Inspection on 04/02/09 for 129 Neale Avenue

This inspection was carried out on 4th February 2009.

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

129 Neale Avenue 07/03/07

129 Neale Avenue 07/12/05

129 Neale Avenue 18/01/05

129 Neale Avenue 19/08/04

129 Neale Avenue 17/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sense (Neale Avenue) 129 Neale Avenue Kettering Northants NN16 9HG     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: Ruth Wood     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 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 28 Information about the care home Name of care home: Address: Sense (Neale Avenue) 129 Neale Avenue Kettering Northants NN16 9HG 01536415385 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): debbie.stone@sense.org.uk Sense, The National Deafblind and Rubella Association Name of registered manager (if applicable) Mrs Deborah Joy Stone Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability sensory impairment Additional conditions: Sense (Neale Avenue) care home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 6 Physical disability (PD) 6 Sensory impairment (SI) 6. The maximum number of persons to be accommodated at Sense (Neale Avenue) is 6. Date of last inspection Brief description of the care home As part of the Sense East organisation, 129 Neale Avenue, Kettering provides specialised personal care for up to six people with profound sensory impairment, learning disability, and physical disability. The property, which is leased from East Lindsay Partnership Housing, trading as Linx Homes, has been extensively renovated by the registered provider, and is well Care Homes for Adults (18-65 years) Page 4 of 28 care home 6 Over 65 0 0 0 6 6 6 Brief description of the care home equipped to meet service users physical and sensory needs. 129 Neale Avenue is a two storey building located in a quiet residential street in Kettering, near to the town centre and its amenities. Internally, there are wide corridors and a purpose built lift provides access to the first floor bedrooms. Bedrooms (all single) have specially designed en suite facilities to cater for peoples physical needs. There are two larger bedrooms on the ground floor with en suite facilities that include specialised baths that can be electrically raised and lowered. The communal facilities include a lounge, dining room and a conservatory area used for activities. There is a large enclosed garden to the rear of the property. Fee levels are negotiated individually with placing authorities. Care Homes for Adults (18-65 years) Page 5 of 28 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: The inspection visit took place on a weekday between 13:45 and 18:45. During the visit we spoke with three staff members and observed the practice of a further three. We spoke to staff about their understanding of peoples needs and the training and support they were given to help them meet these. We directly observed staff interaction with the people that live in the home, and watched how they offered support to people during their evening meal. Although the particular disabilities of people living at Neale Avenue mean that we could not speak to them directly, we did spend time interacting with them and observing and responding to their individual methods of communication. Care Homes for Adults (18-65 years) Page 6 of 28 We looked at staff recruitment and training records, medication records and those relating to fire safety. We also looked at two peoples support plans and their daily notes. We spoke to the manager and deputy manager about the systems in place for making sure that the quality of the service is maintained and improved in the home, and looked at the internal audits that the parent organisation, Sense conducts to ensure this. In addition to the inspection visit, this report has been informed by the Annual Quality Assurance Assessment (AQAA) completed by the registered manager. This document, issued by the Commission, asks the service to outline how it has maintained and improved quality in the preceding year. The document also gives us certain statistical information. The Commission also issued five surveys to staff members asking for their experiences of recruitment and training. The responses of the four returned surveys also inform 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 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive assessment ensures that peoples needs and aspirations can be met. Evidence: The Statement of Purpose gives up to date information about the service and a Service Users Guide can be made available to people living, or wishing to live in the home, in their preferred format, such as braille, large print or audio tape. Sense East has a central assessment team, who visit people who wish to live at Neale Avenue in their existing settings, and undertake a comprehensive assessment. This includes discussion with all those currently involved in their support, gathering professionals assessments and direct observation of, and interaction with the person. No new person has come to live at Neale Avenue since the previous key inspection. At that visit we found assessment documents for the most recently admitted person to be comprehensive and detailed. The registered manager had arranged a series of visits to allow the new person and their existing carers to test drive the home before taking Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: the final decision to move in. Quality assurance audits, seen as part of the inspection process indicate that the assessment process remains as comprehensive. Care Homes for Adults (18-65 years) Page 11 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent support plans give staff the information they need to meet peoples needs and help them facilitate people