Inspection on 12/02/09 for The Meath Epilepsy Trust

This inspection was carried out on 12th February 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

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Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Meath Epilepsy Trust Westbrook Road Godalming Surrey GU7 2QH     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: Mavis Clahar     Date: 1 2 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 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: The Meath Epilepsy Trust Westbrook Road Godalming Surrey GU7 2QH 01483415095 01483414101 gordonh@meath.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Meath Epilepsy Trust care home 64 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: 64 64 The maximum number of service users to be accommodated is 64. The registered person may provide the following categories of service only: Care Home only - (PC) to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (PD) Learning disability over 65 years of age (LD(E)) Physical disability over 65 years of age (PD(E)) Date of last inspection Brief description of the care home The Meath Epilepsy Trust provide are and accommodation for up to 64 individuals with either learning disability or physical disability or both. The Charity has been changed from the meath to The meath Epilepsy Trust and the providers from The meath Home management Committee to The meath Trustee Company Limited. The Meath Epilepsy Trust is situated in Godalming, Surrey with easy access to public amenities in the nearby Town centre and public transport, the railway station within easy walking distance for able bobied people. Accommodation at this home is provided Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home in several units compromising of an office, communal area, kitchen, bathrooms, toilets, showers laundry facilities and some bedrooms have tracking device installed. Wheel chair users can be accommodated. The home is spread out on three floors which are accessed via the stairs or passenger lift. The Meath Epilepsy Trust is set in extensive grounds with mature trees and is well maintained, secure and accessable to service users. There is also a private car park available for visitors to the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This is the first Key Inspection of the service since the new registration when the name of the service was changed from The Meath to The Meath Epilepsy Trust and the Providers from The Meath Home management Committee to The Meath Trustee Company Limited in March 2007. Fees at this home are in the range of 850 pounds to 1180.76 pounds per week. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection,(CSCI) was undertaken by Mrs Mavis Clahar on the 12th February 2009 and lasted for seven hours and thirty minutes commencing at 09:47 hours and concluding at 17:15 hours. The registered manager Care Homes for Adults (18-65 years) Page 6 of 29 Mr Gordon Hennessy was away from the home and the deputy manager assisted the inspector on this visit. The Commission for Social Care inspection (CSCI) Inspecting for better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps CSCI (us) to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CSCI(us) and is referred to throughout the report. The registered manager of the home is a registered nurse with many years experience in nursing and managing care of of people with learning disability and special needs. He articulates his responsibilities for the clinical guidance and supervision of all staff and for the Pre assessment of proposed service users wishing to enter the home. The assessment team includes another registered nurse with special expertise in Epilepsy care. The first part of the inspection was spent in discussion with the deputy manager, when an outline of how this visit would be conducted was discussed and agreed. A partial tour of the home and gardens was conducted. Each service user bedroom is personalised by the service user to suit their likes and taste. Generally the home is clean and tidy. The home has a good size garden, with easy access by the service users. Time was spent reviewing service users care notes and sampling carer workers records, which were not all up to date. The information contained in this report is gathered mainly from, service users notes and records kept by the home, along with observations of the interactions of various service users and their carers, discussions with some service users and with care workers present on the day of the visit. Also from information contained within the ten completed service users surveys, four staff surveys and one professional visiting the home on a regular basis. No requirement was made on this visit but recommendations of good practise were discussed and are entered in the main text of the report.The final part of the visit was spent giving feedback to the deputy manager about the findings of the visit. The inspector would like to thank the service users and staff and visiting professionals who spent time completing the pre inspection questionnaires and the service users and staff who spent time speaking with us on the day of the visit. 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 Care Homes for Adults (18-65 years) Page 8 of 29 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions to the home are not made until a full needs assessment has been undertaken to ensure the home can meet the needs of the service user. The assessment is conducted professionally and sensitively and involves the service user and their family or representative. Evidence: Initial assessment carried out by Referrals and admissions co-ordinator who is also a registered nurse specialising in epilepsy care and management. Assessment is managed by visiting the prospective client in their home or school. A copy of social services assessment care plan carried out by the care manager is also obtained. Once funding is agreed the prospective service user is invited to visit the home and transition processes are discussed with the client and their relatives. Full information is then given to the client and relatives about the home. This includes Statement of purpose, terms and condition service users guide, information regarding how the home is being run and the responsibilities of the client should they become a member of the household. A pack containing the arrangements the home has for respecting service Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: users dignity and privacy, service users comments form, information on human rights Act, Mental Capacity Act easy read summary, evacuation policy and rights of those in the homes care and Choices. Care Homes for Adults (18-65 years) Page 12 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. Service users are involved in the review of their care, and agreed changes are documented in their care plans, thereby ensuring all care workers have access to this new information.The home encourages service users to make decisions about their daily lives, and to take risks as part of their independent lifestyles, with assistance from the key worker when necessary. Evidence: Random review of service users files demonstrated that service users assessed needs are documented in the care plans and the reviews demonstrated that changing needs are recorded. Three service users files were reviewed and it was apparent their aspirations and goals were documented with outcomes for each. All service users present during the visit were introduced to the inspector. We are of the opinion that the service users are aware of their likes and dislikes, their goals and aspirations as they were able to discuss quite openly with the inspector different aspects of their week day pursuits. It is obvious from