Inspection on 18/11/08 for Leighton House

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good 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

Leighton House 30/01/07

Leighton House 04/11/05

Leighton House 17/05/05

Leighton House 03/12/04

Leighton House 17/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Leighton House Merry Den Care 44 Station Street Cinderford Gloucestershire GL14 2JT     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: Janet Griffiths     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Leighton House 44 Station Street Merry Den Care Cinderford Gloucestershire GL14 2JT 01594827358 F/P01594827358 merrydencare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Denise Carol Leighton Name of registered manager (if applicable) Mrs Denise Carol Leighton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Leighton House was first registered in 2004. The home provides care for two service users with learning disabilities. The property is a two-storey terraced house located close to the centre of Cinderford. Service users are accommodated in single rooms on the first floor. Each bedroom has a hand basin. There is a shared bathroom and toilet on the first floor and a toilet on the ground floor. There is a lounge and a separate dining room, as well as a small garden at the rear with seating. The home provides transport for the service users and supports them to access activities in the local community. The service provider is in day-to-day charge of the home and acts as manager. It was reported that fees for the service ranged from 509 to 519 pounds per week at the time of the inspection. Prospective service users are offered information about the home including copies of the Statement of Purpose and Service Users Guide. 2 Over 65 0 care home 2 Care Homes for Adults (18-65 years) Page 4 of 30 Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes.The inspection took place over 6 hours on one day in November 2008. The service manager/provider was unable to be present during this inspection but the Company Secretary, her husband, was, together with the house coordinator. Some feedback was obtained from staff and service users through discussion and survey forms. Records checked included care plans, risk assessments, health care notes, staffing files and information about training. The registered manager completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing information about the service and plans for further improvement. Comments from this and the surveys received have been included in the Care Homes for Adults (18-65 years) Page 6 of 30 report. The judgments contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. 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 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 9 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. A satisfactory framework exists for referral and assessment ensuring that people have access to the information they need enabling them to make a decision about whether they wish to live at the home. Evidence: The revised Statement of Purpose and Service Users Guide were both examined and a copy seen in each service users file. The Service Users Guide is now in visual format and the home is working on other documents to produce them in the same format. Although there have been no admissions since the last inspection, the assessments of both service users were seen and were found to be informative and to clearly identify their individual needs. The AQAA states that both service users had a full assessment both by Social Services and the home, covering all the requirements in Standard 2 and any prospective service users are invited to the home on an introductory process. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clear system of care planning is in place helping to promote the quality and consistency of the support. People living in the home are offered real choices helping them to take control over their lives. Risks are being managed safeguarding them from possible harm Evidence: The care of both people living in the home was examined by reading their care plans and other associated records, talking to them about the care they received, observing them during the visit and talking to staff about the care they provide. The AQAA states that they have introduced a thumb print of one service user which is a detailed profile of them which is very helpful for new staff to have an understanding of the service users disabilities. This is also to be completed for the second service user. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: Each person had an individual assessment from which relevant care is planned and risk assessments developed where required. These both reflected the current needs of that person and showed evidence of regular review. It was discussed that one service user likes to be included in the care planning process whist the other prefers not to. Risk assessments were in place for a range of potential hazards with evidence of review. The AQAA states that each service user has their own live personal care plan updated on a daily basis and regularly reviewed with the service user and their family. They have risk assessments on their care plans and regular meetings where they can voice their needs or aspirations. Financial records for each person living in the home, were also examined as were receipts obtained and these were found to be generally satisfactory although it was noted that there were receipts in one file for weekly fish and chips purchased locally which were on the menu as the main meal for that day. It would be expected that unless this had been a specific choice of a service user, other than the main meal offered that this should be paid for by the home as part of housekeeping. This is being addressed. Any restrictions or limitations to freedom of choice were recorded in care plans and the rationale noted. Both people living in the home continue to make progress in independent living skills going out and using public transport independently and shopping on their own and in one case increasing control over their medications and finances. 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. Service users are supported to take part in activities which correspond to their needs and interests, helping them to lead full and active lives and be part of the local community. Appropriate support is provided in order that the people living in the home can remain in contact with people who are important in their lives. Arrangements are in place to ensure that service users rights are respected and that they are given support to meet their responsibilities. People living in the home are offered a varied and balanced diet which promotes their health and respects their preferences. Evidence: Each person has a scheduled activity programme for the week and staff are allocated where necessary to help them participate in these activities. This is mainly providing transport to some venues as both service users are able to carry out most activities Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: that they enjoy independently. Talking to service users and staff in the home together with examining records confirmed that they both lead full and active lives corresponding to their interests and needs. These include a variety of activities in the local community to include visiting cafes, shops and leisure centres. One has been on holiday this year with the providers, the other chose to remain at home meeting with friends and enjoying occasional day trips. One enjoys his art and music, whilst the other is interested in sports such as swimming and exercise, whilst also enjoying gardening, shopping and computer activities and has weekly routines for all of these. Daily records confirmed what each person had done during the day. On the