Inspection on 27/11/08 for Twyford Lane (11)

This inspection was carried out on 27th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Twyford Lane (11) 20/03/07

Twyford Lane (11) 07/08/06

Twyford Lane (11) 16/12/05

Twyford Lane (11) 28/07/05

Twyford Lane (11) 17/12/04

Twyford Lane (11) 02/09/04

Twyford Lane (11) 18/12/03

Similar services:

Flint House

The Cotswold Home

Fairways

Treloar College

Rush Court

The Maypole Nursing Centre

Fir Tree Lodge

Chilmington House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Twyford Lane (11) 11 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE     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: Chris Schwarz     Date: 2 7 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 29 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 29 Information about the care home Name of care home: Address: Twyford Lane (11) 11 Twyford Lane Browns Wood Milton Keynes Bucks MK7 8DE 01908639089 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): The Disabilities Trust The registered provider is responsible for running the service Name of registered manager (if applicable) Ms Rosalind Ann Tysom Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical disability - PD Date of last inspection Brief description of the care home 11 Twyford Lane is a small home, registered to provide long-term rehabilitative support and accommodation for up to three service users. The home is situated on the Browns Wood development in Milton Keynes. The home is one of three properties on the Twyford Lane development, all of which are run by the Brain Injury Rehabilitation Care Homes for Adults (18-65 years) Page 4 of 29 3 Over 65 0 Brief description of the care home Trust. The home is a single storey construction. Service users benefit from single room accommodation and there are also communal spaces situated centrally within the home. At the front of the home there are communal car parking spaces. There is a shared garden centrally situated on the development. Twyford Lane is well appointed to access all bus routes, enabling service users to be able to travel to local amenities relatively easily. 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 unannounced key inspection was conducted by Chris Schwarz over the course of a day and covered all of the key National Minimum Standards for younger adults. The last key inspection of the service took place on 20th March 2007. Prior to the inspection, a detailed self-assessment questionnaire was sent to the manager for completion and comment cards were sent to a selection of people living at the home, staff and visiting professionals. Any replies that were received have helped to form judgements about the service. Information received by the Commission since the last inspection was also taken into account. The inspection consisted of discussion with the manager and other staff, opportunities to meet with people using the service, examination of some of the homes required Care Homes for Adults (18-65 years) Page 6 of 29 records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and people who use the service are thanked for their co-operation and hospitality during this unannounced visit. What the care home does well: What has improved since the last inspection? What they could do better: Verification of satisfactory Criminal Records Bureau clearance needs to be confirmed on headed paper by someone authorised to do so within the organisation, and needs to be dated and signed and confirms the check is satisfactory and at what level it was undertaken (enhanced or standard). Staff rotas need to show the hours carers are expected to cover in order that there is a clear record of who was on the premises at any given time. Mandatory training needs to be updated for all staff or attended first time for new staff to make sure that staff have the right skills and competencies to meet peoples care needs. Care Homes for Adults (18-65 years) Page 8 of 29 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 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. People using the service are thoroughly assessed prior to admission and are given opportunity to visit the service beforehand to ensure it meets their needs. Evidence: A detailed statement of purpose and service users guide were in place at the service and had been recently reviewed to update information. Both documents would be useful in providing prospective users with a range of information and help them or their representatives make a decision about moving in. People using the service had copies of these documents in their personal files, which they keep in their rooms for reference. There had been one new admission since the last inspection. The service user had moved from another of the providers services in the area which provides more intensive support for people who have brain injuries. A care plan file and risk assessments were therefore already in place for the person and detailed assessments had been undertaken such as a rehabilitation plan. In another persons file, there was Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: evidence of a detailed initial assessment undertaken by the clinical psychologist and a pre-admission report prepared by the consultant clinical neuropsychologist. Two service users returned surveys. One person said they received enough information when considering a placement and that they were consulted about moving in, the other person could not recall. Copies of peoples contracts were contained within their personal files. Fees for the service are assessed according to need and details of current charges may be obtained by contacting the provider direct. