for all service users, covering all areas of potential risk. Through observation and discussion there was evidence that service users have a large measure of control over their daily lives. Service users were observed to be able to get up and go to bed at a time of their choosing, and to have choice over mealtimes and what to eat. Service users were observed to move freely around communal areas, including the homes garden. To help service users have more control and choice over their daily lives, the home has adopted various communication methods to help service users communicate who have very limited verbal communication. For example, the home has worked with speech and language therapists to develop an objects of reference book for one service users, which enables them to make choices around meals, activities, personal care etc. There was evidence that service users have the opportunity of been involved in the day to day running of the home. For example, part of the communal area in the home has recently had a new wood panel flooring installed, the inspector was informed that service users were involved in choosing this. Service users also have the opportunity of been involved in the recruitment and selection procedure for new staff. Service users are involved in planning menus and choosing activities. The home has a confidentiality policy in place, this makes clear under what circumstances a confidence may be broken in the health, safety and welfare interests Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: of service users and others. Staff spoken to demonstrated a good understanding of the issues involved around confidentiality. Care Homes for Adults (18-65 years) Page 14 of 30 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. It is the judgment of the inspector that service users are supported to live valued and fulfilling lives. Service users have access to the local community, and are supported to take part in a variety of social and leisure activities. Evidence: Service users are able to participate in various day services, such as St Bartholomews Day Service and the Mayflower Day Centre. These services provide the opportunity to develop and maintain relations with others, and to meet new people. In addition, they also provide various activities, such as body massage, reminiscence and creative movement, as well as going on day trips. The home itself supports service users to take part in a variety of social and leisure activities, both in house and in the community. In house service users have access to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: television, DVDs, music, computers, guitar, foot spa, aroma therapy and Shiatsu-DoTherapy. In addition the home has its own sensory room. Service users have access to a number of community based social and leisure activities, some of which help to meet needs around equality and diversity issues, such as visiting the cinema to view Asian films. Service users also go to pubs, restaurants, swimming and bingo. The home also arranges various outings, for example to the countryside. On the day of inspection two service users went out for a drive and a meal. Service users are offered an annual holiday away from the home as part of the basic contract price. A recent holiday has been to Bognor Regis, and one service user is planning a trip to the USA to celebrate their 60th birthday later this year. Service users are supported to visit a place of worship of their choice, on the day of inspection one service user visited a Catholic church, while another service user regularly visits a Hindu Temple. Service users have access to community facilities,, including shops, markets, parks, cafes and hairdressers. Service users are provided with a choice of food, and are able to be involved in the preparation of food, and also food shopping. On the day of inspection food served appeared appetizing and nutritious, and support with eating was provided in a sensitive manner. Mealtimes were observed to be relaxed and unhurried. Kitchens within the home were found to be clean and tidy, and food was stored appropriately. The temperatures of fridges are checked daily. The home seeks to meet equality and diversity needs through food, for example traditional English and Indian dishes are regularly offered. Records were kept of menus, although it was noted that there were several gaps in these records, and closer attention should be paid to ensuring a comprehensive record is kept of food provided. Care Homes for Adults (18-65 years) Page 16 of 30 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. It is the inspectors judgment that the home is able to meet the personal and health care needs of service users. Personal care is provided in a sensitive and respectful manner, and medication is well managed in the home. Evidence: Care plans indicate that service users are encouraged to manage their own personal care as much as possible. It was positively noted on the day of inspection that where support was required with personal care, this was provided in a manner that promoted the service users privacy and dignity. Service users are able to choose their own clothes to wear. Individual Health Action Plans are in place for all service users, these were found to be of a good standard. Plans set out the needs of service users around health related matters such as diet, diabetes and foot care, and outline how the home is able to meet those needs. Monitoring is carried out to help reduce health related risks, for example it has been highlighted that one service user is at risk of choking, there food is prepared appropriately to reduce this risk, and a member of staff stays with them Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: whilst they eat. Records are maintained of medical appointments, these indicate that service users have access to relevant health care professionals as appropriate, including