day of inspection one had been out and about all day, whilst the other attended an activities centre during the morning and went shopping during the afternoon and had written his shopping list out ready for this. When the second person returned from his day out he was happy to show us his room, which he had decorated very individually with his unique artwork and also showed the drawings he had completed during the day and talked about his friends and Christmas. He was pleased to hear on his return that his new glasses were ready for collection and arrangements were being made between him and the staff to do so. In discussions with the staff and records examined it was seen that both keep in regular contact with their families and friends, with one going home regularly at weekends. Both service users were seen coming and going in a relaxed way and choosing where in the home they spend their time. Their independence is strongly promoted and they are encouraged to develop skills such as cooking, washing and cleaning. One was observed during the day preparing sandwiches for his lunch and later his afternoon tea and fruit and finally doing his ironing. Staff also confirmed that he is quite confident in dealing with his laundry. The other possibly needs more encouragement but does lay the table for main meals and washes up. Minutes of several residents meetings were seen within the records and a recent one held on 29th October 2008 discussed changes in staffing within the home and the residents feelings about these. Both the newly appointed co-ordinator and the new carer have been well received and both confirmed when spoken with that they feel they are settling in well. Residents and staff between them, plan, shop and prepare their meals and a menu plan was seen displayed in the kitchen together with shopping lists. The home aims to provide a balanced and healthy diet whilst also promoting choice and respecting individual preferences. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: The AQAA states that as a result of listening to the people who live in the home they are going to promote either short breaks or day trips. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are being met, helping them to stay well and offering them support in accordance with their needs and preferences to promote their dignity and self esteem. People who live in the home are also supported to control and administer their own medication as far as possible enhancing their independence. Evidence: At this time, the only personal care support required within the home was occasional prompting, although an assessment had been organised with an occupational therapist for one person, to see whether aids for bathing such as bath rails and for assisting with putting on a seat belt in a car may be beneficial. The way in which people would like to be supported with their care needs was clearly identified in their care plans. Through observations, surveys and speaking with service users it was confirmed that their privacy was respected. Health care and other associated records confirmed that service users are supported to access routine health care needs to include visits to the chiropodist, optician, health Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: clinic for influenza vaccinations and doctors appointment where required. Their weight is also checked monthly and dental records are on file for checks to be made when necessary. Discussions with the staff and examination of records, provided evidence that people living in the home are supported to keep and manage their own medication with support if required. It was discussed that this support has been increased in one case where the service user appears to be requiring more analgesia at the moment and this is being closely monitored. All staff receive medication training as evidenced by the training records seen and records are kept to indicate the degree of assistance required and what medications each person is taking. The medication policy has been updated since the last inspection and was seen. The AQAA states that both service users are supported with self administration of medication and the home has policies and procedures to meet the requirements and the medication acts. 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. Systems are in place to enable complaints and concerns to be raised by people using the service or on their behalf and to safeguard people from possible harm or abuse. Evidence: A pictorial complaints procedure has now been developed and was seen. There have been no complaints received related to the home since the last inspection but one anonymous complaint was received by the Commission, related to the domiciliary care service, and forwarded to the Provider who carried out a thorough investigation following their complaints procedure, obtaining the views of all the service users and reporting back, demonstrating that when required they follow their complaints procedure satisfactorily. Regular residents meetings are held and from the minutes seen they demonstrated that the views of the people living in the home are listened to and acted upon as much as is reasonably possible. From the staff surveys received they also confirmed that they knew what to do if either service user or their families had any concerns and there were good systems in place to pass on information related to the service users, although one felt that feedback from management could sometimes be improved. Staff spoken with and training records and policies seen provided evidence that staff all received adult protection training and had access to the relevant policies and Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: procedures. The policies on whistle blowing and protection of vulnerable adults have been reviewed and amended in April 2008 and no staff are appointed to work at the home until a check has been made on the Protection of Vulnerable Adults list and a Criminal Records Bureau check has been completed. The AQAA states that they ensure that all service users, family and staff are aware of the complaints procedure and all staff are trained and regularly updated in adult protection. 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. People live in a home that is safe, clean and well maintained and recognises their diverse needs by providing an environment that matches their personal requirements and promotes their comfort and well being. Evidence: The AQAA states that the environment complies with the living requirements detailed in the standards. It is clean and comfortable and service users are able to choose how their rooms are decorated and are involved with decisions about decoration of the communal areas of the home if they wish. Over the last 12 months they have decorated the living and dining room and updated the fire and emergency systems to comply with the latest fire regulations, which includes fitting new fire doors. The kitchen has also been recently redecorated and decoration of the hallway and landing are in progress. All areas seen when visited were clean, bright and comfortably furnished and appeared well maintained. We were invited to see both service users rooms and they were very happy that they had been enabled to choose how their rooms were decorated and furnished. A cleaning schedule was in operation. Just one area was noted as requiring attention. This was to a worn vanity unit in one bedroom, which was being addressed. Care Homes for Adults (18-65 years) Page 21 of 30 Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by a competent and skilled staff team who have access to a training programme which provides staff with knowledge about the diverse needs of people living at the home. Recruitment and selection procedures are also followed to ensure that people who live in the home are being safeguarded from