Inspection on 09/10/08 for The Walled Garden

This inspection was carried out on 9th October 2008.

CSCI found this care home to be providing an Excellent 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

The Walled Garden 31/10/06

The Walled Garden 01/12/05

The Walled Garden 09/05/05

The Walled Garden 06/12/04

The Walled Garden 15/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Walled Garden Calcot Grange, Mill Lane Reading Berkshire RG31 7RS     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: Kerry Kingston     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 27 Information about the care home Name of care home: Address: The Walled Garden Calcot Grange, Mill Lane Reading Berkshire RG31 7RS 01189451712 Telephone number: Fax number: Email address: Provider web address: walledgarden@btconnect.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Cate Lovelock Type of registration: Number of places registered: Residential Community Care Limited care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The Walled Garden is a residential care home offering twenty-four hour personal care to ten adults of both sexes who have learning and associated behavioural difficulties. The home is a two-storey building and has a single storey extension built on the side of the house. The home is situated in a quiet residential area approximately five miles from Reading Town Centre. There are local facilities within walking distance of the home. The home has its own vehicle and service users are able to access public transport, as appropriate. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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 last Key Inspection of this service took place on the 31st October 2006. The current fees are 88,647 Pounds to 199,687 Pounds per annum. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 11.00 and and 5.00 pm on the the 9th of October 2008. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the service manager. Surveys were sent to the people who are supported by the service and other interested parties. Discussions with the manager and three members of staff took place. Care Homes for Adults (18-65 years) Page 5 of 27 Some people who use the service have difficulty communicating with people who do not know them so observation of people and their interactions with staff took place during the visit to the home, two people who use the service were also spoken to. Any information collected by the Commission for Social care Inspection, since the last inspection has also been included in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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. That the home ensures that it assesses peoples needs, that they are inolved in the assessment and it is able to meet the identified needs. Evidence: The last admission was on the 6th Novemeber 2006. The home has a flexible admissions procedure which changes with needs of the idividual. There is a pictorial placement agreement, with pictures and signs having been developed to allow people as much opportunity as possible to understand its content. The individual has an introductory programme of visits, which are designed to meet their needs. The needs and views of the other people who live in the home are carefully considered before an admission takes place. People are fully assessed by care managers and the home. The home complete an assessment which includes all areas of care, social needs and emotional well being, this acts as a baseline for peoples progress or changing needs to be monitored against. Risk assessments are completed prior to admission or shortly thereafter. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: There is also a client profile and an essential lifestyle plan that is completed with the individual as soon as possible after admission. Care Homes for Adults (18-65 years) Page 10 of 27 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. The home make sure that people know their assessed and changing needs which are reflected in their care plans. People are encouraged to make as many decisions as they are able about their life and risk assessments support people to as much Independence as possible. Evidence: Care plans for four people were seen, all care plans are detailed and include peoples cultural, physical, emotional and religious needs. Care plans are totally individual and meet any diversity or equality needs. They include all areas of the persons life and goals and goal plans which can be easily monitored for development and necessary change. Care plans include an essential Lifestyle Plan , which states what people do on a day to day basis, their preferences, likes and dislikes and how staff support them with their chosen lifestyle. The areas of support include, personal needs, physical ability, sensory needs, social relationships, communication and co-operating with others. All care plans seen had been formally reviewed every six months or more often Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: if needed, care plans are updated after the review has taken place. Key workers have a monthly meeting with the people who use the service to discuss their care plans, progress and or concerns. There is a monthly progress report and goal plan review charts, always completed with the person. The monthly progress charts note things I want to continue, what Id like to change and what things are like for me. The home has bi-monthly forums at which staff discuss with the people who use the service any new policies, procedures or general issues or changes that are to take place. They are also used to remind people of existing policies such as complaints, safeguarding and recruitment. Members of the forum have also helped to develop the 23 policies and procedures that they consider to be of interest, into service user friendly formats that is, pictures and signs or