Inspection on 21/06/09 for Kismet House Care Home

This inspection was carried out on 21st June 2009.

CQC found this care home to be providing an Adequate 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

Kismet House Care Home 26/07/07

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kismet House Care Home 92 Walliscote Road Weston Super Mare North Somerset BS23 1EE     The quality rating for this care home is:   one star adequate 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: Melanie Edwards     Date: 2 1 0 6 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 30 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 30 Information about the care home Name of care home: Address: Kismet House Care Home 92 Walliscote Road Weston Super Mare North Somerset BS23 1EE 01934628631 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) : kismet.92@talktalk.net Kismet House Care Home Ltd care home 9 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 9 May accommodate Mental Disorder, excluding learning disability or dementia (MD) 9 Date of last inspection Brief description of the care home Kismet House is a small home registered for 9 residents with Mental Health Problems. It provides a supportive environment where residents can pursue their chosen life style within an agreed and risk assessed programme. The House is situated close to local amenities and walking distance from the shops and the beach. Current fees are 475 to 690 pounds a week. Care Homes for Adults (18-65 years) Page 4 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: one star adequate 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: We met four of the five residents who are living at the home. We spent time observing residents and staff together. We joined a small group of residents for lunch. We met the owner of the home Mrs Arshi, the registered manager, Mrs Siobhan Dolan and a care assistant. We looked at a range of records to do with the running and management of the home. The records we saw included one care plan, one assessment record, three medication Care Homes for Adults (18-65 years) Page 5 of 30 records, staff duty records, supervision information, accident records, fire records and menus. We saw all of the environment. We used the AQAA, this is an annual quality assessment document that all homes are required to complete, to help form the judgments in the report. We found that the home was operating within the required conditions of registration set down by us. The conditions of registration set out the type of care, the needs of residents and the numbers of residents who may stay at the home. 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 7 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 8 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. Residents needs are assessed when they move in. The necessary information about the home is available for people to help them to understand the service provided. Evidence: We read in the AQAA document that the home do the following to make sure that residents views are part of the running of the home: All service users are encouraged and supported to contribute to regular service users meetings. Each service user has the opportunity to express their views and opinions and put suggestions forward for any improvements or changes they would like. All meetings are documented and acted on within a set time frame. If suggestions are not possible due to limitations of house rules policies and procedures then this would be discussed in the meeting and reasons for why it can not happen is then explained to all service users. This could be a suggestion like, wanting to drink alcohol in house. Service users are given the Care Homes for Adults (18-65 years) Page 9 of 30 Evidence: opportunity to express their views and opinion by completing an annual questionnaire where they can put their views about the care and support and service we provide anonymously or known. The management would then identify what needs, needs to be addressed and put forward to the staff in a staff meeting and acted upon within a set time frame. Kismet House provide an opportunity for relatives and family members to put their opinions and view about the service provided across either verbally or in writing. This is also extended to external professional known to service users so their opinion and views can be identified and put forward. This enables the management to have a holistic approach to the running of the home and to ensure the service provided meets the individual needs of each service user. All questionnaires and feedback letters are placed in the homes quality assurance folder. The management has an open approach within the home and service users staff and family members can discuss issues or concerns without hesitation knowing they will be supported and guidance given. The management ensures that the service users wishes are adhered to by having a robust complaints procedure in place. The service users have available to them a leaflet that is easy to understand and follow, it explains the procedure and who to talk to. The management will then follow all complaints within a realistic time frame and follow all procedures set out to ensure smooth process without disruption or difficulties. Kismet House has a suggestion box for all service users and persons working or using the service. This is placed in the vestibule so all persons have easy access. The suggestions are then put forward in service users meetings and staff meetings to ensure they are addressed. Service users have an advocate service available for them to use if they choose to do so. This has recently been an excellent service for one of our service users and a positive outcome. To find out some more about what level of information there is available for residents about the home we looked at a copy of the service users guide and the statement of purpose. We saw in the service users guide that there was up to date information about the type of care and service that is provided. The statement of purpose and the service users guide contain useful information about the service. We saw