Care Home: 14 Marloes Walk

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 14 Marloes Walk 14 Marloes Walk Sydenham Leamington Spa Warwickshire CV31 1PA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Martin Brown     Date: 0 8 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 30 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 30 Information about the care home Name of care home: Address: 14 Marloes Walk 14 Marloes Walk Sydenham Leamington Spa Warwickshire CV31 1PA 01926452804 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) : Turning Point care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 14 Marloes Walk is a care home with nursing care for eight younger adults with severe learning disabilities and physical disabilities. The service providers are Turning Point. Ownership of the home is being transferred to Warwickshire Council, from South Warwickshire Primary Care Trust. The two bungalows were purpose built and the home was opened in 1994. Four service users are accommodated in each of the bungalows. The bungalows are connected and have a shared office, sensory room and laundry. The home is close to a small row of shops and is close to the town of Leamington Spa. All of the bedrooms are single, without en-suite facilities. There are two adapted bathrooms and a sensory room. The home and gardens are suitable for wheelchair users. The service aims to provide care, support and a good quality of life primarily for people who have very little independent mobility, and who have great difficulty in communicating their needs and wishes. The fee for each person, per week, is currently £1613.50 per person. Care Homes for Adults (18-65 years) Page 4 of 30 Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report has been made using information that has been gathered by the Care Quality Commission. The inspection visit took place on 8th April 2009, between 9.30am and 3.30pm. It was a surprise visit, so that the home could be seen how it usually is, without any special preparation. Two residents were out throughout the visit; all others residents were seen at some point during the inspection. A tour of the premises was made, relevant documentation was looked at, and observations of the interactions between residents, staff and their environment were made. Policies and procedures, and care records, were examined. The experiences in the home of three residents were looked at in depth. This is known as case tracking. Staff from both shifts, as well as the deputy manager, were seen and Care Homes for Adults (18-65 years) Page 6 of 30 spoken with. The manager was not present. Following the inspection, four relatives of people living at the home were spoken with by telephone. The Annual Quality Assurance Assessment, containing information about the service, completed by the manager, and returned before the inspection, also informed the inspection. This AQAA gives details of what the service considers it does well, and what areas it needs to improve on. The deputy manager, staff, and the people using the service were welcoming and helpful throughout. 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 8 of 30 Care Homes for Adults (18-65 years) Page 9 of 30 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 30 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 benefit from thorough assessment of their needs and can be confident that the service is committed to supporting individual aspirations. Evidence: The home had a new admission at the end of last year. The self assessment form returned by the service explained how this was done. It was a gradual process with social worker support to ensure the process was guided, as far as could be gauged, by the needs and wishes of the person themselves. It is a constant theme of this service that, because of the profound disabilities of the people living at Marloes Walk, the service has to work very hard to gauge individual preferences, in order to meet wishes, as well as needs. Records in this persons care plan show careful observation from the outset of the admission process, in order to gauge and meet this persons needs. Staff acknowledged that, three months into this persons stay, they were still learning about the best ways they could be supported. There were very positive signs of the person being able to progress and re-learn skills. Staff spoke of this, and it was confirmed in comments by a relative, who commented that this person had improved Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: so much since moving to Marloes Walk. Another relatives noted how staff seek relevant information from relatives, to help their understanding of individual needs and wishes. Care Homes for Adults (18-65 years) Page 12 of 30 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. Good, clear guidance continues to support staff in providing consistent care for residents. The home continues to assist and heed residents in decision-making. An appropriate balance continues to be struck between ensuring that residents are safe and comfortable, and that they have new and varied experiences. Confidentiality of sensitive information is potentially compromised by the understandable wish to make information accessible. Evidence: A sample of three care plans were looked at in depth. These showed that guidelines for care continue to be clear and well illustrated with photographs, and regularly reviewed to take account of any changing needs. Through a mixture of communication guides, care plans, daily recordings and staff sharing of information, residents needs are met in a consistent and well-informed manner. Staff showed throughout a good knowledge of the residents and their needs and wishes, and acknowledged how reliant they were Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: on translating gestures and eye moments to gauge certain residents wishes and moods at times. Where a resident was relatively new, staff acknowledged that they were continually learning, and this was reflected in recordings. A very good quality communication guide had been specially developed for this person. Staff acknowledged that this was likely to need revising as the service continued to develop their understanding of this persons needs. Unfortunately, this otherwise excellent communication guide had not been dated to facilitate a timely review of its continued appropriateness. One relative commented that staff made a point of asking who people were in family photos, and requested close family birthdates, so as to better support each resident as having family involvement. Daily recordings showed a sensitive, professional and observant records being kept by staff. Some of these were a little confused by attempts to write in the first person. Staff spoken with felt that , while writing in the first person was appropriate for communication guides and similar, it was not appropriate for daily recordings. Staff continue to work hard to ascertain the wishes, likes and dislikes of those living in the home. This is acknowledged by staff and relatives to be difficult at times, but staff share knowledge and experience, and are supported by guidelines, to make positive choices that reflect the wishes of the individuals concerns. Staff observe such as eye movements and facial expressions to gauge the well-being of people living at Marloes Walk, and their enjoyment or otherwise of activities and sensory experiences. All relatives spoken with commented on the hard work and dedication of staff in this respect, and of the positive results this bought. Staff continue to support individuals in a variety of activities, without compromising safety concerns. Clear and thorough risk assessments are in place for such as holidays. Relatives commented on how they feel people living at Marloes Walk are in very safe hands, while also knowing that they are supported to have experiences that their disabilities might otherwise have limited. A number of individual files, many containing what should be regarded as confidential information, were on display in lounge areas. Staff advised that these should normally be in the bedrooms of the individuals concerned. It is appreciated that there needs to be a balance between privacy and relevant information being accessible, and that communication guides and support folders need to be readily available. Staff spoken with did agree that if potentially confidential information is in communal areas, it should at least be in cupboards behind doors. They also agreed that lounges would look more homely with less files on open display. Care Homes for Adults (18-65 years) Page 14 of 30 Care Homes for Adults (18-65 years) Page 15 of 30 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. The service continues to work hard and effectively to minimise the impact of individual disabilities on the ability of residents to experience the outside world and take part in stimulating and socialising activities. The service supports individual rights by enhancing their status as valued individuals. Eating is managed safely and with the aim of increasing independence and self-help wherever possible. Evidence: Two residents were out at day services. Two more residents went out later to the theatre in Birmingham. Staff spoke of individual holidays planned for residents this year, and of how these are to be planned and supported. Residents are supported to use local facilities such as shops, with staff recognising that they value the stimulation and social contact that these present. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: One person enjoyed time spent in the snoozelum, showing an obvious interest in the lights. The service also plans themed nights and meals, to which relatives are invited, and these provide additional stimulation and interest for all concerned. Staff showed a good awareness, gained by long experience, of individual likes and dislikes, as well as an acknowledgement in some cases, that they cannot always be sure how much a person may be enjoying an activity. There was acknowledgement amongst staff that holidays abroad, though commendably ambitious, may not have benefited individual residents sufficiently to justify the cost and effort in arranging them. Family contacts are supported and maintained. All relatives spoken with talked of the supportive and informative nature of the service, and how they were welcomed at any time. We are always kept informed, and our views are asked on any plans, were two comments made by relatives. Observations during the inspection showed individual rights respected, with all interactions taking place in a friendly, respectful manner, with the needs of the individual concerned being central. The service works hard and effectively in helping establish individual identity and rights and valuing them as individuals, whether by individualising rooms, spending quality time with people, reading to them, singing, seeking to establish what provides enjoyment and stimulation, and avoiding that which may cause distress. Some people living at Marloes Walk require peg feeds. This is done under professional guidelines by appropriately trained nursing staff. Where residents are assisted to eat, this is done according to agreed guidance by outside professionals. Some individuals are supported by peg feeds as necessary. Staff and relatives commented on the progress made in eating that has been made by some residents. Meals are freshly prepared by staff using a variety of nutritious ingredients to make them