Inspection on 19/01/09 for Tewin Road (1)

This inspection was carried out on 19th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tewin Road (1) 24/01/07

Tewin Road (1) 25/01/06

Tewin Road (1) 02/06/05

Tewin Road (1) 14/03/05

Tewin Road (1) 18/11/04

Tewin Road (1) 11/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 14/03/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tewin Road (1) 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU 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: Jeffrey Orange Date: 1 9 0 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 32 Information about the care home Name of care home: Address: Tewin Road (1) 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU 01442214796 01442244250 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CareTech Community Services Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 6 6 0 0 learning disability physical disability Additional conditions: This home may accommodate 6 people with learning disability or physical disability (when associated with learning disability). Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Tewin Road provides respite care for up to six people with a learning disability and associated physical disabilities. It can also provide day care for up to two people. There are approximately fifty clients that currently use the service, staying for different periods of respite at different frequencies. There are two shared care beds for service users with a physical disability. The building is an ordinary detached two-storey house in a residential neighbourhood, close to parkland. The home has a lounge, dining room, small office, laundry room and kitchen. There are two bedrooms on the ground floor for use the use of shared care clients with physical disabilities and an assisted shower room. There are four bedrooms on the first floor and two bathrooms. Fees at the home are determined on an individual basis following assessment. Copies of the latest report on Tewin Road by the Commission for Social Care Inspection are available in the home. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We last visited Tewin Road in January 2007 when we found that people living there were cared for well. We stared this inspection visit early in the morning and stayed in the home until about lunchtime. This meant that we could meet the people who live in the home as they were getting ready to go out for the day to different places. Some of the people we saw were about to go home after staying at Tewin Road for a few days. Before they went out we spoke to some of the people in the home and saw other people as well. People have sent us surveys telling us what they think about staying at Tewin Road. We have also received surveys filled in by people who work at Tewin Road and from relatives of people who visit Tewin Road. These have all been very helpful and have given us a lot of important information. The manager sent us a long document called an AQAA. This is a self-assessment document that says how well people staying at Tewin Road are being looked after and how things might be able to be made better. It also has some interesting Care Homes for Adults (18-65 years) Page 7 of 32 facts and figures for us to look at. While we were at Tewin Road, we talked to people who work there and to the manager. We walked around the home and looked at the garden to see how well they are looked after. We were able to look at some important paper records about the way the home is run and organised. This included details about how people staying at Tewin Road are helped with any medicines they need to help keep them healthy and to the care plans they may have helped put together. Care Homes for Adults (18-65 years) Page 8 of 32 What the care home does well One person told us; I like coming up here and everyone that sent us surveys told us that they thought Tewin Road provided good care for the people that stay there. When we were visiting, it was calm, pleasant and relaxed and everyone seemed to be getting on with each other very well. We found that people who work in Tewin Road had done the paperwork they have to do very well to make sure that records were correct and up to date. When we talked to people who work in Tewin Road they said Happy staff leads to lack of staff turnover (that means how often staff leave) and that equals happy and relaxed service users ( That is the people who stay at Tewin Road for respite). The manager does a good job looking after the people who stay in Tewin Road for respite and in helping and supporting people who work there. Care Homes for Adults (18-65 years) Page 9 of 32 What has got better from the last inspection The dining room and lounge have been changed around to make it better for people who use them while they are staying at Tewin Road. There has been some decoration done to some bedrooms to make them nicer for people staying at Tewin Road. People who work in Tewin Road have been on training to learn new things and to help them help people staying at the home even better. The manager has made sure that the things we asked her to do after our last visit have been done. Care Homes for Adults (18-65 years) Page 10 of 32 What the care home could do better Some parts of Tewin Road still need painting and looking after better. Care Homes for Adults (18-65 years) Page 11 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Jeffrey Orange 33 Greycoat Street London SW1P 2QF 02079792000 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 12 of 32 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 13 of 32 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 considering Tewin Road for respite care for themselves or someone they are responsible for can be confident that before any admission for respite care there will be a thorough assessment of their individual needs and an appropriate process of introduction to the home to help ensure that only those people whose respite needs can be met fully are admitted for respite care. Evidence: When we looked at the information that the home provides to people considering a period of respite at Tewin Road either for themselves or for someone they are responsible for, we found that it is comprehensive and very specific to their individual needs, for example