information about the qualifications of the staff employed, and the accommodation. The philosophy of care and how the service aim to meet residents needs is also included. The complaints procedure is in each service users guide so people know how to complain. There are copies of the services users guide and the statement of purpose available for people so they can get hold of information about life in the home. We read one of the residents assessment records to see how their needs had been assessed by the home. The assessments are done to identify what sort of support and care a person will need in the home. We saw up to date information about the persons range of mental health needs. We saw that the assessment record had been regularly reviewed and updated. Care Homes for Adults (18-65 years) Page 10 of 30 Care Homes for Adults (18-65 years) Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care plans show how their needs are being met, however a lack of up to date risk assessments could put residents and staff at risk. Residents are being very well supported to make decisions and to take risks in their daily lives. Evidence: We read one residents care plan so that we could find out how residents are supported to meet their mental health needs. We found that the care plan contained a good level of information about the persons range of needs and what should be done to help them meet those needs. We saw a good level of information in the care plan about the life history of the person and what matters to them. The care plan had been reviewed and updated regularly. This demonstrates residents needs are monitored and kept under review. However we did not see information in the care plan about the potential risks the person may face and any risks from particular activities that they do. This is Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: needed to show what approaches staff should take and to keep the residents and the staff safe. Residents told us they go out with staff for a range of social and therapeutic activities. This is good evidence of how residents are well supported to take risks in their daily lives. There are regular house meetings for residents and staff to discuss what they feel matters about the day to day running of the home. We saw good evidence that residents are actively involved in the choice of meals served in the home. Residents told us they are asked what they like and meal choices are also discussed at residents meetings. Care Homes for Adults (18-65 years) Page 13 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. Residents can life a full and varied life style and can do what matters to them. Residents are provided with a well balanced diet. Evidence: The residents who we met told us that they go to a variety of leisure and social facilities including the local swimming pool and local community based facilities such as shops and the pub. Residents and staff are involved in housekeeping tasks. We also saw residents assist with the lunch time meal service. This is a way that residents are encouraged to build up their independence in daily living skills. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Residents can have their own key to their bedroom if they want to, to give them more privacy. The residents we met told us that staff polite and generally helpfull. We saw in the home photos of recent holidays and social events that residents had taken part in. One of the residents told us about a recent residents holiday to Weymouth, they said this had been, really enjoyable. We were told by staff and by residents that the home encourages contact with family and friends. Some residents see their relatives regularly. We looked at a copy of the current record of meals that residents have eaten over the last four weeks. We saw there were a variety of dishes recorded as available for each day. We saw a varied choice of meal options available for the residents. Meal choices included a range of traditional, nutritional meals. The lunchtime meal of barbecued meats and salads was healthy and appetising. Care Homes for Adults (18-65 years) Page 15 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. Residents are supported to meet their physical and emotional needs . Overall residents medication is handling administered and disposed of safely. However there need to be improvements made in administering and recording of residents medications. This is to make sure all prescibed medications are given to residents. Evidence: There is some useful information in the AQAA document about how the home support residents with their personal and health care needs:The staff and manager ensure that all service users using our service receives a high level of care and support that meets their individual needs on a daily basis. Each service user has an individual care and support plan with up to date risk assessments. Each service user has full participation and included in all aspects of their care plan and risk assessments. The setting up and reviewing of care plan and risk assessments is a collaborative relationship and service users sign when in agreement with them. All service users participate with care plan meetings and medication reviews their views and wishes are first and foremost. Giving them control over their daily living and own development Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: and programme. All service users have a named key worker and or a social worker community care worker care co-ordinator or placement officer. This is to ensure each service user is receiving the level and type of care to enable them to lead a fulfilling life style and have the necessary care and support in place to maintain their mental and emotional wellbeing. Service users within Kismet have a choice to which GP they have and make their own decisions with regards to their medical treatment. Service users are encouraged and supported by staff to attend medical appointments and health checks and Kismet provides the transport to and from appointments. Kismet House has a robust medication policy, for staff to adhere to. Training is given to all staff to