attractive to individual residents. Care Homes for Adults (18-65 years) Page 17 of 30 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. Residents continue to benefit from a service that that works hard and effectively to ensure that essential individual support needs are met in a way that individuals are comfortable with. Evidence: Staff continue to pay great attention to residents to enable them to have a good knowledge of what they are doing is what individuals are happy or comfortable with. Relatives made many complimentary comments on how well staff respond to individual needs, with positive results for individual well-being. Staff were seen to be working as a team, and using and adding to guidance and existing knowledge as to meeting the needs and wishes of the most recent admission. This too was commented on by a relative, who was most impressed at the way this person had progressed since moving to Marloes Walk. Other relatives compared Marloes Walk very favourably with other care services. There was much evidence of the support and guidance of relevant outside professionals. One staff spoke of a programme, supported by outside professionals, to Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: introduce objects of reference to help residents better communicate. Most medication is dispensed via blister packs. Medication Administration Record Sheets were looked, and these, alongside additional recording sheets that showed a daily record of numbers of individual tablets remaining, demonstrated accuracy in administering and recording. A sample of medications were checked, and amounts remaining tallied with records of what had been dispensed. There is a book and record of a controlled medication, ready for use when necessary. Controlled medication is stored appropriately. Two medications, alongside with some food supplements, where stored in a fridge in a kitchen. Although the risk was currently minimal, and the fridge was not being used for general foodstuffs, staff agreed that such medications can only be completely safely kept in a lockable fridge. The health needs of people living at Marloes Walk continues to be acute in several instances, and the service has ensured it has appropriate support and guidance from outside agencies. This was evident in discussion with staff, relatives and other agencies, and in individual records. Clear palliative guidelines, drawn up with outside professional support, were seen to be in place for one person, and staff spoken with were aware of these. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The open and transparent nature of the service continues to help protect vulnerable residents from abuse and neglect. Staff continue to show a commendable commitment to understanding and meeting the needs and wishes of people living at Marloes Walk. Evidence: We have received no complaints regarding this service over the past year. The service advised that they have not had any complaints. All relatives contacted had nothing but praise for the service, and commented that if they did have any concerns, then they were confident that raising them with the manager would soon resolve them. One relative noted that since they raised a concern about not always being informed of any health or other difficulties, they are now always informed immediately of any such problem. Several relatives commented that communication with the service was very good. There are complaints, concerns and compliments forms readily available. There was only evidence of unsolicited compliments from relatives. Staff spoken with were aware of how the profound disabilities of the people living at Marloes Walk made them especially vulnerable, and were able to discuss what they would do if poor or abusive practice was ever suspected. A sample of financial records Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: for monies handled on behalf was looked at, and this was accurate, and showed that expenditure was properly accounted for, and that a sound system for protecting residents finances was in place. Throughout the visit, staff continually demonstrated their commitment to ascertaining, as far as they could, the views of residents in all day-to-day matters affecting them, from where they were sitting, to what they ate, and how they reacted to visual or other stimulus. Relatives commented positively on staff commitment to observing and heeding whatever signals residents might make to indicate pleasure or otherwise. Care Homes for Adults (18-65 years) Page 21 of 30 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. Residents continue to benefit from a clean, spacious, and hygienic environment that continues to be homely. Individualised bedrooms promote the well being and personalities of individuals. The improvements in the garden typifies the hard work of staff and management in improving the environment for those living at Marloes Walk. Evidence: The environment is spacious and airy, and well suited to the needs of the people using it. There are hoists and other equipment in frequent use, but the home is spacious enough not to appear cluttered. The home was clean and hygienic on the day of the inspection. Pictures and decorations help make the home more homely, with photographs of social events and activities also brightening up walls. Bedrooms, in particular, are personalised in line with the needs and interests of the individual, with lots of decorations, pictures and personal possessions. Outside each bedroom is a letter rack for post. Relatives commented on how hard the service worked to make each bedroom personal, and always sought advice about appropriate furnishings and decoration. Bedrooms are not en suite. For those with such profound needs as those living at Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Marloes Walk, en suite would involve large individual specialised baths. There are currently two well-equipped bathrooms, although the equipment needed makes these less spacious and a little less homely than other parts of the home. Staff advised that residents enjoy baths and the sensations associatated with them. The snoozelum room is now a well-used feature of the building. One resident spent some of the morning content in this room, stimulated by the lights and music. The garden continues to be developed, and now has a trampoline, and raised gardening beds, barbecue and seating areas. Staff and management have obviously worked hard to achieve better outdoor facilities for those living at Marloes Walk. The laundry was clean and tidy, and good hygiene procedures were in place. The home was fresh and airy throughout. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Marloes Walk benefit from a good ratio of well trained, properly recruited staff who are well motivated to maintain and improve the quality of life of all those living in 14 Marloes Walk. Evidence: Rotas showed that very few agency staff are now used. The ones seen on the rota twice that week were named, and previous rotas showed they had been consistently used as cover. Staff said that, if emergency cover was needed, regular staff tended to work overtime, rather than use someone unfamiliar with the residents and their needs. The rota did not show any evidence of staff working excessive hours. Staff commented that they felt training was now much more service specific, that is, more relevant to meeting the needs of the people living at Marloes Walk. Areas such as infection control and palliative care were now targeted by training. Staff were enthusiastic about National Vocational Qualification training, with the majority of staff now having achieved, or working towards, National Vocational Qualification level 3 A sample of three staff records was examined, concentrating on the most recent recruits. These showed that safe recruitment practices continued to be adhered to, Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: with evidence of references, Criminal Records Bureau checks, employment history, training and induction. One staff spoke comprehensively of the areas covered by induction training. Staff commented that one of the previous difficulties, the lengthy delay between someone being recruited and them starting the job, had now been reduced so that the latest recruit was starting within a month of being recruited. Previously, staff advised, this process had taken many months, with the result that potential staff often went elsewhere. Throughout, staff were seen to interact with residents in a warm, positive and individual manner. Staff were observed to stimulate, or soothe residents, according to circumstances. In discussion, staff showed their enthusiasm for supporting and enabling residents to the best of their ability. This was echoed by many comments from relatives, who noted, in particular the dedication of staff: Nothing is too much trouble They give up a lot of their own time Some come in early, and stay late, if there is a problem. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents continue to benefit from living in a well-run home that promotes their health, safety and well-being. The service provides a safe secure environment that is a springboard for individuals to be able to enhance their quality of life and increase their living skills. The service is viewed extremely positively by relatives of those who use it. Evidence: The manager was not present during the inspection. The service was running effectively in her absence. The home was suitably staffed, staff were clear on their roles, and of the needs of residents, and a variety of activities were in place. Regular visits by the registered provider or their representative were in evidence, with brief feedback on specific areas of the service. The organisation has recently surveyed relatives as part of its Quality Assurance process. Several relatives spoken with commented on having received surveys to complete. Staff on the day of the inspection did not have details or results of these, or previous, surveys. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: As noted elsewhere in this report, staff work hard to ascertain the wishes and views of the people who live at Marloes Walk, in their every day interactions with them, and in using professional support, and the views and information provided by relatives. Relatives commented very positively on the running of the home, and the service it provided. Typical comments were: They do so many different things. The manager is very approachable. Nothing is too much trouble. There is a lot of love and affection. They speak to them as people. I give them all eleven out of ten. The returned self-assessment form showed all health and safety checks taking place at required intervals. No hazards were noted during the inspection. Records of Fire Safety checks were seen to be satisfactorily maintained, and staff were aware of what to do in the event of fire alarms being activated. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 2 6 10 All communications guides and similar documents should be dated to ensure their timely review. The home should review storage and accessibility of individual information, so that confidentiality and homeliness is not unduly compromised. All medication, including refridgerated medicine, should be stored securely. 3 20 Care Homes for Adults (18-65 years) Page 29 of 30 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 30 of 30 - 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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