Inspection on 20/11/08 for Acorn House

This inspection was carried out on 20th November 2008.

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

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

Other inspections for this house

Acorn House 22/11/06

Acorn House 14/02/06

Acorn House 11/08/05

Acorn House 05/11/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Acorn House 2 Eastbourne Terrace Westward Ho! Bideford Devon EX39 1HG three star excellent service The quality rating for this care home is: 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: Susan Taylor Date: 2 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Acorn House 2 Eastbourne Terrace Westward Ho! Bideford Devon EX39 1HG 01237420777 01237423623 arkenquiries@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ark Care Homes Ltd Name of registered manager (if applicable) Mr Robert James Lewington Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Room 6 must not be used to accommodate a service user until:- 1. En-suite facilities are fully fitted in the identified adjacent room 2. Certified by Building Control department 3. Approved by the Fire Authority 4. National Minimum Standards are met The home is to be registered to accommodate 6 service users who have a learning disability and are within the age range of 18-65 years. Date of last inspection A bit about the care home Acorn House can take up to 6 residents who have a learning disability. The age range is 18 - 65 years. It is a terraced house in the seaside village of Westward Ho! The home is near to Northam burrows, which is a nice place to walk. The shops are a short walk away. The house has a private garden to the front and a courtyard to the rear. There is a minibus that people use with staff to go out. Or people use local buses to get to Bideford or Barnstaple. Everybody who lives at the home has their own bedroom. Nobody has to share a room. The fees for the home range from £1,795 to £2,516.25. Social services usually pay this. People have to pay for chiropody, some activities toiletries, magazines and newspapers. The most up to date inspection report is on the notice board in the staff office. Anyone can read this. Acorn House has got three stars. This means the people who use this service experience Excellent quality outcomes. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home We talked to all the people who live at the home. We looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. We sent surveys that people filled in. The comments 2 people made are in the report. We talked to 3 staff at the home. What the care home does well People tell us that Acorn House is a well run home and a happy place to live. People make decisions about what they want to do day to day and are helped to plan for the future. There is a good choice of meals at Acorn House. People say that they are listened to and their choices are respected. People tell us that they get the support they need to learn new skills like doing their washing or cooking. People know how to make complaints and tell us that they can voice their concerns. They also feel that staff listen to them. The manager always does checks on people before they are allowed to work. This will make sure that people are protected that live there Staff are kind and encourage people to improve their lives. Staff regularly get training. This means that they all keep up to date and understand how to care for people that live at the home. People tell us that they feel safe. The home is clean, comfortable and well looked after. What has got better from the last inspection . Staff records are kept secure and properly looked after. Each person’s Doctor has agreed they can take certain tablets or cough syrup if they get a cold or flu. Staff have had an update about moving people, first aid and handling food safely. What the care home could do better People should have their assessment and care plans in pictures and easy words. So that they can talk about them with their keyworker. The registered people must apply to the Commission for a manager to be registered. So that everyone knows who is responsible for day to day running of Acorn House. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Susan Taylor Unit D1 Linhay Business Park Ashburton Devon TQ13 7UP 01364 651800 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.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 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 . Potential new people benefit from a good admission and assessment process, which ensures that the home can meet their needs. Evidence: Information that provider sent to us verified that the admission and assesment process had been improved since the last key inspection. We looked at two care files, which demonstrated that information had been obtained from placing authorities about the people before they moved into Acorn House. Assessments had been regularly reviewed since. Staff told us that the information had enabled them to get to know people when they first moved into the home. We tracked the assessment process for someone that has epilepsy. Records demonstrated that the person needs to be monitored closely to ensure that their safety is maintained during a seizure. Additionally, the assessment was detailed and provided staff with a clear picture of how the person would present if they were having a seizure, how it would progress and what treatment would be needed. An emergency plan had been written and gave good guidance about when staff should use prescribed treatment and when to involve emergency services. Assessment documents were not in a total communication format. However, information that the provider sent to us demonstrated that they are aware of this and plan to improve this in the future. This will ensure that people are fully involved in planning their care and will be able to refer to this themselves at reviews. 