Inspection on 28/01/09 for Cameron Road (51)

This inspection was carried out on 28th January 2009.

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

Cameron Road (51) 23/02/07

Cameron Road (51) 17/01/06

Cameron Road (51) 07/09/05

Cameron Road (51) 07/03/05

Cameron Road (51) 10/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cameron Road (51) 51 Cameron Road Seven Kings Ilford Essex IG3 8LG     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: Jackie Date     Date: 0 5 0 2 2 0 0 9 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. 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. 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 29 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Cameron Road (51) 51 Cameron Road Seven Kings Ilford Essex IG3 8LG 02085038219 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : h3050@mencap.org.uk Royal Mencap Society care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home only - Code 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 - Code LD Date of last inspection Brief description of the care home 51 Cameron Road is home for five peoplewith severe learning disabilities and challenging behaviour. People have little or no verbal communication skills, and very limited ability to make decisions about their lives. They all need a lot of support and supervision from staff. The house is semi-detached and is in Seven Kings, in the London Borough of Redbridge, close to bus routes, the station and local shops. Each person has his or her own bedroom. On the ground floor there is a lounge, kitchen, bedroom and shower room. The remainder of the bedrooms, another bathroom and the staff office/sleep-in room are upstairs. The garden has a range of garden furniture and is used by the people living there. Some people go to day activities outside the home and the others go out with staff. At the time of the visit four men and one Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home woman were living at home. Information about the service provided is contained in the service users guide. Care Homes for Adults (18-65 years) Page 5 of 29 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 inspection was unannounced and took place over two separate days. The reason for this was that we needed to return to the service to check staff records and to meet people living there. This was a key inspection and all the key inspection standards were tested. Staff were asked about the care that people using the service received, and were also observed carrying out their duties. As far as possible people using the service were asked to give their views on the service and their experience of living in the home. All of the shared areas and four bedrooms were seen. Staff, care and other records were checked. Feedback questionnaires were sent to people who use the service, staff and other Care Homes for Adults (18-65 years) Page 6 of 29 professionals. The feedback was received from, or on behalf of, two people who live at the home and one healthcare professional. In addition three relatives provided verbal feedback. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in December 2008. Information provided in this document also formed part of the overall inspection. We would like to thank the people living at Cameron Road and staff for their input during the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 29 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 29 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. If a vacancy arose the required information will be gathered on a prospective user of the service and they and their relatives could spend time in the home to find out what would be like to live there and to enable the person to make a choice about living in the home. People and their representatives have a written contract/statement of terms and conditions and will therefore be clear about what they are entitled to. Evidence: Standards 2, 3, 4 and 5 were tested. All of the five people using this service have lived together at Cameron Road for several years. Therefore they have not been any new admissions for some time. However, the organisation has an admissions procedure that includes gathering information and assessment. It also includes a facility for people to visit the service and have a transition period. Mencap have introduced a new assessment tool covering Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: a variety of different areas and this would be used as part of any assessment of a prospective user of this service. Each person has a contract/statement of terms and conditions. The contracts were available at the home. This means that there is clear information about the service that will be provided to each individual. Care Homes for Adults (18-65 years) Page 11 of 29 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. Peoples individual plans provide staff with the information that they need to meet individual needs. Risk assessments are appropriate and people are supported to take risks according to their needs. Strategies are in place to keep people as safe as possible. Evidence: Standards 6, 7, 9 & 10 were tested. Each person has an individual plan and these are linked to the National Minimum Standards. The plans contained appropriate information about each person and the support that they need. However these were not user friendly or person centred. At the time of the last inspection plans were supported by the use of photographs and symbols. The degree to which people can be involved in the development of their plan is very limited due to their profound learning, communication, and behavioural Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: difficulties. The manager said that they are developing video clips and more photographs to assist people and examples of these were seen. The plans seen were all up to date and had been reviewed regularly. They contained detailed information about each person. Files contained minutes of review meetings and confirmed that relatives and other relevant people had been invited. People living at the home have