Inspection on 22/12/08 for Montbelle Road, 88

This inspection was carried out on 22nd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Montbelle Road, 88 02/01/07

Montbelle Road, 88 09/11/05

Montbelle Road, 88 04/05/05

Montbelle Road, 88 04/11/04

Montbelle Road, 88 25/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Montbelle Road, 88 88 Montbelle Road New Eltham London SE9 3NY     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: David Lacey     Date: 2 2 1 2 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 © (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 29 Information about the care home Name of care home: Address: Montbelle Road, 88 88 Montbelle Road New Eltham London SE9 3NY 02088515999 H/O02082971207 Janw@Plusservices.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: PLUS (Providence & Linc United Services) care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 5 he registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Montbelle is an extended, semi-detached house in a quiet residential street in New Eltham. The home caters for up to five younger adults with mild to moderate learning disabilities. The residents have their own bedrooms, furnished and decorated to their own tastes, and use of communal facilities that include a lounge/diner, kitchen, laundry room, conservatory (which doubles as a staff office) and a large garden. There is a toilet and bathroom on the first floor, a shower room and toilet and a separate toilet on the ground floor. There is unrestricted parking in the road at the front of the house, and close by are bus routes to Catford, Bromley or Lewisham. Residents are supported to live as independently as possible. There is a manager, deputy manager and up to six support workers, and there is 24-hour cover in the Home. At the time of Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home our inspection in December 2008, the provider was reviewing the fee levels. Please contact the provider for information about the current level of fees charged. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included an unannounced visit to Montbelle. The inspector met with the three residents who were in the home on the day of the inspection, and with the deputy manager and members of staff on duty. The inspector toured the premises and the residents who were in the home showed him their rooms. Documentation was sampled for inspection, such as care plans, medication records, and policies and procedures. Information from the homes Annual Quality Assurance Assessment (AQAA) has been used to inform the inspection process. This self-assessment document focuses on how outcomes are being met for people using the service. Care Homes for Adults (18-65 years) Page 6 of 29 At the time of writing this report, the inspector was waiting to receive responses to our survey of residents and relatives. There have not been any changes to the homes registration details since the previous inspection. The last inspection of this service was completed on 02/01/2007. 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. Care Homes for Adults (18-65 years) Page 8 of 29 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 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 10 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 have their needs assessed, to ensure the home can meet them. Residents are provided with written terms and conditions for their placement at the home. Evidence: Although no new residents had been admitted to the home, it was evident that the current residents had each received full needs assessments before they had been offered admission. Each of the residents had an individual written contract or statement of terms and conditions with the home. 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. Residents are encouraged to be involved in planning and reviewing their care. Care plans are comprehensive and reviewed regularly. Residents make decisions about their life in the home, and are supported to maintain their independence. Evidence: Three residents care plans were sampled for inspection. Care plans had been drawn up based on comprehensive assessment of each of these residents needs. This had been done with the involvement of the residents whenever possible. There were risk assessment and risk management plans in place, and advice had been obtained from other professionals such as the psychiatrist or the speech and language therapist. There was evidence in those plans sampled to show that planned support activities had been carried out. Each resident is allocated a key worker, to enhance the level of service provided. The home aims to balance residents needs for independence and the need for them to Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: be safe. Independence is promoted wherever possible. Any restrictions placed are few and are for the safety and welfare of residents, for example not leaving the home unaccompanied. Residents are encouraged to make decisions wherever possible in respect of activities, food, domestic tasks, the decor and layout of their rooms, their personal appearance and clothes they choose to wear. People living at Montbelle are involved in all aspects of the running of the home. The menu is worked out between them each day to allow flexibility and a more spontaneous choice rather than planning too far in advance. All residents are encouraged to take part in decisions about the running of the home. It was understood residents have also contributed their views as to the desirable criteria for new staff members, and that one has taken part in staff selection. 