Inspection on 30/10/08 for 85 Highfield Avenue

This inspection was carried out on 30th October 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

85 Highfield Avenue 24/01/07

85 Highfield Avenue 05/10/05

85 Highfield Avenue 28/06/05

85 Highfield Avenue 13/01/05

85 Highfield Avenue 15/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 85 Highfield Avenue 85 Highfield Avenue Aldershot Hampshire GU11 3DA     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: Damian Griffiths     Date: 3 0 1 0 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 30 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 30 Information about the care home Name of care home: Address: 85 Highfield Avenue 85 Highfield Avenue Aldershot Hampshire GU11 3DA 01252350677 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Beverley Hilton Type of registration: Number of places registered: United Response care home 6 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 6. 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). Date of last inspection Brief description of the care home 85 Highfield Avenue provides a service for up to six younger adults with a learning disability. Staffing is provided twenty-four hours a day. Service users are encouraged to maintain their independence and rules are kept to a minimum. Visitors are welcome and service users families are encouraged to play an active part in their relatives life where appropriate. The home has well-established links with local general practitioners and community nursing team to support and enhance the service provided. The home has been developed and managed by United Response and is well established in the local community. The home is situated in a residential area on the outskirts of Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 6 Brief description of the care home Aldershot. Transport facilities are provided for service users to access local facilities and larger towns in the area. 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 key unannounced inspection took place over 4 hours. The inspection was carried out by Mr Damian Griffiths, Regulation Inspector. The Registered Manager, Mrs Beverley Hilton and her Deputy Service Manager, representing the establishment were available throughout the inspection. A full tour of the premises took place and a number of documents and files including three service users care plans, staff recruitment files, quality assurance information and the annual quality assurance assessment (AQAA) were examined as part of inspection process. A number of surveys returned to CSCI about the service were also considered in writing 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users received a comprehensive pre-admission assessment of thier care needs before moving into the home. Evidence: There had been no vacancies at the home for some years and existing service users had received a thorough assessment of their care needs involving input from a variety of social and healthcare practitioners. The home was planning to review its assessment process over the next 12 months and its AQAA stated that it was; developing a package that can be tailored to fit any individual considering moving into the service. The manager advised that there had been no further development in this area. Five CSCI surveys had been completed by representatives of the service users. All agreed that they had received enough information to make an informed choice before moving into the home. One service user commented; I am more than happy here its like home. Care Homes for Adults (18-65 years) Page 10 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users benefited from the homes creative care planning methodology that accurately recorded everyday care needs that had been monitored, assessed and recorded to ensure that service user choices could be implemented quickly and safely. Evidence: Three CSCI surveys were returned by care staff confirming that they always received up-to-date information about the needs of the service users they supported. The three care plans sampled had been constantly monitored and assessed. The home used a range of assessment processes to compile accurate individual care plans such as the, Person Centered Thinking Tool (PCTT) that ensured it addressed issues raised in the Mental Capacity Act (2005) regarding the task of making sure service users choices were respected and best interests were acted upon. The Keeping Track System (KTS) ensured that any support required was monitored, Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: recorded and reviewed as part of the care staffs daily task work. This ensured that the care plans were always active and a pattern of service user activity could be determined and measured by the methadology in use. Care staff time and training had been identified and implemented using Involvement Support Profiles detailing the staff alocated to service users. CSCI surveys received on behalf of the service users confirmed that they made decisions about what they wanted to do each day including what they wanted to do at the weekend and that care staff always acted on what they said. Care plans contained details of regular multiagency reviews concerning service users. Service user choices and any potential risks were automatically assessed and recorded as a matter of course. Comments received from the CSCI surveys of healthcare practitioners confirmed; (care staff) have embraced care coordination meetings very well and helped them to be the bedrock of multiagency care. