Inspection on 22/08/08 for Courthouse Road

This inspection was carried out on 22nd August 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.

Other inspections for this house

Courthouse Road 24/08/06

Courthouse Road 01/11/05

Courthouse Road 23/06/05

Courthouse Road 08/03/05

Courthouse Road 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 07/11/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 237 Courthouse Road 237 Courthouse Road Maidenhead Berkshire SL6 6HF     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: Helen Dickens     Date: 2 2 0 8 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 27 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 27 Information about the care home Name of care home: Address: 237 Courthouse Road 237 Courthouse Road Maidenhead Berkshire SL6 6HF 01628 625457 Telephone number: Fax number: Email address: Provider web address: courthouse.rd@owl-housing.org Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Owl Housing Ltd Mrs Jacqueline Lewis care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). 0 Over 65 0 Date of last inspection Brief description of the care home 237 Courthouse Road provides accommodation and care to four residents who have a learning disability. The proprietors of the home are Owl Housing Limited. The home is a domestic style four bedroomed detached house in a residential area of Maidenhead. It is situated near to local shops and the town centre with easy access to the M4 and M40. Accommodation is provided in single bedrooms on the ground and first floor. There is a lounge with dining facilities for residents on the ground floor. There is a large well kept rear garden and car parking to the front of the house. The home is staffed by a team which comprises of a manager, deputy manager and support workers. Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 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: This key inspection was unannounced and took place over 5.5 hours. The inspection was carried out by Mrs. Helen Dickens, Regulation Inspector. The registered manager was on leave so the deputy manager and the two staff on duty, represented the establishment. A partial tour of the premises took place and a number of files and documents, including resident’s assessments and care plans, staff recruitment files, quality assurance information, and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. A number of questionnaires returned to CSCI by staff and the GP earlier in the year were also considered in writing this report. Care Homes for Adults (18-65 years) Page 6 of 27 Fees at this service are £1,512 per person per week. The inspector would like to thank the residents, staff and deputy manager for their time, assistance and hospitality. What the care home does well: What has improved since the last inspection? The AQAA listed a number of improvements since the last inspection including developing the garden areas with the addition of patios, pathways, a decked area and a summerhouse. The raised flower beds were delightful and the staff member Care Homes for Adults (18-65 years) Page 8 of 27 responsible for this should be congratulated for their hard work and creativity. Residents meetings have been introduced since the last inspection and action plans have been developed to support any recommendations from annual reviews. Health checklists have been introduced which provides a working document for each resident, incorporating their goals in relation to maintaining good health. More indoor activities have been purchased and regular sessions are booked at the leisure centre sensory area. New furniture has been purchased for the lounge and a new study area has been created. A resident has had a new bedroom made downstairs which also contains en suite facilities. Staff had attended two Team Awareness days on the subject of safeguarding adults. The deputy managers post has been further developed in recent months whilst the manager has been taking temporary responsibility for another Owl service which is currently recruiting a new manager. 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. Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 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. Prospective residents would have their needs fully assessed prior to moving into this home. Evidence: The current residents have lived at this home for a number of years so their original assessment records would have been archived. However, there is a policy in place setting out arrangements for new admissions. The AQAA states that the Statement of Purpose and Service User Guide outline the services offered by the home. There is no current evidence of the admissions process in action as there have been no new admissions but suitable policies are in place if this situation changed. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents assessed and changing needs are recorded in their care plans and they are encouraged to make decisions and take reasonable risks in their day to day lives. Evidence: The AQAA states that Service Users have individual lifestyle plans which identify their preferences and needs with future goals recorded in action plans. Two files were sampled on the day of the inspection. Both residents had essential lifestyle plans (covering personal attributes, important people, places I like to visit etc, all with photos of the actual places, and good detail on things I like to do.) These plans were in picture and word formats which meant residents would be able to be included more in their plan. Care Homes for Adults (18-65 years) Page 12 of 27 Strategies were clearly written for supporting clients e.g. in relation to activities of daily living such as personal care, mobility etc. There were also clear guidelines for managing challenging behaviour. Risk assessments were in place e.g. in relation to moving and handling. Health checklists with health promoting activities and goals were on each file. Annual action plans for each resident