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. Engagement by residents in various activities is encouraged. Their rights and responsibilities are recognised in their daily lives. Residents have a varied diet and contribute to decisions about the content of menus. Residents are supported to maintain links with their families and friends. Evidence: People living at the home are supported to have access to a range of training and employment opportunities. Examination of care plans and discussion with residents showed they are encouraged to take up opportunities for personal development and to engage in fulfilling activities. Two residents have employment, one within the PLUS organisation and the other working for a retail company. It was evident that residents are supported to maintain links with family and friends. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: One resident was away from the home visiting family, and the visitors book showed there had been family visitors to the home. Staff members try to promote family contact where this is in the best interests of residents. One of the residents told the inspector about her family, showing him photographs and talking about how she visits them and that they can visit her at Montbelle. A telephone is available for residents to make or receive calls. Residents are enabled to choose their own clothes and hairstyles, when accompanied by staff members on shopping trips. Two residents spoke about how they were able to choose their own decoration and personal items for their own rooms and to choose whether they wish to take part in particular activities. During the inspection, staff were supporting residents to engage in various activities. As it was the Christmas holidays, residents day centres were closed. A resident who has restricted communication is able to make his preferences known. He was relaxed and cheerful with staff and other residents, and was enjoying playing music in his room. Another resident was doing a puzzle game during the morning and later enjoyed playing a board game with a staff member in the afternoon. The home has made sure residents are asked regularly about their satisfaction with the food provided and about their food preferences. The menu showed a good variety of dishes and residents had contributed to the choices being made. Residents said they have enough to eat and drink, and were positive in their comments about the food. The home had a good supply of both fresh and frozen foods. 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. Residents physical and emotional health needs were being met, based on assessment of their needs and with the involvement of the individual resident and their family. Residents receive support from staff flexibly and as far as possible in ways they prefer. Any resident who is assessed as able to self-medicate is supported to do so. Medicines were being safely managed, though the home should aim to make sure two people sign for receipt of medicines and should update the staff signature and initial list. Evidence: Care plans seen showed how personal care needs were to be met. Residents said they were happy with the ways in which staff help them. Daily records were being kept to show the care provided and to record those tasks that residents had undertaken for themselves. Care plans and daily records showed how personal care was provided. Staff spoken with talked with knowledge and confidence about residents individual needs and preferences. Residents were all registered with a GP and were being supported to access health services appropriately. These were provided either in the home or by attendance at local clinics and surgeries. It was evident from discussion and from relevant documentation that a range of professionals contribute to meeting Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: residents health needs, for example, occupational therapists, physiotherapists, speech and language therapists, psychiatrist and dietician. Links are maintained with the community learning disability team to support staff with meeting residents needs. Medication administration was generally well managed. Our previous requirement about medication had been met. One resident is able to manage their own medication and the relevant risk assessment had been carried out. Staff members who administer medication are trained to do so and the training is recorded. The storage of medicines was satisfactory. A sample of residents medication was examined and tallied with those recorded on the medicine sheets. Each resident had a list of homely remedies, which had been reviewed and signed by the homes GP in March 2008. Each residents file had information about what their medication is for and about the possible side effects and contraindications. Monitoring reports dated August 2007 and May 2008 from a local Primary Care Trust about the homes medication practices were seen and were both satisfactory. The staff signature list should be updated (see recommendations). Some staff had entered either their initials or their signature but not both. The receipt of medication for a resident had been signed by one person only. It was understood from the deputy manager that sometimes there is only one staff member in the house, for example, if residents are away at their day centres. Nevertheless, it is good practice for two people to check receipt of medication to minimise the chance of errors, and the home should aim for this to happen whenever possible (see recommendations). There were no controlled drugs (CD) in the home on the day of inspection. The home does not have a CD cupboard and the deputy manager was advised that, should the home need to store any CDs in the future, it would need to meet the relevant legislation about storing them. This would necessitate obtaining a CD cupboard in which to store the drugs. This would need to be a metal cupboard of specified gauge, with a specified double locking mechanism, and fixed with either rawl or rag bolts to either a solid wall or a wall that has a steel plate mounted behind it. 