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The local community was accessible to service users, their personal routines and relationships with family and friends were supported and service users enjoyed a varied diet of healthy and nutritious food. Evidence: Care plans were tailored to suit service users preferences and the Keeping Track System enabled staff to assess the success and risk of any activity chosen. Service users were free to choose their favourite activity and care plans detailed visits to use local community facilities such as places to eat, swim, shop, visiting local day centres and going on favourite walks. The home had its own transport ensuring easy access to local facilities and day trips out. The evidence in place confirmed the stated aims made in the AQAA in the section titled What We Do Well; sensitive flexible personal care support, providing personal care in a way preferred to the individual and in a manner Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: that provided continuity of care... maintaining peoples privacy and dignity and respecting their individuality. We recognise peoples rituals and routines. Friends, family and healthcare practitioners were included in any care planning and evidence of regular contact could be found in the daily record of events featured within the care plan folders. A healthcare practitioner commented; irrespective of staff and other difficulties the team who have shown steadfast commitment to the individuals they serve and their enthusiasm is a credit to them. The homes AQAA recorded details of events; we had a big garden party last autumn to help promote and maintain relationships with friends and families; this success was repeated at Christmas with carols around the tree...we support people to see their families individually too, this has included taking someone to...visit for the day with her sister/brother and spending a day in (a shopping centre) with one person and her/his extended family. There was evidence in care plans and the many photographs of service users recording various trips out and activities that confirmed the homes commitment and support in this area. Each care plan contained service users likes and dislikes and listed routines that enabled the service user to feel safe,secure and listened to, for example; John (not real name) likes to be spoken to softly and routines such as; Freda (not real name) likes to relax and soak in the bath. There was evidence to show how the home had worked with other social, health care practitioners and relatives to ensure that any negative behaviours and risks generated by service users routines and rituals were displaced. For example the home had reduced potential risks and negative behaviour by ensuring that specialised equipment was made available throughout the home to use whenever required. The equipment was creative, practical, unobtrusive and available to all at the home. The CSCI survey completed by a healthcare practitioner confirmed the homes commitment; I was impressed with the motivation and dedication staff showed in personalising and identifying individuals lifestyle wishes and favoured activities, food, interests and supported residents in accessing these within budget constrictions. Service users were able to choose their meals from a six-week menu plan. Records showed that meals were nutritious a wholesome and a dietician connected to the local GP surgery was available to periodically check that their diet continue to be beneficial to health and well-being. Service users were observed receiving sensitive and practical support during mealtimes. The kitchen was in constant use throughout the day and care staff took turns to cook and support service users to prepare light snacks for themselves. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The service users relatives assisting them to complete the CSCI survey agreed that staff treated them well and commented; to my knowledge staff seem exceptional in the care and treatment of my son/daughter. 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. Service users benefited from regular health care assessments and the homes commitment to support them in a way they preferred ensuring regular contact with healthcare practitioners was maintained. Care staff ensured that service users medication was safely dispensed and recorded ensuring their ongoing health and safety. Evidence: CSCI surveys received from health care practitioners confirmed that service users individual healthcare needs were being met and commented that staff were; very flexible and willing to take on new responsibilities and training in this area of care. Care staff had received the relevant training ensuring that they had a good understanding of each service users health care needs and how to support them when in need. Care plan folders contained detailed healthcare action plans, evidence of regular monitoring in Agreed Working Practice (AWP) records available in the service users care plan folder and as described in the homes AQAA; an AWP describes exactly how support is to be provided to a specific person. For example an AWP in personal Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: care would describe the routine, or in what order an individual likes their support, likes/dislikes, what communication to use or how to support that person if they were having a bad day. The home had ensured that service users requiring prescribed medication had received the help and support through safe care practice. Medication Administration Records (MAR) confirmed that medication given to service users had been recorded accurately to reflect the prescribed dosage as directed by the GP . The medication prescribed had also been detailed in the service users care plan records ensuring greater clarity and it corresponded with the Keeping Track System listing the care staff who were administering the service users medication on any given day. 