Care Home: 218 Kingsway

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What the care home does well Positive comments were made by people living at the home. These included "the home is nice so are the residents and staff", "I go to the hairdressers on my own", and "I like the food". The service provides a comfortable and structured home life for people and they are supported in their chosen lifestyle. The home encourages people to speak up and people confirmed staff listen to what they say and act on their wishes. Staff have a good understanding of their role and responsibilites and of peoples` needs, and were able to give examples of how people are supported. What has improved since the last inspection? The home has met the requirements and recommendations from the last inspection. The Statement of Purpose has been reviewed to make clear the expectations that individuals must undertake household tasks. A record is now kept of peoples` goals, activities and occupation in care planning. Care plans have been kept under review and updated when necessary. Staff have received training in keeping people safe from abuse, how people communicate and how staff should respond appropriately to help ensure good professional relationships are maintained at the home. What the care home could do better: People would benefit from the Service User Guide being updated with current information in accessible format. An individual`s moblity needs must be risk assessed when accessing the stairs to help ensure thay are are being supported safely. The safekeeping of some medication needs to be reviewed so that people are protected. The manager needs to act upon advice from a fire specialist and review the fire risk assessment relating to this. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 218 Kingsway 218 Kingsway St George Bristol BS5 8NS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Webb     Date: 0 6 1 1 2 0 0 8 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 27 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 218 Kingsway 218 Kingsway St George Bristol BS5 8NS 01179476315 01179709301 max@aspectsandmilestones.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Aspects and Milestones Trust Name of registered manager (if applicable) Ms Nicola Jane Josefowicz Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: May accommodate up to 5 persons aged between 18 and 64 years with Mental Disorder. Date of last inspection Brief description of the care home 218 Kingsway is a care home for five younger adults of both sexes with mental health care needs. It is operated by Aspects and Milestones Trust and managed by Ms. N. Jozefowicz. The property is semi-detached, with an appearance of a domestic dwelling, which blends well with its local environment. It is adjacent to a shopping precinct and major bus routes. The fees range from #289.00 - #420.00 per week. The main aim of the home is to provide 24 hour support with enduring mental health needs. To provide a holistic approach to individual needs, and to have an experienced and competent staff team to meet those needs. 5 Over 65 0 care home 5 Care Homes for Adults (18-65 years) Page 4 of 27 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 inspection that took place over one day. We case tracked the care and support of the people using the service by looking at various reports and documents. These included care plans, assessments, how people are supported in taking risks safely and how some people are given their medication. Staff recruitment and training records were also looked at. We were shown around the home by people living at the home, spoke with them, staff and the manager. We looked at information received since the last inspection. This included the Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 5 of 27 Surveys were received from people living at the home and staff, of which the findings and comments have been included in the report. All five requirements have been met from the previous inspection. One requirement and three recommendations have been made through this visit. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 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 wishing to use the service have information they need to help them make a choice. They would benefit from the Service User Guide updated and in accessible format. Peoples needs are assessed to help them to be met. People benefit from a written individual contract. Evidence: The home has a Statement of Purpose providing relevant information about the service, including the range of needs the home can meet. A requirement has been met for the Statement of Purpose to be reviewed and include the expectations that people living at the home are involved in helping with household tasks and other general routines of the home. The Service User Guide now needs to be reviewed to include the agreed rules of the home and other up to date information for both prospective people wanting to use the service, and those existing people living at the home. It was recommended this document is developed in an accessible format to help people understand the information. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: There is no change since the last inspection in that there are still five people living at the home, with most of them having lived together for many years. We were told that the home is a nice place with nice staff and nice residents. All four surveys received from people using the service confirmed they had been asked if they wanted to move to Kingsway. Also, that they had enough information to help make a decision to move there. One comment was I came over to see what the home was like. Care files confirmed peoples needs have been assessed by both placing authorities and the home. Regular reviews of their care had taken ensuring needs are being met and monitored. Care files had current contracts that were dated and signed. These set out the terms and conditions of peoples stay at the home. