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Inspection on 01/07/08 for Tudor House - Pangbourne

Also see our care home review for Tudor House - Pangbourne for more information

This is the latest available inspection report for this service, carried out on 1st July 2008.

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

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

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: Tudor House - Pangbourne Farm Lane Maidenhatch Pangbourne Berkshire RG8 8HP     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: Kerry Kingston     Date: 0 1 0 7 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. the things that people have said are important to them: They reflect 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 28 Information about the care home Name of care home: Address: Tudor House - Pangbourne Farm Lane Maidenhatch Pangbourne Berkshire RG8 8HP 0118 974 5030 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: TACT UK Ltd Ms Cynthia Vickery care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: 6 6 Over 65 0 0 Date of last inspection Brief description of the care home 2 5 0 7 2 0 0 7 Tudor House is a large detached house, surrounded by farmland, situated approximately three miles from Pangbourne village. The nearest bus stop is two miles away and Reading and Newbury, approximately six miles away, provide a comprehensive range of amenities. Tudor House provides accommodation and care for up to six residents, aged between eighteen and sixty-five years of age, who have a learning disability and some of whom also, have a physical disability or challenging behaviour. Care Homes for Adults (18-65 years) Page 4 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The last Key Inspection for this service was completed on the 25th July 2007. This is a report for the key inspection, carried out by Kerry Kingston,which included a routine unannounced site visit to the service. This took place between 10.00am and 5.30 pm on the 1st July 2008. The current fees of the service are from £1318.44 to£1567.44 per week. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the manager. Surveys were sent to the people who are supported by the service and other professionals. Discussions with the manager, the service manager , two staff members and two people, who use the service took place. Observation of other people took place during the visit to the home. Reviewing records of the people who use the service and other records and procedures was also used to Care Homes for Adults (18-65 years) Page 5 of 28 collect information on the day of the visit. All information received by the Commission since the last inspection, about this service was also taken into account when producing this inspection report. 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 7 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 8 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. The home has robust assessment and review procedures to make sure that they are able to meet the individual needs of the people who come to live there. Evidence: There have been no new admissions since 2006. One person moved in, in December 2006. They had a full assessment which had been completed with their involvement and the care plan had been agreed prior to their admission. The home had a clear record of the individuals needs and their aspirations are recorded as dreams and wishes. The admission was reviewed at six weeks,three months and then a full review was held six months later to ensure that the placement was meeting the persons needs. The review of the appropriateness of the placement for one person, has identified that the home cannot meet their specialised needs and they are working co-operatively with other agencies to resolve this issue in a way that also takes into account the individuals preferences. Care Homes for Adults (18-65 years) Page 9 of 28 Four of the people who use the service who returned surveys said that they had enough information about the home to decide if it was the right place for them, before they moved in. Care Homes for Adults (18-65 years) Page 10 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. The home makes sure that care plans help staff to meet people needs and that the people who use the service are as involved as possible in writing them. People are supported to make as many decisions as they can for themselves and robust risk assessments mean that people can be as independent as possible. Evidence: Care plans for three people with diverse needs were looked at. They included detailed information, necessary for staff to be able to meet their needs and to work towards goals. Care plans included comprehensive assessments for each person which note any equality and diversity issues, for example one notes how to ensure an individuals privacy and any other special needs they might have as a result of a specific diversity, Care Homes for Adults (18-65 years) Page 11 of 28 is met. Anothers very specialised needs are noted in their care plan and assessments. Care plans also have detailed personal support plans which include personal care, eating and drinking, communication, household activities, community activities and any specialist needs relating to behaviour. Some of the support plan guidelines are not dated. Care plans are reviewed regularly by key workers who write a monthly summary and a minimum of an annual multi-disciplinary review is held. All residents have an advocate, these will be working more closely with individuals when there are firmer plans for people to move to a supported living environment. People attend house meetings which are held jointly between staff and residents and discuss all aspects of the running of the home, residents are encouraged to participate in the meeting. Individuals needs and progress is a topic discussed