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. Information about how to make a complaint was understood by service users and their relatives who were confident that the managers and care staff would listen and and act upon any concerns they had. Staff understood the Safeguarding procedures and how service users might respond if they were affected by any safeguarding issues ensuring that service users welfare and safety was promoted. Evidence: A relative completing the CSCI survey commented; I would make a complaint, if it were ever necessary. Yes, I do know how to go about it. And, John (not real name) is able to express his feelings if unhappy, family aware of complaints policy. Service users relatives completing the CSCI survey confirmed that they had no concerns regarding making a complaint and knew who to talk to if they were unhappy. Details of how to make complaint were featured in the service users care plan. The home kept a complaints and concerns book listing all details of any situations arising including any discussions that had taken place. Evidence was in place showing details of how a care practitioners concerns had been investigated and implemented satisfactorily. Discussions with the staff team had been recorded along with how they were to manage the situation in the future. The homes AQAA also confirmed good practice: acknowledging how people communicate their frustrations, anxieties through Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: behaviour... there had been no complaints logged within the last 12 months. Safeguarding procedures ensuring the health and safety of service users was in place and in accord with Hampshire safeguarding procedures. The home had been required to activate the process on one occasion this year. Care staff questioned about protecting vulnerable service users understood the safeguarding issues, were confident and able to describe how they recognised and understood when service users were distressed and upset. A relative completing the CSCI survey also confirmed this; I am sured that, John (not real name) would show unhappiness and the staff would ask him what was wrong. They are very aware of his characteristics and personality and needs. Another comment from the the service users point of view recorded him/her stating that; Staff know if I dont like anything. 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. The service users benefited from living in a well maintained, comfortable clean and homely environment providing personalised accommodation and communal support. Evidence: The home was well-equipped to meet the needs of its service users who had access to a range of facilities provided. The garden at the back of the accommodation provided a choice of different areas for the service users to enjoy and experience including; a shady pergola covering the patio area ,raised beds for the growing vegetables and space to wander and be alone. All communal areas were comfortable clean and provided a homely environment. The home had recently fitted a new kitchen that was in constant use by care staff and service users. Part of the kitchen had been allocated for the service users who could enjoy easy access because the worktop had been purposely lowered to ensure that all service users could take part in cooking activities.Service users rooms reflected their personality and choice and contained personalised items, photographs and favoured ornaments. A comfortable and safe area on the landing contained coloured lights and optics so that the service users were able to relaxe and enjoy a sensory experience. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: The laundry area, also in use all day, was clean, tidy and laundered clothes had been organised to ensure that service users clothes were not lost. The toilet area was clean and tidy and without offensive odours. A record of maintenance was available for inspection confirming the AQAA statement statement; we have an effective repair a reporting system. 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. Care staff received training and updates relevant to meet their needs and the care needs of service users and they were confident with the training system in place that promoted consistency of practice. The home had ensured that robust recruitment procedures were followed to ensure the well-being of service users and new care staff. Evidence: The homes AQAA pledged to; ensure that all staff receive the appropriate training, support and supervision. Continue to inform good practice through team meetings, support staff through the Common Induction Standards and keep the NVQ programme high on the agenda. Care staff were observed working sensitively and confidently with individual service users demonstrating an ability to work at the service users own pace. The service users were at ease with care staff and were able to communicate their needs without fuss. Care staff consulted were confident and able to describe the homes working practices and procedure such as the Keeping Track records, Shift Planners and Involvement Support Profiles that enabled them to adjust and implement service users daily care needs and match work duties. Four personnel folders were sampled and care staff consulted to establish that the training they had received was relevant to the needs of service users at Highfield. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Comments received in the CSCI survey completed by care staff and relating to training needs and staff/management communication indicated that there was confidence in the systems used at the home for example; if any needs change of the people we support we request and receive extra training in that area. Induction training was available to assist each new recruit to the home and a care worker confirmed that they received bimonthly supervision as standard and the ability to request extra supervisions when required. Training such as, health and safety, safe manual handling, food hygiene and first aid were amongst the mandatory training in evidence and service user focused training such as, challenging behaviour, epilepsy awareness, makaton and autism confirmed the statements made in the AQAA . Robust recruitment procedures had been implemented and the organisation, United Response, had ensured that they had received a Protection of Vulnerable Adults first (PoVA first) clearance and the necessary notification and clearance from the Criminal Records Bureau (CRB) before allowing new care staff to work alone with service users. Personnel files also contained the necessary documents showing specific personal details and references ensuring that new care staff being recruited had all the necessary motivation and skill to work with service users at the home. Service users relatives completing CSCI surveys confirmed the commitment and skill of care staff at the home; to my knowledge the staff seem exceptional in care and treatment of my son/daughter. Others commented; my son/daughter is very happy and extremely well cared for in every way. 