simple language. Monthly resident meetings are held, where people discuss the more day to day issues of the home such as people making too much noise, menus and outings and activities. People have a written agreement of limitations of freedom of choice, liberty of movement and decision making, they sign this agreement or it is indicated that it has been explained to them. Some freedoms and decision making opportunities are limited by peoples difficulties in controlling some behaviours , the manager and staff team are very aware of and knowledgeable about the effect of the Mental Capacity Act on their day to day work. Advocates are used in the home when possible, but advocacy services do not have the resources to respond to requests from people. The people who use the service have comprehensive risk assessments which encourage Independence in as safe a way as possible. Each individual has risk assessments , appropriate to their individual needs such as community presence, travelling in vehicles, going to church and performing household tasks. Those seen were up-to-date and ammended as necessary when any changes occurred. Care Homes for Adults (18-65 years) Page 12 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enable people to be involved in a variety of interesting activities that include being part of the community. They are encouraged to keep in contact with family and friends and their rights and responsibilities are fully respected. The home provide a varied and interesting diet and people are encouraged to be as involved as possible in choice and production of the food they eat. Evidence: The essential lifestyle plans include day care profiles these include literacy, numeracy, sensory, relaxation, art, music, sport, cookery and household tasks. Goals for one person included activities such as swimming and trampolining. The day activities enhance the programmes for development for individuals such as physical activities for those who need to be aware of weight issues, for their health. One person has Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: achieved a certificate in Food Hygiene and another person is working towards it, residents join with any staff training that is appropriate for them. Peoples day care programmes are varied to meet their diverse needs People choose activity programmes but are encouraged to attend appropriate ones, especially if they have motivation issues. People have good access to the community and risk assessments ensure people have equal access whatever their special needs,for instance wrist bands are used for two people , who would not be safe to be out in the community without them. One person is supported to attend church, and people visit pubs and other local facilities. Everyone has an annual holiday if they choose, some people have long weekends or day trips depending on their needs and choices. The provider fully finances the holidays and trips. One survey said I can fish and walk and ride my bike, another said I like my daycare. On the day of the visit one person said I have lots to do, another said there is plenty to do, I have lots of activities and another described a trip they are about to take, that they chose and were helped to plan. Contact with families is encouraged and the home have positive relationships with most of the families and friends of the people who live there. Some people go to stay with families on a regular basis. The type of contact with families is noted in peoples notes and important family dates such as birthdays and anniversaries are also noted, people are helped to keep in contact, as is appropriate. The home has a service user charter which includes giving people a quality of life with respect for their individuality, Independence and choices, confidentiality and privacy and safeguards from discrimination. It also includes the responsibilities of the people who live in the service and what is expected of them. People choose their menus at the monthly meetings and some people help with the preparation and production of the meals. The kitchen has been refurbished to make it more service user friendly and the colours and style were chosen by the people who live there. People have weight charts, if appropriate and the home is aware of any nutritional needs of people . Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home works hard to ensure that they meet the needs of the people who use the service, in the way they they prefer. Peoples emotional and physical needs are very effectively met and medication is administered safely. Evidence: Care plans include peoples preferences and individual needs and choices. Monthly reviews completed with the key worker include what Id like to change. The home also has the service user charter which sets out peoples rights and the care they should receive. People were seen being treated with respect and dignity and staff had a good knowledge of people and how their care should be delivered. One persons preference is for same sex care, with the allocated carers identified by wearing clothes of a particular colour. People have a health Action Plan, which describes the health needs of the individual, it also includes health care notes and any charts needed to monitor ongoing health such as weight. The people choose their own G.P and currently all use the same Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: surgery. The home has a good relationship with the surgery and at a recent change of G.P residents were taken to meet him, so they knew him prior to a medical appointment. A survey received from a health professional said, they are good quality staff and have a very caring and professional approach. The home have a detailed protocol for the use of Epi-pens which are signed by the G.P (a recommendation made at the last inspection visit). The home seeks advice from psychologists, psychiatrists, community nurses