Care Home: 1-2 Orchard Mews

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What the care home does well People receive appropriate levels of support and care. People`s preferences and personal choices are respected. People living at the home are supported to make choices about their life style, to take part in various activities and to keep in contact with friends and family. People have access to a full range of health care support as necessary and receive personal support in the way they prefer and according to their needs. The home is well furnished, comfortable and homely. The home is clean and tidy and good standards of hygiene are maintained throughout the home. What has improved since the last inspection? Policies and procedures have been kept under review and the home has continued to improve the decor and furnishings within the home. Requirements from previous inspections have been met. Medication procedures have improved and so has record keeping in respect of staff recruitment. This has meant that people are offered greater protection. What the care home could do better: There were no requirements or recommendations made as a result of this inspection. We saw sufficient evidence that the home is being managed safely. They do however need to ensure that an application to register the person currently managing the home is submitted. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1-2 Orchard Mews Bakers Drove Rownhams Southampton SO16 8AD     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 Johnson     Date: 0 9 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.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: 1-2 Orchard Mews Bakers Drove Rownhams Southampton SO16 8AD 02380739076 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Choice Support care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies service only: Care home only - (PC) to service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Learning Disabilities (LD) Date of last inspection Brief description of the care home 1-2 Orchard Mews consists of two purpose built bungalows with through access via the office. The home can provide accomodation for up to six people who have a learning disability. One staff team operates throughout the two bungalows. However people living at the home tend to keep their own area of the home. We do not have the current fees. Anyone requiring this information should contact the provider directly. 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 purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards, compliance with regulations, compliance with previous requirements and to assess what the outcomes are for people who live at this home. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out over one day on 9th April 2009. During the visit we looked at all key standards and followed up on requirements that were outstanding from previous inspections. All regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Care Quality Commission and the predecessor organisation the Commission for Social Care Inspection. Care Homes for Adults (18-65 years) Page 5 of 28 The person managing the home completed an Annual Quality Assurance Assessment (AQAA) prior to this inspection. Information recorded in that document was taken into account and forms some of the evidence for this report. Surveys were sent to three people living at the home, twelve members of staff, four healthcare professionals and one care manager. At the time of writing this report we had received completed surveys from two people living at the home, nine members of staff and two health care professionals. During this visit we looked at the physical environment including, peoples rooms and all communal areas of the home. Staff and care records were inspected. Some members of staff were spoken with and others were observed during their day to day interactions with those living at the home. We examined records, policies and procedures. We spoke briefly with the people living at the home. The person managing the home was not at the home during this visit. However we had a telephone discussion with them a few days later and were able to clarify and discuss any issues and provide them with feedback. and discuss issues. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 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 8 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. Peoples needs are assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the persons needs. Evidence: The last inspection of this home carried out on 22nd April 2008 found this outcome area to be good. The Annual Quality Assurance Assessment (AQAA) told us that the home had admission policies and procedures in place and that these were followed. We saw evidence to support this during our most recent visit. We looked at the assessment information obtained by the home and the homes assessment process in respect of the two most recent admissions to the home. In both cases there was recorded evidence that a thorough assessment had been carried out. This involved people being able to visit the home on several occasions. Assessment documentation for one person showed that they had visited the home on seven occasions before moving in. During these visits they had been able to have a meal and meet other people living at the home. Staff from Orchard Mews had visited the person Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: at their previous setting to observe the persons care routine. The home had recently sent us an updated copy of their Statement of Purpose. It was noted that this document named the person currently managing the home as the Registered Manager. However the named person has not yet submitted an application to The Care Quality Commission to become the registered manager. This was discussed with the person managing the home and they stated that it was an error and that it would be corrected. Care Homes for Adults (18-65 years) Page 10 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. People living at this home are fully supported with their care and support needs. Evidence: The last inspection of this home carried out on 22nd April 2008 found this outcome area to be good. On that occasion our findings were that, peoples needs were kept under regular review and recorded in detailed and personalised plans of care that promoted independence. Evidence collated during this most recent inspection demonstrated that this has been sustained. As part of this inspection we looked at the care plans for two people. The care plans seen were comprehensive and were integrated with risk assessments and risk management plans. The plans had been reviewed at regular intervals or as and when a change in a persons support needs had occurred. The care plans looked at were written in the first person and were person centred. Care plans demonstrated that peoples independence is promoted and highlighted each persons abilities as well as Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: their needs. Sections in care plans included Staying healthy, Communication, keeping Safe and Where and when do I need support. Care plans demonstrated that people are offered choice and that respect for the way people liked to be supported was taken into account and acted upon. Each section of the care plan had a section entitled Why do I need support , Where and when do I need support, How is support given and what will my plan help me achieve. Other sections of the plan addressed support needs associated with, My friends and family, Being part of community, and Using my community. All of the sections were in a format most suitable to the persons needs. Risk assessments and risk management plans had been produced for any identified risks. These were also written from the persons point of view and identified what the actual