Inspection on 04/02/09 for Appleton Lodge

This inspection was carried out on 4th February 2009.

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

Appleton Lodge 08/02/07

Appleton Lodge 15/12/05

Appleton Lodge 05/09/05

Appleton Lodge 20/12/04

Appleton Lodge 24/05/04

Appleton Lodge 23/02/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

Key inspection report Care homes for adults (18-65 years) Name: Address: Appleton Lodge Bath Hill Terrace Great Yarmouth Norfolk NR30 2LF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Craig     Date: 0 4 0 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Appleton Lodge Bath Hill Terrace Great Yarmouth Norfolk NR30 2LF 01493843720 01493334380 john.matheron@ntlworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Jane Allison Matheron,Mr John Edward Matheron care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 1. The registered person may provide the following category/ies of service only: Care Home only Code PC 2. The maximum number of service users who can be accommodated is: 15 to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia Code MD Date of last inspection Brief description of the care home Appleton Lodge is a semi detached Victorian building situated close to Great Yarmouth town centre and sea front. Accommodation and care is provided for 15 adults who have mental health problems. There are now 15 single bedrooms as the proprietors have made some internal changes to the existing accommodation. The range of weekly fees for services is 307 pounds to 491 pounds. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 5 15 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 peterchart Poor Adequate Good Excellent How we did our inspection: Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. The fieldwork of this inspection was carried out over a period of five hours, during which time a number of people living at Appleton Lodge were observed and spoken with and a tour of the premises was undertaken, which included seeing peoples personal rooms - with their permission. Discussions were also held with some of the staff on duty, the manager and one of the deputies. Care Homes for Adults (18-65 years) Page 5 of 28 Various records were looked at in detail, which included care/support plans, staff files and other records relating to health and safety. Meanwhile, a well completed and detailed Annual Quality Assurance Assessment (AQAA) was returned to The Commission, as requested, prior to this inspection. No requirements or recommendations have been made as a result of this inspection. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? A vast amount of home improvement work has been undertaken, which has further helped to enhance peoples quality of life. All staff working at Appleton Lodge currently have a minimum of NVQ2 or equivalent. Notifiable incidents are now reported to The Commission more promptly. Mandatory training is currently up-to-date for all staff, including additional training in adult protection. The notice board now clearly displays details of the staff that are currently on duty. Care Homes for Adults (18-65 years) Page 7 of 28 The care/support plans are more organised, making it easier to access and review specific notes and records. The complaints folder also includes internal comments that have been made by the people living at Appleton Lodge. 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 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. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with good quality information about the home, so they are able to make an informed choice about living there. People have the opportunity to visit the home and detailed needs assessments are completed before they move in. Evidence: The care plans looked at during the inspection contained copies of pre-admission questionnaires, which also included detailed risk assessments and very descriptive personal profiles, all of which were noted to have been completed prior to people moving into Appleton Lodge. Each person was also noted to have been provided with a copy of the homes statement of purpose and it was confirmed that the contents are reviewed every six months (unless something specifically needs updating in the meantime). One particular person told of how they had visited Appleton Lodge regularly over a period of six months, starting with a few hours, then over-night stays and eventually Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: moving in permanently. They said that they liked their room a lot and had all their own belongings in it. Residency Placement Agreements were seen on peoples files, which had been signed and dated by the service user and the deputy manager. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Appleton Lodge have their changing needs and personal goals reflected in an individual plan of care, they are able to make decisions about their lives and are supported to take risks as part of an independent lifestyle. Evidence: Three care plans were looked at in detail and individual discussions were held with each person, which helped to confirm that the contents of the plans were accurate. The contents of the care plans included very comprehensive information, to ensure consistency of care and make sure that each person is genuinely treated as an individual and receives the level of support they require. The contents of the care plans were made up of sections such as: Personal Profile, which included a physical description, photograph, details of professionals involved in the persons care (such as keyworker, doctor, social worker Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: and consultant psychiatrist), admission procedure checklist and pre-admission questionnaire. Assessments, which included risk assessments covering areas such as harm to others, self neglect, onset of dementia and respiritory problems - the risk assessments seen as having been regularly reviewed and updated/amended as necessary. A completed residential care assessment was also seen to be kept on file. Care Plans, which included general principles and further detailed risk assessments covering areas such as mental health, physical health, psychological/social/emotional wellbeing, spiritual and cultural issues, talents, hobbies and interests and finances. Other information was seen relating to recovery - independent living and activities and residents comments, the Mental Health Act, emergency arrangements and review arrangements. All areas within the care plans section were seen to have been clearly written and also included good personal descriptors such as [name] enjoys the company of others and gets on well with staff. [name] responds