and any other health care specialists, as is necessary. The home works closely with the Community Team for People with Learning Disabilities to support peoples behavioural and emotional needs. People have detailed, behavioural guidelines, as necessary. The home often write the guidelines that are then approved by the C.T.P.L.D professionals. Peoples care plans are reviewed quickly if there are any issues about their health or emotional well being. The home use the Boots Monitored Dosage system to administer medication, the pharmacist visits the home once a year to ensure they are administering correctly and are always available to offer help and advice, as necessary. The last medication audit was in November 2007 and no issues were noted by the pharmacist. Staff do not administer medication unless they are trained, and judged as competent, to do so. Individuals are risk assessed and the home is able to put a programme in place to support people to self administer if it is safe and appropriate. No medication errors have been reported in the last year and the medication storage was seen to be secure. The home uses medication prescribed to be taken as necessary to support five people to control their behaviour, others use as necessary medication for pain relief. There are detailed guidelines for their use and a senior staff member has to give specific permission. The people involved are aware of the use of the medication and the psychiatrist explains to them why they are taking medications to help with behaviour control, they are reviewed every three months. Care Homes for Adults (18-65 years) Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that peoples views are listened to and acted upon and are protected from all forms of abuse. Evidence: The home has a robust complaints policy that is produced in a variety of formats, which were developed with residents involvement. Surveys noted that people know how to make a complaint and who to talk to if they are not happy. Two people confirmed this on the day of the inspection visit. Some people who use the service would need help to make a complaint and the staff are aware of non-verbal behaviours that may indicate that people are not happy or have a concern. People can also talk about or indicate any concerns they have at the various house meetings that occur regularly or at their monthly key worker review meetings. The home has no recorded complaints in the last twelve months and the manager confirmed that they had not received any. The manager confirmed that there have been no safeguarding concerns about the home, in the past twelve months but they have referred an ex member of staff to the local authority as an activity they had been involved in could have been detrimental to some of the people living in the home. All staff receive safeguarding (Protection of Vulnerable Adults) training during their induction and are further trained during their first few months of service. The home has a pictorial system for people to use to express their feelings if they feel that they are being bullied, bullying and staying safe are topics that are discussed at the bi-monthly resident forums. Staff Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: spoken to were very clear about the Safeguarding procedures and about their responsibilities to protect and keep safe the people they work with. People who use the service have been involved in producing a keeping safe policy for themselves and their house mates. The Commission has received no information relating to complaints or Safeguarding issues. People have their own bank accounts and their benefits are paid into them directly, the care plan notes how much support people need with their finances and how the staff ensure their financial safety. Financial records were not looked at, on this occasion. Some people who use the service, display behaviours that might cause harm or distress to themselves and/or others. The home has detailed behavioural guidelines to ensure that they and others are as protected as possible. The home has a no restraint policy but staff are trained to use de-escalation techniques, restraint is included in the training but would only be used in emergency situations. Incident and accident reports cross reference with records of any restraints used and are carefully reviewed by the manager. Care Homes for Adults (18-65 years) Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensure that they provide a pleasant environment that meets the needs of individuals and the group. It is kept clean and hygienic. Evidence: The home suffered a fire in July 2008 but people have now returned to the home. Some people, who were able to stayed as the home has an extension that was not damaged. Other people were re-homed to places which were considered to meet their needs best, for a short time. The provider ensured that the repairs took as little time as possible, one of the surveys said I like being back at the Walled Garden. The home has been repaired and refurbished to a high standard with a new wet room with adaptations for the person who is visually impaired and a complete redecoration of the house. Peoples private space is adapted to meet any diverse needs they have and reflects their personalities and personal taste. Communal areas have pictures and art work displayed and looks very homely. The home has an extension that allows three people slightly more Independence from Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: those in the main house. One person told me that they really liked their room and chose the colours and furniture for it. The extension is to be officially opened imminently and is to be dedicated to a deceased former resident. The administration office is in the grounds of the home along with a day care building. The garden is well kept and well used by people, when the weather permits, it has two adult