Care Home: 12 Middle Green Road

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What the care home does well This is a well-run happy home where residents are given good quality care by a cheerful team of workers. The whole of the staff team work well together and are highly skilled and experienced. They know the needs of residents well and are liked and trusted. The Manager takes time to listen to residents opinions and is quick to respond to any requests or suggestions made. It is clear that residents lead fulfilling lives and can make choices about what they do each day. Residents have a say in how the home is run and what happens at the home each day. Residents say that they like living at the home, which is comfortable and clean. They have their own rooms which are decorated and furnished to their own tastes and liking. The staff that work at this home are very good at encouraging residents to learn new things that help to make them independent. The staff encourage residents to make choices about their lives. The activity programme is varied and interesting and includes trips out to local places of interest. Residents say that there is plenty to do and enjoy taking part. Residents attend various clubs where they can meet new people and make new friends. The staff work well together as a team. Staff at this home know the needs of residents well. They work with other professional people to improve the quality of life for the residents and to enable residents to be make choices about how they live their lives. Written records are good and help staff to know what care residents need. What has improved since the last inspection? The home has had a new wet room fitted to provide more choice of bathing facilities for the residents. What the care home could do better: There are no new requirements arising from this inspection. A recommendation has been made to redecorate the stairwell, office and bedroom doors and walls where paint is chipped to improve the environment for the residents. Key inspection report Care homes for adults (18-65 years) Name: Address: 12 Middle Green Road 12 Middle Green Road Langley Slough Berkshire SL3 7BN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Willis     Date: 1 9 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: 12 Middle Green Road 12 Middle Green Road Langley Slough Berkshire SL3 7BN 01753532415 01753532415 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.voyagecare.com Milbury Care Services Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. 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: Learning disability (LD). Date of last inspection Brief description of the care home 12, Middle Green Road provides twenty-four hour care for up to four people with learning disabilities. The home is a detached chalet style bungalow in a residential area of Langley Slough. It is close to local shops and the transport links and facilities in Slough Town Centre. On the ground floor there are four single bedrooms, a lounge/dining room, kitchen, a bathroom and a cloakroom. On the first floor there is a staff office/sleep in room, laundry room and bathroom. The staff team consists of a manager, senior support worker and support workers. The fees range from 1432.61 to 1507.87 pounds per week Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 4 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 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: This inspection of the service was an unannounced Key Inspection. The inspection took place on Tuesday 19th January 2010 between 09:30 am and 3.30 pm. and covered all the standards for adults. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents. Any replies were used to help form judgements about the service. Consideration has also been given to other information that has been provided to the Commission since the last inspection. The inspector toured the building, examined records and met all of the residents. The inspector also spent time talking to staff and observing how care was being delivered to the residents. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals with various religious, racial or cultural needs. This service is good at Care Homes for Adults (18-65 years) Page 6 of 28 meeting the needs of residents with a range of diverse and complex needs. The inspector gave feedback about her findings to the Homes Registered Manager at the end of inspection. A discussion also took place with the Homes Operations Manager by telephone. There were no legal requirements made as a result of this inspection. The Commission has received no information concerning complaints since the last inspection which took place on 4th April 2007. Care Homes for Adults (18-65 years) Page 7 of 28 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 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 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. Prospective residents are fully assessed prior to their admission to ensure their needs will be met effectively by the home. Evidence: Although there have been no new admissions to the home in the past year, the AQAA states that the home has a comprehensive admissions policy in place which details the holistic assessment that will take place prior to admission. It is clear that the policy emphasises the need to fully involve the person to be admitted, their family, advocate and a multi-disciplinary team of professionals. It is clear that significant time is spent planning the admission. The prospective resident is central to the process and the home endeavours to put both the family and resident at ease by fully involving them in the admission process from the outset. All new residents receive a comprehensive needs assessment before admission, which is carried out with skill and sensitivity by experienced and qualified staff. The home is efficient at obtaining a copy of the care management assessment and insists on receiving a copy of the care management care plan before the individual is admitted. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Information gathered forms the basis of an initial care plan. The involvement of the resident is central to the process and a range of methods is employed to gain the views of the prospective resident. This may involve the use of advocates. Information is gathered from a number of sources including the resident themselves, family members and a range of health and social care professionals. The assessment focuses on achieving positive outcomes for the resident and ensuring that any equipment or specialist support needed by the resident is available on admission. The cultural and diversity needs of the resident are considered and specific needs are catered for. Gradual introductions are made to the home to ensure that the resident is comfortable in their new surroundings and accepting of their move to the home. Formal reviews are held at frequent intervals to ensure that the resident is settling into their new surroundings. 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. Residents are encouraged to make choices about their lives and to take everyday risks. The written records accurately reflect the individual needs, aspirations, goals and lifestyle choices of people using the service. Evidence: Examination and case tracking of two residents evidenced that the care plans at the home include a personal profile and detailed life history. All of the documentation is person centred and takes into consideration the cultural needs of the resident. The plans are individualised and have been developed using plain English and simple terms however, the plans are not particularly user friendly and could be developed further to make them easier for residents to understand. From examination of care documentation and discussion with management and staff it is clear that the home positively encourages residents to develop new skills and to achieve a level of independence. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The care plans evidence that residents are encouraged to participate in the routine activities of the home within the limits of their individual capabilities. Current residents are encouraged to be involved in the preparation of meals, the laundering of their clothes and the cleaning of their bedroom as part of their documented care plan. Examination of care records and risk assessments evidenced that the necessary support and supervision are provided to keep residents safe whilst they engage in these everyday tasks. There was evidence that the home positively encourages and supports people to develop life skills. This has led to a degree of risk taking. The management of risks takes account of the specialist needs of the individual balanced against their personal aspirations for independence, choice and normal living. Risks have been fully assessed and guidelines have been put in place to minimise the risk to people using the service. The inspector case tracked two peoples care. Records were up-to-date and accurate. It was clear that the staff have tried to involve people that use the service in the care plan process from the outset and their input was clearly recorded in the care files. Where necessary external advocates have been involved to support the resident in routine decision-making. The residents who were being case tracked had an up-to-date social work review on file and it was clear that the home works in partnership with other agencies to benefit residents. The care records were comprehensive and holistic in detail and provided sufficient information for staff to provide the appropriate care. Residents had agreed their personal programs and goals and these appeared realistic and achievable. 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. Residents are provided with the opportunity to participate in a range of leisure activities suited to their needs. Residents are encouraged to maintain contact with the local community, their friends and relatives. The meals in the home offer residents choice and variety. Special dietary needs can be catered for effectively. Evidence: From examination of care plans, daily records and discussion with staff it was evident that the home promotes citizenship and the rights of the residents to enjoy an ordinary meaningful life. Residents are provided with the opportunity to engage in activities that are both stimulating and worthwhile. They are encouraged and supported to make good use of communal facilities and are actively encouraged to be Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: an integral part of the community in which they live. The activity programmes are displayed in a pictorial format so residents know what they are doing each day. Examination of one residents programme indicated that they are offered a variety of in-house and external activities including dance sessions at Two left feet, aromatherapy, bowling, cookery lessons, local walks and sessions at WAMSAD a local club for people with disabilities. One resident goes to slimming world sessions each week to help them to achieve weight loss and several residents go to the local Mencap disco each week. Residents choices in relation to activities are well documented and their activity programme is well monitored and forms part of their on-going review. At home residents are involved with the shopping, cooking, cleaning and laundry activities. These activities form part of the individuals care plan. Whilst at home residents listen to music, watch television or DVDs, or go for local walks with their friends. People at the home are encouraged to be part of the broader community and one resident attends a local church group. Several residents regularly stay with family at weekends and all residents have members of their family that advocate on their behalf. Due to staff shortages none of the residents were able to participate in an annual holiday in 2009. Day trips to places of interest and the seaside were arranged instead. There are plans to ensure that everyone has an opportunity to have a holiday in 2010 and residents have recently attended a meeting to decide where they will go on holiday this summer. Two residents have chosen to go to Disneyland in Paris by Eurostar whilst another has decided they would like to go to a country cottage. The home is now fully staffed and has sufficient bank staff available to fully support the residents. The home provides a nourishing menu, which meets the cultural needs of residents. Residents are provided with choice and variety and there was evidence that residents are regularly consulted about the menus. Mealtimes are a social occasion and to encourage socialisation residents are encouraged to eat together in the dining room. 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. Peoples physical and personal support needs are well met at this home by well-trained and competent staff that administer residents medication safely and appropriately. Evidence: It was clear from the records and discussion with management that all of the residents are registered with a local GPs surgery. Regular health checks and routine screening and treatments are offered by the practise and several residents regularly see the practise nurse for blood tests and other advice and treatment. The doctor also offers residents regular vaccinations against flu and other illnesses and the decision as to whether or not to have treatment is documented in the residents records. Records indicate that all residents have a physical health care plan and plan of support. It identifies the residents needs and identifies long term health goals. The documents were well kept and up-to-date. Residents also have regular dentistry, podiatry and attention to their vision and hearing and their attendance is appropriately recorded in the care records. A number of the residents are regular attendees at hospital. Details of the outcome of these appointments and any changes in treatment or medication were well documented in the care plans and daily records. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: From examination of two care records it is evident that residents physical and personal care needs are well met by the home. All care given is documented in the daily diaries and was observed to fully validate the content of care plans. Observation of practise concluded that care was provided in a manner, which maintained the residents right to dignity, privacy, independence and choice. The home has in place robust medication policy, procedure and practise guidance. Staff are aware of their responsibilities in relation to the safe administration of medication and have been properly trained. None of the current residents self medicate. The system used for the safe administration of medication is the monitored dosage system. This system reduces the likelihood of medication error and provides an accurate record of administration. All staff have been fully trained in the safe use of the system. 