Inspection on 07/11/08 for Baxter Close (1)

This inspection was carried out on 7th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Baxter Close (1) 22/11/07

Baxter Close (1) 18/01/07

Baxter Close (1) 23/06/06

Baxter Close (1) 08/03/06

Baxter Close (1) 19/12/05

Baxter Close (1) 03/02/05

Baxter Close (1) 18/10/04

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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: Baxter Close (1) 1 Baxter Close Crownhill Milton Keynes Bucks MK8 0BE     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: Chris Schwarz     Date: 0 7 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. 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: Baxter Close (1) 1 Baxter Close Crownhill Milton Keynes Bucks MK8 0BE 01908260005 01908695643 reception@macintyrecharity.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) MacIntyre Care Type of registration: Number of places registered: care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 2 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 1 Baxter Close is part of three separately registered services located close together in Crownhill, Milton Keynes. They form a small service group providing accommodation and support to nine adult service users with learning disabilities. 1 Baxter Close is a bungalow and accommodates two people. The homes are located in an area with reasonably good public transport to the city centre. There is a corner shop at the end of the road. The group of homes is managed from Marley Grove, which also provides accommodation for three service users requiring higher levels of support. The staff Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 2 Brief description of the care home team works as one group, flexibly covering the needs of service users in all the three settings, rather than being specifically allocated to one or another. Together, Marley Grove and Baxter Close aim to enable people with learning disabilities to live as independent lives as possible. 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 unannounced key inspection was conducted by Chris Schwarz over the course of a day and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place in November 2007. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and surveys were sent to a selection of people living at the service, staff and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, examination of some of the homes required records and a tour of the premises. People using the Care Homes for Adults (18-65 years) Page 6 of 30 service were away on leave at the time of this visit, whilst their bungalow was being redecorated and the kitchen refurbished. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection process. The manager and staff are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? Care plans are better organised, up to date and informative and provide a much improved account of peoples individual care needs with accompanying assessments to minimise risk. Information about how people make decisions is clearly recorded so that staff can support people when they need it. People using the service are being offered opportunities to pursue leisure interests and activities to provide them with stimulation and variety. Authorisation to use homely remedy medicines (over the counter preparations) has been obtained from peoples doctors to make sure they are suitable. Evidence of recruitment checks on relief staff and a volunteer is in place to show that appropriate checks have been undertaken. Care Homes for Adults (18-65 years) Page 8 of 30 Better support arrangements are now in place to meet care needs and additional funding has been requested of the placing authority. 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 9 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 10 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. The service has a range of information available to prospective users to help them make a decision about moving in and detailed assessment procedures are in place to make sure that needs are fully identified before a placement is offered. Evidence: A statement of purpose and service users guide were in place for the service, both updated this year to reflect current provision. Both provided a good range of essential information about the service which would assist people in making a decision to move in. There had not been any new admissions since the last inspection. Two documents were in place at the service, Getting to Know You and Moving into MacIntyre which the manager would make use of in the event of considering prospective users for a placement. Fees are assessed individually. Details of these can be obtained by contacting the provider. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: From surveys that were received back, people using the service said they had been asked if they wanted to live at the service and had received enough information about it before moving in. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good regard for the diverse needs of the people living at the home and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plans had improved significantly since the last inspection of the service. One persons file from each of the three services was looked at. Each had a photograph of the person, for easy identification, and a detailed care plan and accompanying risk assessments. Files had been better organised and indexed. Each contained essential information about the person, an All about me pen picture, details of people who support the person, intimate care guidelines including preferred gender of staff to give assistance, and an outline of the persons daily routines. Files contained details of support needs in relation to eating and drinking, cooking, personal space, domestic tasks and decision making and choices. This latter section had been added since the Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: last inspection to outline how people using the service make decisions and was divided into decisions the person can make for themselves, those they need some support with and those they need full support with. Each file contained a vulnerability action plan, the persons likes and dislikes, how the person communicates, their learning activities, support in managing finances and cultural and faith needs. Peoples physical and mental health needs had been well documented and included information about any other people involved in their care, such as a dietician. Peoples physical and emotional care needs had been recorded as had behaviours causing concern, with information on how to support people in these areas. Files contained a copy of local authority review notes as well as in-service ones. All information had been dated and was current. The manager also showed examples of person centred plans which had been produced on the computer. Two of these were looked at and included photographs and video footage of the people and what was important to them. The manager advised that other users had opted for a format which better suited them, such as scrapbooks. Risk assessments were in place for a range of issues. Each person had an overview sheet which outlined whether particular aspects of daily living were applicable, with a separate risk assessment if a need had been identified. Those that were seen covered personal care, medical and health support needs, relationships and emotional support, finance, learning opportunities, domestic/life skills, leisure, transport, home safety and challenging behaviour. All had been produced this year when care plan files had been reworked. Management of peoples finances was looked at for three people across the three services, one person who needed full support and two who needed minimal input from staff. Each person had their own wallet with individual transaction records and receipts in place. Balances were checked and tallied with the records in each case. Guidelines were in place at the service for managing peoples money. People using the service said in surveys they are involved in decision making and can make choices about what they do during the day, evenings and at weekends. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities are available to people using the service to provide them with stimulation and contact with family, friends and the community is supported to maintain social links. People are supported to eat healthily to keep them well. Evidence: People using the service attend day service opportunities run by the provider at nearby Great Holm, such as drama, crafts and performing arts. There is also a bakery and coffee shop run by users and a garden nursery. Some of the service users across the three services had been to the gym on the day of the inspection as part of their weekly activity programme, one person finished at lunchtime and returned home to use her computer and then do household chores and three were away on leave, including the two people living at this service. This was to enable redecoration and refurbishment of the kitchen to take place. Records were being kept by staff of what leisure activities Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: people were involved with and also when they had declined opportunities. Some of the activities attended included football matches, meals out, parties, going into the city centre shopping, going to the supermarket and a fun fair. There is a people carrier adapted vehicle which is used to transport people from each of the three services to and from day services and other activities. Some of the users have their own motorised scooters to get around. There is also a bus route that runs from the end of the road into the city centre for those people who can access public transport. Service users at Baxter Close have a cat, Pickle. Peoples care plans provided details of what they do during the week. Their social likes and dislikes had been recorded, as had information about how they access the community. Family and social contact was also noted. People using the service select their own menus and are supported to prepare meals with staff. One of the people living at Baxter Close had been receiving input from a dietician and the advice was being taken into account to make sure he was receiving the right diet. 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. The health and personal care needs of people living at the service are well met, promoting health, well-being, taking into account their preferences and religious or cultural requirements. Medication practice needs some improvement to make sure medicines are given in a safe manner. Evidence: Care plan files provided detailed information about the type of support and assistance people using the service need. New documents had been introduced, My personal health profile and My health which were being worked through. Peoples medication was also noted in their care plan files. Baxter Close had a bath with a hydraulic seat to enable service users to bathe safely. Records were being kept of appointments attended by people using the service and the outcome. These were largely up to date and included well person check ups. The manager was advised to make sure that one persons optician checks were arranged at the necessary frequencies as the records did not show this happening. Records showed Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: that people using the service have access to specialists as well. Medication was being managed centrally from Marley Grove. The manager said that only one of the people living at this service required medication and when he needs it, it is taken off the premises from Marley Grove and taken round to Baxter Close. This is not a safe practice and does not comply with The Royal Pharmaceutical Society guidance. A requirement is made for a medication cabinet to be fitted in the service to make sure that medicines are handled safely. Medication administration records were in good order with staff signatures alongside prescribed dose times. Since the last inspection, doctors have signed written authorisations to use homely remedies and a log book is maintained of any such use. A photograph of the service user was included in the medication administration records. There was a list of specimen staff signatures. Records of medicines disposed of were in good order. 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. Complaints and safeguarding are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. Evidence: The service had a safeguarding (adult protection) procedure in place as well as a copy of the local authority multi agency guidance. From information provided in the preinspection self-assessment, the manager said there had not been any safeguarding incidents and confirmed that this was still the case. The Commission is not aware of information to the contrary. Staff training records showed that they receive input on safeguarding vulnerable adults. The service also had a Speaking up document which covered whistle blowing, grievance, bullying and harassment. An important appendix to the policy with key contacts was not included. It is recommended that this piece of information is obtained and made available to staff. People using the service said in surveys they knew who to speak with if they were not happy, such as staff and the manager. In information provided in the pre-inspection self-assessment, the manager said there had not been any complaints and verified during the inspection that this was still the case. No complaints have been made direct to the Commission. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: There is a Peoples Forum held for users at any of the Milton Keynes services which meets each week to discuss any issues. A complaints poster with contact names and addresses has been produced for the three services for people to refer to. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Redecoration of the service and refurbishment of the kitchen was taking place at the time of the inspection, to improve the environment. Evidence: Baxter Close is a bungalow located a short drive or bus ride from the city centre. There is a corner shop at the end of the road. The service has one double bedroom. The kitchen was being refurbished with the sink and the skeletons of cupboard units fitted and new lighting installed. New flooring had also been laid. Redecoration to the whole bungalow was taking place with workmen finishing off the toilet and bedroom at the time of this visit. They envisaged finishing a short while after the inspection. The service had a pleasant lounge area with a door leading to the back garden and there was also a dining area. There was a bathroom with a hydraulic bath seat and separate toilet. The garden had ramped access for wheelchair users to access it. There was covered space to the side of the bungalow for storage of motorised scooters. The service was naturally in some disarray with furniture and belongings moved out of rooms being painted and placed in those that had been finished. Staff would be putting the rooms back in order and tidying up before the people using the service retuned from their holiday. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: 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. Staff have the skills and competencies to meet the needs of people using the service and have been thoroughly recruited to reduce risk of harm to them. Evidence: Staff said in surveys that they are given up to date information about peoples needs and their induction had covered areas they needed to know about. They said training was relevant to their role and helped them keep up to date with new ways of working. They described regular opportunities to meet with management for support. They said they knew what to do if anyone raised a complaint about the service and considered the ways in which information is passed on usually worked well. They felt there were usually enough staff to support people. In conversation with staff during the inspection they mentioned that at times staffing is tight across the three services due to increased needs. In respect of Baxter Close, one member of staff now spends time in the morning exclusively supporting the two service users with whatever needs doing following a requirement made at the last inspection. The manager had made the inspector aware that additional funding has been requested where care needs have increased although nothing had been agreed yet. Staff considered they had the right skills and experience to support peoples different Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: needs. People using the service said that staff treated them well and they listen and act on what they say. In information provided in the pre-inspection self-assessment, the manager stated that the staff team comprises seven people, three of whom have achieved National Vocational Qualification level 2 or above. No staff had left in the past year. Recruitment checks of the last two staff to join the team were looked at and found to be in good order. Original documentation was being stored at the providers central offices in the city centre. There was evidence of recruitment checks being carried out on a former member of staff who does some voluntary work with a service user, and also for the two relief staff that are used occasionally. No agency staff were needed to cover the rota. Training records showed that three of four permanent staff records were in good order with evidence of attending mandatory training. One persons records were incomplete with no certificates to prove that infection control, food handling and first aid training had been attended or that the staff member had been on a course to understand and respond to challenging behaviour. The manager said that these courses had been attended and they were indicated as such on a matrix grid that was in place for the whole team. She was advised to make sure the member of staff brings in the certificates promptly to provide the necessary evidence. Courses that were booked and due to be attended soon included dementia, risk assessment, link working, autism, recording and observation, person centred thinking and understanding and responding to challenging behaviour. Staff can also access e-learning modules on the organisational values, health action planning, person centred planning, communication, safeguarding adults and foundation food safety. A requirement was made at the previous inspection for new staff and relief staff to have the necessary mandatory training before working on shift. There have not been any new staff employed to look at their records. The manager said that she is not made aware of the training undertaken by the reliefs she uses. There is a system of approved relief staff that the service can use. The list for this is maintained by the external line manager for the service. The service which uses the relief staff the most takes responsibility for maintaining training records and ensuring that courses are up to date. No written evidence is communicated to other managers who use the relief staff that this is the case. It is recommended that evidence of training undertaken by relief staff is made available to the manager and is available at the service for inspection, to make sure that both mandatory and specialised training is in place to meet the needs of people using the service. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: A house guidelines file was in place which contained useful information for staff in addition to the main corporate policies and procedures. It included emergency procedures, daily, weekly and monthly tasks to be completed, kitchen and bathroom cleaning schedules, managing peoples finances, security of the premises, visitors policy, guidelines on link working, service user illness procedure and emergency telephone numbers. Care Homes for Adults (18-65 years) Page 25 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 and administration of the home promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The service has an experienced manager who is registered with the Commission and has achieved the Registered Managers Award. She is due to go on maternity leave early next year and arrangements have been made for one of the staff team to act up during this time. Appropriate hand over arrangements and training were already underway at the time of this visit and informal support arrangements had already been offered by a nearby manager. Monitoring of the service takes place by the external line manager and reports summarising the visits up until August were available to read. The arrangement of the line manager carrying out the visits is not ideal and would be better suited to someone who is in a more impartial position and a recommendation is made to this effect. The Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: manager had sent out surveys at the beginning of the year and the six that were returned were read. The findings had not been collated into a report with a response to areas which had been highlighted as poor, such as the environment. It is recommended that this is done, to pull together the findings and to inform those who completed surveys what is being done about shortfalls they identified. Health and safety was being managed well. Staff were checking fridge and freezer temperatures as well as hot water temperatures. Monthly health and safety checks were being carried out of the premises and portable electrical appliances had been checked in August this year. There was a current gas safety certificate in place. Risk assessments were in place for individual and generic tasks, including fire safety. There was no certification to verify that electrical hardwiring had been checked at the service and a recommendation is made to address this. 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 1 20 13 A medication cabinet is to be 15/12/2008 fitted in the service. This is to ensure that medicines are handled, stored and administered safely. 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 22 35 The key contacts information of the Speaking up document is to be obtained and made available for staff. Evidence of training undertaken by relief staff is to be made available to the manager and available at the service for inspection. The findings of any survey exercise are to be collated into a report and shared with those who participated and other interested parties, in order that the outcomes and actions to be taken are known. Monitoring of the service is to be undertaken by someone who is outside of the management chain, to offer an impartial view of the quality of care. The electrical hardwiring of the service is to be checked to make sure it complies with safety specifications. 3 39 4 39 5 42 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. 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