in the meetings with the individual being involved in these discussions with the staff team. Two people spoken to said that they attend their reviews and any meetings about themselves, they can make choices about what they do, what time they get up and most other things. One person said ‘I am happy because I can choose my own food and make my own snacks’. Both people said that they can mainly choose who they do ‘things with’ and who ‘their key worker is’. The four surveys returned from the people who use the service noted that they can ‘always’ make decisions for themselves’. The home has robust risk assessments which cover all the necessary areas for individuals, these include any areas of activity within the home that could be a risk such as kitchen,laundry, and activities that may be a risk to individuals such as money management,medication, cross gender personal care and community activities. There are also specific assessments for ‘special’ activities such as swimming,holidays and transport. Risk assessments are regularly reviewed and up-to-date. The risk assessments seen promote independence, access to new activities and experiences for people. For instance some support people to look after their own finances as far as they are able. One person looks after his own finances, two people partially look after their personal monies and two people are fully supported to deal with their finances. Staff were observed interacting positively with people and appeared to have a good understanding of their communication systems, although these were not as clearly recorded as they could be in care plans. Staff were able to outline the communication systems used by those who are not verbally communicative. Care Homes for Adults (18-65 years) Page 12 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 home makes makes sure that people can have an interesting and rewarding lifestyle by helping them to participate in activities in the home and in the community. People are offered a healthy and nutritious diet and are given as much choice as possible. Evidence: Individual residents have an activity programme that is designed to meet their diverse emotional, physical and social needs. The weekly activity schedules do not fully reflect the activities participated in by individuals as they are very flexible and people can Care Homes for Adults (18-65 years) Page 13 of 28 make daily choices, within reason. The daily notes are of a very good standard and fully reflect the activities participated in everyday. They include noting peoples’ choices with regard to activities such as planned activities declined and what was chosen instead. People have a varied activity schedule and attend external day services and activities within the home. The service uses home activities as a method of enhancing,teaching and maintaining skills such as domestic tasks including baking and cleaning. Residents were observed participating in activities without a staff presence and confirmed that this was their choice . Staff were observed taking people out into the community. Two people who use the service said that ‘they have plenty to do, they don’t get bored and they can often choose what activities to do.’ One person indicated that they don’t get bored and they like what they do. Surveys returned by four people who use the service noted that they can always do what they want to. People use the local community, going out for meals, leisure facilities and church if they wish. The home has transport as the nearest bus is several miles away and the home is in a very rural setting, residents do not contribute to transport costs as a matter of course but will contribute to petrol costs for long, individual journeys. None of the residents go out unaccompanied. Everyone,who lives in the home, has an annual holiday organised according to their individual needs and wishes. Everyone has a door lock on their rooms and can hold the keys to them if they choose. Staff were observed treating people with respect and two people said that the staff are good and treat us ‘well’. Three people who live in the home said they ‘liked’ living there comments were it is a good place to live, there’s probably something bad about it but I can’t think of what.’ ‘It’s good living here I don’t really want to live anywhere else’. One person smiled and said yes when asked if they liked living in Tudor House. The manager is aware and alert to cultural issues and differences between residents and staff and confirmed that it did not cause any problems, she described some work that had been done by herself and the team in this area. Family contact varies three people have ‘active’ contact , one has very limited contact and two people choose to have no contact at all. The home ensures advocates are sought for people especially those with no active family contact. One person recently met an old friend at a social function and the home has helped to re-establish the relationship by encouraging and enabling visits and communication between them. Menus seen were varied and reflected peoples’ tastes. Two people said that the food was very good and they could always choose something else if they didn’t like what was on the menu. Three people confirmed that they help to choose menus and will help with kitchen chores. The home has pictures available to help people with menu planning but these are generally not used. Care Homes for Adults (18-65 years) Page 14 of 28 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. Peoples health and personal care needs are met and staff support them in the way they prefer. People may benefit from having a better support plan to help them with any behaviours that adversely impact on themselves or others. Medication records are accurate and show that peoples medicine is administered safely. Evidence: Care plans for three people were seen, peoples’ preferences and likes and dislikes are recorded on the care plans. People have personal support plans which address specific diversity needs including same gender or cross gender personal care and specific needs around physical ability and emotional needs such as inappropriate sexual behaviour. People are generally able to choose who they want to help them with their personal care and how much help they want (as far as is practicable.) A clearer communication plan, particularly for those who do not have verbal Care Homes for Adults (18-65 years) Page 16 of 28 communication skills may assist staff to understand preferences and choices although staff spoken to were able to demonstrate their understanding of peoples’ communication methods. Specialist support is accessed, as necessary such as people having regular psychologists and psychiatrists appointments, speech therapy and physiotherapy. Regular general health checks are carried out and noted on the healthcare records. Some people had behavioural support plans and some did not for instance one person who displays challenging behaviour has a support plan but this had been developed in their previous home, it is not dated. A person who occasionally displays challenging behaviour has no detailed behavioural support plan. The four surveys that were returned noted that staff ‘always’ treat people well. None of the people who use the service self-medicate, staff administer their medication. The records seen were accurate and the home has met the two medication requirements from the last inspection. Staff receive ‘in-house ‘ training and assessment before they are able to administer the medication and receive external training provided by the organisation as soon as possible after induction. The home uses a monitored dosage system (NOMAD) and seeks and receives advice from the pharmacist, as necessary. The pharmacist visited in October 2007 and was satisfied with the medication procedures and systems being used. The amount of medication on the premises, tallied with the number recorded but the recording system was quite complicated and not being used in a consistent way by the staff team. There was a discussion with the manager about ensuring recording systems are as simple as possible to minimise the risk of errors and of having the least possible number of medications on the premises. 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. People are listened to and their views are acted upon. People are kept and feel safe from any forms of abuse and staff are fully aware of safeguarding polices and procedures. Evidence: The complaints procedure is robust and has been produced in a user friendly document . Two people spoken to said that they knew who to tell if they were not happy and were very confident that they would be listened to one person said ‘of course they listen to me they have to, I live here’. Four surveys received note that they all know how to make a complaint. There has been one complaint, with two elements received by the home since the last inspection. Appropriate action had been taken by a senior manager but the investigation and outcome of the complaint was not well recorded. The complainant however had been contacted by a senior manager and was happy with the outcome of her complaint. There have been no Protection of Vulnerable Adults (safeguarding) issues recorded by the home since the last inspection. Two people spoken with said that they felt ’safe’ and that staff make them feel ‘safe’ in the home and out of the home. All staff receive safeguarding training and were able to describe what action they would take in event Care Homes for Adults (18-65 years) Page 18 of 28 of them suspecting that a resident was not being looked after properly. The Commission has received no information with regard to complaints or safeguarding issues, since the last inspection. The home does not use restraint and there are some behavioural guidelines in place, however these could be more detailed, properly dated and they could deal with more of the behaviours that residents find it difficult to cope with (see outcome personal and Healthcare Support.) The financial records of two people were seen and they were in good order, all necessary receipts are kept. The organisation audits all financial records annually and the regulation 26 visitor looks at finances and financial records, in detail. 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 offers people a pleasant, clean and comfortable environment , which meets their individual and group needs. Some areas could be presented in a more homely way. Evidence: The house is clean, tidy and adequately decorated. Bathrooms are well decorated and clean but could be more homely. Bedrooms are well kept with new flooring in some. Carpets throughout the building are clean and no stains or wear was apparent. There were no curtains in the main lounge and few ornaments as one person pulls them down and throws things away. The home is not overlooked so they are not needed for privacy but lack of curtains and ornaments makes the room feel very bare. Two people who live in he home, said they ‘like’ the sitting room’ and don’t mind it being a bit bare One person described the multitude of different things done to try to keep curtains up. One person said that some of the good things about living in the home was their bedroom and the garden. The garden is reasonably well kept but there are some ‘stinging nettles’ that need cutting. One person was seen to be using the garden, he has his own garden furniture. Care Homes for Adults (18-65 years) Page 20 of 28 Staff receive infection control training and food hygiene training with the more general health and safety training. The home had an environmental health visit in April 2008 which recorded no major issues and no follow up action from environmental health. 