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 . People are involved in planning their care and quality of life at the home. Evidence: People living in the home who returned surveys verified that they always received the care and support they needed. We looked at the care files for 2 people to establish whether they had a care plan that had been discussed and reviewed with them and or their advocate. Peoples needs included individuals with epilepsy, communication, behaviour and mental health issues. All the care plans seen had been regularly reviewed. The plans were person centred, although given the needs of people were not in a format that made them accessible to the individual. We were told the care plans would be made accessible. For example the assessment about a person with communication difficulties highlighted that pictures should be used to enable them to communicate their needs. The acting manager showed us an example of a care plan in a total communication format. Implementing this will ensure that people are fully involved in planning their care and will be able to refer to this themselves at reviews. In a survey 100 percent of people responding verified that they make their own decisions about what they do during the day, during the evenings and at weekends. We observed this to be the case whilst we were at the home. We looked at duty rosters that were person centred and showed that people always had at least 1:1 and sometimes 2:1 care, which corresponded with the arrangements agreed with the placing authority. This means that people get the support they need to learn new skills and staff have the time to completely focus on the needs and wishes of that person. At Evidence: the same time, we observed that people living in the home are treated as individuals and given respect by the staff looking after them. We observed one person telling staff that they wanted to go out to buy photo frames and doing some bird watching in the afternoon. The person told us that they are a member of the RSPB. Two peoples financial records were examined. The provider told us that fees are paid into Ark Care Homes Ltd.- clients money account from which money is transferred into individual accounts. We were shown statements for this account. Both people had their own savings accounts and we were shown statements for these. Balance sheets had been completed and were audited and found to be in order. Two signatures were seen on balance sheets denoting withdrawals. Receipts for purchases tallied with entries seen in the records. The provider told us that a qualified accountant audits the accounts. Additionally, records demonstrated that transactions are regularly audited as part of the organisations quality assurance processes. The provider told us that they do not expect people living in the home to pay for meals for staff whilst they are out. We were shown records demonstrating that a meal allowance is provided and how this is managed week by week. We saw receipts that tallied with the entries and in turn, corresponded with outings that people living in the home had gone out on. The home had policies and procedures about risk assessment and management. In practice comprehensive risk assessments had been completed and were detailed. For example, one person whose file we looked has epileptic seizures. Each file clearly set out ways to minimise identified risks and hazards, whilst at the same time encouraged the individual to be as independent as possible. We observed that staff followed the measures set out. People were kept safe; whilst at the same time had freedom to do what they wanted to do. 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 . Peoples preferences are met with regard to the hobbies, meals and activities they are involved in. Evidence: We spoke at length to the two people whose needs were tracked. We also observed what they and the others living in the home did during the day to keep themselves occupied. In surveys 100 percent of people tell us that they can do what they want to during the day, evening and at weekends. People made comments such as I like watching birds and going shopping and I go and stay with my Mum and I like films. The provider verified that the home has its own minibus. The number of staff on duty meant that people had 1:1 or sometimes 2:1 support at particular times of the day. This enabled them to do what they wanted to do during the day. One person said they liked watching birds and is a member of the RSPB. Their bedroom was brightly decorated and homely with lots of photographs and books about wildlife. Every person had an activity program. A wide range of local resources was used and people verified that this reflected their individual interest such as shopping or bird watching. The acting manager told us that people at Acorn House had been offered the opportunity to go to the Breakaway Club but chose not to prefering their own company. People were coming and going from the home all day. A member of staff and one person was watching a film that the individual had chosen and was clearly Evidence: enjoying it. Later in the day, this individual showed us their vast video collection of films in their room. Activity and behavioural programs for individuals whose needs we tracked demonstrated that considerable support is being given to help them learn important skills like road safety, domestic chores and budgeting. We read assessments that demonstrated that risks had been assessed and were being managed around these tasks. Additionally, we observed this being put into practice with the individuals concerned over the course of the inspection. For example, we observed a person being prompted to clean his room, which he did with support from a member of staff. In records we saw that people have a lot of contact with friends and relatives. One person said that they sometimes stay with their family overnight. People said they liked the food. We observed lunch and evening meals being served over the course of the day. It was a relaxed atmosphere as people chatted over the meal. Staff preparing the meal said that they knew peoples likes and dislikes because this information is written down in their care files. We observed individual preferences being catered for. One person who had particular nutritional needs because of chronic illness and allergies was also offered extra supplements that their GP had prescribed for them. The provider said that they have made provision in the budget so that every person has money set aside for staff to use to pay for their meals whilst out with them. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Acorn House provides person centred care. The team utilise all the resources available to them to ensure that the care they deliver to people is based on best practice. Evidence: We tracked the care of a person who needed palliative care. A nutritional assessment had been done because the person had a number of food allergies and the individual needed their weight to be monitored monthly. We observed the person being offered extra food supplements that had been prescribed for him. Additionally, a detailed care plan had been also been written, which demonstrated that staff closely monitored levels of pain and discomfort that the person was experiencing. This provided staff with excellent guidance and was clear to follow. Daily records for the person demonstrated that regular advice had been sought from healthcare professionals at the hospice about the palliative care the person needed. Similarly, other records demonstrated that the persons pain relief medication altered according to their level of need due to pain and discomfort. The person showed us a colour chart in their bedroom, which staff used with them so that they could rate the level of their pain and/or discomfort. The person verified that they were comfortable and free from pain. Therefore, we concluded that this persons needs were well met. We tracked the assessment process for someone that has epilepsy. Records demonstrated that the person needs to be monitored closely to ensure that their safety is maintained during a seizure. Additionally, the assessment was detailed and provided staff with a clear picture of how the person would present if they were having a seizure, how it would progress and what treatment would be needed. An emergency and rescue plan had been written and gave good guidance about when staff should use prescribed treatment and when to involve emergency services. Staff verified that the rescue treatment could only be given by authorised staff that had undergone training. Evidence: Mar charts verified that only authorised staff had given this medication as needed. We were shown a box that is used when the person goes out, which contained emergency information in addition to the rescue medication. Correspondence in care files demonstrated that other social and healthcare professionals, for example the Consultant for the Community Learning Disability Team have a lot of input into the care of people living in the home. This has ensured that peoples personal and healthcare needs are regularly assessed and well met. The acting manager told us that a new medicines cabinet had been ordered and would meet the legal requirements. Medicines were stored securely and records relating to when these had been given as prescribed to individuals where well maintained. We discussed how homely remedies are used in the home for common illnesses such as colds and flu. The acting manager showed us a homely remedies policy. However, individualised assessments were not in place for each person at the home. We recommended that this be done and approval be sought from the individuals GP. The day after the inspection, we received an email from the acting manager to verify that this had been done and that she was awaiting approval from each persons GP. 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 living at Acorn House are protected and understand that they can voice their concerns, if they have any, safe in the knowledge that these will be dealt with. Evidence: 100 percent of people responding in a survey verified that they knew how to complain and who to speak to if they were unhappy. One person told us that they would tell a carer or XXX [the acting manager] if they were unhappy. Information that the provider sent us verified that no complaints or allegations had been made in the previous 12 months. 100 percent of people responding in a survey felt that the staff always treated them well and listened to them. The home had a written policy and procedure for dealing with suspected allegations of abuse. We spent sometime observing interactions between staff and people living at Acorn House. Staff engaged with people continuously at the right speed and demonstrated genuine warmth and attention, which people appeared to respond to and enjoy. We looked at training records for four staff. All the staff had attended a course covering the protection of vulnerable adults. Information sent to us by the provider told us that all staff had also been trained in non-abusive techniques to diffuse potential aggression. Two staff that we spoke to individually also verified this. They both had a clear understanding of the whistle blowing and safeguarding procedures within the home. We looked at two care files. All of the people whose care we tracked had behavioural plans that were detailed and provided staff with clear guidance about caring for the individuals. The service used an Antecedent, Behaviour and Consequence [ABC] assessment framework to establish underlying causes for aggressive or agitated behaviour. If such an incident occurred, staff told us that an incident report would be completed, although this was rare because of the skilled interventions of staff with the people living there . We were shown the template, which required the person completing it to provide detailed information about what had happened and action taken to diffuse the situation. We spoke to two people in particular about their life at Evidence: Acorn House and they made comments such as I like it here and I like my room and I go out a lot. 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 . People live in a comfortable, well-maintained home that is clean. Evidence: 100 percent of people responding in a survey felt that the home was clean. Information sent to the Commission by the provider as verified that there is a refurbishment plan in place. Since the last key inspection, the entire home had been decorated, new furniture purchased for the lounge and for people living in the home. Maintenance certificates for gas, electrical and fire installations verified that external contractors had inspected all of these. We toured the premises and two people showed us their bedrooms. Bedrooms varied in size and layout and had ensuite facilities. All were personalised and spotlessly clean and provided comfortable private space for the individual concerned. One person had a sitting area in which he could entertain visitors. People told us that their bedrooms had been decorated and had chosen the colours and new furniture. Communal areas felt comfortable on what was a cold November day. The acting manager told us that maintenance staff were always available to do repairs. We met an external consultant who was in the process of doing