Inspection on 13/10/08 for Hagden Lane (336-338)

This inspection was carried out on 13th October 2008.

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

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

Other inspections for this house

Hagden Lane (336-338) 24/10/06

Hagden Lane (336-338) 26/10/05

Hagden Lane (336-338) 11/01/05

Hagden Lane (336-338) 17/08/04

Hagden Lane (336-338) 04/03/04

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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: Hagden Lane (336-338) 336-338 Hagden Lane Watford Hertfordshire WD18 7SH     The quality rating for this care home is:   three star excellent 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: Sheila Knopp     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 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 29 Information about the care home Name of care home: Address: Hagden Lane (336-338) 336-338 Hagden Lane Watford Hertfordshire WD18 7SH 01923213015 01923218416 linda.harris@turning-point.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs L Harris Type of registration: Number of places registered: Turning Point Southern Area Office care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: This home is registered for 6 people with a learning disability or mental disorder (when associated with learning disability). Date of last inspection Brief description of the care home Numbers 336 & 338 Hagden Lane form a residential home for six service users with learning disability/mental disorder excluding dementia, run by Turning Point. People are accomodated in two semi-detached, three bedroom houses situated in a residential area in the town of Watford. The houses are within easy reach of the shopping centre, public park and leisure facilities. Public transportation is walking distance away. There is no parking space except on the main road. Each of the two houses has a patio that leads into their own back garden. There is garden room at the bottom of one of the gardens that is used as an an additional area for social events and functions. All the Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 6 6 Brief description of the care home bedrooms are on the first floor, except for one at ground floor level at No 336. Each house has a kitchen / diner and lounge. The bathrooms and toilet facilities are adequate for the number of service users living in the home. The main administrative office is at No. 336. The Service User Guide, which provides information about the home, can be obtained from the manager together with details of individual fee arrangements. 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: 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: Our last inspection of this service was on 24th October 2006. It was our opinion at that time that the home had achieved good outcomes for the people who live there. This meant we carried out an annual service review on 11/12/07 rather than an inspection involving a visit to the service. This inspection was carried out over 2 visits made by one inspector on 13/10/08 & 23/10/08. For the purposes of this report the Commission is referred to as we. During our visits we were able to meet all the residents and had discussions with staff and the manager. We have also assessed the information we have received between our inspections and Care Homes for Adults (18-65 years) Page 6 of 29 the last review. This includes the managers annual quality assurance assessment (AQAA), which managers are required to complete each year. It provides information on what is being done to monitor the quality of the experience and outcomes for, people living at Hagden Lane and gives us some numerical data. We made survey forms available to people living and working at Hagden Lane and health and social care professionals who are regularly involved with service users, so they could give us their views. We received completed surveys from 2 service users, 1 member of staff and 3 health care professionals. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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. People can be confident that Hagden Lane will be a suitable place to live and staff will be able to meet their needs because, together with other people who know them, they will be involved in a detailed assessment, before they move in, and be given the opportunity to try out the service. Evidence: To look at how people are involved in choosing whether Hagden Lane is a suitable place for them to live, we reviewed the information available for someone choosing the home. People living at Hagden Lane confirmed they had been asked if they wanted to move in. One person told us, I had several visits to Hagden Lane and liked it so I was happy to move there. Another person said I came for tea first. We were able to see from the records we looked at, that detailed assessments from people who know the individual concerned are obtained and reviewed before offering Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: them a place. This includes family members and health & social care professionals. Visits to the houses are arranged so people can meet the other people who live and work there, including overnight stays. Information about the service is available in pictorial formats. Staff are increasingly using computers to provide other images and formats for information. The manager told us they have purchased a Widget program to help produce information in a symbol format, to help one service user in particular. Each resident has a tenancy agreement. This gives them information about the service and sets out in detail what is included in the fee, the role and responsibility of the provider and the rights and responsibilities of the individual service user. The manager tells us this is reviewed annually with each service user. Each person also has a My own personal file which provides information about Turning Point and Hagden Lane polices and procedures. 