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 a satisfactory complaints system. Residents feel their views are listened to and acted upon. Residents are protected from abuse and exploitation by staff that can demonstrate knowledge of the homes safeguarding adults policy. Evidence: The service has a complaints procedure, which is clear and accessible to residents. It has been produced in a user-friendly pictorial format to aid residents understanding. Residents are provided with information on how to make a complaint to the home, the time scale for response, and the stages and process of the Organisations complaint procedure. Examination of the complaint records indicated that there have been no complaints made to the home since the last inspection and no information about complaints has been reported to the CQC since then. There was evidence in staff files and from discussion with staff, that they receive training in safeguarding adults as part of their formal induction to the home. This learning is later consolidated when undertaking NVQ training in which it forms a core module. Staff interviewed were aware of the homes whistle-blowing policy and understood the importance of protecting residents from abuse and exploitation at all Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: times. There have been no safeguarding adult investigations about this home since the last inspection and no referrals made to the POVA (Protection of Vulnerable Adults) list. 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. Standards of hygiene, decor and furnishings in this home offer residents a comfortable and homely place to live Evidence: From a tour of the building it was evident that service users live in a warm, clean and comfortable environment. All areas of the home were found to be clean and hygienic. The home is decorated and furnished in a modern and comfortable way. Residents are encouraged to see it as their own home and to add their own personal touches to the environment. The home would benefit from redecoration in some areas particularly the stairwell, office and bedroom doors and walls where paintwork is chipped. This would improve the environment for the residents. The home has been designed for small group living where residents can enjoy maximum independence in a discrete non-institutional environment. All bedrooms are furnished to a satisfactory standard and have been individually personalised to meet the needs and preferences of the residents. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: There are suitably equipped bathrooms and toilets conveniently situated around the home. The laundry has appropriate facilities for the laundering of residents clothes and linens and there are appropriate infection control procedures in place to protect residents from harm. 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. Residents are provided with care and support by a team of well-trained and caring staff that have been robustly recruited. Evidence: Staff recruitment files are held centrally by the Organisation and have been examined separately by the CQC. However, the AQAA states that recruitment of workers at the home is robust and transparent and meets the necessary standards. The Manager was able to confirm that all necessary checks are undertaken on prospective staff to ensure the safety and protection of residents. Examination of the staff training records and detail in the AQAA evidenced that several of the current staff have either gained or are in the process of attaining NVQ qualifications at levels 2, 3 & 4. Additionally, regular refresher training is provided in core skills as well as more specialised training in non-violent crisis intervention, philosophy of care, autism, mental health needs, medication administration, epilepsy, PEG feeding, rectal diazepam, communication skills, diabetes and person centred planning . The organisation has also introduced Elbox training which provides staff with access to refresher training on line at a time which is convenient to them. Several staff have had the opportunity to train as trainers in specific areas such as fire wardens and manual handling and are able to cascade the training to other staff at the home. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Details in the AQAA and discussion with the Manager confirmed that staff have undertaken induction and foundation training to Skills for Care specification. Additionally several staff have completed LDAF training to enhance their knowledge and skills. The staff training records were well kept and contained copies of induction training, training certificates, supervision and appraisal records. These were examined to evidence compliance with good practise. The Homes Manager undertakes regular audits of the training records and identifies future training needs and requirements linked to fulfilling the business and financial plan for the home. 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 safe and well managed by a competent manager and professional staff team. The home seeks and focuses on the views of its residents on an on-going basis. Evidence: The registered manager Iona Campbell has 16 years experience in management and has completed an NVQ 4 in care, an Advanced Management in Care qualification and the Registered Managers Award to further enhance her knowledge and skills. She is supported in her role by a well qualified Deputy and stable staff team. Staff confirm that the Homes Manager demonstrates effective leadership skills and is hands-on, accessible and supportive. The Manager and Deputy have been covering a management vacancy in a neighbouring care home in addition to carrying out their duties at Middlegreen Road. This has resulted in management being overstretched at times. There is a need for the Organisation to resolve their management difficulties elsewhere in order that the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: management of Middlegreen Road may return fully to their duties. The staff of the home aspire to providing high quality care to the residents in line with the aims and objectives of the home. The staff say they are kept well informed and up-to-date and that they have the opportunity to express their opinions openly in staff meetings, supervision sessions and staff handovers. They say that they are provided with plenty of opportunity to express concerns, share information and to feel included and involved in the way the service is delivered. The Organisation carry out an annual service review of the home to measure the homes success in meeting its aims and objectives. The review is used by the Organisation for quality assurance purposes. The outcome of the review help the Organisation to identify where improvements could be made to the quality of its services. Additionally the proprietors representative visits carried out under Regulation 26 monitor the homes performance against quality standards on an on-going monthly basis. Records of the visits were well documented and up-to-date. The system for managing residents money was examined. The home has a safe procedure for deposit or withdrawal of residents money. Receipts are kept of all cash spent on behalf of residents and there are two signatories to all transactions. The accounts are audited by Senior Management on a regular basis. A number of health and safety records were examined including fire records and hot water records. The checks evidenced that essential servicing and maintenance of equipment is undertaken routinely to safeguard the health and welfare of residents. Servicing and safety certificates were available on file. Unnecessary risks to the residents are identified using comprehensive risk assessments that are reviewed at regular intervals. So far as possible risks are reduced or eliminated. 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 24 Redecoration of the stairwell, office and bedroom doors and walls would improve the environment for the residents. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC 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. 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