an asbestos survey, which once reported upon may provide recommendations for the provider to follow to ensure that the health and safety of people living and working at the home is maintained. Information sent to us by the provider verified that the department of health guidance has been used to find out the effectiveness of infection control practices in the home . Additionally, ten of the staff have attended training about the prevention and management of infection control. We observed that there was a plentiful supply of aprons and gloves, which in people living in the home and staff used appropriately. The acting manager told us that people had been had been asked whether they wanted to have a flu vaccination, which most had chosen to have. Evidence: 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 . Recruitment practices at Acorn House are robust and therefore protect the people living there. The training and development programme ensures that competent and knowledgeable staff cares for people. Evidence: The duty roster for the week of the inspection was examined and accurately recorded the names of staff, and duties that had been worked. As discussed under previous sections, the number of staff on duty means that people always had 1:1 and sometimes 2:1 support at particular times of the day. This enabled them to do what they wanted to do during the day and during the evening. We observed that staff were attentive and supported people in an unhurried way that was totally person centred. There is a diverse staff team at Acorn House; the gender mix matches that of the people living there. We looked at three staff files, one of which was of individual appointed since the last inspection. Relevant pre-employment checks, including references (CRB and POVA checks) had been taken up. Therefore, the recruitment procedures are robust and ensure that individuals are suitable to work with vulnerable adults. We spoke to 3 staff who were on duty, all had been given a staff handbook and General Social Care standards at the point of being employed by the organisation. Training records demonstrated that staff has training in all key areas of health and safety. Additionally, staff had been given training about management of epilepsy, NAPPI (advanced), autistic spectrum disorder and sexuality all of which are relevant when working with people with learning disabilities. Staff spoken to said that they were offered regular training updates, and positively encouraged to do NVQs (National Vocational Qualifications) in care. Information sent to us by the provider tells us that 100 percent of the staff have completed an induction consistent with Skills for Care standards and 80 percent have gone on to achieve the NVQ2 award. Evidence: 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 people that live at Acorn House benefit from living in a service that is person centred and well run. Evidence: The Registered Manager resigned the position in April 2008. The Team Leader was promoted to Acting Manager and was in this position when we inspected the home. The Acting Manager reports directly to the General Manager and Director at Head Office who is the Responsible Individual. Records demonstrated that regular visits are made to the home by the General Manager and Director and management meetings held at Head Office. We discussed these interim management arrangements with the provider, who told us that an application to register a manager would be submitted in due course. The provider gave the Commission a clear picture of the current situation in the service, in a document entitled AQAA (Annual Quality Assurance Assessment), which we promptly received. The information provided was clear and enabled us to know what to focus on during the inspection. Additionally, it was clear that the provider fully embraces quality assurance and puts the people living in the home at the centre of everything they do. At the same time, they were open about what they could do better and able to demonstrate continous improvement in various areas throughout the course of the inspection. The certificate of registration was displayed in the hallway, which is a legal requirement. We also saw the public liability certificate, which was valid. Comprehensive Health & Safety policies and procedures were seen, including a poster Evidence: displayed near to the office stating who was responsible for implementing and reviewing these. We spoke to 3 staff who told us that they had been given regular training about all aspects of health and safety. At the last key inspection, we reported that some aspects of health and safety training had lapsed. However, the provider has ensured that all staff have attended refresher courses about food hygiene, manual handling and first aid. We were shown the induction pack and saw that completion of this had been recorded in the files we looked at. We toured the building and observed that cleaning materials were stored securely. Records of accidents were kept and showed that appropriate action had been taken. For example, two of the people whose care we tracked had had minor accidents and received first aid from qualified staff. Best practice had been followed with regard to the recording and body maps had been completed to show where the individual had been injured. The fire log was examined and demonstrated that fire drills, had taken place regularly. Similarly, the fire alarm had also been regularly checked. Certificates verified that an engineer had installed the fire alarm. First aid equipment was clearly labelled. Maintenance certificates were seen for fire alarm and electrical systems. The provider had verified in information sent to the Commission that a local electrician had inspected both the electrical system and appliances. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 People living in the home, should be able to access their assessments in a format that is accessible to them, for example by using pictures or simple language. People living in the home, should be able to access their care plan in a format that is accessible to them, for example by using pictures or simple language. The provider should ensure that an application for registration is submitted so that the people living in the home continue to live in a well managed service. 2 6 3 37 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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