included their holidays, activities, and healthcare. Each resident also has a daily diary with an A4 page per day recording how they spent their day. Residents are given opportunities to make decisions in their day to day lives. Some residents are not able to communicate verbally but staff were observed to communicate well with them and to anticipate their needs. Residents were given choices in relation to all aspects of their care plan, the decoration and refurbishment at the home, and menus. The inspector visited one resident in their room and found it to be very personalised with the residents choice of decor and furnishings, and plenty of examples of the resident being surrounded by their own choice of activities including a small aquarium, particular music videos, and their camera and camcorder. On the day of the inspection the residents were preparing for a summer ball that evening and the inspector saw that all four had chosen their new and very individual outfits which were hanging ready in their rooms. They were then offered various personal grooming opportunities and one was seen to have a facial, whilst two others had opted to have their nails painted. Records are kept about how residents are involved in decision making in their day to day lives. The AQAA states that Risk assessments for all aspects of service users lives are in place and reviewed regularly. This was confirmed in the two files sampled by the inspector. Residents led active lifestyles and risk assessments were in place to ensure any particular hazards were minimised. There was good guidance to staff on managing challenging behaviours from residents. Action is taken as risks are identified for example one resident who could no longer manage the stairs was moved to a refurbished room downstairs. The home monitors residents in relation to any health concerns, for example seizures and falls. There is also a fire risk assessment on file for each individual resident noting their awareness and appreciation of fire. Care Homes for Adults (18-65 years) Page 13 of 27 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. Residents have the opportunity to take part in enjoyable and meaningful activities and to be part of the local community. Family and friendship links are encouraged, and residents rights and responsibilities are respected. The home offers a pleasant mealtime experience for residents who are encouraged to be involved in menu planning. Evidence: Residents engage in a variety of activities and 237 Courthouse Road also has a lovely garden with some sensory features, a sheltered seating area, and very pretty raised flower beds. Staff said the residents did enjoy the garden when the weather was nice Care Homes for Adults (18-65 years) Page 14 of 27 and had had a summer barbecue. The four residents were taking a trip to Blackpool for the lights in September, and on the evening of the inspection were all going to the Owl summer ball. Residents are encouraged to be part of the local community and the two care plans sampled showed residents engaged in a number of activities including attending college, going to day care, shopping, going to the local cafe, and using leisure facilities such as the swimming pool and going to bowls. They also use local healthcare facilities including the GP practice, dentist and podiatrist. Family and friendship links are encouraged and staff were very knowledgeable on residents families. They encouraged residents to show the inspector photographs of family and friends, as well as the many photographs of social activities and outings they had participated in. Residents healthcare plans identified any needs they had in relation to personal relationships and how these might be addressed. On the day of the inspection it was noted that this home has flexible routines for residents and there was a very relaxed atmosphere. Residents were observed to be engaging in different activities as they chose. At the start of the inspection one was watching TV, another was watching a Take That concert on the TV in their room, and another finishing their breakfast at the dining table. Residents could choose whether to be alone or in company and they had free access within the home, though would be accompanied by a member of staff whilst in the garden, for safety reasons. Staff said residents help to choose the menus on a weekly basis and those residents unable to communicate verbally would be supported to make choices in other ways. Staff were knowledgeable of residents likes and dislikes and these were recorded in their care plans. Breakfast time is flexible and one resident was finishing theirs around 10.30am. Residents had their lunch together which was fish and chips on the day of the inspection. Staff on duty eat with residents with gives a more homely feel to mealtimes. On the day of the inspection residents had their evening meal at lunchtime as they were all going out for the evening and wouldnt be back until late. Residents files showed that dietary advice is taken as necessary and residents encouraged to maintain a healthy weight by a combination of diet and exercise. The AQAA states that a record is kept of the food given to residents. Staff said residents are encouraged, where possible, to assist with some domestic tasks. Care Homes for Adults (18-65 years) Page 15 of 27 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. Residents receive personal support in the way they prefer and require and their health needs are met. Arrangements for the administration of medication protect residents. Evidence: This home has clear guidelines on file for how residents would like their personal care to be delivered. Activities throughout the day were noted to be flexible e.g. residents had their main meal at lunchtime as they were going out that evening, and were offered a rest in the afternoon until it was time to start getting ready to go out. As the residents and staff were preparing for the Summer Ball that evening there was plenty of