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. The management of the home was supported by care staff and residents representatives who confirmed that the home was run in the best interests of service users and promoted good practice. It was recommended that the manager apply to the commission for registration as manager for both of the United Response Homes that are currently in her care. The views of service users and their relatives were regulaly consulted and the home was committed to reviewing how it secured service users views in order to ensure that their best interests were being realised. The home took care to respect and implement health and safety procedures within the home to ensure the safety and welfare of the service users and care staff were always considered. Evidence: Care staff completing CSCI surveys confirmed that their manager met with them Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: regularly to give them support and discuss how they were working. Comments received from service users representatives about the current management practice at the home included; to my knowledge staff seem exceptional in the care and treatment of my daughter/son. A health care practitioner commented and; Highfield Avenue has made a good transition from the move of the home manager with no negative impact on my clients and none that is apparent on staff or the other service users. The registered manager had been working at the home for a number of years and currently manages another of the organisations sister homes situated nearby. The deputy service manager (DSM) assists with the management arrangement currently in place. The homes AQAA explained how the new management arrangement worked; to ensure a robust management structure, a deputy service manager has been appointed to work across both services. The role of the senior manager (SM) is primarily concerned with the day-to-day management whilst the DSMs role is specially focused on practice leadership and development. The two roles spend two days a week in each house, on the fifth day the two managers work together at one or other of the houses. The manager advised that she wished to confirm the management arrangements with the commission after a relatively successful six months since implementation. It is recommended that the manager apply for registration for both homes in order to assess the current management practice. Application details are available on the CSCI website. Care staff completing the CSCI survey indicated that they felt supported under the current management arrangement one commented: in the service I work in we have a good support team who will do everything and give all their time to support service users. We communicate well as a team and always try to achieve whats best for the people we support at the service. The home had informed CSCI that it was seeking to develop another way of gathering information from service users about the quality of care they received the AQAA stated; in October 2008 our organisations Inclusions Team will be carrying out an observation at Highfield of support we provide. This assessment process can also include questionnaires to team members and families about the work we do. This will form a key part of our auditing this year. This was still under review. The manager advised that the available formats used to print sybols for easy read summaries such as, widget and makaton did not guarantee service users understanding of questions being asked and care staff remained the most reliable source when service users required information translated for easier understanding. A parent completing CSCI survey on behalf of their daughter/son who said; staff know if I dont like anything. And a relative commented; communication between Highfield service and myself is very good indeed. I can always speak to either the manager or one of my Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: son/daughters key workers when I ring. Health and safety practices were in evidence throughout the home including the garden area. Scaffolding from a neighbouring home had encroached into the grounds and in the interests of the service users safety this area had been made out of bounds. As stated in the previous section of this report staff had received relevant health and safety training. Safety procedures and risk assessment had been regularly assessed and recorded. This included monitoring water quality, fire safety, accident reporting and care of common chemicals used throughout the home. A record of maintenance work was available and there was ample evidence of regular risk assessment in all areas. Some attention to the completion of a safety check relating to water safety was in need of attention.The manager advised that she would see that this was done. Health and safety practices at the home ensured that the best interests of the service users were being promoted. A relative completing CSCI survey commenting about the home; My son/daughter, is very happy, and extremely well cared for in every way. Please see the recommendation section of this report Care Homes for Adults (18-65 years) Page 27 of 30 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 28 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 39 It is recommended that the registered manager should apply to CSCI to register as manager of both homes, 85 Highfield Ave and 15a Vale Road in order for the commission to ensure that the current arrangements are fit for purpose. 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 © (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 30 of 30 - 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!