ensure they are competent to administer medication. All Staff receive regular update training to comply with current up to date legislations and policies. Kismet House has close links with Lloyds Pharmacy who provide blister packed medication. All medication is prescribed by the service users GP or Psychiatrists. Regular medication reviews are arranged by the manager and the community mental health team. We saw information written in residents care records about the preferred daily routine of the residents and particular likes and dislikes in their daily lives. This helps staff to be able to meet residents needs in the way that is preferred by them. To support residents with their health needs they use local GP practices. There is also specialist support provided from other external professionals including the psychiatrist, dietician and the community mental health nurses. We saw information in the residents daily records that showed us staff keep a monitor residents and observe their overall health. Staff will call the doctor if they are concerned about the person. We checked procedures for administration, storage and disposal of medication to see if residents medication is handled correctly. We looked at the medication administration charts of three residents. The stock of medication we saw was satisfactorily organised. The medication administration chart was legible, up to date and contained the signature of the dispensing member of staff. This demonstrates medication is given to residents safely. The staff who administer medication do regular training to enable them to do this safely. We noticed that two resident are prescibed medications,(specifically topical creams and ventalin inhalers).There was no written evidence that either the residents looked after these medications themselves and self administered, or that staff give the medications to them. This could mean that the medications have not been given to the residents concerned. Care Homes for Adults (18-65 years) Page 17 of 30 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. Residents can make complaints if they need to. The home has systems in place to try and keep residents safe from abuse . Evidence: We read the complaints records find out how complaints are responded to by the home. There had been two complaints made since before the last inspection. The complaints related to the attitude of two members of staff and had been properly and robustly dealt with by Mrs Arshi. During our site visit to the home we were told that one member of staff had allegedly shouted at one of the residents recently. We informed Mrs Arshi of this allegation and she agreed to carry out a full investigation. We are going to monitor the outcome of the investigation. The residents who we met said they could talk to the Mrs Arshi or the manager Mrs Dolan if they need to. We saw a copy of the homes complaints procedure this has our contact information as well if people need to get in touch with us. We saw the minutes of residents meetings. The meetings are a way that residents can make known any complaints they may have. This is a way residents take control in Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: their lives and can make complaints if they need to. We saw a copy of the homes policy relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. The staff have done training understanding the principle of the protection of vulnerable adults from abuse. The staff we met had an understanding about the subject of abuse. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe satisfactorily kept and clean home. The home is a place that is suitable for residents needs and lifestyles. Evidence: Kismet House is in a residential area of the town of Weston super mare. The home is a short distance from the main shopping area of the town. The home is near to bus routes shops, pubs and a church. This means residents can be part of the community where the home is situated. The home is a three storey building and people use the first two floors of the building. There is no lift so the home would not be suitable for someone with reduced mobility. We found the home looked clean in the parts that we saw. The environment looked to be satisfactorily maintained. Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: Three residents kindly showed us their bedrooms. We found the bedrooms looked clean and satisfactorily maintained. The bedrooms in the home are for single use. We saw that rooms had been decorated in different colours and we residents had chosen their own colours for their rooms. Residents had personal possessions with them in their rooms. We saw residents sitting at the dinning room and in the lounge talking together. We noticed that residents looked settled in the home. There is a patio area that we saw residents use,we noticed how relaxed people looked sitting outside. We saw bathrooms near to communal areas and bedrooms. We saw that the bathrooms and toilets were clean and had towels and soap to help minimize risk from cross infection. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a lack of staff supervision taking place. This is needed to enhance the skills of staff and to improve overall care for residents. Generally recruitment procedures are in order however there needs to be a tightening up in obtaining employees references. Evidence: We checked the number of staff on duty for the last four weeks. We saw that there are two care staff on duty for a day shift. There is one member of staff who works at night. Mrs Dolan works additional to the two staff on duty each day in the week. She is also available on call outside of these times for support and advice if needed. Based on the evidence from the inspection the number of staff on duty at any time meet residents needs. We looked at staff employment files of three care staff. We saw written professional references taken up for new staff prior to offering work at the home. However for one member of staff who has recently been recruited there was only one written reference. Two references are needed as a way for employers to recruit only the sort of people who are suitable