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from care plans that show how they want to be supported and how their needs should be met. People are involved in making decisions about their lives and in the planning of the care they receive. Some risk assessments support people to take risks safely as part of their lifestyle. Some areas need to be further developed. Evidence: All five care plans were seen. They contained a personal profile and information relating to peoples physical and mental health, family networks and preferred routines. A requirement has been met for care plans to include goals, activities and peoples occupation. A requirement has also been met for peoples care plans to be to be reviewed. Surveys from staff confirmed they are always given up to date information about peoples needs. Staff also spoken with said this helped in supporting people appropriately. Individual Care Programme Approach (ICPA) meetings are held Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: yearly. These were seen in care files and showed the involvement of people, staff and healthcare professionals. The manager has started to review personal profiles and we were told they will be called About Me, aimed to develop a more person centred approach. This has been included in the homes business plan and will be followed up at the next inspection. Restrictions are recorded with the involvement of the people living at the home and other healthcare professionals. Strategies were seen in place to support people with their behaviours and home has sought advice from specialists if needed. Staff complete daily notes recording peoples general well being and if there are any changes to their care needs. Records showed peoples competency in different areas of their lifestyle such as crossing the road, bathing, and household tasks. These showed that if the person is assessed as not competent a risk assessment is completed to show how they should be supported safely. One persons needs have changed and this needs to be reflected in their care planning and competency. A risk assessment must be carried out for them regarding their mobility and how they should be supported safely when accessing the stairs. Three people are happy to be left alone and detailed care plans showed how people had been assessed for this and with the outcomes of this decision. Three surveys received from people using the service confirmed they make decisions about what they do each day, and during the evening and at weekends. Comments included I make decisions about going to college, and workshops and voluntary work and I go home to my Mum and Dads house. I stay overnight and go back in the morning. Comments made in another survey were discussed with an individual as they had asked to speak to the visiting inspector. They were able to show how they made decisions. Two other people spoken with were also able to give examples of choices made. Care Homes for Adults (18-65 years) Page 12 of 27 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 benefit from taking part in educational, social and recreational activities. They are helped to keep in contact with family and friends if wanted. People are supported in making choices about their lifestyle and are helped to take responsibility in their daily lives. People benefit from a varied menu and are able to choose the food they like. Evidence: Two people spoken with told us about the activities they were involved with both in the community and work placements. These included working in a charity shop and in a cafe. Other people attend college, workshops and voluntary work. Activity care plans show peoples aims, and how staff are to support with the aims and long term goals. Some people are independent in leaving the home to make visits to the local community. We were told Shops are quite near and bus routes. One of the reasons Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: why I like this home. I go to the hair dressers on my own. We were told a trip to the pantomine had been organised for the Christmas period. Some people have been on holiday including a pamper weekend, an outward bound trip and five days on the Isle of Wight. One person told us they were going to a Cliff Richard concert. The home supports people to keep in touch with families and friends. A family member visited a relative during this visit. We spoke with them and they said they were very happy with the care and support the home offered their relative. People are involved in the routines of the home, helping with the preparation of food and general cleaning. Peoples agreed household tasks are discussed at house meetings and recorded. This was seen through a rota and people also confirmed the tasks they did. People have a designated day when they stay at home to clean their rooms and do their laundry. Menus are discussed weekly when people can make choices and a menu book showed peoples preferences. Menus seen showed a varied diet with healthy eating options encouraged. Some people can make their own drinks and snacks. One person spoken with said I like the food. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported respectfully with the way they want with their personal care needs. People can expect their healthcare needs to be well met and monitored for any changes. People are supported safely with the administration of medication. The safe keeping of some medication needs to be reviewed so that people are kept safe. Evidence: Most of the people using the service are independent with their physical care needs. One person needs such support and their care plan showed their personal care needs and preferences. Guidelines show staff how they should be assisted with bathing and getting ready for the day. An ensuite has been has been provided for them to help support their mobility needs and so that their privacy is respected. We were told by people spoken with that staff are respectful towards them. Records showed dates of appointments for medical appointments, and the outcome. Information about peoples health needs is passed on to staff through handovers and a communication book that records any changes staff need to be aware of. One person Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: has sensory needs and has been supported by The Royal National Institute for the Blind (RNIB) helping to maintain areas of their independence. The manager has completed training in the Mental Capacity Act and has involved other healthcare specialists in assessing peoples capacity to make complex decisions. This is good practice. Individual mental health plans showed long term aims, and how staff should be supporting people through action plans. Surveys received from people using the service confirmed they are always treated well by staff. Comments included The staff are very good at understanding my needs. They are always there to speak to about my mental health problems. The staff are very good. Three people are independent in taking their own medication. Risk assessments showed their competency levels had been assessed and that they are able to self administer medication safely. One person told us they informed staff when they had taken their medication, and showed us that they kept their medication on a window shelf in one of the lounges, during the day. This practice was discussed with the manager and the safety of other people living at the home and visitors. The manager said the other people living at the home would not take the medication but agreed that generally this was unsafe practice and ensured this person would be asked to keep them safe during the day. A recommendation is made to reveiw this practice and will be followed up at the next inspection. Staff administer medication to the remaining two people. The records of the administration of their medication was consistent with medication held. Written protocols were seen for when required medication needed to be administered by staff. Care Homes for Adults (18-65 years) Page 16 of 27 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 can expect they will be listened to and that staff will act on their views. People are protected from abuse with staff having been trained in safeguarding practices and procedures. Evidence: People sign to agree they have seen the complaints procedure and that this has been explained to them. One person said they had made a complaint, that the manager had dealt with it and they were happy with the outcome. This was also seen recorded in the complaints log. All surveys received from people using the service confirmed they know who to speak to if they are unhappy and that they know how to make a complaint. Comments included Dont want to make a complaint and another stated the name of their keyworker, the manager and other staff they would go to. One person said The home has a complaints book and I can talk to staff in private. Three surveys said staff always listen and act on what people say. Another survey said this happens sometimes. Since the last inspection staff have received training in abuse and the protection of vulnerable adults. Staff have also attended training facilitated by an external trainer in how the home communicates with people and the different perceptions people may have. This was in response to two requirements for staff to maintain good professional relationships with the people living at the home and that the manager must ensure Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: people are safeguarded from abuse. Staff spoken to had a good awareness of how people should be treated, understood the vulnerability of individuals and how abuse could occur. It was felt that because staff have known the people living at the home for so many years, and have close relationships, they were treated as part of a family. However they were able to give examples of how to prevent abusive practice in the home. It was evident that staff have taken these issues seriously. One staff member said they were now very aware of how to speak to people and that further improvements could be made. The home has arrangements to support people with their finances. Two peoples finances were examined and financial records were found to be consistent with balances held. Six monthly financial audits are carried out by the Trust helping to monitor practice. Care Homes for Adults (18-65 years) Page 18 of 27 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. The home is well maintained so that people living at the home can live in a comfortable and clean environment. Some aspects of fire safety need to be reviewed. Evidence: Kingsway is a semi detached property located in a residential community. A small shopping area is close to the home and there are bus routes to Bristol City centre. The property is arranged over two floors with shared space on the ground floor and bedrooms on both floors. Three surveys received from people living at the home said the home is always fresh and clean while another said sometimes. A comment confirmed the residents have to do chores in the home. My chore is to do the bathroom. People spoken with said they helped to keep the home clean. People are provided with single rooms that are lockable. People are given keys to their room. Some people were seen locking their room and being responsible for keeping their own key. Those bedrooms seen reflected peoples individual taste and preferences. The home has a maintainence programme and two bedrooms have been decorated since the last inspection. One person told us Love my bedroom. Another