evidence that residents choose their own clothes, hairstyle and makeup. Staff had taken some residents to a well known high street retailer to purchase their ball outfits during the recent sales. One had a beautiful silk sequined skirt and all four residents had perfectly colour co-ordinated outfits and accessories. Aids and equipment in are in place as required, for example, one resident whose Care Homes for Adults (18-65 years) Page 16 of 27 needs have changed recently had been provided with a new bedroom and bathroom downstairs, a special bed, a hoist, a parker bath, and a wheelchair. Specialist advice had been taken from the occupational therapist and physiotherapist when the problems started earlier in the year. Reports for both specialists assessments were on file. The healthcare needs of residents are assessed and documented. Each person has their own Health Checklist which identifies, with residents, health promoting activities together with goals and end dates. For example one resident who wanted to maintain a healthy weight included diet and exercise as part of their Checklist. The health of residents is monitored and actions are taken in a timely fashion. For example the resident above who developed mobility problems had specialist assessments and the necessary equipment provided. Staff support residents to access local NHS facilities and assessments from health professionals including the dietitian, the Learning Disability Team, and physiotherapists. Records of health monitoring e.g. seizures, falls etc are kept, as are records of appointments such as the podiatrist, the dentist, and the breast screening clinic. Medication at this home is supplied by the local pharmacy and there is a medication policy in place to guide staff. Staff are trained by the community pharmacist and there are further plans to do more regular competency assessments for staff in relation to medication administration. Currently there are no Controlled Drugs at this home. The community pharmacist last inspected the medication arrangements in February 2008 and no issues were highlighted as needing attention. It was not clear how frequently medication training is repeated for staff and this was clarified with the manager on her return from holiday. It was suggested to the manager that downloading the CSCI pharmacists guidance from the website would be one way of keeping up to date with best practice guidance on the administration of medication. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents complaints would be taken seriously at this home, and policies and procedures designed to protect residents from abuse are in place. Evidence: There is a complaints procedure in place and a pictorial version is available. Residents can also raise issues at Regulation 26 visits by the provider, or at the fortnightly residents meetings held at the home. No complaints have been made to CSCI about this service since the last inspection. During the inspection staff were observed to communicate well with residents and would pick up if they were unhappy or had concerns. There is a safeguarding adults policy in place at this home and all staff cover this subject in induction training. This was confirmed on the two staff files sampled. In addition, all staff have had further training in the last year following a safeguarding issue which has now been satisfactorily concluded. There are clear guidelines available to staff on strategies for dealing with challenging behaviour. Care Homes for Adults (18-65 years) Page 18 of 27 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. This home offers a homely and comfortable environment, which is clean and hygienic throughout. Evidence: 237 Courthouse Road offers a very homely environment for residents. A partial tour of the premises took place including three out of the four bedrooms, and all the communal areas. Bedrooms were observed to be personalised and there was evidence of residents having been involved in choosing the decor. All communal areas were bright and cheerful and the home was fresh smelling throughout. Wheelchair access is now available and facilities for those with a mobility impairment have improved with the downstairs refurbishment. Premises are in keeping with the local community with a lovely raised flower bed at the front of the house. There has been a lot of work in the gardens this year and both the front and rear of the property looked well cared for. The back garden now has raised flower beds with some sensory aspects to the garden. There is a summerhouse and a bench built around a tree for extra seating in the garden. The new en suite bedroom downstairs offers a more appropriate arrangement for a Care Homes for Adults (18-65 years) Page 19 of 27 long time resident who now has reduced mobility. The furnishings and decor have been personalised as much as possible though one piece of furniture needed a repair, and the lino in the en suite bathroom continued through into the sleeping area which detracted slightly from the otherwise homely ambience. Staff said keyworkers had helped the occupant to choose which pictures and photos to display.This bedroom had taken up the second communal room within the property though the outside facilities had been improved and the lounge diner offered a spacious and comfortable area for residents. There are plenty of photos of residents in communal areas. There is also a laptop computer in the dining area which is mainly for staff but they also use it to show things to residents, e.g. internet sites where they can look at clothes prior to clothes shopping outings. Another bedroom visited had an aquarium, soft furnishings in that residents favourite colours, a TV, and plenty of personal items including soft toys and jewelry. This home is clean and fresh smelling throughout. Staff said they did the cleaning and the gardening, both of which were done to a high standard. The laundry facilities are appropriate for the size of the home and there are good handwashing facilities throughout. The AQAA states staff that have had infection control training and two staff files sampled confirmed this happened in February 2008. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by competent and qualified staff. Recruitment checks protect residents. The needs of people living at this home are met by appropriately trained staff. Evidence: Staff on duty on the day of the inspection were observed to be approachable and residents seen to look to them for support and advice. They were sensitive towards residents and anticipated their needs, communicating well with them. The AQAA states the home has low levels of staff sickness and a low turnover of staff, showing the commitment of the current workforce. All current staff either have an NVQ qualification (5 out of the 9 staff already have an NVQ), or will be starting in the next year. Therefore exceeding the NMS of having a minimum 50 of care staff with a qualification. Two staff files were sampled. One already had an NVQ Level 3, and the other had just started this qualification. The AQAA also states that New staff must complete induction and LDAF/LDQ during their six month probation period. Both staff files sampled showed staff had completed the LDAF training. Care Homes for Adults (18-65 years) Page 21 of 27 Recruitment arrangements are carried out jointly with the head office and most records are kept there. However, Owl Housing keeps a checklist for each staff member regarding their recruitment information and these would be available for inspection. During this inspection checklists for the two staff files sampled were missing and these were faxed over. The deputy manager was asked to ensure that the required checklist is available for all staff and available for inspection. Those records sampled showed that proper recruitment checks had been carried out including CRB and povalist checks. References had been taken up, and identifications had been checked. The service should look at the CRB website for guidance on the length of time CRB certificates may be kept as there were some old certificates still being stored at the home. There is a staff development programme in place and a structured induction programme. As stated earlier, all new staff will do the LDAF foundation training within 6 months of appointment. Two staff files sampled showed there were good training opportunities for staff and the provider has a training programme in place. The home manager has a training budget and funds additional courses to the mandatory ones set down by Owl Housing. Care Homes for Adults (18-65 years) Page 22 of 27 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. This home is well managed and residents views are taken into account in the development of the service. The health, safety and welfare of residents are promoted and protected at this home. Evidence: Residents benefit from living in a well run home. Their are clear lines of accountability and the current manager has been in post since 2000. She has the necessary qualifications to be a care home manager and is also qualified to deliver training to staff. The AQAA states that in the last year she has qualified as an Internal Verifier for NVQs. She is currently managing a second home for Owl Housing as a temporary arrangement due to the managers post becoming vacant at the other service. A competent deputy is in day to day charge of the service and assisted with the inspection. The deputy manager has an NVQ Level 3 and the AQAA states she has also Care Homes for Adults (18-65 years) Page 23 of 27 attended management training courses. Her training record confirmed this and showed she had completed coaching and mentoring training, supervision training, recruitment and selection training, and disciplinary investigations training. There are a number of quality assurance processes in place including an annual development plan, monthly Regulation 26 visits, and fortnightly service user meetings. There are reviews of care plans carried out by the service and by the local authorities who have placed residents at this home. Owl Housing has a good format for service user surveys but the manager said that residents at this home could only complete these with a great deal of help from staff. Year on year development for residents can be followed in their care reviews and there are clear goals in their personal and healthcare plans. The AQAA states the service completes quarterly performance monitoring reports and follows in-house monitoring systems, for example in relation to health and safety. Owl Housing has policies and procedures in place in relation to health and safety. Risk assessments are in place for example in relation to moving and handling, nutrition, and bathing. There is clear guidance for staff on how to support residents and on strategies for managing challenging behaviour. The AQAA states that The home works closely with the Housing Association to ensure the fabric of the home and equipment are maintained in a safe and working state. Staff records showed staff had done training in a number of health and safety related subjects including fire awareness, medication training, handling people with special needs, food safety and safeguarding adults. On the day, the only Environmental Health Officers report available was from 2005. In a conversation with the manager following her holiday she thought there had been a more recent inspection. She was asked to either get a copy of the more recent report from the council, or follow up with them when next visit is due. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 15 34 The CRB website should be consulted for guidance on how to keep CRB records, and in particular how long to keep these records. The manager was asked to follow up on the last inspection report from the environmental health department. 16 42 Care Homes for Adults (18-65 years) Page 26 of 27 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). 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