to work with vulnerable people. All staff do a criminal records bureau Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: check before starting employment. These checks also aim to make sure the home employees only suitable people to work with residents. We met one member of staff who told us they are working towards completing a national vocational qualification in care award. Mrs Arshi said a significant number of the team have either completed national vocational qualifications or are working towards them. We asked to see two staff recent supervision records. We saw some really good evidence from last year that staff had been motivated and supervised. However we saw no evidence for this year to demonstrate that staff are being regularly supervised in the work that they do. Care Homes for Adults (18-65 years) Page 24 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. Mrs Arshi is trying very hard to run the home for residents benefit, there are good ways for there views to be listened to and represented. The health and safety of residents and staff is protected. Evidence: Mrs Dolan has been the manager of the home for over three years. She has a number of years of experience caring for people with a range of mental health needs. She has been registered with us as the manager of the home. This demonstrates she is fit and competent to be the manager. We saw residents approach Mrs Dolan and look relaxed in her company. This helps show us residents feel comfortable with her. Mrs Dolan is well supported in her work by the owner of the home Mrs Arshi. Mrs Arshi takes a very, hands on approach in the home and works there most days. Residents we met knew Mrs Arshi and said she was, very nice and helpful. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Mrs Dolan has written some useful information in the AQAA document about her roles and responsibilities :The manager has gained a lot of experience over the last few years and her skills and ability has improved greatly. The manager has gained new qualifications in Health and Social Care, Children and Young Persons Advanced Counseling Skills and is currently under taking Foundation Degree in Counseling. As the manager it is my responsibility to ensure the smooth running and safety of the home. That the written aims and objectives for the home are achieved and that all persons comply with the policies and procedures set out. That the home complies with all current laws and standards. The safety and wellbeing of service users is my top priority and ensure that all staff maintain safe working practice and know their responsibilities and roles. As the manager I have an open, transparent and friendly approach that enables persons to approach without fear, prejudice, discrimination or difficulty. I ensure that all staff, service users, families and representatives has an opportunity to put in writing their concerns, worries, grievances, thoughts and wishes as well as their praises and positives. I am committed to development and positive change that enhances the service and provides and high quality of care for the service users. Through enthusiasm, commitment and positive outlook I motivate staff and service users alike to lead a more fulfilling life to grow and develop. Ensuring also that I encourage fresh new ideas and open to constructive criticism for change. As the manager I ensure that all files records and documentation are factual concise and clearly documented and up to date. Ensuring also all files are regularly reviewed and maintained when required. To also ensure that all persons are aware of any changes and inform all persons of any visits inspections and opportunities to discuss changes that may take place. As the manager I ensure that all staff has regular supervision, reviews and personal development programmes. That staff are fully trained to do their tasks and job description in order to meet the needs of the service users. That I am up to date with any changes and implement those changes to ensure safety of all persons within the home. also ensure that all persons are fully aware of fire and emergency procedures and training is given and updated recorded and signed. That all persons are competent to work and that the home is a safe environment to reside and work in. There are residents house meetings and residents can talk about what matters to them.We saw minutes of recent staff meetings. The minutes we read showed that staff are consulted about the running of the home and can make their views known. We saw up to date evidence that Mrs Dolan ands Mrs Arshi have been carrying out a full quality audit of the care and the service in the home. This is a really good way to review overall standards in the home and to improve them even more. We found that the environment looked safe and satisfactorily maintained in the areas we saw. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: All of the staff do regular training in food safety. This is a really good way for staff to help residents to prepare and cook food in a safe way.We saw records that showed staff check the temperatures of all high risk cooked food before it is served to people to make sure it is hot enough and safe to eat. We saw evidence that staff do training in health and safety matters including first aid, infection control and fire safety. This should help protect residents if staff are knowledgeable and well trained in health and safety principles and practices. We checked the fire logbook record and it showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment are carried out and are up to date. 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 1 9 15 All residents must have up to 29/06/2009 date risk assessments in place. Health and wellbeing. 2 34 19 Ensure two references are obtained for newly recruited staff. The protection of residents. 22/06/2009 3 36 18 Staff must be regularly supervised in the work they do. Safety and well being of the residents. 22/06/2009 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 29 of 30 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. 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