swings and plenty of safe space for people. The manager has further plans for developing the available space to make best use of it for the people who use the service, these include a quiet room and re-siting the laundry. The home has good quality laundry equipment and the home was seen to be clean and hygienic throughout. Care Homes for Adults (18-65 years) Page 20 of 27 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. The home have a competent and well trained staff team who are able to meet the complex and diverse needs of the people who live there. The home has a robust recruitment policy to ensure that staff are safe to work with the people who use the service. Evidence: The home has a large staff team of 34, there is a minimum of seven staff per shift between 8am and 10pm and three waking night staff. One person has 1:1 staffing 24 hours per day. There can be up to nine staff on duty if there are special activities or appointments, the management team are not include in the care hours and are therefore additional to the seven. The assistant manager compiles the rotas and ensures that there is a good skill and experience mix of staff. Some staff are allocated to specific people and she ensures that they are able to meet the diversity needs of the individual. Peoples surveys said staff are always there to help me and another said I like the staff they are kind. Staff spoken to were competent and knowledgeable about their role and the needs of the people in their care. Two staff recruitment files were seen and they included all the necessary information to ensure the safety of the staff members. People who use the service are involved in Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the recruitment process, they meet candidates, interact with them and give their views about candidates to the interviewers. They are also involved in the probationary meetings before the staff member is appointed as a permanent staff member. 28 of the 34 staff have N.V.Q. 2 or 3 qualifications or a relevant degree. Staff confirmed that there are fantastic training opportunities provided by the home. Training records showed that what the home considers as mandatory training is up to date, this includes Safeguarding (which is up-dated regularly), infection control, medication, Health and safety, essential skills, Crisis prevention, 1st aid and fire safety. They home was also involved in a pilot project developed by skills for care to help those people who were not confident to do academic work to achieve N.V.Qs. This was done by observation of practical work and was very successful. Staff confirmed that they have regular supervision and appraisal to assist them with their work. Care Homes for Adults (18-65 years) Page 22 of 27 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. The home is very well run and focuses on the needs of the people who live there. There is a robust Quality Assurance process which includes the views and feelings of the people who use the service and assists staff to provide an improving lifestyle for the residents. People are kept as safe as possible by adherence to Health and Safety Policy and procedures Evidence: The management of the home has not changed, the manager is very experienced and has a Registered Managers Award. She is assisted in the management of the home by an assistant manager and a deputy. The manager is actively involved in the day to day activities and operations of the home and is very knowledgeable about the needs of the people in her care. Staff spoken to said they get great support from the management team and it is a good home with an open culture, there is daily access to management and if the staff Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: get things wrong they work to improve it rather than lay any blame. They spoke of offering the people who use the service respect and dignity and as many choices as possible. The manager is in control of the home and has plans for further development to improve the life experiences of the people who use the service. There is a robust Quality Assurance system which includes regular visits by a person on behalf of the provider (regulation 26 visits), a bi-monthly residential forum, resident meetings , staff meetings and questionnaires sent out to all interested parties. An annual development plan is produced when the questionnaires are returned and other information is collated from the various forums where people can air their views. The annual development plan is auditted prior to the next set of questionnaires being sent out. There have been several developments since the last inspection including the building of an extension to allow three people to live more independently, kitchen refurbishment so that people can more easily participate in meal preparation and more availability of training for staff. Other developments planned are the conversion of a room for use as a quiet room and re-siting of the laundry. The home had an environmental Health Visit in April 2008, which resulted in a four star (very good) rating. A fire in July 2008(caused by contractors working in the roof) resulted in a 36 second evacuation and the fire officer complimenting the staff on their actions during this event. The fire evacuation procedure is produced in a pictorial format so that all the people who live there can understand what they need to do. The manager confirmed that all the Health and Safety maintenance schedules are adhered to. Staff receive all the necessary Health and Safety Training which is up-dated at appropriate intervals. The home keeps detailed accident and incident forms that are reviewed by the manager who ensures any necessary action is taken to minimise the risk of recurrence. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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. 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