very complex needs in terms of their behaviour and consistency is very important. Therefore individual routines and preferences are clearly documented. For example one person is helped to dress and undress in a set sequence and there is a personal care checklist to assist this process. Daily logs are kept for each person and entries are made in the morning, afternoon and night time. These gave clear information about what each person has done and how they have been. It also gives information about the non-verbal clues staff have used to decide how a person is. There were up-to-date risk assessments covering the necessary areas and these were relative to each individual, the activities that they do and their own specific behaviours. For example, eating, throwing things out of the window, self-injury, epilepsy and finances. Staff spoken to were very aware of individual behaviours and the risks that this brings in a variety of situations. They were able to describe how they minimised risks. For example they were discussing and planning their strategies for when a potential new member of staff visited later in the day as one person does not like strangers. Personal records are stored securely in the office and staff are aware of issues confidentiality. Care Homes for Adults (18-65 years) Page 13 of 29 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. People are encouraged to be as independent as possible, to take part in activities and to be part of the local community. People are supported to keep in contact with their relatives and visitors are made welcome at the home. People are given meals that they have chosen, like, and that meet their needs and preferences. Evidence: Standards 11, 12, 13, 14, 15, 16 & 17 were tested. All of the people living at Cameron Road need support from the staff when they go out Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: and this needs to be one to one due to their complex needs and behaviour. Four people attend different day services and in some cases the staff team provide support for this as well. Since the last inspection additional day services have been secured for some people and for another person funding for outreach services has been obtained. On the first day of the visit only one person was at home. Others were at different daytime activities. Two people went on holiday. One to Centre Parcs and the other to Butlins. A third person goes to Spain with his family each year. The other two people cannot cope with holidays and as far as possible have extra days out. Due to behaviours it can be difficult for people to be supported in the community but staff work hard to support people in whatever is suitable. One person goes to the pub and the cafe during quieter periods. Another likes to go out for walks, to go on the bus and to go shopping. Staff and relatives confirmed that people are doing more apart from going to day centres. Staff also said that they plan ahead more and work out and implement strategies to enable people to do things as safely as possible. One of the local day centres is due to close in a few months time and the manager is working to cover activities when this happens. People are encouraged to do things in the house and for themselves. For example, one person folds clothes with support and also mops the floor. We saw a short video and photographs of another person helping to decorate the Christmas tree. Four people have regular contact with their families. One person goes home to stay with his mother for a few days each week and another goes home for Sunday lunch every couple of weeks. As previously stated another person goes on holiday with his family. Relatives are invited to reviews and relatives spoken to confirmed that they attended these meetings. One relative spoken to said that her relative likes to go out for walks but because of the snow it wasnt possible to do this. However staff had taken the person out in a taxi to Ilford shopping centre so that they could still go for a walk. Another relative said, it is a pleasure to visit. Menus seen were healthy and nutritious and there was a lot of fresh food and vegetables in the home at the time of the visit. None of the people living at the home have any specific dietary requirements. One person is of West Indian origin and records confirm that he occasionally goes to a West Indian restaurant. During the course of the visit one person asked for a cup of tea and a member of staff made this. Later another person came home from the day centre and when he was ready asked for his coffee, which he was helped to make. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 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. People who use this service receive personal care that meets their needs and preferences and staff support them to get the health care that they need. People are given their prescribed medication safely. Evidence: Standards 18, 19 & 20 were tested. All of the people living at Cameron Road need support with their personal care and details of the help they need and how they prefer to be supported are in their individual plans. For one person in particular there is a detailed set personal care routine that staff follow and a personal care checklist that staff complete. This plan confirms that the person can choose their clothes with help and that their favourite colour is blue. It also states that the person can undress but needs help to dress. Dressing must also be in set sequence. This process is in place to minimise the anxiety for the individual and to reduce challenging behaviour. There is only one female resident and staff on duty and records confirmed that shes always assisted with personal care by female staff. A relative said that the people using this service are Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: treated with respect. People are supported to receive the personal care they need in a way that is appropriate for them. Each person is registered with a local GP practice and receive specialist input as and when required. This includes input from the psychiatrist. Staff support people