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is good regard for the diverse needs of the people living at the service and their requirements related to their disabilities, lifestyle choices and personal preferences are sought, recorded and met by the staff team, respecting their rights, choices and individuality. Evidence: Care plans were in place for each person using the service. Each persons file contained a photograph of the service user and information had been collated about their education and work history, family and social contacts, funding authority and care manager details, next of kin, family composition, other contacts, cultural and religious practices and dietary requirements. Details of past medical history were noted, current medication and any aids and adaptations that were needed. In each file there were risk identification checklists covering areas such as self harm, potential for violence, absconding, wandering, falling, fire risk and cognitive, health and sexual considerations. The checklists were then summarised in another document. For one Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: person who was visually impaired, the file showed that there had been involvement from an occupational therapist and the Royal National Institute for the Blind had been contacted as well as the local Bucks Association for the Blind. Part of the persons weekly programme included a Braille session. For another service user who required a halal diet, his care plan made this clear and observation of practice at the service was that staff were respecting this, as outlined in the next section of the report. There was very detailed information in all files looked at on how staff needed to support peoples needs. Rehabilitation plans outlined peoples long term goals, general functional goals, primary neurobehavioural deficits, barriers to rehabilitation, medication and managing behaviours. Detailed behavioural guidelines were seen in files, prepared by the clinical psychologist, to help support service users with tasks such as preparing meals, dealing with aggression and supporting users with their morning routine. Peoples care needs were being reviewed at least monthly in clinical meetings and their goals reviewed at least annually as part of annual reviews. All documents looked at had been dated and signed and there was evidence of service user involvement. Two peoples money was being managed by the service, the third person managed it himself. There was a lockable cash tin in place for each person and individual transaction records were being kept. Two staff now sign alongside each transaction as a good practice. Both tins were checked and the contents tallied with recorded balances. Receipts were in place to verify expenditure. Service users were seen to make decisions such as planning their menus and whether to spend time in their rooms, the lounge or smoking outside. House meetings and meetings with the other two services on the site take place to discuss any issues that people have. One person had involvement with a local advocate and a poster from the advocacy service was pinned onto the notice board in the kitchen. Each service user had a personal file which they keep containing useful information such as a copy of the service users guide and statement of purpose, a copy of their contract, a range of policies such as access to files, their rights, bullying, confidentiality, service user involvement, personal monies and the complaints procedure, a copy of the house rules, information on where the latest copy of the inspection report for the service can be found, a copy of their care plan, accompanying risk assessments, rehabilitation plan and review notes. 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. Activities are available to people using the service to provide them with stimulation and to increase their independent living skills. Contact with family, friends and the community is supported to maintain social links. Evidence: Each person had a weekly programme to help them acquire or improve independent living skills. People using the service were each seen planning individual menus with staff for the following week as part of their programmes. One of the service users requires a halal diet and staff had supported the person to make appropriate choices and to shop for meat and meat products that were appropriate to his needs. Each person had their own food drawer in the freezer and their own shelves in cupboards. Service users were seen making their own lunch and tidying up afterward, with verbal support from staff when needed. Copies of their menus were displayed in the kitchen Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: for reference. During the afternoon of the day of inspection, service users and staff went out by bus to a supermarket to shop for the following week. All service users had bus passes entitling them to free transport. The service is located close to a bus route which takes people into the city centre where there is a good range of sports, leisure and retail facilities. Care plan files provided information about peoples family and social contacts and a record was kept of these. One of the service users had been out the previous evening for a Christmas meal with members of Bucks Association for the Blind. One person enjoyed reading a daily newspaper during the morning. People using the service were provided with information about their rights and responsibilities in the personal files they keep in their rooms. It is expected that they participate fully in their rehabilitation programmes to benefit from a placement at the service and some coaxing was seen to be needed from staff at times. 