risk was, why it was important to the person to engage in the activity, what had happened before (the likelihood), what might happen in the future (the consequence) and what would happen if the person could not undertake the activity. All care plans looked at provided evidence that people had been consulted and involved in formulating their plan. Staff working at the home told us that they were provided with up to date information about the needs of those living at the home. One person commented, When a care plan is updated or reviewed the changes are highlighted to the people that need to know and discussed with all at the next team meeting. Care Homes for Adults (18-65 years) Page 12 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 living at the home are able to make choices about their life style, and are supported to develop life skills. People are supported to engage in activities and to keep in contact with friends and family. Evidence: The Annual Quality Assurance Assessment (AQAA) provided evidence that people living at the home have the opportunity to take part in a variety of individual activities in the community and within the home. The AQAA listed some of the activities that people took part in, these included; accessing day centres, lunch clubs, socialising with friends and family, menu planning, shopping, arts and crafts and holidays. On arrival at the home one person was out at a day service, another person had gone out for lunch with staff and another was preparing to go and spend the weekend with Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: family. Throughout the day people people living at the home were observed to go out with staff support. We arrived at the home at 11:15 am and one person was eating breakfast. From discussion with staff and the person themselves it was evident the home did not have any enforced routines regarding mealtimes and that people were free to make their own choices. In discussion with one person living at the home they told us that they liked living at the home. When asked what were the good things about living at the home the person said that staff helped them to do things, took them out to places, helped them to go shopping for personal items and involved them in shopping for the home. The care plans examined and other associated documents looked at demonstrated that people are supported and encouraged to try new things, set realistic goals for themselves and are supported to pursue these. During our visit staff were observed to take one persons mail to them unopened and provide support accordingly. Peoples care plans described the level of support that people needed with meal preparation and using kitchen appliances. In discussion with one person living at the home their description of their care and support needs confirmed to us that they were receiving the level of support that they had been assessed as needing and as recorded in their support plan. Evidence was seen that people are offered a balanced menu. Meals can be chosen based on individual likes and health care needs. People who use the service have very specific eating and drinking guidelines in place to ensure their safety and wellbeing is maintained and these have been completed with input from the specialist health care team. We observed staff supporting individuals at meal times in a relaxed and unhurried setting. Care Homes for Adults (18-65 years) Page 14 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. People are fully supported with their health care needs and have access to a range of specialist health care support. People receive personal support in the way they prefer and according to their needs. Improvements made to medication procedures mean that people are better protected. Evidence: At the last inspection of the home carried out on 22nd April 2008 we made a requirement regarding ensuring that medication was administered as prescribed and that medication administration records were maintained accurately. The Annual Quality Assurance Assessment (AQAA) told us that since the last inspection, a whole review of the medication system had been undertaken. We saw evidence to support this during our most recent visit to the home. We examined the medication records of two people while at the home. From examination of these records it was evident that staff were following correct administration recording procedures. On this occasion there were no unexplained gaps Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: in any of the medication administration records examined. In both cases there was a photograph on the medication file for ease of recognition and a grab sheet detailing the persons prescribed medication. This had been implemented to be used in an emergency situation or if for example a person was admitted to hospital. We checked stock amounts of medication held at the home against records and these balanced. Records had been maintained to evidence that medication disposed of and returned to the pharmacist had been recorded and signed for. Records were kept of any medicines leaving the home such as when a person was away from the home and this ensured that there was a clear audit trail and that all medicines received into the home could be accounted for. The person managing the home had introduced a regular audit of of the administration records against amounts of stock held and we saw that this had been undertaken by the person managing the home or their deputy. We saw evidence that all staff involved in the administration of medicines had been trained to do so and that their competency to do so had recently been reevaluated. We know from previous inspections that people had been supported with their health care needs and had access to a range of health care support services. The AQAA stated that, We work in partnership with health care professionals to address the health needs of our service users. Everyone is supported to have regular check ups and health appointments as required. We support some people who have complex health needs to a high standard. Staff are trained by the district nurse to complete invasive treatments. When asked whether the home sought advice and acted on it to manage or improve peoples health care needs, one of the two health care professionals who completed a survey answered usually and the other responded always. When we asked them whether peoples health care needs were met and if the home respected peoples privacy and dignity one responded always and the other said usually. In discussion with one person living at the home they told us that they were supported to attend all medical appointments. Examination of the care plans for two people provided evidence that peoples health care needs were being monitored and that appropriate levels of support were being provided to maintain their health care needs. Within the care plans each person had an individual health support plan entitled My Health. These had been reviewed regularly and provided evidence that people were supported to access dentists, gps, care managers and other specialist support. Information recorded in peoples care plans described the way that people liked to be supported with their personal care support needs and took account of peoples right to privacy and dignity. Care Homes for Adults (18-65 years) Page 16 of 28 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. The home has procedures to protect people from harm and abuse. Systems are in place for people to address any concerns or complaints that they may have. Evidence: The training records for staff confirmed that training in adult protection takes place and staff who returned a survey all knew the procedures for reporting any concerns. The Annual Quality Assurance Assessment (AQAA) told us that everyone living at the home had access to an independent advocacy service. In discussion with one person living at the home they told us that if they were unhappy about anything they would speak to the manager. Examination of the homes complaints log and records from the organisations head office provided evidence that concerns and complaints had been dealt with and actioned appropriately. The home has the facility to looks after peoples money. We looked at the procedures for looking after peoples money and checked the records for two people. All transactions had been recorded and receipted as per the homes policy with regular checks carried out by the person managing the home. Recorded evidence seen at this inspection proved to be an accurate reflection of the procedures described within the AQAA. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: At the last inspection we made a requirement that All monies belonging to each service user must be held in individual accounts. This was because larger amounts of money belonging to people were held centrally and small amounts of money were requested and sent by the organisation, which was then held in the home. As the person managing the service was not available on the day of this inspection it was difficult to assess compliance with this requirement. We have since however spoken with the person managing the service and have received confirmation of the action that has been taken to address this. 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. People live in a safe, clean, well maintained and homely environment. Evidence: During the visit to the home we saw all communal areas and a selection of peoples bedrooms. Bedrooms reflected peoples individual tastes and needs with specialist equipment such as hoists in place where necessary. People had been able to personalise their rooms with pictures, belongings, televisions and audio equipment. People were observed to access and spend time in their rooms as they chose. This is consistent with our findings following previous inspections. On the day of the visit the home was clean and tidy. The Annual Quality Assurance Assessment (AQAA) stated, There is a cleaning rota in place for staff to follow. We have had an environmental health inspection, which went well and there were only two actions which have now been completed. During the visit we saw evidence that the home had infection control procedures in place and all staff had signed to demonstrate that they had read and been made aware of the policy and procedure for the transfer and disposal of clinical waste. The AQAA identified the improvements that had been made since our last inspection Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: and those that were planned for the future. These included, new flooring in one of the bungalows, kitchens had been repainted, a new assisted bath had been fitted, all communal areas had been redecorated and some furnishings had been replaced. We reported at previous inspections that both kitchens were showing signs of age. The home informed us that after negotiation with the housing association that own the building, it has been agreed to replace both kitchens. We were shown plans of the forthcoming refurbishment. 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. Staff are well trained and employed in sufficient numbers to meet the needs of people living at the home. Evidence: During the visit to the home staff rotas were examined. These confirmed the rota to be a true reflection of actual staffing levels. Staffing levels remain constant and are maintained at the same level as at previous inspections. Rotas are planned in advance and it was seen that they had been planned for the forthcoming weeks. This was consistent with the findings of the last inspection. Nine members of care staff returned a survey to us and seven of those said that there were usually enough staff to meet the individual needs of all the people who lived at the home. The remaining two responded that there always were. One person commented, As with all places there are times, sickness for example when the house maybe running on minimum staff. Choice Support has an agreement with the Commission for Social Care Inspection that staff records will be held at their head office. However as part of this agreement they are required to hold evidence within the home that certain checks have been Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: completed including the dates of when these were obtained. At the last inspection of the home we made a requirement regarding this. At this most recent visit we found that the requirement had been met. We looked at the files of three members of staff, two of whom had been employed since the last inspection. These confirmed that an appropriate recruitment process had been followed and that this included; the submission of an application form, an interview, the receipt of two written references and that both Criminal Records Bureau and Protection of Vulnerable Adults checks had all been completed prior to the person commencing work at the home. Staff told us in the surveys that Criminal Records Bureau checks and references had been undertaken before they were able to start work at the home. From examination of staff files and feedback from surveys it was evident that the home provides training and development opportunities relevant to their work. The AQAA reported that twelve of the thirteen permanent staff had achieved an NVQ level 2 or above and that one staff member is currently undertaking the course. This means that the percentage of staff with this qualification has increased since the last inspection. All staff who returned a survey told us that they were receiving training that was relevant to their role, helped them meet and understand the individual needs of people living at the home and kept them up to date with new ways of working. One member of staff commented, Along with the mandatory training, a yearly training guide comes to the house and I can request extra training courses that I believe would help me. Several people including myself are doing NVQ. We asked health professionals whether in their opinion staff had the right skills and experience. One person responded that they usually did and the other said always. 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 is being safely managed. The home is well maintained and equipment is serviced to keep everyone safe. Evidence: Since the last inspection the organisation has appointed a new manager. Although they have yet to apply to the Care Quality Commission to register we have been told that this is due to be submitted and that the applicant was in the process of gathering all relevant documentation such as a Criminal Records Bureau check to be submitted with the application. We will monitor this. We are satisfied that all requirements made at previous inspections have now been met and this report provides evidence to support this. Several staff members commented that there had been an improvement in the management of the home since the new person came into post. Staff cited improvements in medication procedures, the level of support that they received and the general organisation and running of the home. Data recorded in the Annual quality Assurance Assessment Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: (AQAA) told us that policies and procedures are kept under regular review and examination of a sample of these confirmed this. The AQAA also gave details and evidence that maintenance checks, tests and servicing of equipment are carried out on regular basis. Evidence seen during the visit substantiated this. Examination of the fire logbook demonstrated that regular and thorough testing and servicing of the homes fire detection and fire-fighting equipment and other appliances had been carried out as appropriate. 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!