to attend their medical appointments. Each persons file contains a record of medical appointments and these show that they have checks for the optician, dentist and when needed the chiropodist. The outcomes of all the visits are documented and show that peoples health care needs are monitored and addressed. One person refuses checkups and this is also clearly documented. Records show that people have medication reviews and three people have had their medication changed. As result of this they are more responsive and are talking more. A relative said that her son is unable to speak but the staff are observant and take action if he appears to be unhappy or in any trouble. Therefore people are supported to receive the health care that they need. None of the people living at the home are able to self medicate and medication is administered by staff that have been trained to do this. Medication is administered via a monitored dosage system and is stored in a locked cabinet. A relief worker confirmed that she had received training regarding medication and also that she had shadowed other staff at the home before administering medication. The procedure at the home is that two staff administer medication. Staff have also received training in the administration of rectal Valium. There is a protocol in place that states if a trained member of staff is not available to administer the Valium an ambulance should be called. There is also a protocol for how and when the rectal Valium should be administered. This was devised by the community nurse and agreed and signed by the GP. Therefore staff can be clear as to how and when this medication should be administered. The necessary medication records are kept and were appropriately completed and up to date. They also contained a photograph of each person and this is good practice. There was a handwritten entry and for accountability any handwritten entries made by staff must be endorsed with the date and the signed initials or signature of that person. The local pharmacist visits regularly to check medication storage and records. Therefore people are receiving their prescribed medication correctly and as safely as possible. Care Homes for Adults (18-65 years) Page 18 of 29 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 Cameron Road are safeguarded by the working practices and support of the staff team. Evidence: Standards 22 & 23 were tested. There is a user friendly complaints procedure and this includes pictures of the manager, service manager and a senior officer in Mencap as people that you could talk to if you werent happy. The complaints procedure was displayed in the home. However it is unlikely that any of the people living in the home would be able to make a complaint but a relative said that she is able to talk to the manager and if she has any concerns he is very receptive and acts accordingly. There was one recorded complaint, from a relative, about the building and this had been passed the owners of the building. Staff spoken to said that they had adult protection training with yearly refreshers. They were aware of safeguarding issue and their responsibilities in this area. The AQAA (Annual Quality Assurance Assessment) also states that all new staff have attended Mencaps protect and respect training. The section on staffing later in this report gives information that confirms that there is an appropriate recruitment procedure and this also helps to safeguard people living in the home. Due to complex Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: and challenging behaviour some restrictions are placed on people. For example one person does not have a sink or chairs in their room and the wardrobe is locked. This has all been agreed and detailed in their file and the family are aware of this. Relatives spoken to were happy with the care that was provided. A relative said, all the staff are very kind and caring and treat the residents with respect. None of the people using this service are able to manage their own finances. Each person has a financial assessment that is updated annually. The family of two people manage their finances and the service manages the remainder. The manager is appointee for benefits and the manager and the deputy are signatories on the accounts. Both people must countersign any withdrawals. Cash and other paperwork is stored in a safe in the cabinet in the office. Staff on duty have the key to the cabinet. Cash is checked daily as part of the handover. It is also checked as part of the monthly monitoring visits carried out by the service manager. The cash held for three people was checked as part of the inspection and was found to be correct in that cash held agreed with records. Receipts were seen for items purchased. Therefore safeguards are in place for peoples finances. Care Homes for Adults (18-65 years) Page 20 of 29 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 clean home that is suitable for their needs. Ongoing efforts are being made to make it more comfortable and homely. Evidence: Standards 24, 25, 26, 27, 28, 29 & 30 were tested. The house is in the Seven Kings area of Redbridge and is near to the local shops and bus routes. The communal space consists of a lounge, kitchen/diner and a garden. These areas are clean and satisfactorily maintained and decorated. Since the last inspection the lounge has been decorated and new furniture and rugs purchased. A relative said, the lounge now looks homely with the new suite. Each person has a single bedroom that has been personalised to meet his or her individual preferences. One person has an automatic door-opening device to enable him to access his bedroom when he wants to. Covers have been fitted to some radiators as required by the previous inspection. However these are just pieces of unpainted wood and they do look unsightly. A recent monitoring visit by the service manager also highlighted the covers as needing attention. It is recommended that the radiator covers be replaced with ones that are Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: more domestic and homely in design. There is a