dentists and chiropodists. The home uses continence products with the advice of the local Continence Advisory Service. Used continence products are disposed of appropriately. The home has a comprehensive medication policy, and all staff undertake training, which includes an assessment of their competence, before they are able to administer medications. Medications are stored securely in designated locked medication cabinets. No service users currently self medicate, or are on any controlled drugs. Records are maintained of medications entering the home, and of those that are returned to the pharmacist. Medication Administration Record charts are maintained, those examined by the inspector were found to be accurate and up to date. Guidelines are in place around the administration of medications prescribed on a as required basis. Care Homes for Adults (18-65 years) Page 18 of 30 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. It is the view of the inspector that the home has taken reasonable steps to help protect service users from the risk of abuse. Appropriate policies and procedures are in place, and staff undertake training in adult protection issues. Evidence: The home has a complaints procedure, which includes timescales for responding to any complaints received. All service users are given their own copy of the procedure included in the Service User Guide. The procedure has also been produced in other formats, including audiotape, to help make it more accessible to service users, and to meet needs around equality and diversity issues. The home maintains a complaints log, although the AQAA supplied by the home states that no complaints have been received within the past year. The home has a policy in place around adult protection, which makes clear that staff have a responsibility for reporting any suspicions of abuse. Leaflets are also on display around the home detailing staff responsibilities with regard to adult protection issues, and the home has a whistle-blowing policy in place. Staff have undertaken training around adult protection issues, and those staff spoken to demonstrated a good understanding of their roles and responsibilities with regard to adult protection. The home holds money on behalf of service users in a locked safe. Records and Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: receipts are maintained of financial transactions involving service users monies, those records checked by the inspector were found to be satisfactory. Care Homes for Adults (18-65 years) Page 20 of 30 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. It is the view of the inspector that the home is suitable to meet its stated purpose with regard to the environment. The home is generally well maintained, and service users have access to adequate amounts of private and communal space. Evidence: The home is located in the Plaistow area of the London Borough of Newham, close to shops, transport networks and other local amenities. The home is purpose built, and consists of five flats, three of which are for single occupancy, the other two each house two service users. The home is not in keeping with other homes in the area, and has a large surrounding wall which tends to separate it from the surrounding area. Each flat has its own lounge/dining area and toilet and bathing facilities. In addition, there is a large garden which service users have free access to. Bathing facilities were found to be clean and tidy, and free from offensive odours. Bathrooms had working locks fitted, which included an emergency override device. Furniture and fittings in communal areas were generally well maintained, and domestic in character. The AQAA supplied by the home indicates that new floors have been fitted in some communal areas, and there has been a considerable amount of decoration work carried out over the past year. The AQAA indicates that service users were involved in choosing this Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: new decor. All service users have their own bedrooms. Bedrooms seen by the inspector were decorated to a good standard. Service users have been able to personalise their room, for example with family photographs and their own possessions such as televisions. Bedrooms contained appropriate furniture, including table, wardrobe, chest of draws and a chair. Curtains, carpets and bedding were well maintained and domestic in character. The home has taken steps to help prevent the spread of infection. Laundry facilities are appropriate in scale to the size of the home. Hand washing facilities were situated around the home. COSHH products were stored securely, and staff are provided with protective clothing such as gloves and aprons. There were however some maintenance issues that must be addressed. In particular, the carpet was loose on the stairs in flat one, posing a health and safety risk that must be addressed promptly. There was also a smashed pane of glass in the garden, and several tiles were either missing or broken in bathrooms. All of this must be addressed. Care Homes for Adults (18-65 years) Page 22 of 30 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. It is the inspectors judgement that the home is staffed in sufficient numbers to meet the needs of service users, and that staff are sufficiently experienced and qualified to carry out their duties. Evidence: The home provides 24-hour support, including waking night staff and an emergency on-call procedure. There was a staffing rota on display, this accurately reflected the staffing situation on the day of inspection. The inspector was pleased to note the relatively high staffing levels, at the time of inspection all service users had one to one staff support, although this level is not maintained at all times. Through observation and discussion there was evidence that staff have a good understanding of the collective and individual needs of service users. One service user has recently been admitted from another home within Heritage Care, and the inspector positively noted that a member of staff who had worked with them in their old home, now continues to work with them at Nicholas Court. This staff member demonstrated a good understanding of the needs of the service user. Staff were seen to interact with service users in a respectful and friendly manner. At times service users made it clear that they wished to be left alone, and staff were seen to respect this. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: All staff are provided with a copy of their job description, and a copy of the General Social Care Council codes of conduct. There is a built in handover period at the beginning of every shift, which includes checking service users monies. Regular staff meetings are held, and all staff are able to contribute to the agenda. All staff undertake a structured induction on commencing work, this includes a period working supernumerary in the home, shadowing more experienced members of the staff team. Staff have access to regular training opportunities, recent training has included health and safety, infection control, manual handling, first aid, epilepsy, challenging behaviour and adult protection. The AQAA supplied by the home states that all care staff have an NVQ in care, and staff spoken to during the course of the inspection confirmed that this was the case. The AQAA supplied by the home states that the home has relevant employment related policies, including on equal opportunities and recruitment and selection. The AQAA also states that appropriate checks such as CRB checks are carried out on all staff. Again, staff spoken to were able to confirm that this was the case. Care Homes for Adults (18-65 years) Page 24 of 30 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. It is the inspectors judgement that this is a generally well run home, and that health and safety within the home is well managed. Evidence: Although the homes manager was not present during the inspection, staff spoken to informed the inspector that they found the manager to be approachable and accessible. The AQAA supplied by the home states that the manager has an NVQ Level 4 in Care and the Registered Managers Award. The AQAA indicates that the home has all necessary policies and procedures in place in line with National Minimum Standards. Those checked by the inspector, including adult protection and medication were of a satisfactory standard. Record keeping was generally of a satisfactory standard. Confidential records were stored securely, the inspector was informed that staff and service users can access their own records as appropriate. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Staff meetings, staff supervision and care plan reviews all contribute to the quality assurance within the home. Previous inspection reports were available to view in the home. However, the most recent Regulation 26 report available to view in the home was dated from June 2005. Staff informed the inspector that they believed Regulation 26 visits were happening regularly, but that they had no recollection of having access to any reports from these visits. It is required that monthly unannounced Regulation 26 visits take place, and that the home retains a copy of the report of these visits, which is available for inspection. Staff have access to relevant health and safety training, for example on fire safety, food hygiene and first aid. Fire extinguishers were situated around the home. Fire alarms are tested weekly, and were last serviced on the 15/10/08. The home holds regular fire drills. Hot water temperatures are tested weekly, and COSHH products are stored securely. The home has in date safety certificates for PAT testing and electrical installation. The home has in date employers liability insurance cover in place. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R 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 1 1 4 (1) The Statement of Purpose must be updated to include recent developments. 01/09/2006 Care Homes for Adults (18-65 years) Page 27 of 30 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 1 4 The registered person must 31/03/2009 ensure that the homes Statement of Purpose is subject to regular review, and that it contains accurate and up to date information. So that prospective service users and others can have access to up to date and accurate information about the home. 2 2 14 The registered person must ensure that comprehensive pre admission assessments are carried out on all prospective service users before they move in to the home. To ascertain if the home is able to meet the needs of any prospective service users. 31/03/2009 3 9 13 The registered person must ensure that comprehensive risk assessments are in place for all service users, 31/03/2009 Care Homes for Adults (18-65 years) Page 28 of 30 covering all areas of potential risk to themselves and others. To help promote the health, safety and welfare of service users and others. 4 24 23 The registered person must ensure that the following maintenance issues are addressed: loose carpet on stairs must be made good; broken and missing tiles in bathrooms must be replaced; the smashed window pane must be removed from the garden. To help ensure the health, safety and welfare of service users and others. 5 39 26 The registered person must ensure that monthly unannounced Regulation 26 visits take place, and that a report of these visits is maintained within the home and is available for inspection. To help monitor the care and support provided within the home. 28/02/2009 15/02/2009 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 29 of 30 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 © (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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