being available in a number of alternative formats including on a DVD, this helps people to access and understand the information they need to make an informed decision about using Tewin Road for their respite stay. When we discussed the assessment and referral process with the manager and when we received comments from people who have been involved with the process on behalf of themselves or people they are responsible for, we found that it appears thorough and that it now includes three tea visits, which are designed to help people get a feel Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: for the service and to meet other people living or working in the home at that time. This helps them decide if Tewin Road will meet their needs appropriately. The referral process from the local authority who have a block purchase arrangement with the home and the assessment process by the home includes not only the person concerned but also any family and carers or other health and social care professionals involved with their care. This ensures that the process is very much centred on the individual concerned and helps to achieve a joined up approach which supports all those concerned and gives them the best opportunity for a stable and successful outcome. The initial visit process includes an induction for the person concerned, a series of one to one talk times and support sessions and an opportunity to feedback and influence the process of familiarisation with the service. People told us that they usually get enough information about Tewin Road to help them make decisions. We went to see Tewin Road before they started respite there. Care Homes for Adults (18-65 years) Page 15 of 32 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 who receive respite care in Tewin Road can be assured that they will be encouraged and supported to control their own lives to the greatest possible extent. This will be done within an individual framework of risk assessment that ensures that they can do so safely, whilst also recognising the need for them to be able to take reasonable risks. Evidence: When we looked at care plans we found that they included evidence that they are reviewed in a monthly support requirement review and also included records of one to one talk-time sessions between the people living in the home and care staff. Each care plan seen had a risk assessment review log that had been completed at least six monthly. This should mean that any changes in need or risk are identified, with appropriate action taken to ensure that they continue to be met and addressed. We found when we looked at care plans that they were very comprehensive and included a good level of individual, person centred information which should ensure Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: that people receive respite Care in a way that meets their needs taking into account their individual requirements, preferences and goals. On the day we visited, some people were getting ready to return to their homes as their period of respite care ended. I like coming up here was one comment received and when we received survey returns from people who use Tewin Road for respite care, they told us they either always or usually could make decisions about what they do each day, and that they could always or usually do what they want to do during the day,evening and weekend. I like going out one the bus with the staff one told us. When we looked specifically at risk assessments we found that the system of risk assessment in use is focused on expanding and finding opportunities to build confidence and independence, rather than taking an over-cautious and protective view of risks that could prevent people receiving respite care at Tewin Road being able to achieve the greatest degree of independence that they can do safely. The home told us in their AQAA that they have already identified a need to improve some of the homes documentation in order to enhance the ability of those people receiving respite care who cannot read and access all parts of their individual plans to both understand them and also to contribute to them more effectively. Care Homes for Adults (18-65 years) Page 17 of 32 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 using Tewin Road for a period of respite care can be confident that they will be helped to maintain their usual contacts, routines and activities outside of the home as far as that is possible and that the home will also provide appropriate activities for them, however these could perhaps be more frequent and varied. Evidence: When we spoke to people who have periods of respite care in Tewin Road, when we received comments in surveys from the relatives or carers for people who make use of Tewin Road for respite care and when we read the information provided by the home in their AQAA, we found that people using this service are encouraged to invite friends and relatives to maintain contact with them during any period of respite care and that wherever possible they are supported to maintain their regular pattern of activities, such as day care,college or employment where applicable. Its been good one person told us, another indicated that they were going home to Dad. Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: When we observed care during our visit we saw a person being taken through their daily notes and what they would be or had been doing. We were told that each person using the service has a daily diary completed that they then take home with them at the end of each period of respite and included in this are details of any activities taken part in. In their AQAA the home identify a need to provide more activities and to increase the number of drivers so that additional trips could be provided outside the home. One survey returned suggested the home could Try to rely less on television for the clients (sic) and spend some time on other entertainment eg reading, games and cooking. One person who stays regularly at Tewin Road told us that they would like Tewin Road to have a computer to go on to play games and write. We were told that people staying in Tewin Road for respite are encouraged to help with menu selection, shopping and cooking in line with their personal choice so that they retain independence and