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. People living at Hagden Lane can be confident their plan of care will provide staff with information on things that are important to them, how they wish to spend their time and how any risks will be managed. Evidence: To look at how people are able to make choices about their lives we had detailed discussions with 2 people living at Hagden Lane and their key workers. We found that service users are involved in developing and updating their personal portfolios, which provide a detailed account of how people wish to lead their lives and their goals and aspirations. Service users are involved in reviewing the information recorded about them with their key worker and encouraged to write their own personal plans. We saw that staff had invested time in making sure this happens. We found that people are encouraged to lead independent lives. Staff and service Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: users are aware of steps they need to take to encourage independence but also keep themselves safe. Staff respond quickly if people are not home when they say they will be. Where appropriate service users are encouraged to take their mobile phones and personal alarms with them. We have seen from the notifications we receive from the manager that where risks are identified for example when people are out on their own in the community, action is taken to provide support and develop peoples awareness of the action they should take if they do not feel safe. The aim of Hagden Lane is to enable people to live independent lives so training and support to develop skills is given a high priority. We were told about examples of people being able to travel for longer distances on their own. The manager told us that Turning Point have set up a national group of service users, referred to as Champions, who guide Turning Point to develop services led by service users. One of the people living at Hagden Lane is a Champion and has attended the national group which involved an overnight stay in a hotel. 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 live as part of the community, spend time doing things that they want to do and give them a sense of achievement and self-worth. People are encouraged to make decisions about their lives and maintain contact with people who are important to the. People are helped to manage their day to day lives and prepare meals they like with guidance and support from staff on budgeting, shopping and cooking. Evidence: To see if people were living the lifestyle they choose we had discussions with people living at Hagden Lane and looked at the records which told us how people spend their time and what choices they have made. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Two of the service users we had discussions with are very aware of the aims of the home to promote their independence. One person has recently been supported to take up paid employment. The manager reported this involved support with completing an application form and attending an interview, which had increased this persons self esteem. Two of the residents have been very involved in developing and maintaining the gardens of each house and take obvious pride in their achievements. One person told us they feel free to go out when they want. Another person said they I like going to the cinema, I like going to church, I like playing golf. Each person has an individual program of activities which provide them with opportunities inside the home and outside in the community during the day, evenings and weekends. This includes support to spend time with their families and entertain friends in their own home. Two people have now got bikes and go for bike rides. As well as providing an additional social activity there is the added benefit of increasing fitness. One person told us about using their bus pass to get around the county and further afield. The managers self assessment (AQAA) identifies other areas where people have been supported to develop their independence from enabling a service user to move into their own flat to teaching someone to make a cup of tea. Residents are allocated a food budget and cook their own meals with varying degrees of support from staff. The manager reports All shopping, cooking and meal times are individualized. The need to promote peoples privacy is well understood by staff. Residents have keys to their rooms and staff do not enter without the agreement of the service user. There is a shared leisure room in the garden. It has been well fitted out with relaxing furniture a snooker table, TV and music equipment. Judging by the photographs we saw, this is well used by both groups of residents and there has been a focus on themed nights, giving people the opportunity to explore different cultures and foods. People were very positive about the party nights. Care Homes for Adults (18-65 years) Page 15 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 can be confident that they will be involved in decisions about their health and personal care, supported to use local community health services and to take their prescribed medicines to keep them well. Evidence: To look at whether people were receiving the personal care and support they need to maintain their health we spoke with service users and staff. We reviewed the systems for managing medicines that have been prescribed for each person. Service users have very detailed personal portfolios in place which describe their personal preferences and the support they need to manage their personal care. Each person also has a detailed heath plan. This provides information about their health needs and the health care staff in the community who are involved in supporting them. People use the local community services and have regular checks ups. Where possible service users are encouraged to visit doctors surgeries on their own and take responsibility for their own health with staff providing back-ground support. A health professional said, I always find the carers who accompany (service users to the Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: surgery) are sensitive, helpful and informative. However another health professional felt communication with staff could be improved. We found that there are safe systems in place, to make sure people have the medicines they are prescribed. People moving on to independent living have been supported on a program to manage their own medication but no one is currently managing their own medicines. There are regular audits of the records to make sure medication is being given