Inspection on 02/12/08 for RNID

This inspection was carried out on 2nd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

RNID 20/02/07

RNID 22/02/06

RNID 20/09/05

RNID 27/01/05

RNID 09/09/04

Similar services:

Foxley Lane (121a)

Avenues (The) (Neave Crescent)

Banstead Road South (21)

Rela Goldhill Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: RNID 113 Brondesbury Road Kilburn London NW6 6RY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Lawrence     Date: 0 3 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.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: RNID 113 Brondesbury Road Kilburn London NW6 6RY 02073288540 02083728965 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): RNID Care Services Name of registered manager (if applicable) Anthonia Adamma Oguh Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 sensory impairment Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following categories: Sensory Impairment - Code SI Date of last inspection Brief description of the care home 113 Brondesbury Road is a care home run by the RNID and provides support and accommodation for six residents who are hearing impaired, some with additional sensory impairments. Family Housing Mosaic owns the property. The staff are also trained to support additional needs that include visual impairment, mental health issues, mild physical disabilities and learning disabilities. The house is located in Kilburn and is close to local shops, tube and bus routes. The house is a modernised semi detached property in a quiet residential area. The accommodation is on three floors with the communal rooms being on the ground floor. There is no wheelchair Care Homes for Adults (18-65 years) Page 4 of 29 care home 6 Over 65 0 6 Brief description of the care home access. There are six single rooms with bathroom and toilet facilities on each floor. There is a small well-kept garden to the rear of the house with a patio area and barbecue for the residents use. Parking is limited. Residents are funded by the Local Authorities based in London and the Home Counties from where the residents originated. The weekly fee for the home is £1,150. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection of the home took place on Tuesday 2nd and Wednesday 3rd December 2008. We reviewed outcomes for residents against the National Minimum Standards for Care Homes for Adults. We did this by spending time talking to the homes manager and staff, checking care records and seeing all communal parts of the home. An expert by experience was invited to take part in this inspection and visited the home on Wednesday 3rd December with the Inspector. An expert by experience is a person who has a shared experience of using services who can help the Inspector to get a better view of what it is like to live in the care home. The expert by experience came with a British Sign Language interpreter and they spent two hours talking with four of the five people who lived at Brondesbury Road. Key parts of the report completed by the expert by experience will be used as evidence to Care Homes for Adults (18-65 years) Page 6 of 29 support the judgements in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may want to live in the home can be sure that they will be given information about the services provided, in a format that is easy for them to understand. People will be supported to make an informed choice to move into the home. Evidence: Service users interested in coming to live at Brondesbury Road undergo a full assessment prior to admission and potential risks are identified. Visits are encouraged to meet service users and staff. Prospective service users also have the opportunity to have overnight stays so they can see what is on offer at different times of the day. This also enables us to assess their individual needs in our environment. Families and other interested parties are also welcome to visit. Extract from the providers Annual Quality Assurance Assessments (AQAA). During this visit the Manager told us that the RIND had produced information about the home in an easy read format to make the information more accessible to some Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: potential residents. The RIND had also produced a British Sign Language DVD with information about the services provided in the home. One person who lived in the home returned a confidential questionnaire we sent to them as part of this inspection. They said that they had been asked if they wanted to move into the home and they had enough information to help them decide whether or not to move in. We saw that the home and the provider had clear procedures for the referral and admission of new residents and these were known to the Manager and staff. We checked the care plan files for three of the five people living in the home and saw that one person had recently had a full care needs assessment completed by a local authority social worker as part of his annual review. We also saw that all three people had signed a Licence Agreement and had been given a statement of the terms and conditions of residence as part of the admission process. when they moved into the home. The expert by experience spoke with four people living in the home. All four people said that they were pleased or very pleased with the services provided in 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. People living in the home know that their care needs will be assessed, recorded and regularly reviewed. Staff work with residents to identify, agree and meet specific goals. Assessments are regularly reviewed to make sure that risks to residents are minimised. Evidence: All service users have an individual plan of care and service users are involved in their care. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we looked at the care plan files for three people living in the home. We saw clear evidence that two people had worked with their key workers to prepare for and review the care and support they received. One of the plans had been reviewed in September 2008 and the other in November 2008. The third plan had not been reviewed since 2006. We discussed this with staff and the homes Manager. They explained that the persons needs had changed little and the local authority Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: responsible for funding his placement had not taken part in a planned review. Managers and staff from the home must make sure that each persons care plan is regularly reviewed. This will make sure that staff have up to date information about the persons needs and how they will be met in the home. Staff should also make sure that they sign and date all care records, including care plans and risk assessments. The care plans we saw all included good information about each persons needs and personal goals, as well as an emphasis on what each person was able to do for themselves. One persons plan included a detailed strength and needs assessment that he had completed with support from his key worker. The assessment was very person centred and we saw evidence that the issues and personal goals identified had been used to update the persons care plan. We saw that care plans were used to develop action plans that covered personal care, leisure, culture and religion / faith needs. We also saw from the daily care notes completed by staff working in the home that the resident was being supported to address goals identified in the assessment, care plan and action plan. Daily care notes also gave us evidence that people were being supported and encouraged regularly to make decisions about their daily lives. The expert by experience asked four residents if they had a care plan, did they discuss what goes in their care plan with staff and if they had care plans in a format they could understand? Two people told the expert by experience they had a care plan and understood it. They said they had regular discussions about what goes in it. One resident was not very clear about what a care plan was, even though this was explained to him. During this visit we also saw that staff working in the home also completed assessments to identify and minimise potential risks to residents. We saw that these assessments were detailed, relevant and regularly reviewed. Staff had completed the assessments to consider issues in the home, the local community and specific issues including holidays away from the home. The expert by experience asked four residents do you feel you are treated with dignity and respect and is your privacy safeguarded? All four people said that they are respected, with one resident adding they treat me like an adult. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to take part in appropriate activities that they choose. People are involved in community activities and have contact with relatives, friends and other people. Evidence: I love living at Brondesbury Road. Clients and staff are nice and supportive. I go on social activities, holidays, theatre, cinema, swimming, the gym with other clients and supported by staff which I always enjoy. I want to stay here for more years to come! Comment from a resident. Service users are asked what leisure activities they would like to occur. Monies are budgeted to support service users activities and holidays. Service users attend religious ceremonies at local churches. Service users manage their own finances Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: wherever practical and possible. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we saw that residents leisure interests were well recorded as part of their care plans. We saw that one resident went to a day service twice a week and also went swimming regularly. His leisure interests were well recorded and arrangements had been made to support him to take part in activities he chose. The second person went to an Adult College maths class once a week, the local church every Sunday and a local gym several times a week. We saw that his key worker was also working with him to arrange a computer skills class. The third care plan file we reviewed also showed that the person went to a local day service, a local church and a gym. Entires in daily care notes completed by care staff also showed us that residents were supported to go to a range of leisure activities, including the cinema, theatre and football matches. We saw that the contact details for residents relatives, friends and other significant people were clearly recorded as part of their care plans. Daily care notes showed that residents were able to keep in touch with other people, either independently or with support from staff. Staff told us that, wherever possible, residents were encouraged and supported to cook their own meals. Most people prepared their own breakfast and support was available at lunch times and in the evenings. Daily care notes showed that staff supported people to budget and shop for their own food and help was also provided to maintain and learn cooking skills. The menu book kept by staff showed us that residents were supported to plan and prepare a variety of nutritious meals. The home had an attractive dining room where residents could choose to eat their meals. The expert by experience asked four residents about their interests outside the home. Two people told the expert by experience they currently go to college, with a third going when the college is better equipped. One resident enjoyed the cinema, in particular sci-fi films like Independence Day and Men in Black. Three people go to the local gym as a group and one goes to the pub. Three of the four residents liked shopping, sometimes with key worker support but also without support. This happens once the shopkeeper knows them and can communicate with them more effectively. The fourth resident who is deaf/blind needs higher level support and receives this from his key worker and other residents. He said he was happy with this arrangement. The residents also told the expert by experience they were looking forward to Christmas. I have my decorations ready and I am going to the Christmas carols were two of the comments. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of people living in the home are well assessed and recorded. People are supported to keep appropriate health care appointments and their medication is managed safely by staff. Evidence: My key worker helps me in my day to day activities and listens to all my needs. Comment from a resident. If a service user prefers to self medicate and is safe to do so, support and advice is given. This would be risk assessed before any decision is reached depending upon the potential hazards and whether any control measures can be put in place to reduce any hazards. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we saw that peoples preferences regarding the support and care they received were very well recorded as part of their care plans. Care plans we saw emphasised the importance of maintaining peoples independence, with most people needing prompting from staff to meet their personal care needs. The care plans also Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: included information about peoples preferred routines. We saw clear evidence in peoples care plans that they had been involved in writing the plans and agreeing goals. We also saw that the plans were produced in formats that were easy for residents to understand. We also saw that peoples health care needs were well recorded in their care plans. We saw evidence that people were supported to make and keep appointments with primary and specialist health care services, including mental health services. We saw evidence that staff from the home had completed excellent joint work with one person and other health and social care professionals. This had resulted in significant improvements in the persons mental health and a reduction in the persons use of specialist services. The Manager told us that the home used a Monitored Dosage System (MDS) provided by Boots for all prescribed medication. We saw that medication was securely stored in a lockable metal trolley. The Manager told us that none of the current residents managed his own medication. We checked the medication records for all five people living in the home. These records were up to date and well completed by staff and we saw no errors or omissions. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are cared for safely. Complaints and safeguarding concerns will be dealt with appropriately by staff. Evidence: I have support from my key worker and staff members. Id speak to my key worker and the Manager if I wasnt happy. Comment from a resident. Staff deal with physical and verbal aggression appropriately. Guidelines are written for service users with potential challenging behaviours and all staff are trained in physical intervention to deal with any such incidents. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we saw that the provider had produced information about the homes complaints policy and procedures in formats that were easier for some people to understand. We saw that a version had been produced using symbols and a British Sign Language (BSL) version was also available on DVD for residents to watch. We checked the homes record of complaints and saw that there had been no formal complaints since our last visit. Staff and the Manager told us that most complaints from residents were dealt with informally, either at the weekly house meeting of individually. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Staff also told us that they had completed the RNIDs Safeguarding Adults training as part of their core training. Staff told us that the home had a copy of the local authoritys safeguarding adults policy and procedures for reference. The Manager confirmed that there had been no safeguarding adults investigations or referrals since our last visit. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good standards of private and communal accommodation for residents. Evidence: Brondesbury Road provides a very homely and comfortable environment. All the rooms in the service are up to CSCI minimum standards and the service users are involved in decorating their own rooms. They choose their colour schemes and can have what furniture they want. The home is bright and spacious and is free from offensive odours. Extract from the providers Annual Quality Assurance Assessment (AQAA). 113 Brondesbury Road is a modernised, semi-detached house on a residential road in Kilburn. Communal areas are on the ground floor. There is a lounge, kitchen / dining room, office, laundry and accessible toilet. There is level access to the ground floor and all rooms on this floor are accessible to people using wheelchairs. There are four residents bedrooms on the first floor and two bedrooms on the second floor. There is a bathroom and separate shower room on the second floor. There is a toilet and shower attached to the ground floor staff office. There are enough bathrooms and toilets for residents use. The home has an accessible garden with patio area and Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: barbecue. During this visit we saw all communal parts of the home and one residents bedroom. We saw that all parts of the home were clean and hygienic when we visited. All parts of the home were well decorated and comfortably furnished. The expert by experience commented the living room was clean with a happy, homely feel and the bathroom was clean. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has enough staff to meet residents care and support needs. Staff are well trained and supported by the manager and the provider. Evidence: The recruitment process for RNID is a very comprehensive process. Staff are carefully screened and references are always checked thoroughly, including criminal records checks. Each member of staff has an annual appraisal and their performance and competencies are assessed. As a result of these appraisals the staff will have training needs identified along with other objectives set to improve their competencies and knowledge. Extract from the providers Annual Quality Assurance Assessment (AQAA). When we arrived for this unannounced visit, the homes Manager was on duty with 5 care staff. We checked the homes staff rota and this accurately recorded the number of staff on duty. We saw that staff worked well together during the two days we spent in the home and residents were supported promptly and efficiently. The staff handover we saw gave staff an opportunity to pass on important information about each person living in the home and their changing care needs. Information in the providers Annual Quality Assurance Assessment showed that all but Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: one of the staff working in the home had completed their National Vocational Qualification (NVQ) Level 2 training. Most staff had then gone on to start or complete their Level 3 qualification training. The two staff files we checked during this visit also showed us that staff had completed core skills training and regular refresher training. The staff files also included all of the pre-employment checks needed to make sure that only people suitable to work with vulnerable adults were employed in the home. These included written references and Criminal Records Bureau (CRB) checks. Staff told us that they had regular supervision with the homes Manager and said they found this helpful. The Manager confirmed that each member of staff had supervision every 6-8 weeks, or more frequently if needed. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed by a person who has the experience and qualifications to manage a registered care home. Care records kept in the home are well maintained and residents are supported safely. Evidence: The home has a quality assurance programme that includes seeking feedback from the service users and other stakeholders. The home is subject to its own internal audit process and the Regional Services Manager carries out monthly Regulation 26 visits. Extract from the providers Annual Quality Assurance Assessment (AQAA). The homes Manager told us that she had been in post for 3 years. She is a qualified social worker and has 13 years experience of social care work with children and adults. She also told us that she is completing her National Vocational Qualification (NVQ) Level 4 Registered Managers Award and a Diploma in Management Studies. We have registered the Manager as a suitable person to run a registered care home for vulnerable adults. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The Manager and staff told us that RNID used an annual quality assurance assessment as part of each residents annual review. We saw copies of these assessments on the three case files we checked as part of this inspection. This was good evidence that residents were consulted about the ways they were supported. Staff also told us that a weekly house meeting was held to discuss the day to day running of the home and any issues that residents to bring up. The Manager completed and returned the Annual Quality Assurance Assessment (AQAA) we sent to her a s part of this inspection. Information from the AQAA showed us that RNID had developed all of the policies and procedures needed to meet the National Minimum Standards and these were reviewed regularly. During this visit we checked a selection of records kept in the home, including residents care plans and risk assessments, daily care notes and medication records. We saw that all of the records were up to date and well completed by staff and standards of record keeping in the home were good. We saw that a fire safety risk assessment had been completed in October 2008. We also saw that other health and safety checks were carried out regularly and recorded. The Manager confirmed that RNIDs Regional Services Manager visited the home each month to carry out a monitoring visit. We saw that written reports were sent to the home after each visit, detailing issues discussed and actions agreed. We also saw that the visits included time spent talking with residents to get their views on the services they received. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The care and support provided to each person living in the home must be reviewed regularly. This will make sure that staff have up to date information about each persons care needs and how they will be met in the home. 27/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Staff should make sure that all care records, including care plans and risk assessments, are signed and dated to show that they have been regularly reviewed. 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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