said they liked their new double bed and curtains. One person has their own ensuite with suitable aids to support them with their independence. There are sufficient bathing and toilet Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: facilities for others. Shared communal space includes a lounge and dining area, a smaller television and music area and a kitchen. There is a smaller table in the kitchen where lunches and breakfast can be eaten. Since the last inspection a separate smoking area has been provided. A conservatory has been added to the property for this use with comfortable seating. We were shown a box room on the first floor and told that the door is kept open at night as the homes cat sleeps in this area. The manager is recommended she follow the advice given from a fire service relating to fire safety in this area and that the fire risk assessment is reviewed. There is a laundry room that is sited away from the kitchen. Care Homes for Adults (18-65 years) Page 20 of 27 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 staff team that have a good understanding of their role and responsibilities, who are trained and supervised to meet peoples individual needs. Recruitment procedures are robust to help ensure people are kept safe. Evidence: Staff spoken to had a good understanding of peoples needs and were able to give examples of how they should be supported. They told us about their role and responsibilities and the aim of the home. The staff team currently consist of nine staff including the manager, care staff and assigned workers who were originally bank workers. At the time of this visit there were two fulltime staff vacancies and sickness being covered by the staff team. There is generally one person on duty during the day and the night. Additional staff are rotered if people need support with activities. All four staff surveys received said there are usually enough staff to meet individuals needs. The home follows the organisational recruitment policy and procedures ensuring prospective staff have appropriate checks made before starting work. These include a Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: full criminal background check and references taken up to help keep people living at the home safe. All four staff surveys received also confirmed this was the practice. Correspondence was seen that satisfactory checks had been made and received. Staffing files contained terms and conditions of employment and showed staff had signed that they had understood the code of conduct. Three staff surveys confirmed their induction period covered everything very well for what was needed to know to do the job. One survey said this was the case mostly. New staff have to complete a competency pack that includes understanding all areas of meeting peoples care needs, the running of the home, and policies and procedures. All four staff surveys confirmed they are given training that is relevant to their role and helps them understand peoples needs. Training records showed that staff have attended appropriate training including communication, diabetes, and working with people who self harm. We also saw records showing staff had attended manadatory training in first aid, fire, manual handling, food handling and health and safety. Half of the team has a National Vocational Qualification. Other staff who are not qualified complete competency packs to help ensure their knowledge and good practice is monitored. All four staff surveys confirmed they meet regularly with their manager to discuss their work and are given support. This was also confirmed by staff spoken with. Care Homes for Adults (18-65 years) Page 22 of 27 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 using the service benefit form a well run service with good outcomes for people. The views of people are sought and acted on. People and staff benefit from health and safety procedures aimed to protect. Evidence: The Registered Manager has worked at the home for many years. She has relevant experience in a care setting, is a Registered Mental Health Nurse and has a National Vocational Qualification in Management. Staff spoken with told us the manager is always approachable and supportive and people living at the home told us they were happy with how the home is run. Peoples views are sought through reviews and monitoring of their care, and regular house meetings encourage people to make decisions and choices about the way they want to live. A yearly audit is carried out by the home, through questionnaires, in consulting with people, their families and other professionals involved in their care. Results of Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: these were seen in the Statement of Purpose. The Trust also carry out a quality assurance audit that links to the national care standards helping to monitor all areas of the management of the home. An action plan is developed from this setting out improvements that can be made. The home follow health and safety policies and procedures and monthly health and safety checks are carried out around the home by staff. These practices were seen through appropriate record keeping. Records are kept of accidents and incidents to both people living at the home and staff and action taken. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 9 13 The registered person shall ensure unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. Risk assess an individual accessing the stairs. 31/01/2009 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 3 1 20 24 Include up to date and current information in an accessible Service User Guide. Review the safekeeping of an individuals medication. Review fire risk assessment relating to advice given by fire trainer. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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