as prescribed. Detailed instructions are available for individuals who need emergency medication and staff are trained in the use of specialist procedures. Information about the medicines being given is available and service users sign consent forms. The managers self assessment (AQAA) states that each service user has an outpatient appointment every three months, to monitor their health. Care Homes for Adults (18-65 years) Page 17 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 are able to give their views and any concerns or complaints they have are taken seriously. People are supported by staff who are well known to them which means they respond consistently and appropriately in challenging situations. People are supported by staff who have been checked to make sure they are suitable to work at Hagden Lane. Evidence: We spoke with service users and staff and looked at records available to us, to check whether service users feel they are listened to and protected by the policies and procedures in place and to investigate their complaints and ensure staff are suitable. Each person living at Hagden Lane has their own pictorial copy of the complaints procedure. The manager reported a copy is now also available on CD Rom and increasingly Turning Point are developing computer based resources which service users can access to tell them what is going on in the organization. In addition to one to one meetings with their key worker and house meetings there are opportunities, which some service users choose to take up, to attend advocacy Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: sessions to enable people to give their views and receive outside support. Service users are encouraged to write the minutes of their house meetings as further involvement in the process. We have not received any complaints between our inspections. The records we saw told us that there is a robust approach to recording and investigating any concerns people using the service may raise. Where these have involved investigation under the Hertfordshire Safeguarding adult procedure, the local authority have in the main been alerted by staff in the home, to concerns raised by individual service users and staff have co-operated fully to identify any follow up action required. There is a stable well trained group of staff which means they approach challenging situations consistently. Service users know what response to expect and take more responsibility for their actions. This has led to a decrease in reported incidents. The service users we spoke to demonstrated understanding of this area. Service user finances are regularly audited to make sure they are in order. A service user confirmed that they had been involved in learning about money and budgeting. People are able to lock their rooms and keep personal items secure in their rooms. Care Homes for Adults (18-65 years) Page 19 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. The people living at Hagden Lane live in comfortable well furnished houses that enable them to develop their individual skills and interests with the support of staff. Evidence: We spoke to residents about their homes and what the facilities were like. Both houses are well maintained with the emphasis being on providing a homely domestic style atmosphere. The furniture and furnishings are of good quality and well maintained. Both houses have benefited from considerable redecoration and updating over the last 3 years. One of the residents spoke of being involved in decorating the kitchen of their house. The manager told us that Turning Point carry out an annual survey of their properties and action will be taken to meet any recommendations made. Each house works independently so people have access to their own kitchen and laundry area for preparing meals and doing their washing. There is space for each persons food shopping and freezer supplies. Two service users told us they managed their own rooms and kept them clean. All areas of the houses we visited were fresh and clean. An infection control audit has been completed and staff receive training so they are kept up to date with this area of practice. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The managers self assessment (AQAA) told us that a result of listening to service users housework is no longer done at the weekends and one person moved rooms when the opportunity arose to provide more space for their entertainment systems and personal belongings. Each person has a key to their room and it is understood that staff do not enter without their permission, unless their is an emergency. Advice on adaptations or equipment needed to provide people with additional support to maintain their independence are obtained from occupational health staff as necessary. Each house has their own well kept garden. These reflect the different styles individual service users involved in gardening, have developed. There are areas for people to sit included covered areas for those who smoke. A garden room fitted out to provide a venue for social activities is shared by both houses. Care Homes for Adults (18-65 years) Page 21 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are well supported by a staff team they know who recognize them as people with individual needs and aspirations. This is because staff are checked for their suitability to work with vulnerable people and receive the training, support and supervision they need to promote peoples rights and respond to their diverse needs. Evidence: We spoke to residents and staff, reviewed the surveys we received and recruitment and training records to assess whether staff were provided in sufficient numbers and had the training and skills they need to support people living in the two houses. We spoke with 3 staff during out visit. They showed a good approach to promoting the independence of service users and to their role as key worker. A staff member who completed a survey said We encourage the service users to interact in the community, we have a homely atmosphere and teach new skills, always remembering the service user is at the heart of everything we do. Two of the service users we spoke with in detail were able to tell us about their relationship with their key worker and the support they provide on a day to day basis and through difficult circumstances. Two of the service users confirmed the staff were good. A service user returning from holiday was obviously pleased to be home and eager to tell staff about it. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: The manager is aware of promoting a gender balance within the staff team so that male and female service users have a choice of people to relate to. Staff are able to access expertise within Turning Point and the local community learning disability team, for guidance in areas outside their own expertise. One health care professional who returned a survey to us said that staff needed more awareness of mental health issues and how it affects individuals on a daily basis. The staffing rota we saw shows that staff are arranged to support the service users while they are at home, with 1 member of staff to 2 service users during the day and 1 member of staff covering each house at night, on a sleep-in arrangement. However staff reported when a new service user moved in this was changed to a waking night to help that person settle in. Staff also work flexibly to fit in with the social arrangements of service users during the evening, weekends and to support people having holidays. The staff are all reported to have qualifications at NVQ level 2 or three which is above the 50 level set out in these standards. New staff receive an induction setting out the core training and values of Turning Point, which they complete within 6 weeks and covers the required areas including working with diversity and promoting a person centred approach. They then move on to a more in-depth shift leader course, which they complete within 6 months. We also saw evidence that training is provided by community specialist to cover specific procedures that are individual to specific service users. Each member of staff has a personal development plan which identifies any updated training they need and enables the manager to ensure staff are kept up to date. Turning Point training, service user involvement and its polices and procedures and quality monitoring systems are all based on the promotion of positive outcomes for service users and meeting peoples diverse needs. There is a low staff turnover. We have seen over the last 3 years a growing confidence within the staff team, which has promoted a consistent approach to supporting service users, increasing independence and reducing the incidence of challenging situations. Our previous inspections have identified that there are robust recruitment procedures in place to make sure suitable people are employed. There has only been one new appointment since our last visit. Our check on the recruitment procedure and records, again confirmed that people have the required checks before they start work and receive the training and support they need through regular supervision, staff meetings and annual appraisal. Turning Point are also involving service users in staff interviews. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Two people told us that staff had spoken about other service users or staff in inappropriate situations. For example in front of a service user or at a meeting about another matter.This is an area for the manager to take forward with staff. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that Hagden Lane is being run in their best interests and their safety will be protected, because the service is managed in a way that promotes their rights, values diversity and recognises the importance of staff training and health & safety checks. Evidence: The information we have about Hagden Lane from our inspections over the last 3 years confirms that the service is managed in the best interests of the people who live there. The manager and organization have met their legal responsibilities and we have not had to make any requirements in that time, to improve services or safeguard the people who live there. Linda Harris is an experienced well qualified manager whose expertise is currently being used by Turning Point to overseeing another of their services, as well as Hagden Lane. Service users did comment to us that they were not seeing as much of her as they used to. This is clearly an area for Turning Point to keep under review, to make Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: sure the quality of service at Hagden Lane is maintained. We have seen Turning Point developing its quality assurances processes to reflect positive person centred outcomes for service users and service user involvement in developing standards and giving their views locally and through national forums. Each service user is reported to receive a copy of Turning Points annual report in a suitable format. Regular visits are made to Hagden lane by an area manager to review the quality and management of the service on behalf of Turning Point. Turning point quality auditing & monitoring process include detailed reports of accidents and incidents which are then risk assessed and ranked according to their impact on individuals and the service. Members of staff team have responsibilities for different aspects of the service and we saw the records of the regular health & safety audits carried out and any remedial action required. The training records we looked at confirm staff receive the training they need to promote safe working practices. Service users are also involved in learning about safety and attend fire training at a fire station along side the staff. There is a fire safety risk assessment in place and the Hertfordshire Fire safety service confirmed that the home met current fire safety standards on 5/10/07. Since that time records of regular checks on equipment have been kept up to date. There are good record management systems in place to ensure staff are kept up to date and policies and procedures are regularly reviewed. There are good systems in place for ensuring equipment is regularly serviced and our spot check of records confirmed the information provided in the managers self assessment (AQAA) was up to date and reliable. 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 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 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - 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!