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. The health and personal care needs of people living at the service are well met, promoting health, well-being, taking into account their preferences and religious or cultural requirements and ensuring that they receive medication in a safe and consistent manner. Evidence: Care plan files contained information about peoples health care needs and any aids or adaptations they needed to assist with daily living. Input from health care professionals employed by the provider such as an occupational therapist, physiotherapist and clinical psychologist was evident from notes and guidance on files and records were being kept of appointments with external professionals such as doctors and nurses. Preventative health measures such as influenza vaccination was evident; a record of weight was being kept for one person who was trying to loose weight and his weekly programme included sessions on a treadmill. He had talking scales to be able to monitor his weight. Medication was being managed using a monitored dose system. The manager was Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: starting to re-evaluate staff competency to administer medicines and a completed assessment for one member of staff was looked at. Medication was securely housed in the office. Medicines were clearly labelled and within use by dates. There were no controlled drugs in use at the time of this visit. Medication administration records were in good order with signatures alongside prescribed dose times. Sample staff signatures were contained within the medication records folder. There was evidence that all but one new member of staff had undertaken training on safe medication practice. 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. Complaints and safeguarding are effectively managed to listen to views of people who live at the service and reducing the risk of harm to them. Evidence: In the pre-inspection self-assessment the manager said there had not been any complaints about the service in the past twelve months and no safeguarding referrals or incidents were noted. She confirmed that there has not been any change since the information was provided. The Commission is not aware of information to the contrary. A complaints procedure was in place and people using the service had been provided with a copy each in their personal files. People using the service knew how to make a complaint from information in surveys. Procedures were in place for safeguarding vulnerable adults and a copy of the local authority multi agency guidance was in the office for reference. Training records for staff showed that some refresher of first time input was needed on safeguarding and a couple of places had been booked for a course in December 2008 to start to rectify this. Care Homes for Adults (18-65 years) Page 19 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 premises are clean, well decorated and adequately maintained, promoting a positive environment for the people who live there and which is suitable for the range of disabilities that people have. Evidence: The service is located in Milton Keynes and is a short drive from the city centre or Bletchley. There are good public transport links into the city centre and Bletchley where there are good ranges of shops, places to eat, sports, leisure and recreational facilities. The service is one of three small group homes on the Browns Wood estate. 11 Twyford Lane is a detached bungalow with level access into the building and throughout. It has three single bedrooms, each with an ensuite bathroom. There is a lounge with patio doors to the garden shared by the three services. The kitchen/dining area is modern and also has patio door access to the garden. There is a small staff office/sleeping in room with its own toilet and shower leading off from the kitchen/diner. The service has a useful utility room leading off the hallway for the washing machine and dryer with storage space for cleaning products. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: The building was clean and odour free. People using the service said in surveys that the home is kept fresh and clean. They are expected to be fully involved in household chores as part of their programmes of rehabilitation. The manager advised in the pre-inspection self-assessment that a new tumble dryer, cooker and hob had been purchased since the last inspection. The external line manager confirmed during the visit that quotes were being obtained to redecorate the whole house. Care Homes for Adults (18-65 years) Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides sufficient staff cover to meet needs and undertakes recruitment procedures to protect people using the service from risk of harm. Gaps to training could mean that staff do not have the right skills and competencies to support the people who live there. Evidence: The staff team comprised five staff with no use of agency or temporary workers. One person had left the team in the past year and a new worker joined in October 2008. In information provided in the pre-inspection self-assessment, the manager said that three staff had achieved National Vocational Qualification level 2. The homes manager had recently completed the Registered Managers Award. The recruitment file of the newest member of staff was looked at. It contained evidence of required checks being carried out although information about the Criminal Records Bureau check was weak. It consisted of a plain piece of paper with the name of the person, the Criminal Records Bureau certificate number and date of expiry. The manager advised that originals of Criminal Records Bureau certificates are kept at the providers headquarters. Where this is the case, it is expected that verification of satisfactory Criminal Records Bureau clearance is confirmed on headed