Care Home: 185 Passage Road

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What the care home does well Peoples` needs are assessed before they move to the home to help ensure they can be met. They can visit the home before moving in to see if it is the right choice for them. The care plans and risk assessments of the people living at the home show how people should be supported with their assessed needs, preferences and behaviours. Staff said they are given information about the people so they can be supported in a consistent way. People living at the home have opportunities to take part in various activities in the community. The home is run in peoples` best interests. What has improved since the last inspection? People moving to the home had their care needs assessed so that staff could make a decision as to whether they can be met. Staff have been trained in meeting the needs of the people living at the home. This includes appropriate training for the work they perform. Care plans and risk assessments set out how people should be supported with their needs. They included how people had made decisions about their lifestyle, were being supported with their spiritual needs, and their individual communication needs. People living at the home had their medication reviewed with positive outcomes for two people. The complaints pocedures were being folllowed helping to ensure people were being listened to. The fire safety arrangements for the people living at the home had been reviewed. What the care home could do better: People living in the home must be provided with an up to date contract that shows the terms and conditions of their stay. Some people would benefit from more information in their communication profiles so that staff support them consistently. The manager needs to follow up action for the back garden to be accessed by all the people living at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 185 Passage Road 185 Passage Road Brentry Bristol BS10 7DJ     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: Sarah Webb     Date: 2 2 1 2 2 0 0 9 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 29 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 29 Information about the care home Name of care home: Address: 185 Passage Road 185 Passage Road Brentry Bristol BS10 7DJ 01179509586 01179699000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.brandontrust.org The Brandon Trust Name of registered manager (if applicable) Ms Ruth Martin Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 7 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) - maximum number 2 Learning disability over 65 years of age (Code LD(E)) maximum number 2 Mental Disorder (Code MD) - maximum number 3 Date of last inspection Brief description of the care home This home is registered to accommodate 7 male residents with a learning disability. The current resident group have a variety of complex needs whose ages range from 43-88 years. The Registered Providers for this home are the Brandon Trust. This single level home is situated on Passage Road and is close to local amenities. There are Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 2 0 2 3 1 8 0 2 2 0 0 9 Brief description of the care home local bus stops providing easy access to the city centre and to Cribbs Causeway and its shopping facilities. The home blends easily into the local community and is in keeping with the neighbouring properties. The home is fully accessible to the current resident group providing ground floor accommodation. However a ramp is needed to ensure full access to the grounds for residents whose mobility has deteriorated. There is a large well-kept garden mainly laid to lawn with fruit trees. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced Key Inspection of the home that took place on 22nd December 2009. The pupose of the visit was to review the requirements and recommendations previously issued and to review the care practice in the home. We looked at all the information we had received about the service since the last Key Inspection. A Quality Assurance Assessment (AQAA) was sent to the home and information gained from this has been used to inform this report. We spoke with the Registered Manager, a senior member of staff and a member of the care staff. We spoke with two people living at the home, one of whom was able to give Care Homes for Adults (18-65 years) Page 6 of 29 their views about living at the home. We looked at records relating to the people living at the home including care plans, risk assessments and the administration of medication. We also looked at records relating to the general running of the home and health and safety issues. Care Homes for Adults (18-65 years) Page 7 of 29 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. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people wanting to live at the home have up to date information made available for them, to help them decide if they want to live there. Peoples needs are assessed before they move to the home to help ensure they can be met. People wishing to move to the home can visit to help decide that this is the right choice for them. Not all information in the agreements setting out terms and conditions of peoples stay at the home were current. Evidence: We saw a new Statement of Purpose and Service User Guide in place had been reviewed and rewritten meeting a requirement made at the previous inspection. Information relating to how people were involved in making decisions about moving to the home and how the privacy and dignity of the people living at the home was Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: respected had been included. We saw that the sizes of the rooms, the range of the needs of the people living at the home and the arrangements for activitities and visitors had also been included. There had been one new person admitted to the home since the last inspection. We saw the Trusts Referrals and Admissions Policy and a new in-house policy. The procedures as set out in the policy had been followed. Social Services had carried out an assessment of their needs before moving to the home helping to ensure they could be met. They had been involved in making a decision about moving to the home and had visited on several occassions to meet the other people living there. This was seen through appropriate documentation in their care files. We saw people living at the home had agreements in place about their accomodation. We noted that one persons agreement setting out their board and lodging arrangements referred to their previous placement and needed updating. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans and risk assessments of the people living at the home show how people should be supported with their assessed needs, preferences and behaviours. They are supported in making decisions about their lifestyle and their changing needs are monitored through regular review of their care. Evidence: A requirement had been met for each person to have a plan in place to show how their assessed needs were to be met. Support plans had been developed for each person and records showed their needs were being met through a consistent approach. We saw five peoples Planning for Life Folders that contained comprehensive information about how they should be supported. They included peoples individual preferences and routines. Information was presented in an individual person centred way through pictures and symbols. This helped people to be involved and understand their care planning. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: A requirement had been met for support plans to be developed for people living at the home who had communication needs. We saw two peoples communication profiles that contained detailed information, and presented information individually and in an accessible way using pictures and symbols. We noted that other people would also benefit from fuller information. We saw records of when an individual had made choices and the action staff had taken in response. Staff had attended training in the Mental Capacity Act and had a good understanding about the processes in supporting the rights of the people living at the home to make decisions about all aspects of their lifestyle and in considering their best interests at all times. Daily communication reports showed the activities people had been involved with during the day, and their general wellbeing. Monthly summary reports completed by individuals keyworkers were seen to be reviewing peoples care on a regular basis and any changes to their care and support. A requirement had been met for risk assessments to show how staff had been supported in dealing with some peoples inappropriate, aggressive and violent behaviours. We saw risk assessments that had been developed and reviewed. Information was seen that gudied staff in supporting people with behaviours that challenged the service. We saw records of multidisciplinary meetings in individuals files where staff had involved other professionals and sought their advice. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have opportunities to take part in occupational, educational, social and religious activities in the community. They are supported in keeping in contact with their families and friends. People living at the home benefit from a varied range of choice of food. Evidence: A requirement had been met for people, if they wished, to have opportunities to fulfil their spiritual needs. One person enjoyed going to church and staff had supported them with this preference. Staff were also in the process of arranging for them to link up with their previous church. We spoke to them and were told they were happy living at the home. The majority of the people living at the home had been involved in a range of Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: occupational and educational activities. These included paid employment, attending day services and a specific service for deaf people. Some people had choosen not to be involved in any planned activity. We spoke to an individual living at the home who told us they worked at a farm and described the daily tasks they carried out. It was evident by the way they spoke that they enjoyed this placement and that it was a meaningful part of their lifestyle. A requirement for care plans to include the social, educational and occupational needs of the people living at the home has mostly been met. The majority of the care plans showed us how these needs were being met. There were some areas that needed some more detail such as one persons occupational needs and this was discussed with the Registered Manager. We saw records of when people had been supported to access the community. These included trips out, regular skittles activities, cinema, shopping and eating out. An individual living at the home confirmed five people living at the home had been involved in an annual holiday to Cornwall during the summer which they had enjoyed. A member of staff spoken with told us people were getting out more often since having accessible transport for the home. The Annual Quality Assurance Assessment told us that although improvements had been made for people to participate in opportunities in the community, this was still an area that could be further improved. We saw that there were some people living at the home who had contact with their family members, whilst others had friendships outside the home. Staff helped to maintain this contact and this was seen through individuals care planning. We saw records of how people living at the home were involved in the daily routines. These showed that some people helped with the household tasks such as laying and clearing the table and with the food shopping. We saw the menus had provided people living at the home with a range of choices of food. Breakfast and a light midday snack was offered, while a main meal was prepared for people in the evening. We were told that people were offered an alternative if they didnt like what was on the menu, that staff knew their likes and dislikes. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are treated respectfully with their health care and personal needs reviewed and monitored regularly. They are safeguarded through policies and procedures that set out clear medication practice. Evidence: Support plans showed how people living at the home were supported with all aspects of their personal care in the way they prefered. We saw staff knocking on peoples bedroom door and waiting to be asked to come in. An individual living at the home confirmed staff were respectful and listened to what they had to say. People living at the home had access to National Health Service(NHS) facilities which included regular checks with the dentist, optician and chiropodist. We saw through the health care records of the people living at the home that psychiatrists, Speech and Language therapists through the Community Learning Disabilities Team (CLDT) had provided individual support. This was seen through one persons Health Action Plan that included how they were Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: also supported by healthcare professionals. Health Acion Plans also showed their health care decisions about their preferences and routine checks. Information such as General Practitioner(GP) and surgery had been presented through photographs helping them to be involved in the planning of their care. Pictures and symbols helped them in communicating their feelings and specific needs recorded included religious beliefs, dietary and medication needs. An appointments diary had recorded when they had accessed healthcare support. Medications had been administered through a monitored dosage system by the staff. Records of administration had been signed by the staff following administration and codes had been used to indicate the reason for not administering the medication prescribed. Medication profiles were seen and stated the medications prescribed, the purpose and their side effects and the prefered way of taking medication. For people on when required medications, protocols were seen to guide staff on administering medications as intended by the prescriber. We saw controlled medication was being kept safe and a controlled medication register was in place. A requirement made at the last inspection has been met for the manager to ensure that the people living at the home all require when required sedatives for agitation. This has been met through all the people living at the home having had an intense review of their medication. This has resulted in two people having had their medication reduced. It was evident that this has had a positive impact on their well being and the general atmosphere in the home. Staff training records confirmed all staff had completed medicataion training to help ensure the people living at the home were supported safely taking their medication. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported to express their concerns with their complaints listened to and acted upon. People living at the home are safeguarded from abuse through a staff team team trained in understanding all aspects of abuse. Evidence: The Trusts complaints procedure is included in the Statement of Purpose. We saw accessible complaints procedure for the people living at the home in their Planning for Life folders. We were told by the Registered Manager that complaints had been discussed and raised during house meetings. This had helped to raise the profile of complaints and reinforce to the people living at the home that it was peoples right to express their concerns or complaints. A requirement had been met for the Manager to ensure that complaints were taken seriously and acted upon. We saw that there had been one recorded complaint since the last inspection. The appropriate procedure had been followed in investigating the complaint. Action taken and the outcome of the complaint had been recorded. An individual confirmed they knew who they would speak to if they were unhappy. They said they had made complaints in the past, that they had been listened to, and had Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: been happy with the action taken. The Trust has policies and procedures to follow in the event of a disclosure of abuse being reported. We spoke to a member of staff who confirmed their understanding of the procedure to follow and that they would always report any concerns relating to abuse to the Manager. New staff are provided with abuse awareness training during their induction. Staff training records confirmed all but one member of staff had received up to date refresher training in abuse. We were told that this member of staff was new and due to complete their induction. We saw there were safe financial systems in supporting the people living at the home with their finances. This helped to protect people from financial abuse. There were facilities for the safekeeping of cash and valuables on behalf of the people living at the home. A sample check of cash held was undertaken and the records confirmed the balance was correct. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a clean and homely environment. The accessibility of the garden space by all of the people living at the home has begun to be actioned. Evidence: The home is situated on Passage Road and close to local amenities. There is a local bus service providing easy access to Bristol city centre and to the Cribbs Causeway shopping facilities. The home blends in with the local community and is in keeping with the neighbouring properties. The accommodation had a ramp to the front of the home. A pathway around the property was in the process of being developed for further accessiblity for the people living at the home. We were told by the Manager that funding for a a lift had been requested for the back of the property. This would ensure everyone living at the home can access the rear garden and had been raised as an issue in previous inspections. This will also be followed up at the next inspection. There was raised garden decking at the back of the property where people living at the home can smoke. A temporary cover had been put over this area to help protect people from cold and wet weather. All the bedrooms except for one are on the ground level. Those seen were well Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: decorated and had been personalised with individual choice of colour and personal belongings. Communal areas were clean and tidy. We saw people relaxing in the lounge that was homely, with a good standard of furnishing. There had been some internal redecoration that had taken place and it was evident the staff team had generally helped to make improvements in creating a more homely environment. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience 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 benefit from a competent staff team who have a good understanding of their role. People living at the home are protected through robust recruitment procedures. Evidence: We spoke with a member of staff who demonstrated their knowledge, experience and how the needs of the people living at the home were met. They had a good understanding of their role and responsibilities and confirmed they had received training in appropriate areas in the support needs of the people living at the home. The Manager and staff spoken with considered that the staff worked well as a team and were supportive of each other. It was confirmed that vocational qualification is encouraged with seven staff holding a National Vocational Qualification(NVQ) in level 2, one in level three, and a further two staff in the process of completing level three. Staff personnel records were held at the Trusts headquarters. We saw employee employment records kept at the home to show recruitment procedures are robust and keep the people living at the home safe. These record sheets showed us that the manager had seen the staffs personal details, Criminal Record Bureau (CRB) checks and references. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: A requirement was oustanding at the last inspection for all staff to receive appropriate training for the work they perform and that they are updated in training considered compulsory. We saw through the training matrix that this had been met. Two staff had attended training in Autism, all staff had attended refresher training in first aid, and all had completed food hygiene training. All but two staff had attended manual handling refresher training with training being booked as two staff had recently returned to work. We looked at the supervision records of the staff and noted that all staff had been receiving regular formal supervision. This was also confirmed by a member of staff spoken with. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at the home can be reassured that the home is well managed with the home run in their best interests. The health and safety of the people living at the home is promoted Evidence: There have been changes to the management of the home since the last inspection. There is a new Registered Manager who is also a Locality Manager. This role includes responsibility for the overall management of other care homes registered by the Trust. The Manager is supported by two senior staff who are responsible for the day to day running of the home. We were told through the Annual Quality Assurance Assessment that the new managerial structure has given staff clarity and unity. It was evident from speaking to staff that the changes have had an impact on the home for the better. We were told that the management team were approachable and that staff felt supported. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The Brandon Trust operates a quality assurance system based on National Minimum Standards (NMS) which the staff use to audit the quality of the care provided and where standards are not met an action plan is developed. We were told by the Manager that this process was due to be carried out in Jnauary 2010. The views of the people living at the home are encouraged through house meetings, keyworker support, and reviews of peoples care. Since the last inspection, the Fire services had inspected the premises and identified areas that did not comply with fire legislation. We saw an action plan had been put in place to remedy failures. We saw a fire risk assessment had been reviewed and updated in May 2009. Individual fire risk assessments had been developed for the people living at the home to help ensure their safety in the event of a fire in the home. Records showed staff had received fire training, and regular fire drills had been carried out. We saw checks had been made to help ensure the people living at the home and staff worked in a safe environment. This included annual checks of portable electrical equipment, gas safety checks and hoists. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 5 5 People living at the home 09/04/2010 must be provided with an up to date contract setting out the terms and conditions of their stay. So that they are given information about living at the home. 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 24 Develop communication profiles further to include more information about how people communicate. The manager needs to follow up action for the back garden to be accessed by all the people living at the home. Care Homes for Adults (18-65 years) Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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