responsibility appropriately during their time in the home for respite. Care Homes for Adults (18-65 years) Page 19 of 32 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 . People receiving respite care in Tewin Road can be confident that they will be supported to access the health care services they require to maintain their health and well-being and that where the home is responsible for their medication it will be administered safely. Evidence: When we looked at the care plans for people receiving respite care at Tewin Road, we found that they contained an appropriate details as to how, when and where their personal care was to be given. The homes AQAA informed us that all service users have a detailed support plan which identifies any health care support they will need during their respite stay. If any concerns are identified during a period of respite, the home liaise with health and social care professionals and others responsible to ensure that the correct action is taken or referral to specialist services made. This should ensure that no one fails to receive the health care they require through poor communication between the home, agencies or individuals. When we looked at the way that the home records and administers medication for Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: those people having respite care in Tewin Road that do not look after their own medication, we found that it was essentially sound, any records checked were in order, including those to ensure that medication is accurately booked into and out of the home at the start and end of periods of respite care. This suggests that people living in Tewin Road are protected by the medication practises of the home. Where people receiving respite are able to self-medicate, this is recorded and appropriate risk assessments were seen to be in place to ensure that sensitive and discreet monitoring is in place if deemed necessary. Care Homes for Adults (18-65 years) Page 21 of 32 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 who receive respite care at Tewin Road can be confident that they are well protected from actual or potential abuse by staff training and by the way that policies and procedures intended to protect them are enforced and put into practice. Evidence: Those people contacted during this inspection process have all indicated that either they, or those that they are responsible for feel safe and well protected in Tewin Road and that they are aware of how to raise any concerns or complaints that they might have. When we looked at the complaints policy we found that it was easy to understand, was readily accessible and available in different formats, for example a DVD version is kept in the service users information file kept in the home. The home told us in their AQAA that they are also putting the complaints procedure into a specialist pictorial communication format. This should again ensure that everyone can make sense of the complaints process and know what to do if they need to complain. We were told in the homes AQAA that no complaints have been received during the past twelve months. When we received surveys from people responsible for a person using Tewin Road and who had ever had any reason to raise a concern or complaint, they indicated that it had been dealt with promptly and to their satisfaction. Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: When we spoke to care workers they were able to show us that they had a good understanding of what abuse is, what whistle blowing is and what to do if they saw or suspected abuse was taking place.When we saw training records for staff, they included training about the protection of people vulnerable to abuse and the Hertfordshire County Council safeguarding process. When we looked at recruitment files for care workers we found that they contained evidence that the necessary checks had been made to ensure that unsuitable people were not employed to care for people receiving respite care in the home. When we looked at financial records kept by the home in respect of money held on behalf of people staying there for respite, we found that random totals checked agreed with the records and that there was an adequate system of checks and audit in place to protect them. Care Homes for Adults (18-65 years) Page 23 of 32 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 who receive respite care in Tewin Road can be confident that the home will provide a physical environment for them that is essentially clean, hygienic, safe, comfortable and appropriate for their specific needs. The respite care experience for people using Tewin Road would however be further enhanced if existing maintenance issues and routine planned redecoration were given a higher priority and completed quicker. Evidence: When we asked people who receive respite care in Tewin Road if the home is fresh and clean, all who replied told us that it was. One relative, carer or advocate who responded to our survey said that the home would be improved by an update of the house decor and flooring. On the day we visited the home it was clean and tidy, given that there was some decorating being completed and that there were pictures waiting to be hung. The home suffered some structural damage following the Buncefield oil storage explosion and some further cracks have subsequently been found that will need monitoring and attention. We were told that some delay had occurred in carrying out decoration and repairs to the exterior of the property as responsibility between Caretech and other parties had to be established. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: There are some exterior improvements evident such as the new fencing, however there are also areas of rotten wood in doors that could compromise the effective security of the property and the standard of the exterior paintwork is poor in parts, this does not support people receiving respite care as it reflects on the appearance of what is their home for the period of their stay. The home told us in their AQAA that a monthly health and safety audit is carried out in the service, with requirements sent to head office for any outstanding maintenance or renewals. The home have imaginatively swapped the lounge and dining room around, which has improved the layout and practicality of the space available, the lounge and several bedrooms have been redecorated and we were told that this process included people who receive respite care in the home. Because people visit Tewin Road primarily for short respite periods, it is not practical for permanent personalisation of rooms to be achieved, the home has however taken steps to ensure that items such as photographs or special objects of importance for the people concerned can be brought with them to make their space as personal as possible for the period of their stay. Care Homes for Adults (18-65 years) Page 25 of 32 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 . People who receive respite care in Tewin Road can be confident that they will receive care from a well-trained and supported staff team with the skills and experience required to meet their needs. They can also be confident that they are protected by the way that staff are recruited to work in the home. Evidence: They are very nice people was one comment made about the care staff by a person receiving respite care at Tewin Road. When we received comments from people who receive respite care at Tewin Road in the form of pictorial surveys, they all said that staff always treated them well and that staff always or sometimes listen to and act on what they say. The majority of relatives who contacted us were positive about communication with the home and care staff although some reservations were expressed about staff numbers and the process of building familiarity with people who only come for infrequent, short periods of respite care. All of the comments we received, from whatever source were however positive about the overall standard of care and the service provided. One person who expressed some very balanced reservations about the home, nonetheless said They was very contented there, and liked all of the staff and that, above any other is the main thing, if you have peace of mind to leave the person you care for in other peoples care Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: When we spoke to care staff or received comments from them in surveys they were very positive about the training and support they received. The training I receive is very useful in relation to my job, it covers many aspects and is taken on a regular basis with refreshers at intervals. When we looked at training records for care staff, we found that they were detailed and up to date and that in addition to basic training they included specific training appropriate to the people who receive respite care at Tewin Road. The majority of staff have also completed at least level two of the appropriate national vocational qualification (NVQ) and several have more advanced NVQ. All of this shows that Tewin Road gives a high priority to the training of care staff and means that people receiving respite care benefit from receiving care from a skilled and well-trained team of care workers. When we looked at how staff were recruited we found that all the checks required to ensure that people receiving respite care in Tewin Road are cared for by suitable people have been carried out thoroughly. People receiving respite care in Tewin Road benefit considerably from the fact that many of the homes care staff have been with the home for a number of years as this builds consistency and continuity of care which is important to them. On the day of inspection there were adequate numbers of staff on duty to meet the needs of the people living in the home at the time. One person who receives care from Tewin Road noted in their survey, in answer to the question; Can you do what you want at the weekend? Only if the staff could help, most of the time yes, but sometimes busy helping other do what they wanted, and I could not. Some of the staff surveys received raised concerns about the level of staffing if and when the home is at full capacity, although all respondents agreed that the standard of care outcome achieved for people receiving respite care was good. When we spoke to staff and the manager and looked at records of staff supervision we found that this was structured and regular and ensures that care staff are supported to carry out the demanding work that they do, which in turn benefits the people for whom they provide care. Care Homes for Adults (18-65 years) Page 27 of 32 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 . Tewin Road is a well managed home and people who receive respite care there can be confident that their needs, wishes and views are both understood and taken fully into account when decisions about the running of the home, its routines, facilities and operation are being taken. Evidence: When we spoke to the homes manager she was able to demonstrate an excellent understanding of the care needs of people receiving respite care in Tewin Road and had a good understanding of current care issues both locally and nationally. We understand that she has completed her registered managers award and level four NVQ and that she is currently in the process of completing her registration with the CSCI. This is important as it is the way that a persons fitness to manage a registered care service is assessed. Care staff spoken to or surveyed all indicated that they felt well supported by the manager and the supervision and encouragement they receive from her. People receiving respite care will in turn benefit from this positive management and care staff relationship in the home. Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: The homes AQAA informs us that quality assurance is carried out by Caretech on a monthly basis and that action plans are then drawn up as necessary. We saw confirmation of this process during this inspection. As indicated in the responses we received from people receiving respite care in Tewin Road their views are listened to and discussed with them. The AQAA states that these views are then used as a benchmark to work on annual development plans for the home so as to ensure the service enhances the lives of the individuals that use it. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes No 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 30 of 32 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 32 of 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!