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. Residents know who to speak to if they are not happy. Any complaints would be managed in line with the homes complaints procedure. To enhance protection for residents, staff members have completed safeguarding training and know about the homes safeguarding policy and procedure. Evidence: The homes AQAA stated no complaints had been received. A copy of the complaints procedure is displayed in the hallway and a copy is available in the homes service user guide. The deputy manager said that most issues raised are resolved through discussion with residents and/or family members. Residents are given regular opportunities to raise any concerns they may have. A resident said she would speak to a staff member if she was not happy about something. Staff members spoke about the training they had completed in safeguarding adults, showing basic understanding of their alerting responsibilities in this respect. The home has a policy and procedure in relation to this to guide staff. There was friendly and informal interaction between staff and residents during the visit. Residents financial interests are safeguarded. Money held in the home is checked at each handover, and both incoming and outgoing staff members sign the record. Each resident has their own cash box and those who have capacity give consent before Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: these are opened and the money is counted with them. Two residents need more assistance in this area and staff members keep their individual cash boxes in a secure area. Both of these boxes were examined by the inspector and found to be accountable, with amounts tallying both in respect of the ongoing ledger and the amount of cash remaining in the box. Overall, the system appeared to be well organised and to offer clear audit trails. 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. Residents live in a homely, clean and comfortable environment that suits their needs and promotes their independence. Evidence: Residents and staff showed the inspector around the home. Three residents showed him their rooms. Each of them had chosen the decor and had their personal items arranged as they wished. All bedrooms in the home are single occupancy, which offers privacy for the residents. Three bedrooms were assessed against the standards. The carpet in one room was stained and the deputy manager stated this was shortly going to be changed for a laminate floor covering. None of the radiators in the bedrooms were covered, neither was the one in the bathroom, and this is commented on further under standard 42. The home was clean and tidy on the day of the inspection. Soap and towels were available in the bathrooms, toilets and laundry. The kitchen work surfaces were clean and tidy, with utensils and equipment appropriately stored, though repairs and redecoration of the kitchen ceiling needed completion (see requirements). All cleaning materials were locked away. The laundry facilities were working effectively on the day of the visit. These facilities are adequate for the home and are away from food Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: preparation areas. The waste bin in a bathroom was broken and its contents were uncovered. It needed repair or replacement to help ensure good hygiene practice (see requirements). At our previous inspection, we made three requirements to improve specific environmental aspects with regard to the kitchen and bathing facilities, and to the seating in the lounge. It was evident that the home had met those requirements. 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 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 by competent and qualified staff members who receive appropriate training to enable them to meet residents needs. Recruitment practice has been improved. Evidence: The deputy manager was in charge of the home on the day of inspection. She was supported by two care workers. The registered manager was working away from the home at the companys head office. There were four people in residence, though one was out of the home on the day of inspection. Discussion with staff and sampling of staff rotas showed that two staff members are on duty during the day, with one on duty in the early morning and late evening. There is a staff sleep-in arrangement at night. The cultural mix of the staff group reflects that of the homes residents, being a mix of white and black and minority ethnic care workers. As regards gender mix, there are two male residents and, while most of the staff are female, a male care worker was on duty for the afternoon shift on the day of inspection. It was understood the company is a registered training provider with the London Open Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: College Network (LOCN), and is able to deliver all units of the Learning Disability Qualifications (LDQ). All new staff are registered with the LOCN and undergo the induction award within the first six months of their employment. Areas covered include the principles of LD support, the role as a LD worker, health and safety, and protecting people with LD from abuse. Records showed that appropriate training had been provided for staff and was being planned for the future. Staff members who spoke with the inspector were positive about the training opportunities provided, and about how they were able to apply their learning in their work with residents. They said they had completed their induction programmes before starting work in the home. Observations and discussions during the inspection showed there was a good mix of skills and experience among the staff team. The staff on duty showed the necessary skills and attitudes to