the information contained in the care plans that Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the service users were involved in planning their changing needs, and achieving their personal goals. These young people are grouped according to their potentials, and some go out to work full time, some to college and some work part time and some do not work. All service users are being actively supported by the staff team in achieving this goals. Care workers spoken to say the assessment of needs is carried out consistently, and that the service users and their families are very involved. Full review of care needs is carried out on a yearly basis with the service user, the care manager and the relatives and all present are required to sign the agreed care plans.It was apparent that service users made decisions about their lives. Review of randomly selected service users files during tracking revealed that service users can and have changed their minds about a decision they had made and have decided to do something different on the day. In discussion with the deputy manager, we were told the homes documentation on service users choices is based on Respect, Independence, Community participation and Community presence.In discussion with care workers we were told service users are involved in the care of their home. They told us for the more independent service users lunch menus are not really planned, as they are able to have what they want, but dinner menus are planned on Mondays for the week following which they do the food shopping. The deputy manager told us service users are out of the home every day of the week doing their chosen activities either out in the community, at work or at the day centre attached to the home. Household duties are planned around the service users personal activities and their free time. Review of the service users documents revealed service users are encouraged and supported to take risks to enhance their lifestyles supported by suitable risk assessments in place. Care Homes for Adults (18-65 years) Page 14 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. The service has a strong commitment to enabling service users to develop their skills, including social, emotional, educational, cultural communication and independent living skills. Service users are encouraged and supported to identify their goals, and aspirations and work to achieve them.Service users are able to make choices in accordance with their abilities and are provided with balanced diet in pleasant surroundings and in an unhurried way. Evidence: The observed interactions between care workers and service user was relaxed and friendly creating a warm and friendly homely feeling. Service users are encouraged to live a full life and to partake in age related activities such as going to the pub, having meals out attending college of further education, sports, shopping and going to the cinema. Their religious beliefs are documented and acknowledged. In discussion with Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: service users we were told their spiritual needs are being met by the home in agreement with the service users. Review of service users records and in discussion with care workers it was documented that Service users are encouraged to make friends outside of the home and to keep in touch with their friends and families as they wish. Service users are enabled to entertain their guest in the privacy of their bedroom if they so wish. On the day of the visit there were no visitors to the home. Records also indicated and supported by the AQAA that service users attend college of further education,and enjoy suitable work experiences. The deputy manager told us the home is run on the basis that it is a family home where each member is allocated tasks within their capabilities and sometimes tasks are allocated that will stretch the service user, who is always supported and enabled by their key worker and service users achievements are always acknowledged. Completed risk assessments were observed for service users where it is assessed as necessary to the development of the service user. We were told care workers aided by the service users provide catering service for all at the home. However, we were told that some service users were independent and that they did their own food shopping and prepare their own meals in their unit kitchen .The inspector did not sample the mid-day meal but the service users indicated it was delicious, and the amount was right. We observed Service users are allowed to make drinks as they wish with assistance from their key worker if needed. The deputy manager told us that at their weekly menu-planning meeting they discuss the advantages of healthy diet and aid the service users in making healthy choices. They discuss the meals for the week with each service user encouraged to make at least one choice of main or evening meal. The service users on a weekly basis do food shopping. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Carers understand the principles of giving personal care and support and are responsive to the varied and individual requirements of the service users. They recognise that the delivery of personal care is highly flexible, consistent and reliable ensuring that service users receive personal care and support in the way they prefer; and that their emotional and health needs are met.Some of the service users at this home are assessed as capable to self-administer their medication. For all other service users, staff trained to do so administers medication, thereby service users are being protected by the homes policies and procedures on administration of medication. Evidence: Discussions with the deputy manager, two service users and care worker, indicated each service user received the agreed personal care and support as directed in the care plans. Physical and emotional needs identified in the care plans are also met. The care plans are reviewed on a regular basis, visits to the doctor dentist, and dietitian are carried out on an as required basis. Daily care notes are documented dated and signed by the key worker or other care worker as necessary.We were told service users are offered and encouraged to use their right to choose what to do, when to do Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: it, what clothes they buy and wear. The AQAA informs service users are actively encouraged to be involved in making choices in the way the home is run. Review of randomly selected service user files revealed that some service users at the home are risk assessed as capable to selfadminister their medication. Medication is administered by care workers trained to do so to all other service users needing medication in the home. A review of the medication records demonstrated that medication is being administered within the homes policy and guidelines of administration of medicines. We were told all records of all medication received, administered and returned are kept and are available for review. The service users in this home falls into two categories. Those that are supported to maintain activities of daily living and those who need a carer. For those service users who are assessed as needing support, they go out to work, manage their finance, do their own personal and food shopping and cook their own meals. We were told that this method of care is carried out in order for the service user to gain their independence and to prepare them for living in the community on their own eventually. We did not get the opportunity to speak with any of these service users, but information collated from the pre inspection questionnaires completed by service users and returned to us and from the information contained within the AQAA co confirmed this. 