paper by Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: someone authorised to do so within the organisation, and is dated and signed and confirms the check is satisfactory and at what level it was undertaken (enhanced or standard). A recommendation is made to address this. Staff rotas showed that carers work E, L, O and X shifts with no key to denote the hours they are on duty. A recommendation is made to make sure that the hours worked are clear on rotas, so that there is an acceptable record of who was working at the service at any given time. Training records of three of the staff team were looked at. The file of the newest member of staff showed that he had undertaken BIRT basic in September this year and no other courses. It is understood that this is an induction programme run by the provider and covers a wide range of areas although this was not confirmed on the certificate of attendance. The carer was provisionally booked for three courses in December 2008. In file 2 the carer had undertaken safeguarding training in 2005, first aid in 2004, moving and handling in 2005, food handling and hygiene in 2005, medication training in 2006, fire safety in 2006, equality and diversity in 2008 and risk assessment, emergency procedures and control of substances hazardous to health in 2006. Five of these courses are mandatory and needed to be updated when they expired. An update to food handling and hygiene was booked. In file 3 the carer had attended training on fire safety in 2006, risk assessment, control of substances hazardous to health and emergency procedures in 2006, medication training in 2006, first aid in 2005, epilepsy in 2005, moving and handling in 2005, food handling and hygiene in 2005, safeguarding in 2005 and fire safety, emergency procedures and control of substances hazardous to health in 2005. Again, five of these courses are mandatory and needed updating when they expired. Two update courses had been booked. In discussion with the registered manager and line manager about the gaps to training, it was explained that the trainer for the local area had died, with no scope within the organisation at that time for anyone else to carry out the training. Measures were being put in place to train people as trainers and to use external providers to address the shortfalls. A requirement is made to improve staff training to ensure that the staff team has the right skills and competencies to meet peoples needs. It would be sensible to access training from a range of sources, including free courses run by the local authority, to make sure that the service is not placed in this situation again. People using the service said in surveys that staff treated them well and listened and acted on what they say. Care Homes for Adults (18-65 years) Page 23 of 29 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 service promotes continuity and quality of care for the people who live there and ensures that risk is safely managed to reduce the likelihood of injury or harm. Evidence: The service has a registered manager who has achieved the Registered Managers Award. Both she and the external line manager have experience of working with people with brain injuries. The certificates of registration and employers liability insurance were displayed in the hallway. Monitoring visits have been undertaken regularly by the line manager and detailed reports are produced of the findings. The format follows that of the National Minimum Standards for younger adults. Since the last inspection the service has been accredited by the Commission of Accreditation for Rehabilitation Facilities and had its certificate displayed in the hallway. An accessibility audit was seen which forms part of the accreditation, showing that the service meets criteria for people with disabilities. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Staff had access to a number of central and local policies covering a wide range of practice, such as medication and homely remedies, admissions and discharge procedures, health and safety, infection control, access to files and emergency procedures. Accident reports were being completed when necessary and a copy retained on the persons care plan file. All that were seen had been completed fully and signed and dated. Health and safety was being managed well. Portable electrical appliances had been tested in May this year (the report for this needs to be obtained for the service), a current gas safety certificate was in place, there was certification of satisfactory electrical installation and fire extinguishers had been serviced in March this year. The service had a fire based risk assessment which was up to date. Risk assessments were in place for each of the people using the service to enable them to manage independent living skills safely, with input from specialists. 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 1 35 18 Mandatory training is to be updated for all staff or attended first time for new staff. This is to make sure that staff have the right skills and competencies to meet peoples care needs. 31/03/2009 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 32 Staff rotas are to show the hours carers are expected to cover in order that there is a clear record of who was on the premises at any given time. Verification of satisfactory Criminal Records Bureau clearance needs to be confirmed on headed paper by someone authorised to do so within the organisation, and is to be dated and signed and confirms the check is satisfactory and at what level it was undertaken (enhanced or standard). 2 34 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 © (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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!