support the residents effectively, with senior staff giving support to a less experienced member of the team. Staff members were observed to be respectful and caring in the way they interacted with residents. Staff members spoken with on the day of the inspection said they enjoyed their work and that there is a positive atmosphere in the home. The company has been working to improve recruitment practices across all its care homes, including Montbelle. In addition to inspecting documentation, the inspector spoke with the companys human resources manager who confirmed verbally and later in writing that all new staffing appointments are subject to receipt of references, Criminal Records Bureau Disclosure, and health clearance. It became evident that recruitment information for the three staff members selected was satisfactory. Personnel information is held centrally at the companys office and is available for inspection. The company uses a combined staff information form that lists all the recruitment information. Although not all information was available in the home, the HR manager was able to supply evidence that it had been obtained. The home had complied with a repeated requirement made at our last inspection about shortfalls in relation to recruitment documentation. Staff recruitment and selection is carried out in accordance with equal opportunities and with the involvement of residents representatives. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be assured that the commission has judged the manager as fit to manage the home. Residents benefit from a well run home, are involved in how it is run and contribute their views towards this. The provider is monitoring the quality of services, seeking views of residents and staff. Generally, residents health and safety is promoted but one specific improvement is needed. Evidence: The manager is registered with the commission and holds relevant management qualifications in health and social care. She has worked in the home since it opened. The home is organised well and staff appeared to work well as a team. Staff members spoken with during the inspection stated the manager is approachable and supportive, and that they would not hesitate to discuss any matters with her. It was noted the provider had decided not to act on our previous recommendation to make sure the home has adequate IT support for the manager. It was not clear how this benefits residents, as it means the manager spends less time in the home and also Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: they do not have access to such technology in the home. On the day of the inspection visit, the manager was away from the home working at the companys office. When questioned during a subsequent phone conversation, the manager said she needs to spend at least two days each week away from the home working at the office as there is no suitable computer or internet facility at the home so she has to go to the office to complete paperwork. The homes deputy manager provides management cover in her absence. It was evident that the provider had made monthly visits to the home to monitor the quality of services provided. Our previous requirement in this respect had been met. Copies of the providers reports of these visits were available in the home for inspection, and showed the visits had included consultation with residents and with staff. The home aims to promote the health, safety and welfare of its residents, staff and visitors. Health and safety checklists are completed regularly, with the most recent being undertaken in October 2008. An environmental food safety inspection by the local council in October 2008 had been satisfactory. The implementation of fire drills, alarm tests and checking of fire prevention equipment was recorded and up to date. The home had met our previous requirement to repair the fire call point in the conservatory area. Evidence was available that routine servicing and testing had taken place on the electric, gas and water systems. Evidence available on the day of inspection showed the testing of portable appliances had last been undertaken in May 2007, despite the homes fire risk assessment stating this would be done annually (see requirements). However, the homes manager subsequently provided the commission with evidence to show this testing had been repeated in June 2008. As noted in the Environment section of this report, none of the radiators in the bedrooms were covered, neither was the one in the bathroom. There were no individual risk assessments available to underpin the decisions to leave the various radiators unprotected, and the deputy manager was advised this process needs to be completed (see requirements). Care Homes for Adults (18-65 years) Page 25 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 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 16 The registered person must ensure the broken bin in the bathroom is repaired or replaced. To help ensure good hygiene practice. 31/01/2009 2 30 23 The registered person must ensure repairs and redecoration to part of the kitchen ceiling are completed. To help ensure good hygiene practice. 31/01/2009 3 42 13 The registered person must ensure individual risk assessments are carried out with regard to leaving radiators uncovered. To help ensure residents safety. 31/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 27 of 29 No. Refer to Standard Good Practice Recommendations 1 20 The registered person should ensure that two staff members sign for the receipt of medicines whenever possible. The registered person should ensure the list of staff signatures and initials is updated. 2 20 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 © (2009) Commission for Social Care Inspection (CSCI). 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