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. The home operates in a manner that supports service users to air their views and concerns, which are acted upon before they can become complaints.Robust safeguarding policies are in place to protect the service users from abuse neglect and self-harm. Evidence: CSCI has not received any complaints about this home since the new registration, and the Annual Quality Assurance Assessment (AQAA) revealed no complaints made to the home since the last inspection. Included in the service users personal folders is the homes complaints policy and service users guide, developed in pictorial and widget symbol format. We were told issues raised by service users are dealt with instantly before they can become complaints. We recommend that a complaints and compliment log is kept by the home identifying issues raised and their outcomes. This must be available for review by the regulatory inspector.Random sample of care workers files and in discussion with the deputy manager and care worker it was evidenced that care workers are being trained to recognise and report any act or suspicion of abuse to service users. Care worker supported this in discussions. The deputy manager informed us the home is in possession of a copy of the Surrey Multi-agency Protection of Vulnerable Adults Scheme dated 2008. In discussion with Care workers they were knowledgeable about Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: whistle blowing and Safeguarding Adults procedures within the home and the need to be respectful of the service users equality and diversity needs. 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 physical layout of the home enables service users to live in a safe, wellmaintained and comfortable environment, which encourages independence. Evidence: The home has a well-maintained environment, and service users are encouraged and enabled to personalise their bedrooms. The home presents as a safe place to live with bedrooms that meet the National Minimum Standards for Younger People.The management has a good infection control policy: they seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the homes policy and procedures to reduce the risks of infection. It was noted in care workers file that they attend regular training sessions on Health and Safety issues. Care workers spoken to were knowledgeable about suitable storage and disposal of waste, and the need to keep all dangerous substances in a locked cupboard to prevent risk of harm to service users. The home which is divided into units each having its own kitchen, dining area and sitting room presents as comfortable with a main kitchen and dining room. All service users have their own bedroom with en-suite facilities. There is a large garden, which is laid mainly to lawn with garden furniture strategically placed for the use of the service Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: users. The atmosphere in the home on the day of the visit was friendly and relaxed with service users volunteering to show us around their home and their bedrooms. 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. Care workers in the home are trained, skilled and in sufficient numbers to support the service users who live at the home, and to support the smooth running of the home.The homes recruitment policy does not fully ensure the safety and welfare of the service users. Evidence: Review of service users care plans indicated their named key worker supports service users. Review of care workers training files indicated the manager encourages and enables carers to undertake external qualifications beyond the basic requirements to enable staff to assist the service users achieve the agreed care and social needs identified. In discussion with the deputy manager we were told the home employs their own trainer, who identifies and fulfil the identified training needs of the care workers. The home keeps an up to date training matrix, which enable management to see at a glance that training has been accessed in a timely fashion. Review of the staff rota indicated that adequate numbers and skill mix of care workers are on duty over any twenty-four hour period to meet the needs of the service users. In discussion with care workers it was verified that normally the home provided training and regular updates for them. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: The AQAA informs the home has a new and improved recruitment policy and procedure, based on their equal opportunities policy that has the needs of the service users at its core, which is adhered to. However, review of randomly selected staff files revealed Schedule 2 paragraph 6 and 8 of the Care Homes Regulations 2001 [amended] were not being followed. Full discussions with the deputy manager and the Human resource person responsible for selection and employment of staff ensued and we were informed these practises would cease immediately. In discussion with care workers they were very pleased to inform us of their strength in caring for service users at this home based on each service users assessed equality and diversity needs. It was noted that all members of staff were recorded as having had an application to the Criminal Record Bureau (CRB). Review of staff files all demonstrated current CRB reports. 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 management and administration of the home is based on openness and respect, has effective equality and diversity and quality assurance systems to ensure service users views are obtained and acted upon.The manager ensures that care workers follow the policies and procedures to maintain the health, safety and welfare of the service users. Evidence: The registered manager was not available for this inspection. The deputy manager who was in charge of the home assisted with the inspection. There is a strong ethos of being open and transparent in all aspects of the running of the home. The home is service user focused and the manager leads and supports a strong staff team who have been trained to a high standard. It was evident from discussion with service users that they were confident their views underpin all self-monitoring, review and development by the home . They told us the manager listens to what they have to say and act on it. They answered questions when asked and they appear to be very confident with a stranger in their home, and even invited us to view their bedrooms Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: and to participate in their activities. We were told that residents and staff meetings were held, and that service users and care workers opinions were listened to and acted upon. Service users are encouraged and supported to make choices even when these choices might involve some degree of risks, for which appropriate risk assessments are completed.Each service user is registered with the local GP practise, which they access as required. Chiropody service and dental service is also accessed as required. Service users have access to the wider primary health care services and the deputy manager said she is aware of whom to contact if the need arises. The manager ensures that at all times the health, welfare and safety of the service user and care staff are promoted and protected by having suitable numbers of trained care workers on duty at all times to meet the assessed needs of the service users. The AQAA informs the home ensures service users rights and choices are respected, diversity and individualism are also respected and maintained throughout the organisation. 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 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 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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