Inspection on 04/11/08 for Treetops

This inspection was carried out on 4th November 2008.

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

Treetops 28/11/07

Treetops 14/12/06

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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: Treetops Midshires House 10-12 Church Street Riddings Alfreton Derbyshire DE55 4BX     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: Rose Moffatt     Date: 0 4 1 1 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 28 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 28 Information about the care home Name of care home: Address: Treetops 10-12 Church Street Midshires House Riddings Alfreton Derbyshire DE55 4BX 01773528080 01773528285 karla.treetops@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Karla Jane Brown Type of registration: Number of places registered: Midshires Healthcare Ltd care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Treetops is a service for up to 11 adults with mental disorder, providing accommodation, personal care and support. Treetops is situated on the first floor of Midshires House in the village of Riddings, near Alfreton. Information about the home, including CSCI inspection reports, can be obtained from the registered manager. The fees charged curently range from £348 to £1350 per week. The registered manager said that there was a new basic rate of £900 per week and this would be the fee for any new admissions. The manager provided this information on 20th November 2008. 11 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. The last key inspection of Treetops was on 28th November 2007. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key Care Homes for Adults (18-65 years) Page 5 of 28 inspection or annual service review. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. We carried out an unannounced inspection visit that took place over seven hours on one day. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out ten surveys to people living in the home and received seven completed responses. We sent out ten surveys to staff employed at the home and received five completed responses. There were eleven people accommodated in the home on the day of the inspection visit. People who live in the home and staff were spoken with during the visit. The manager was available and helpful throughout the inspection visit. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. Three people were selected and the quality of the care they received was assessed by speaking to them, observation, reading their records, and talking to staff. The inspector was accompanied by an expert by experience, Mr Brynley Mansell, for part of the inspection visit. An expert by experience is a person who, because of their shared experience of using services, and / or ways of communicating, visits a service with an inspector to help get a picture of what it is like to live in or use the service. The expert by experience spoke to people living in the home about the lifestyle in the home and their views of the service. Information from the findings of the expert by experience has been included in the body of this report. What the care home does well: What has improved since the last inspection? What they could do better: The expert by experience commented, It is clear that education is embraced eagerly by the residents of Treetops but to further stimulate their brains in a safe environment a home based computer connected to the internet would be beneficial to those who are unable or who choose not to attend outside courses. The laundry facilities should be improved so that there are enough domestic washing machines for people to use. At present, people are frustrated with the limited facilities available. Care Homes for Adults (18-65 years) Page 7 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a satisfactory assessment process and good pre-admission support for people so that they were confident their needs could be met at the home. Evidence: We received completed surveys from seven people living in the home. Five people said they were asked if they wanted to move into the home, two said they werent asked, though one of these commented that they could not remember. Six people said they received enough information about the home before they decided to move in, one said they did not. We looked at the records for three people living in the home. Each person had assessment information from social services and/or hospital staff, and also an assessment by the home. The manager of the home had visited one person in hospital several times before admission and the person had visited the home before deciding to live there. The AQAA said that weekly support visits to people prior to admission has proved extremely successful and has facilitated a smooth transition period. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: The AQAA said that assessments are completed within seven days of an enquiry about a place at the home. The home then sends a placement proposal to the purchaser of the service, giving details of what the home can provide to meet the persons needs. Copies of this were seen in care records. People told us their needs were met at the home. One person said they were initially anxious about moving to the home, but Im glad I did it now. We received five completed surveys from staff. They all said that they always had up to date information about the needs of people in the home. Staff spoken with confirmed this. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a focus on individual needs and choices so that people were supported and encouraged to make their own decisions. Evidence: We received completed surveys from seven people in the home. Three people said they always make decisions about what they do each day, three said they sometimes did, and one said they never did. Six people said the staff always treated them well, one said staff sometimes did. Five people said staff listened to them and acted on what they said, two people said staff sometimes did. We looked at the care records for three people and each had a support plan. The support plans included details of the persons strengths and needs and their personal preferences about how support was to be provided. The home had introduced new support plans recently and these were seen in one persons records. The new support plans had good details of action required by staff to meet the persons needs. The new Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: support plans were signed by the person to indicate their agreement and involvement. All the support plans had been reviewed monthly, or more frequently where there were changes in the persons needs. There were risk assessments for each person, covering a range of areas, such as smoking, falls, self-harm, ironing, and going out of the home unescorted. All the risk assessments had been reviewed every three months. We observed that appropriate action was taken to minimise risks in the home, such as keeping the kitchen door locked when not in use, and ensuring there was always a member of staff available in the main lounge area. From talking with people, observation and looking at the support plans and daily records we found that people were supported to make decisions about their lives. People were supported to manage their own medication and their own money. One person told the expert by experience that Treetops was like home from home. The AQAA said that two people had been supported through a rehabilitation programme. One was already living independently in the community, and the other was due to move into a flat. The AQAA said they are both true success stories and as a team we feel very proud to have contributed to that success. A local advocacy service held monthly drop in meetings for people in the home. People also had access to advocacy services through a day centre they attended. All the staff at the home had received training about the Mental Capacity Act 2005 and the implications of the Act for people living in the home. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were encouraged and supported to take part in appropriate activities so that the lifestyle offered in the home met their needs and expectations. Evidence: We received completed surveys from seven people in the home. Six people said they can do what they want during the day, evening and at weekends, one person said they couldnt do what they wanted. The expert by experience commented that people were obviously content in their surroundings, and also that Activities such as holidays and daily outings were encouraged and eagerly attended. People told the expert by experience about their daily activities, including educational courses, going to the day centre, using a local gym, going shopping, and visiting relatives. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The expert by experience commented, It is clear that education is embraced eagerly by the residents of Treetops but to further stimulate their brains in a safe environment a home based computer connected to the internet would be beneficial to those who are unable or who choose not to attend outside courses. The AQAA said that the service was aiming to support some people living in the home who had expressed an interest in voluntary work in the local community. People told us they were usually able to follow routines they preferred, such as getting up and going to bed when they wanted to. Any restrictions on routines were detailed in the support plans. We observed people moving freely around the home and grounds. Each person had a key for their own bedroom door. People were encouraged and supported to take responsibility for housekeeping tasks, such as keeping their rooms clean, doing their own laundry, and helping with the preparation of meals. People told us they usually enjoyed the meals at the home. Some people helped with shopping for food and the preparation of meals. There was a kitchenette area for people to make their own drinks, the main kitchen was used for food storage and meal preparation. The menu for the day was displayed in the kitchen and in the kitchenette. The menus were discussed at the monthly meetings for people in the home. One person suggested to the expert by experience that there could be more choice on the menu and that snacks could be more available in between meal times. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The focus on individual needs ensured that people received the personal and healthcare support they required in the way they preferred. Evidence: People we spoke with told us they had the support they needed, including medical support. One person told the expert by experience that the staff ensured there was regular contact with the persons GP. The expert by experience said that people told him they were very definitely treated with dignity and respect. The support plans gave some details of the persons preferences regarding how care and support were provided. There were some references to how privacy and dignity should be maintained. People were supported to access healthcare services where possible, such as GP, dentist and chiropodist. People had regular reviews by a consultant psychiatrist. There was regular monitoring of peoples health, such as checking their weight and blood pressure, and ensuring blood tests were carried out to monitor the effects of medication. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: The AQAA said that improvements had been made since the last inspection by ensuring that people have access to free chiropody and an NHS dentist. Through speaking with people and staff, and from observation, we found that staff were knowledgeable about individual needs and preferences. Staff who responded to our surveys, and those we spoke with, told us they had training that helped them to meet the needs of people in the home. The AQAA said that it was planned to incorporate specialist training for staff into the annual training programme, such as training about substance misuse, detoxification and counselling skills. Medication was stored securely in the office. People who were being supported to manage their own medication had appropriate, lockable storage in their own bedrooms. Staff who administered medication had all received appropriate training. There were suitable protocols in place for people who were prescribed medication to be taken as required. Medication administration records were signed by two staff to show the medication Had been given. If medication was not given, the reasons were noted. One medication administration record had instructions written by hand by staff, (rather than pre-printed by the pharmacist). These instructions had not been signed by the person who wrote them, or counter signed by another member of staff who had checked the instructions were correct. People who were being supported to manage their own medication had appropriate risk assessments in place. One person spoken with was knowledgeable about the medication they were prescribed and confident about managing this on their own. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were effective systems in place so that people were protected and were confident their concerns were taken seriously. Evidence: All seven people who returned our surveys said they knew who to speak to if they were unhappy. Four people said they knew how to make a complaint, one said they sometimes did, and two said they hardly ever did. People we spoke with told us they would tell staff or the manager if they were unhappy about anything. One person told us they had confidence in the manager to deal with any concerns. The complaints procedure was included in the Service User Guide and each person had a copy of this. There were records of complaints with details of the action taken and the outcome. People could raise any concerns at the monthly meetings, or use the advocacy drop in meetings. No complaints had been received by CSCI about the home since the last inspection. Five staff who returned our surveys, and staff we spoke with, all said they knew what to do if anyone had concerns about the home. Staff had received appropriate training about safeguarding vulnerable adults and were aware of the correct procedures to follow if abuse was suspected. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: The personal money of people living in the home was held securely. Records were kept of all transactions, signed by the person and by a member of staff. Some people were supported to manage their own personal finances. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean and well maintained so that people enjoyed a safe, pleasant and comfortable environment. Evidence: The home is in a rural location, set in extensive grounds. It is on the first floor of the building, reached by a flight of stairs. All the people living in the home at the time of this inspection were able to use the stairs without difficulty. People told us they liked the home and its surroundings, and they were pleased with their own rooms. One person told the expert by experience that they enjoyed the peace and solitude of the homes environment. The expert by experience commented that the home had bright colours and a homely atmosphere. There was a large communal lounge and dining room, comfortably furnished, with pleasant views from the large windows. There was a small kitchenette area for people to use to make their own drinks with an adjacent quiet area to sit. The kitchenette area was in need of refurbishing as the sink unit and worktop appeared worn and dated. The main kitchen was suitably equipped and new flooring had been provided since the last inspection. Some rooms had been redecorated since the last inspection. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The bedrooms all had ensuite facilities with a bath or shower and a toilet. The bedrooms seen were individual and personalised with peoples own furniture and possessions. The manager said that, whenever possible, people could choose the decor of the room before they moved in. This was confirmed by one person who had recently moved into the the home. Smoking was not allowed in the home. People who wanted to smoke used a shelter in the grounds. The home had a domestic washing machine and a tumble dryer for people to use. This was situated in a very small area so only one person at a time could have access. Also, the machines could not be used during the evening or at night as there were adjacent bedrooms. There was no other suitable space to provide additional machines, so people also used the main laundry facilities that were shared by another care home in the same building. There was one domestic washer in the main laundry. People commented to us during the inspection visit about the limitations of the laundry facilities, and had also commented about this on the homes quality assurance surveys. The manager said people wanted more domestic machines provided in the main laundry so they could do washing when they needed to without having to wait. The existing laundry area in the home would then be used for storage of cleaning products. Six of the people who returned our surveys said the home was always fresh and clean, one said it sometimes was. The home was clean and free from offensive odours on the day of the inspection visit. Staff had received training about the control of infection and were aware of correct procedures to follow. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory recruitment practices and a good staff training programme so that people were protected and well supported by a competent staff team. Evidence: Six people who returned our surveys said the staff always treated them well, one said staff sometimes did. Five people said staff listened to them and acted on what they said, two people said staff sometimes did. People told us they felt the staff encouraged and supported them. We observed a good rapport between people and staff that helped to create a good atmosphere in the home. People said staff were always available when needed. Staff said that staffing levels were usually sufficient to meet peoples needs. Staff told us, I am very happy in my work, the staff team works well together, and, the training provided is brilliant. We looked at the records for three members of staff. The records included the required documents and information, such as a Criminal Records Bureau disclosure, and proof of identity including a recent photograph. One member of staff had gaps in their Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: employment history on their application form. When brought to the managers attention, this was put right before the end of the inspection visit. People living in the home were offered the opportunity to be involved in interviewing prospective staff. The manager said not all people wanted to do this, but some people did and this had proved very useful. New staff started an induction programme before they started working directly with people living in the home. The induction programme was in line with Skills For Care standards. New staff had a short period of shadowing an experienced member of staff. Staff spoken with said this had helped to build their confidence. Once staff had completed their induction they were enrolled onto a National Vocational Qualification (NVQ) at level 2 or above. The AQAA said that seven of twelve, (approximately 60 ), care staff had already achieved NVQ at level 2 or above, and another three staff were working towards the qualification. The staff training records we saw showed that staff had received all the required training, such as manual handling, fire safety and first aid. Staff had also received training related to the needs of people in the home, such as training about epilepsy, the Mental Capacity Act 2005, and about managing challenging behaviour. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed and there were good systems in place so that the health, safety and welfare of people was promoted and protected. Evidence: The registered manager was suitably qualified and experienced to run the home. People told us they had confidence in the manager to act on any concerns raised. Staff told us, we have a very supportive manager who works well with the staff team, and the service is an absolute credit to the manager. The quality assurance system included monthly meetings for people living in the home and surveys completed by people every six months. The manager said people were informed of the results of the surveys and any action taken to address issues raised. For instance, in the last surveys in August 2008 there were comments about the menus. This was discussed at a meeting and people were asked for ideas and favourite meals to put on the menu. There were reports from the area manager each month with an action plan of work to be completed. The action plan was updated each week Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: by the manager. The AQAA was completed by the manager and returned to us before the due date. The AQAA contained clear, relevant information that was supported by a range of evidence. The AQAA gave details of where the home had improved and where they still needed to make improvements. The data section of the AQAA was accurately and fully completed. The AQAA showed that all policies and procedures had been reviewed in 2007. All maintenance and servicing of equipment was up to date. There were satisfactory records of accidents in the home. The manager had sent notifications to CSCI as appropriate under regulation 37. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 There should be a computer with internet access available for people in the home to use. This could help people to access information about education, employment and leisure activities, and also to keep in contact with friends and relatives. Handwritten instructions on medication administration records should be signed by the person who has written them, and counter signed by another who has checked the instructions are correct. This will help to protect people living in the home and ensure medication is given as prescribed. The main laundry should be equipped so that people are able to use domestic machines when they want to. This would help people to be more independent. 2 20 3 24 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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