bathroom and bedroom on the ground floor and the remainder of the bedrooms, more bathing facilities and the staff office/sleep in room are on the first floor. The garden has suitable garden furniture, a barbecue and an outdoor heater. People like to use the garden in the good weather and since the last inspection this has been landscaped and tidied. None of the people using this service require any specific adaptations at this time. There are enough baths, showers and toilets and these meet peoples needs. All areas of the home appeared to be clean and hygienic and feedback from relatives was that the house is always clean. Care Homes for Adults (18-65 years) Page 22 of 29 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. People are supported and protected by the recruitment practices of the service. Staff receive the necessary training and support to meet peoples current needs and to provide an appropriate service for them. Staff have the opportunity collectively and individually to discuss their own development and any problems and developments within the service. Evidence: Standards 31, 32, 33, 34, 35 & 36 were tested. Since the last inspection there has again been some changes in the staff team but although there are some staff vacancies these are covered by regular relief or longerterm agency staff, as it is very important for staff to know the people living at Cameron Road and vice versa. Two staff are on duty per daytime shift during the week and the manager is supernumerary. There is also an additional member of staff from 4pm to 8pm weekdays and from 10.00am to 7.00pm at weekends. At night there is one waking staff and one member of staff sleeping in. From discussions and observations during the visits it would appear that staffing levels are sufficient to meet Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: peoples needs. Staff spoken to said that there was a good staff team that work together. Staff were very aware of the need for consistent work practice. One relative said that staff read her daughters body language and pick up any problems. Another said, staff are very kind and caring towards my son, his peers and myself. They are calm and relaxed when dealing with difficult behaviours. Staff have job descriptions and are clear as to their individual roles in the home. Four of the permanent staff and three of the relief staff have achieved NVQ level 2 or above. Staff training records are kept and staff receive the training that they need to provide a service for the people living there. Staff said that they attend a lot of training and have refresher courses regularly. Training has included adult protection, medication and autism awareness. The manager is now an autism awareness trainer and can provide this for the staff team. It was evident from discussions with staff that this improved knowledge of autism has helped to positively develop the service. A random sample of staff records were checked during the inspection and they contained the required information to demonstrate that staff had been appropriately recruited. This included application forms, references, proof of identification and CRB (Criminal Records Bureau) checks. Staff confirmed regular supervision and two weekly staff meetings. Staff spoken to said that they get good support and that the manager is open minded. There have also been some team building days. Therefore staff have an opportunity individually and collectively to discuss issues, concerns and the development of the service. Care Homes for Adults (18-65 years) Page 24 of 29 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. People living at Cameron Road benefit from a service that is well managed. They live in a safe home. Evidence: Standards 37, 38, 39 & 42 were tested. The manager has considerable experience of working with people with learning disabilities and of managing residential services. He is a qualified nurse of people with learning disabilities and is also very experienced in working with people with complex needs and behaviour. Feedback from relatives was very positive. For example, Ngai is very hands on, Ngai is marvellous with him, and Ngai is very receptive and straight onto things. Staff feedback was also positive, we get good support, and Ngai is open minded and will try things. He always says if we are struggling to let him know. The quality of the service is monitored by the manager and by the organisation. The Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: service manager carries out monthly monitoring visits and also checks on the progress of the services continuous improvement plan. The organisation also carries out service reviews. The last one took place in July 2007 and the nest review was due to take place shortly after this inspection. All of the necessary health & safety checks are carried out and records are kept of these checks. These records were up to date and accurate. However only one fire drill was held last year and it is recommended that more frequent fire drills are carried out so that as far as is practicable staff and those living at Cameron Road are aware of the procedure to be followed in the event of fire. A safe environment is provided for the people living there. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 Any handwritten entries made by staff must be endorsed with the date and the signed initials or signature of that person For accountability and also to provide an audit trail. 31/03/2009 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 24 It is recommended that the radiator covers be replaced with ones that are more domestic and homely in design. This will help to make the environment more welcoming and homely. It is recommended that more frequent fire drills are carried out so that as far as is practicable staff and those living at Cameron Road are aware of the procedure to be followed in the event of fire. 2 42 Care Homes for Adults (18-65 years) Page 28 of 29 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). 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. 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