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. That the home has, generally, well qualified, well trained and competent staff who are able to meet the needs of most of the people who use the service. The home has a robust recruitment process to ensure that staff employed are suitable and safe to work with people. Evidence: There are three staff on duty per shift as a minimum, one person who is awake at night and one person sleeping in. An extra member of staff is rota’d on duty if there are any special activities happening or to allow people to have some 1:1 or 2:1 support. People, spoken to confirmed that there is always someone available to help you if you need it. Staff said that there are enough staff available to perform all the necessary tasks. Eight of the sixteen care staff have an N.V.Q 2 qualification or above and the manager has an N.V.Q. 4 in care. The two staff spoken to were knowledgeable and clear about their roles and responsibilities. Care Homes for Adults (18-65 years) Page 22 of 28 Three people spoken to said or indicated that they liked the staff and that staff treated them well. Records for the three newest staff were seen and all the necessary records and checks are kept. Staff have received all the mandatory training, including medication and safeguarding (Protection of Vulnerable Adults) training. The induction has been adopted from ‘skills for care’ and an additional disability awareness course is being offered to all staff. The new staff member confirmed that she is in the process of completing her ‘skills for care induction booklet’. Staff spoken to said that there are good training opportunities and a new staff member had completed four courses in the four weeks that they had been in post. They confirmed that the manager and staff team are supportive and offer good care to people who live there. The only shortfall in training is that the staff do not receive any mental health training even though one person has significant mental health needs and another person has very specific needs that staff are not trained to meet. 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 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 ,generally, well managed and people are kept as safe as possible. The home has a Quality Assurance system that looks at the care it offers the people who use it. Evidence: The manager has been in post for some years, she has an N.V.Q. 4 in care and the Registered Managers Award. The Responsible Individual ( area manager) left in October of last year and the manager did not know if a new one has been appointed or registered. The manager was asked to write to the Commission to inform us that the Responsible Individual has left and who the new one is, with the out of date certificate. Staff described the management team as supportive and approachable. People who use the service said that if they had any worries or concerns they would talk to their key worker or the manager. Care Homes for Adults (18-65 years) Page 24 of 28 The Quality assurance process includesmonthly visits, which are detailed and occur regularly. A new monthly visit (Regulation 26) form was developed after the last inspection and now gives a detailed ‘picture’ of the service being offered in the home. The manager reported that the divisional director who completes the monthly visits has been in post approximately two months, she said that things are settling down and beginning to happen with the improved management support. Questionnaires are sent to all interested people and are currently being received from this years’ Quality Assurance exercise. Three care managers forms and two responses from relatives were seen. Once all the information is received, including information,views from the people who use the service the manager incorporates any actions necessary into the annual development plan. Currently the home is working on two plans, one for the eventuality of the service remaining the same for the next year and one for if the planned changes to the service become more imminent. The development plan for the service is that the residential care home will be sold and people will be found housing in a supported living environment. The people who live in the service are aware of the future plans and advocates have been found for everyone so that their views can be represented when the plans become more firm. There are no timescales at this time. The Quality Assurance process and development plan are due to be completed by early August 2008. The AQAA and records showed that all the necessary Health and Safety checks had been completed, the manager confirmed that all checks are carried out at the correct times and that any safety requirements or recommendations are dealt with immediately, she confirmed that all the fire doors are operational and were last repaired in April 2008. The fire risk assessment was up-dated in May 2007 and is due to be up-dated this year. The home keeps detailed accident and incident records but they would benefit from the addition of ‘outcomes’ or what will be done to minimise the possibility of recurrence and signed off by the manager. 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 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 14 23 To develop up-to-date behavioural guidelines to help people to control behaviours that they or others may find distressing or threatening. To provide specific training, as necessary, to enable staff to meet all of the specialist needs of people who use the service, such as mental health. To record what is being done to minmise the risk of accidents or incidents recurring, so that the safety of the people using the service is safeguarded more effectively. 15 35 16 42 Care Homes for Adults (18-65 years) Page 27 of 28 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 28 of 28 - 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!