to make choices in their day to day lives. Evidence: The service and its parent organisation have a good track record in focusing on peoples individual communication needs and ensuring that these are utilised and developed, to enable people to play as active a role as possible in making choices about their daily lives. The two support plans we looked at contained detailed communication plans, outlining each persons individual needs. Observation of staff interacting with people living in the home, demonstrated that information in plans is put into practice by staff. One person, able to give a vocal response, was asked to choose which staff member they wanted to help them with their meal. They were also offered choice through showing and pointing as to the kind of drink that they wanted. Staff also communicate by mirroring peoples gestures and facial expressions and observing responses to see if they are happy with their environment, and / or activity. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We spoke with three staff during the inspection and observed the practice of three others. All appeared very well informed about each persons needs and the importance of good recording to ensure that everyone remained well informed. All four staff who responded to the Commissions survey said that up-to-date information about peoples needs was always in the support plan. Exceptionally detailed daily reports are completed for each person living in the home, which list all their activities and achievements, mood; food and drink eaten and the amount and quality of sleep that they have had. One staff member explained that this was important information as it could impact on a persons mood and abilities the following day. Peoples behavioural needs are also detailed in their support plans; SENSE has a specialist consultant who assists the service staff to set up and review plans in this area. Comprehensive, individual risk assessments are in place, for one person these include the use of their mini-trampoline. Staff were observed to treat each person living in the home with respect, taking account of their individual support needs. This atmosphere of respect is continued within documentation, in the language and tone used. For example if a person requires a specific behavioural plan the following disclaimer is given before it is outlined, The essential nature of documents relating to challenging behaviour, may mean that X is not portrayed in a balanced way. The plan advises staff not to let this distort their view of the whole person. Care Homes for Adults (18-65 years) Page 13 of 28 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 have access to vocational and leisure activities, are supported to maintain contact with family and friends and enjoy a good, well-balanced diet Evidence: Each persons food and drink intake is recorded in their daily notes. These show that a varied diet is served, which takes account of peoples likes and dislikes (including the temperature they like their drinks served) and their cultural needs. Support plans give clear guidance on the support that each person requires when eating and drinking, including their optimum posture and position, any special equipment required, the consistency of the food, the pace of the meal and the ways a person will communicate that they are happy (or not) with this. We observed the serving of the evening meal and noted that staff took account of this guidance, giving people individualised support, which was sensitive to their needs and enabled people to enjoy their meal in Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: a relaxed, unhurried manner. People are well supported to maintain contact with their family and friends, again the way that this should be facilitated by staff is outlined, in detail, in peoples support plans. One person, who likes to phone their mother every week is being supported to learn how to text and e-mail them also. One person meets up on a regular basis with their brother for a regular swimming session. All people living at Neale Avenue attend a specialist day facility operated by Sense and have an individual programme of activity, based on their specific needs. As part of this programme one person has recently stated a work experience session. Everyone living at Neale Avenue has the opportunity to go on holiday, with staff support. Last year, two people went to Euro Disney and other people holidayed in this country at a specialist facility that could accommodate their physical needs. Peoples religious and cultural needs are considered; one person is supported to attend temple regularly and the service has focused on celebrating different religious festivals, reflecting the religion and culture of all the people living in the home. Daily reports indicate that people take part in social activities such as going bowling, going to Gateway Club, horse riding and visiting local football matches. Care Homes for Adults (18-65 years) Page 15 of 28 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, medication and personal care needs are well met. Evidence: The majority of staff have received training in the safe administration of medication and their practice has been observed to ensure their competence in this area. Each staff member will have responsibility throughout their shift for the overall support of one or two people, this includes the administration of their medication. This system allows for people to receive their medication at the prescribed time and not at the time of a generic drug round We looked at two peoples Medication Administration Records(MAR), these were completed accurately and we observed that medication was given at the specified time. Some people take medication as required. One staff member spoken with demonstrated a good understanding of the reasons why one person should be given this particular medication, however it is recommended that this information is formally documented to ensure consistency. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The dispensing pharmacist visits Neale Avenue at least twice per year to assess storage and practice, the most recent visit being on 27/11/09. The manager is aware of recent amendments to Regulations relating to the Misuse of Drugs, which mean that the home must have separate storage for controlled medication. This should be a metal cupboard of specified gauge, with a specified double locking mechanism. It should be fixed to a solid wall or a wall that has a steel plate mounted behind it with Rawl or Rag bolts. No controlled medication is currently stored or administered in the home. All health care appointments and contacts are recorded and there was evidence in daily records and support plans that people have access to specialist medical support, such as neurologists and psychologists and dental care. Personal care needs are outlined in peoples support plans and again staff members spoken with demonstrated a good understanding of peoples individual needs. Plans contain information about all aspects of personal care, including mouth care. Some people have specially adapted baths in their rooms and each person has a detailed moving and handling plan, which includes the level of staff and type of equipment to be used. A pressure area care plan is in place for one person who uses an airwave mattress as part of this. It is recommended that the optimum pressure level for this mattress be sought and monitored. A recommendation was made at the previous inspection that staff should be provided with appropriate training as they provide foot care for people. The medical information file now contains information about how to cut toenails and private chiropody has been accessed for one person. Staff have received specific training in other aspects of health care such as epilepsy, including the administration of emergency medication. Care Homes for Adults (18-65 years) Page 17 of 28 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. Good policy and practice ensure that people are protected Evidence: As outlined earlier, great emphasis is placed within the organisation on recognising the various ways that people communicate their feelings, wants and needs. This includes indicators that inform staff when someone is unhappy about something. Therefore although people cannot formally express a complaint, they can make their feelings known, and staff are trained how to recognise their communication. Relatives and other stakeholders are informed of the formal complaints procedure and are surveyed at least annually for their input into how the service is run. Three of the four staff members who responded to the Commissions survey said that they knew what to do if someone had concerns about someone in the home, one person added, the policies are very clear. Staff receive training in crisis prevention and intervention and in managing challenging behaviour. As part of their induction, staff receive training in the protection of vulnerable adults and complete a questionnaire annually, to update their knowledge. Information in the home on protecting vulnerable adults issued by Northamptonshire County Council is dated 2001. It is recommended that the council is contacted for more up to date information in this area (now called safeguarding) and to see if any training delivered by the local authority would be available to the manager and the Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: staff team. A specific system is in place to convene best interests meetings to determine a persons capacity in relation to a specific choice or about a particular element of their care. The process in relation to one of the people whose care we looked at was fully documented and involved consultation with all those involved with the person, including their parents. We looked at the systems in place for managing peoples monies; these are regularly audited by the parent organisation. All transactions are recorded and receipts kept. The balance of monies checked on the day of the inspection was correct. Three staff members recruitment records were checked. All contained two written references, a Criminal Records Bureau (CRB) check and names had been checked against the Protection of Vulnerable Adults register. Such checks help to make sure that only suitable people work at Neale Avenue. Care Homes for Adults (18-65 years) Page 19 of 28 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 clean, comfortable and well-adapted environment, which meets their needs well. Evidence: We looked at all individual and communal areas of the home. Changes have been made to the decoration of the building to make it more appropriate for deaf blind people. Door frames are darker and contrasting colours have been used on walls and floors. Some peoples bedroom doors have tactile markers. Each persons bedroom reflects their personality and individual needs. Most contain a range of equipment to meet the persons sensory and physical needs, such as specialist beds, chairs, baths and equipment to assist staff to move people safely. All areas of the home were in good repair, clean and fresh smelling. All bathrooms contained gloves and aprons for staff to use when assisting people with personal care and staff records showed that staff had received training in infection control. On arrival it was difficult for us to gain access to the home because the staff members seemed unable to hear the doorbell. This should be looked at to ensure that staff and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: people living in the home know when they have a visitor. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by well-trained, conscientious staff and effective recruitment practices Evidence: Staff were observed to treat people with respect at all times and there was a lot of positive interaction. People living in the home smiled and held out their hands to staff, no negative facial expressions or negative signals were observed from people living in the home in the presence of any staff member. Staffing levels are high, reflecting the complex nature of peoples needs. Staff comments received in response to the Commissions survey included, the staffing level is very good, usually 1-1. One person said that there were always enough staff to meet peoples needs while the remaining three respondents felt that there usually were. Staff were very positive about the training they receive, several during the course of the inspection commented, theres a lot of training! All staff complete a mandatory induction programme over a 12 week period, which covers key areas such as deaf blind awareness, crisis prevention intervention, communication, challenging behaviour Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and protection of vulnerable adults. In their responses to the survey, staff said that their induction had covered what they needed to know and that they continued to receive training relevant to their role, which helped them to meet peoples individual needs. Staff also have the opportunity to undertake National Vocational Qualifications, ten staff have obtained these at level 2 or above. Three recruitment records were checked; each contained a completed application form, evidence of identity, two written references and a Criminal Records Bureau check. Staff files also contained documentary evidence that staff receive regular supervision and appraisal and this was confirmed through direct discussion with staff and responses to the Commissions survey;Supervisions are held regularly. We do get to air our issues and she [the manager] gives us a lot of support, she is very good at this role. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and welfare is promoted and excellent quality monitoring ensures that the service is run in the best interests of the people who live there. Evidence: The registered manager holds a National Vocational Qualification at level 4, the Registered Managers Award and a Certificate in Managing Care from the Open University. She has also undertaken a range of training, delivered by Sense relating to meeting the needs of deaf blind people. The manager can draw on effective support from the wider organisation, such as her line manager and the resources of a specialist in behaviour management. Information available in the homes quality audit, from Regulation 26 visits and directly from staff indicates that the manager promotes an open, positive and inclusive atmosphere, which allows all staff members to actively contribute to ensuring that people receive a high quality service. Staff meetings are held regularly and are generally well attended and staff receive regular supervision and appraisal. Throughout Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the inspection staff were observed to take personal responsibility for their work and ensure that this is carried out to a high standard. Excellent systems are in place for ensuring the ongoing quality of the service and making sure that peoples needs and choices inform how the home is run. Discussions at staff meetings reflect that staff closely observe peoples responses to changes in routine and make suggestions for improving their experiences. This has included ensuring a better variety of food in packed lunches and a wider range of holiday opportunities for people. An annual audit takes place which includes surveying all relatives, staff and stakeholders such as GPs and funders. The results of this audit are analysed and targets are set for any changes or improvements to the service, which are reviewed after 6 months. All financial systems are also independently audited, this includes those in place to manage the monies of people living in the home. Good systems are in place to ensure that peoples health and safety is promoted and protected. All staff receive training in fire safety, food hygiene, first aid, moving and handling and control of substances hazardous to health (COSH) as part of their induction programme and this training is regularly updated. The fire risk assessment was reviewed on 11/12/08 and gives comprehensive information about the appropriate response to a fire in respect of each person living in the home. A disaster plan covering, gas leaks, power cuts, flooding and problems with the water supply is also available. Staff confirmed that they have access to an on-duty manager at all times if they need support or advice in relation to any concern. Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 20 13 Secure storage must be put 30/04/2009 in place for controlled drugs. To meet the requirements of the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 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 19 The optimum pressure for the airwave mattress should be obtained. The mattress should then be monitored to make sure the optimum pressure is maintained. Information as to under what circumstances people should be given as required medication should be placed on their support plan and in the medication administration record, together with the details of the prescribing medical practitioner and the arrangements in place for the medications review. The registered person should contact Northamptonshire County Council to update information on safeguarding vulnerable adults, and to access any training that they provide in this area. 2 20 3 23 Care Homes for Adults (18-65 years) Page 27 of 28 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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