possible harm. Evidence: Both service users were spoken with during the course of the day and confirmed that they were happy living in the home. Prior to this visit they had also both completed surveys where one stated that all the staff treat him well and nicely and the other said he loves living here, its wonderful and is happy to live here because the staff understand him and his needs. During the day whenever one of the service users is at home, a member of staff will be present. Additional staff may be available if required to transport or accompany either person to an activity, social event or health care appointment. Generally it is common practice in a care home for there always to be a member of waking staff or someone sleeping in the home during the night. But this is not the case in this home, as there is a carer sleeping in the adjacent building who can be called if Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: necessary via monitors that are in each persons room. Reportedly they have been called on occasions. It would be expected that risk assessments are in place for night time arrangements in this home specifically as care plans have identified that one person needs help with locking up, to cope with emergencies and has been known to let taps overflow on occasions. It was also noted that this same person does get anxious at times when left in the house alone, although he does have risk assessments suggesting that he can be left alone for several hours. The manager reported following the inspection that there are specific risk assessments for this, which had been seen by the previous inspector and copies are to be provided. She also said that the situation would be monitored continually and changes in the current arrangements would be made if it was felt necessary in the future. The AQAA stated that on application they always issue potential staff with a job description and personal specification and an induction is implemented for all new staff. Over the last 12 months at the previous inspectors suggestion they have changed their application forms and are now documenting notes during interview. Files of three staff who have been appointed since the last inspection were examined on this occasion. All had completed an application form although the career history on these was not always very clear. A new application form has been developed and will hopefully be used in the future. Records have been made at interview but usually on the back of the application form. Again, explanations of gaps in a career history would be clearer written on a specific interview record sheet. Two references had been given but not always from the last employer when someone had worked in a care position previously. All had confirmation of mental and physical fitness and all had a Protection of Vulnerable Adults and Criminal Records Bureau check before they started work at the home. Records of induction, supervision and appraisal were also seen as well as certification for some training completed. The next appraisals are scheduled for January 2009 and the last supervisions completed in October 2008. Staff surveys received stated that they all felt their recruitment and induction were done well and they were satisfied with their training provided and felt that they had the experience and knowledge to meet specific needs. When asked what the home did well they said it had excellent staff and good management generally. It provides lots of opportunities for social integration within the local community, respects service users and their choices and supports them to maintain their independence. One survey said that this is the most professionally committed organisation I have worked for in over 10 years. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Both the newly appointed care coordinator and one new carer were spoken with during this visit and both were happy working in the home and felt that they had settled in well. The care coordinator will be starting NVQ 4 shortly and her new role will include inducting new staff, supervision and possibly recruitment and interviewing potential staff. All staff spoken with during the visit had excellent knowledge of both service users and their needs. The training matrix seen provided evidence of recent training which included medications, COSHH health and safety, food hygiene, moving and handling, alerters training and mental capacity act. First aid training which was cancelled recently will now be held in January. Infection control training was taking place in the home on the morning of the visit. All but one carer and the three new staff have now completed NVQ 2, the care coordinators have either completed or are completing NVQ 3 and one, as stated above is to do NVQ 4 shortly. The AQAA states that over the last 12 months they felt the need to delegate more responsibility to senior staff so that each house coordinator has received supervision training to ensure that they can monitor client and organisational progress. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is competent and experienced, promoting positive outcomes for service users. Effective quality assurance systems are in place involving people who live there. Satisfactory health and safety systems are in place providing a safe environment for both the people who live and work there. Evidence: The manager who achieved the registered managers award in 2003 has worked in a managerial post working with adults with learning disabilities since 1997. Prior to this she worked in less senior roles in the sector. She also has a HNC in Caring Services (managing care). Staff spoken with and the response from surveys received felt that the home was well run, see comments in previous section, and felt well supported generally although one suggested that feedback from management could be improved at times. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The home has a quality assurance programme in place which includes house meetings every two weeks, minutes seen, and questionnaires distributed to family and friends, usually in April each year, results of previous surveys seen and the next one planned may use a version of one provided by the Commission. Health professionals, such as doctors and dentists have also been sent surveys but results of these were not seen. A range of environmental risk assessments were seen in the care files to include road safety and hot water temperatures when bathing. A safety assessment checklist is completed regularly and hazard date sheets were seen on file. Since the last inspection a fire safety check has been carried out and fire and emergency systems have been updated. Fire training is given each year and residents are to be included . Risk assessments and evacuation procedures are in place for each home and fire safety notices have now been produced in visual format. All service and maintenance checks are completed and records were seen to confirm this although it was reported that there was no certificate yet for the Portable Appliance testing completed in October this year. Fridge and freezer temperatures and hot water temperatures are monitored and records are kept. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 34 Ensure that procedures related to service users finances in the text are followed and full and complete records kept. Ensure that through good record keeping a full career history is explored at interview and that wherever possible and relevant a reference from the last care establishment is given. Conduct a risk assessment in respect of the arrangements for night time support/cover, as discussed in Outcome Area 7. 3 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. Care Homes for Adults (18-65 years) Page 30 of 30 - 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. 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