well to 1:1 support and encouragement, especially if anxious or depressed. [name] has regular telephone contact with their relatives, who also often visit. [name] enjoys spending time with the basic skills tutor two days a week. Reviews, which included information regarding keyworker meetings - monthly care plan, general reviews, four weekly reviews and six monthly reviews. Daily Notes and other information such as inventory of property and referral information. The care plans and review arrangements that were looked at had been signed and dated by each resident, the keyworker and the home manager or deputy. Observations during the inspection confirmed that the people living at Appleton Lodge are genuinely supported and encouraged to make decisions for themselves, take risks appropriately and live their lives as independently as possible. All the records and personal information relating to the people living at Appleton Lodge was seen to be stored securely in the main office, thus ensuring confidentiality is maintained. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Appleton Lodge are able to take part in activities that suit them, be part of the local community, enjoy leisure activities as they wish and have good relationships with their family and friends. Peoples rights and responsibilities are respected and recognised in their daily lives. People living at Appleton Lodge are offered a healthy diet and enjoy their food. Evidence: Discussions were had with a number of people during the inspection and one person told how they regularly enjoy walking into town or to the seafront on their own, another person had just come back from town and said they also regularly enjoyed going shopping or popping to the local cafe where they often meet their friends. The people spoken to shared information about their hobbies and interests and the care plans that were looked at also reflected this information. Some of the activities Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: people said they regularly enjoyed included art, board games, bird watching, television and films, walks along the seafront, jigsaw, barbecues, digital photography, model making, shopping, bowling and helping around the house. It was noted for one person that they had attended the Norfolk Adult Education Service and completed an entry level course - An Introduction to IT (Information Technology). Some of the people spoken to confirmed that they had regular contact with friends and family and they could have visitors whenever they wanted. In respect of meals and mealtimes, various observations were made throughout the course of the inspection, which showed people choosing what they wanted for their lunch, when they wanted it and where they wanted to have it. A menu board was seen outside the kitchen and discussions about meals and choices were heard between residents and staff, including some positive encouragement to have something to eat, for some people who needed it. One person was noted to have a meal plan in place due to some health issues and every day the chef will liaise with staff and the person concerned in order to plan healthy meals that meet their diet plan. This person, as well as a few others, specifically said that they really enjoyed their meals. Some of the primary menu choices seen included (1) ham, hash browns and beans spotted dick and custard (2) steak and kidney pie, cauliflower cheese, swede and peas - fruit and ice cream (3) beef stew and dumplings - bread and butter pudding. It was also noted that if people didnt want the primary choice they could either have something totally different or just change it slightly - i.e. mash/chips/roast/rice/pasta, salad or other vegetables etc. A well stocked fruit-bowl was seen to be available for people to help themselves from at any time. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Appleton Lodge receive personal support in the way they prefer, their physical and emotional health needs are met and they are protected by the homes medication policies and procedures. Evidence: Discussions with some of the people living at Appleton Lodge confirmed that peoples individual wishes are acknowledged in respect of the way they are supported, which appeared to be mostly by listening to, encouraging or prompting people with daily or personal healthcare tasks. Some people were noted to require slightly more support than others in areas such as washing/bathing or dressing/undressing. Some people were noted to require more support than others in respect of financial or health matters for example and these were clearly described in their individual care plans - i.e. At [name]s request, their money is kept in the office where they can access it at any time. One person explained how they had been supported recently to get a frame and a wheelchair to help them get around better due to their arthritis getting worse. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Some of the people living at Appleton Lodge administer their own medication and appropriate risk assessments were seen to be in place for this. Meanwhile, the home was seen to have good and safe practices with regard to the handling, administration and recording of medication and no errors or ommissions were noted in the records during the inspection. Other records looked at confirmed that people are supported to have regular and ongoing involvement with various care professionals such as doctor, nurse, psychiatrist, dentist, optician, dietician and chiropodist. In respect of ageing, illness and death, one persons care plan was noted to have information clearly available with regard to their wishes for burial and who they would like to attend their funeral. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleton Lodge has a clear complaints procedure, both formal and informal, which helps ensure that people feel their views are listened to and acted upon. Staff are well trained in areas such as mental health, adult protection and medication, to help ensure people are protected from abuse, neglect and self-harm as much as is possible. Evidence: From the information provided in the AQAA, Appleton Lodge has received one complaint in the last twelve months, which was resolved appropriately, in accordance with the homes complaints procedure. The complaints folder was seen during the inspection and included internal comments by service users, which had been actioned accordingly. Training records were looked at and it was noted that staff are well trained, particularly in areas such as mental health, self-harm, adult protection and medication. Staff spoken to during the inspection had a clear understanding of adult abuse and protection. All staff have recently received further training in adult protection/safeguarding adults, provided by Norfolk County Council. It was also stated in the AQAA that, following a recommendation, the staff at Appleton Lodge will be looking into ways of making the complaints procedure available to Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: people in other formats - such as audio versions. Good records in respect of residents finances were seen to be maintained, and risk assessments were seen to be in place to further help safeguard people from financial abuse. Appleton Lodge also has robust recruitment procedures which is covered in more detail in the Staffing section of this report. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleton Lodge provides a homely, comfortable and safe environment for people to live in, which is clean and hygienic. Evidence: General observations were made whilst undertaking this inspection, which confirmed that people were very much at home and the whole environment was felt to be friendly, comfortable, clean and hygienic. Since the last inspection a great deal of work has been carried out in respect of redecoration/refurbishment and some of this work is still ongoing, although this has not detracted from the very homely environment. It was stated in the AQAA, which observations supported, that the entire building has been re-plastered and re-painted, a new walk-in shower/wet-room and toilet have been installed on the ground floor, as well as a new toilet and hand-basin (also on the ground floor). A new bathroom and shower has been fitted on the top floor and a ground floor bedroom has had a new sink and vanity unit installed. The main lounge has recently been re-plastered, re-decorated, re-carpeted, and furnished with new sofas and armchairs. A new 42 flat-screen television has also Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: been purchased. The office has been re-decorated and has new carpets and equipment. An exterior boiler has also been installed, which has provided additional space inside the home. Every radiator has an independent temperature control valve and a heat safety valve has been fitted to the boiler. The laundry area has been renovated, with new work surfaces and storage areas being installed. Additionally, new fridges, washing machines and a carpet shampooer have been purchased and several people have had new carpets and furniture for their bedrooms. Meanwhile, some of the people living at Appleton Lodge were happy to show their rooms and each of these were noted to be very individual, with peoples personal belongings around them. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleton Lodge has robust recruitment procedures and staff are well trained, with a minimum of NVQ2 or equivalent. Evidence: Three personnel files were looked at in detail during the inspection and each of these was found to be well organised and contain comprehensive information, which confirmed that Appleton Lodge has a robust recruitment procedure. Some of the documents seen in the staff files included: *Completed job application form *credible references *Clear, enhanced Criminal Records Bureau (CRB) disclosures *Medical declarations *Letter of engagement *Induction record *Terms and Conditions *Identification - passport, driving licence, birth certificate and photograph *Appraisals and supervision notes *Individual training sheet and copies of training certificates. With regard to training and qualifications, Appleton Lodge currently has a very high calibre of staff, with each person holding a minimum of NVQ level 2 (or equivalent). All care staff were seen to have completed all six of the Skills for Care induction standards. In-house training is regularly provided and all staff were seen to have received recent mandatory training in areas such as: Moving & Handling, Fire Safety, Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: First Aid, Infection Control, Medication, Food Hygiene, COSHH, Adult Protection/Safeguarding Adults and Health and Safety. Additional training has been undertaken by most staff in areas such as: Mental Health, Advanced Medication, Dealing with Aggression, Aspergers Syndrome, Diabetes, Adult Protection (When Care Goes Wrong), Introduction to the Labelling Theory, Understanding Self-Harm and The Mental Capacity Act 2005. Observations during the inspection showed a warm and friendly staff team, who interacted regularly and naturally with the people living at Appleton Lodge. Discussions with some of the people confirmed that they knew who their keyworker was and any specific roles/areas of responsibility that staff had. Discussions with staff indicated that they were supported well by the management team, as well as each other, and some made specific comments about Appleton Lodge being a lovely place to work. From records seen in the staff files, together with discussions held with staff and the manager/deputy, it was confirmed that staff receive regular support and supervision both formally and informally. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appleton Lodge is a well run home and the people living there benefit from good quality leadership and day-to-day management. A good Quality Assurance process is in place and the people living at Appleton Lodge know their health, safety and welfare is promoted and protected. Evidence: Both the manager and deputy were observed as having very positive, supportive and empowering attitudes towards the staff and people living at Appleton Lodge. A comprehensive Quality Assurance audit was recently carried out by an independent consultant that included feedback from service users, their families and other people connected with the service, which helps to confirm that the views of the people living at the home underpin the self-monitoring, review and development of the home. A report has also been compiled from the findings. Health and safety is promoted well at Appleton and records looked at confirmed that fire alarm and safety tests are carried out on a regular basis. Cleaning materials/hazardous chemicals were seen to be stored appropriately and staff training Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: in areas relating to health and safety was seen to be up to date. It was stated in the AQAA that, following a comment in the most recent Quality Assessment, staff will now sign to say they have re-read the policies and procedures, at least annually. Overall, the atmosphere during the inspection was cheerful and relaxed and observations confirmed that people were genuinely in their own homes, with their best interests, health and happiness being absolute priority. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!