Care Home: 1a Tollgate Road

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What the care home does well People who live at 1A Tollgate Road have their care and support needs met by a team of well trained staff who know them well. Care plans are very well written and help the staff to meet people`s needs in a way that they prefer. People are able to take part in a range of activities that they enjoy and all have a holiday each year doing things that they like. People are supported to make decisions and choices and this means that people have control over their lives. What has improved since the last inspection? The home now has a new bath that has made bathing easier and more enjoyable for people. The home makes sure that activities are as safe as possible for people to enjoy. They do this by assessing any risks and ifpossible removing them before the activity starts. The manager and the deputy manager make sure that the home is well run meaning that people can live the lives they choose safely. What the care home could do better: The manager needs to make sure that information is available to tell people about the home. The home should be visited regularly by people who work for Vision Homes. This is to make sure that the organisation knows what the home is doing well and what they have to do, if anything, to make it better. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1a Tollgate Road 1a Tollgate Road Ludlow Shropshire SY8 1TQ 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: Sue Woods Date: 1 2 0 5 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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: 1a Tollgate Road 1a Tollgate Road Ludlow Shropshire SY8 1TQ 01584877737 01584878063 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) : Vision Homes Association care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only (Code 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) 5 The maximum number of service users who can be accommodated is: 5 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home This is a purpose built care home. This means that it is accessible to people who use a wheelchair. Five people live here at the moment. The home is a short drive from Ludlow town. There are accessible busses that stop nearby. This means that people who live at the home can get around easily, although usually people travel by car which they either own or have the use of. Everyone who lives at the home has his or her own bedroom. Nobody has to share a room. Staff at the home and the manager ask people who live at the home what they think of the service provided and people are able to make choices as to how they live their lives. If you are unable to make choices the home will help you to get support to do so by someone that you can trust. 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 Care Homes for Adults (18-65 years) Page 6 of 30 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 3 star. This means that people who use this service experience excellent quality outcomes. We visited 1A Tollgate Road on 12th May 2009 and stayed there for just over five and a half hours. The home did not know we were coming. During the time that we were there we looked at what it is like to live at the home. We did this by meeting the people who live at Tollgate Road and talking with the manager and staff. As some people could not tell us their views of the home we also spent time watching how staff support people to live their lives. We looked in more detail at how the home meets the care and support needs of two people by meeting and observing the people chosen, talking about their care with staff and looking at their care files. This process helps us understand what it is like to live at 1A Tollgate Road and weather those people receive a good service or not. Before the visit the home sent us the Annual Quality Assurance Assessment (AQAA). The manager completed this. This is a form that tells us how the manager thinks the home is meeting the Care Homes for Adults (18-65 years) Page 7 of 30 needs of the people they support and also tells us other information relating to how the home is run. What the care home does well What has got better from the last inspection The home now has a new bath that has made bathing easier and more enjoyable for people. The home makes sure that activities are as safe as possible for people to enjoy. They do this by assessing any risks and if Care Homes for Adults (18-65 years) Page 8 of 30 possible removing them before the activity starts. The manager and the deputy manager make sure that the home is well run meaning that people can live the lives they choose safely. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 9 of 30 If you want to speak to the inspector please contact Sue Woods 33 Greycoat Street London SW1P 2QF 02079792000 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 10 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 11 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 . The home currently has no vacancies and there have been no admissions for a number of years however information about the service is available, although in need of updating and pulling together, to ensure people looking for a service in the future can make an informed choice about whether the home is appropriate to their needs. Evidence: People who live at 1A Tollgate Road have lived there for a number of years. As there have been no admissions to the home we could not assess as to weather the organisations admissions procedures are effective but we did look at the Statement of Purpose. This document tells someone interested in the home what services it offers and how it supports people to meet their needs. Some information needed updating to reflect current arrangements within the home and for the future the manager would like to develop it in an easy to read format. The manager has not developed a service user guide but again has not needed to supply information to any one in this format. She said that information to make up the guide is available separately and she will bring it all together to ensure that it is easily accessible for the future. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Personalised care plans ensure peoples needs are met and that they receive care and support in a way that they prefer. People are supported to enjoy full and active lives and risks are assessed to ensure people can do so as safely as possible. Evidence: On the day of the inspection we met four of the five people who live at 1A Tollgate Road. One person was away on holiday at the time of the visit. Although people were unable to verbally communicate their views with us it was apparent that people were relaxed and comfortable in their home and were able to communicate their needs to the staff team who were supporting them. People were fully involved in making decisions about their day as far as they were able. Staff are supported to meet peoples care and support needs by care plans that are very detailed, identifying peoples likes and dislikes and preferred routines to support Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: all aspects of daily living. The plans are very person centred and reflect each persons individuality. This means that staff can meet peoples identified support needs how they prefer and this ultimately gives people a better quality of life. During the time we spent at 1A Tollgate Road staff were seen to offer people choices and involve them in all decisions that needed to be made about the day ahead. One person was asked if she wanted to visit the art centre and although initially did not want to, decided nearer the time that she would like to go. Staff were flexible in their approach to enable her to change her made. People requested drinks and had breakfast when they were ready throughout the morning and staff made drinks and food as and when requested. This means that as far as is possible people retain control of their lives. The home supports people to be as independent as they are able and use risk assessments to identify possible risks in activities planned. Likewise risk assessments enable staff to carry out personal care tasks as safely as possible and where risks are identified actions are taken to reduce these risks. Assessments are regularly reviewed to ensure that people continue to be supported safely. The manager has recently developed a generic risk assessment to be completed to support impromptu activities. This means that risk assessments do not restrict people from enjoying activities as and when they like. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live at 1A Tollgate Road have opportunities to participate in activities of their choice and also have the opportunity to enjoy an annual holiday doing things that they like to do. This enables them to lead full and active lives. Evidence: People who live at 1A Tollgate Road are supported to lead full and active lives enjoying a range of activities based on their likes and dislikes as well has having opportunities to try new activities such as ice skating for example. Staff monitor reactions to activities to see if they were successful and people are always asked before the activity if they would like to go. This means that people have the opportunity to try new activities (and access activities that they enjoy) but also retain ultimate control of their lives. At the time of our visit one person was away on holiday. Other people have either been on holiday or are looking forward to a planned holiday later in the year. Holidays are planned to reflect what people enjoy for example the person currently on holiday has gone to a venue with live evening entertainment because he loves loud Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: music and the atmosphere that this creates. Daily routines are flexible to suit how each person feels on the day and staff work well to accommodate peoples needs and wishes meaning people can live the lives they chose. Staff were seen to have good rapports with the people they support and people were involved in conversations and general discussions. The menu is set five weekly and reflects peoples likes and dislikes. The menu shows that people are offered healthy and varied meals but staff said that if someone does not want something on the day they could make something else. Records showed that people eat the foods on the menu that they like and one person was seen to be enjoying one of her favorite foods for breakfast. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The personal and health care needs of the people who live at 1A Tollgate Road are very well documented and fully met enabling them to have a good quality of life. People are safeguarded by the homes system for handling, storing and administering medication. Evidence: The two care records that we looked at showed that people attend regular health care appointments and the home works closely with health care professionals to ensure peoples health needs are met. When we carried out our Annual Service Review (ASR) of 1A Tollgate Road three health care professionals said that the home does well to meet peoples health care needs. Comments included; Provides individualised supportive care to their residents, respectful of dignity/privacy. Carers seem to be supportive of each other and have a good rapport with their residents. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: They always seemed very supportive and caring towards their residents when I have visited. These comments suggest that not only are peoples needs met but they are met in a way that meets peoples individual needs whilst respecting peoples dignity. Interactions seen at the time of the inspection reflected that staff also meet peoples personal care needs in this way. Care plans reflect practice and are very detailed as they describe how personal care should be given to reflect individual needs and preferences. Attention to detail means that staff maintain peoples privacy and dignity in all tasks that they support people with. Manual handling tasks are very detailed with individual guidelines supporting practice. The manager had completed a generic risk assessment to ensure tasks are carried out safely but agreed to do individualised ones to further improve this process. On the day of the inspection one person had a visit from the chiropodist and records showed that one person has regular support from a district nurse to ensure his health care needs are met. Arrangements in place for the recording and storage of medication were satisfactory. Medication recorded in peoples care plans were seen to reflect the medication administration sheets also seen. The manager was knowledgeable about the reasons why people take prescribed medication and information is available to inform staff of any possible side effects meaning that people are safeguarded while taking their medication. Protocols were in place to support medicines given as and when required and this enables staff to know how and when to give the named medication to ensure the wellbeing of the individual receiving it. Protocols were signed by a health care professional who knows the individual reflecting their support and involvement in the process. This suggests that the home works with external bodies to ensure the health and protection of people who receive a service. The home also reported improvements to peoples quality of life over recent months as they have worked with health care professionals to review and reduce the amount of medication people are receiving. As a result one person in particular has been able to make clearer decisions. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The manager and the staff team know how people living at 1A Tollgate Road communicate their feelings meaning that people can express their satisfaction or unhappiness at any aspect of the service they receive and be confident that these feelings will be recognised and responded to. People are also protected by procedures in place for managing concerns and complaints raised on their behalf. People living at the home can be assured that the home operates with their best interests at heart by being knowledgeable of local safeguarding procedures to protect people from abuse. Evidence: The home has a complaints procedure that is now available in an easy to read format. The plan to put the policy onto an audio tape will make it more accessible to the people who live at 1A Tollgate Road although the main way that people would show their dis satisfaction would be through communicating with the staff team who know them well. One person has an advocate and other people have regular contact with family members who would also speak out on behalf of their relative if necessary. The home has received no complaints about the service they provide at 1A Tollgate Road and we have not received any complaints or concerns suggesting that the home is being well run for the people who live there. The home is aware of the procedure to follow if abuse is suspected within the home. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: Staff who spoke with us were aware of the process and said that they would be confident to follow it if needed. All staff receive training to report and recognise signs of abuse and the manager has worked with the local safeguarding team following a referral made by the home in relation to an external agency. This demonstrates that the manager is confident to raise concerns on behalf of vulnerable people. Records are kept in relation to money spent by people living at 1A Tollgate Road and there are safeguards in place to ensure money is accounted for. All records are regularly checked and money is counted each time money is handled. This ensures that any mistakes would be quickly identified. Senior managers monitor recording processes although this does not happen as regularly as the home would like. 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 . People who live at 1A Tollgate Road are provided with a safe place to live and planned redecoration and refurbishment will improve the environment and make it more homely. Evidence: We had a tour of the home as part of the inspection and saw the bedrooms of the people whos care we looked at as part of the process. Bedrooms were personalised and reflected individual personalities and tastes. Rooms were comfortable and equipped to meet peoples individual needs. Information provided to us in June 2008 stated that the bathroom that was awaiting refurbishment at the time of the last key inspection of the service has been completed and this was seen at the time of this visit. The bath has improved the bathing experience of people living at the home. One person had just enjoyed a bubble bath at the time of our visit suggesting the bath is used. The home has plans to decorate some bedrooms this year and replace carpets where necessary. The home is currently waiting to have the hallway decorated. These improvements that are planned will improve the accommodation making it a nicer place to live. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Heath and safety checks to the environment are well recorded and monitoring takes place by the organisations head office to ensure checks take place and any issues are identified and addressed keeping people safe at the home. The manager stated that the home has not recently had an environmental health visit or fire officer visit but was confident that all aspects of fire safety and infection control were addressed to protect people living at the home. Disposable gloves and aprons were seen readily available and staff were seen to use them. We did not look at the fire risk assessment although the manager demonstrated that staff receive fire safety training and that fire equipment is regularly checked to protect people in the event of a fire. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at 1A Tollgate Road receive good care and support from a well trained and well supported staff team enabling their needs to be effectively met within the home. Appropriate pre employment checks on staff who work at 1A Tollgate Road ensure that the home only appoints people who are suitable to work with vulnerable people. Evidence: We spoke with staff on duty at the time of our visit in small informal groups and also some staff spoke with us in private. We gave everyone the opportunity to do this. Staff, without exception spoke highly of the quality of care provided by the home and staff were knowledgeable about peoples individual care and support needs. This is especially important given that the people living at 1A Tollgate Road rely on staff to understand their preferred method of communication to enable them to make choices in relation to how they wish to live their lives. The observations of staff interactions made by us at the time of the inspection were very positive. Staff supported people sensitively and discreetly respecting their privacy and responding to requests promptly. Staff said that they had enough time to carry out their roles effectively and respond to individual needs. They were flexible enough to be able to support the choices that people made in relation to how they would like to spend their day. This Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: enable people to retain control of their lives as far as is possible and live the lives they choose. This is a strength of the service provided at 1A Tollgate Road. Training for staff working for Vision Homes Association remains a strength of the service with staff reporting good training opportunities, many of which are individualised to meet the specific needs of a named person receiving a service. For example along with the manual handling theory training staff are trained to meet the specific needs of people at the home with a practical session following individualised guidelines. When staff were asked what they thought the home did well comments included, Good continuity, Good shadowing for new staff, a Responsive team and Good training One staff member said People have a very good life. Staff felt that management arrangements have improved with the appointment of a deputy manager. People felt well supported. One staff member said that management and teamwork was All going in the right direction. When asked what could be done better the only suggestion was in relation to the long hours worked but it was said that this was already being addressed. One staff member said that that nothing could be improved and the home was the best ive ever known it. The home has a robust induction programme and this will ensure that new staff to the home will receive detailed and comprehensive information required in order to effectively support the people who live at 1A Tollgate Road. The staff files of the last three care staff to join the team were reviewed and found to contain essential information required for the home to demonstrate that people are recruited safely to ensure the protection of vulnerable people. The only exception was that the organisations head office retain proof of staffs identity. The manager said that she would be able to request copies of this information to complete her files kept at the home. 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 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 1A Tollgate Road benefit from being supported by an effective and open management team. Effective health and safety checks mean that the people living at 1A Tollgate Road live in a safe environment. Evidence: The manager of 1A Tollgate Road is well respected by her staff team and has good knowledge of the care and support needs of people living at the home. She was regularly described as excellent. The manager attends training to update her knowledge in relation to personal and professional development. She recently attended Deprivation of Liberties training and as a result she has been able to implement her knowledge within the home and identified that no one currently living at 1A Tollgate Road is having their liberty deprived. Her knowledge, that she will share with the staff team, will ensure the protection and freedom of people living at the home. Vision Homes Association provide the manager with support from a senior manager Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: who is in daily contact and regularly on site and from an accessible training and practice manager who also supports the home on a regular basis. However as we noted at the time of our last inspection, visits required to be carried out on a monthly basis to report on the quality of the service provided at the home are still not taking place and the manager is aware of this. Following the inspection we rang and spoke with the responsible individual for the home Ms Ewa Stefonawski who gave 100 assurance that these visits would restart with immediate effect. She also identified that the format for recording these visits would be reviewed, again to improve the process. Health and safety checks are carried out regularly to ensure the home is a safe place to live and all equipment used within the home, including aids to support the moving and handling of people are well maintained and regularly checked to ensure they are safe to use. Policies and procedures and a number of standard documents are now being produced in an easy read format to ensure that as far as possible they are can be understood by the people who receive a service. The involvement of people using the service in developing these documents reflects the organisations commitment developing a service that demonstrably meets peoples needs. A quality assurance questionnaire was sent out by the organisation in December 2008 asking what people who receive a service, their representatives and the staff team think of the service. The manager had yet to see the outcome of this survey but verbal feedback was said to have been positive. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  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 Description 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 Description 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 1 It is recommended that the home develop a Service User Guide to bring together all information that would inform a new service user about the home and what services it offers (as per NMS 1.2) It is recommended that the home develop individualised moving and handling assessments to support the guidelines already in place. 2 18 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!