Care Home: 22 Abbey Drive

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What the care home does well People wanting to live in the home were able to visit the home and stay overnight to help them to decide if the home would be able to meet their needs or not. Each person had an individual care plan to make sure they got the care and support they need. The care plans included helping people to keep their independence and learn new skills. Each person living in the home had a single room that is nicely personalised to their own taste, providing them with an area where they can spend private time or receive visitors. Relatives were very involved in the home and were made to feel welcome, making sure that family can keep in contact. The kitchens were kept clean and people were helped to eat a healthy diet and also some foods that they like. Each person had a health action plan which helped to make sure that their health needs are met. Medicines were looked after well and staff assisted people to take their medicines safely. Concerns were listened to and staff made sure they take action to sort problems out quickly. The staff and managers know that they need to make sure people living in the home are protected from harm and what to do if someone is harmed. A good recruitment policy was in place so that staff employed were safe to work with the people in the home and they are protected from harm. The staff were very caring and treat people with respect and dignity. Half of the staff have got a certificate (NVQ Level 2) which says they know how to work with the people in the home and how to meet their needs. What has improved since the last inspection? Staff support was more flexible so that people could be supported to lead a lifestyle that meets their diverse needs. The care plans and records were clear and showed that peoples personal and health needs were being met. Training was provided to all staff to make sure that all staff were up to date with basic training in moving and assisting, basic first aid, basic food hygiene, infection control and fire awareness. Special training had been provided to all staff e.g. how to deal with behaviour that may harm service users or staff and to help them to meet the special needs of the people living in the home. What the care home could do better: They should get references from previous employers where staff have worked with people in other care settings to make sure that the person is suitable to work with people living in the home. The fire alarm should be tested weekly to make sure that any faults are identified and the equipment is kept in full working order. Key inspection report Care homes for adults (18-65 years) Name: Address: 22 Abbey Drive 22 Abbey Drive West Grimsby North East Lincs DN32 0HH     The quality rating for this care home is:   three star excellent 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: Kate Emmerson     Date: 2 3 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 22 Abbey Drive 22 Abbey Drive West Grimsby North East Lincs DN32 0HH 01472507311 01472341086 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.linkage.org.uk Linkage Community Trust Name of registered manager (if applicable) Mrs Jane Manning Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 22, Abbey Drive West is a care home providing personal care and accommodation for up to five adults 18-65 years of age who have a learning disability. The home is situated in Grimsby and owned by Linkage Community Trust Care Services. The home is registered for 6 service users but currently one of the bedrooms is used as a staff sleep in room therefore the home only has 5 service users currently. The accommodation is provided in a large two-storey semi detached town house and is close to local transport links, a park and the town centre. All bedrooms are for single occupation. One bedroom has an en-suite and is on the ground floor. 22 Abbey Drive West shares a registered manager with another small Linkage Home situated nearby. All bedrooms are for single occupancy. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home Weekly fees, at the time of the inspection, ranged from £646 to £1167 per person per week. This were due to change 0n 1 April 2010. Additional charges are made for the following: newspapers/magazines and sweets, hairdressing, chiropody and transport for social activities. Information on the service is made available to current service users via the statement of purpose, service user guide and inspection report. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was a key inspection and the unannounced site visit took place over 1 day in March 2010. Prior to the visit we looked all the information we had received about the home since the last inspection and the information sent to us by the home. At the site visit we looked around the home and looked at the records held in the home including care files and health and safety records. We sent surveys to people living in the home and received four completed surveys from them and five staff surveys. The registered manager and a member of staff was spoken to on the day of inspection and two people who lived in the home showed us their care files and their bedrooms. This information was used to form a judgement about the quality of the service. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? Staff support was more flexible so that people could be supported to lead a lifestyle that meets their diverse needs. The care plans and records were clear and showed that peoples personal and health needs were being met. Training was provided to all staff to make sure that all staff were up to date with basic training in moving and assisting, basic first aid, basic food hygiene, infection control Care Homes for Adults (18-65 years) Page 7 of 28 and fire awareness. Special training had been provided to all staff e.g. how to deal with behaviour that may harm service users or staff and to help them to meet the special needs of the people living in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had their care needs assessed in full by a range of professionals and they and their families were given sufficient information about the home so that they could be assured that the home could meet their needs. Evidence: Two care files were examined to establish what processes were undertaken prior to people being admitted to the home. The assessments were very detailed and included information from family members, professionals who had been involved with people in previous care settings. This gave the staff team information on the assessed needs to enable them to provide an individually tailored service to meet the persons complex needs and ensure their emotional stability. One person was in the process of being admitted to the home. Their care file contained a range of assessments carried out by a variety of professionals who Had been involved in the care of the person previously. In addition to this a very detailed assessment had been completed by a senior staff member employed by linkage. A programme of visits to the home had been planned as part of the homes introduction Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: process. The visits were arranged to ensure people were able to make an informed choice about a move into the home by giving opportunity to meet other people living in the home and the staff group and gain some insight into life in the home. Detailed records of these visits were maintained and gave information as to how the person had settled into the environment and how they had interacted with the other people living in the home. The manager felt these visits were an important part of the assessment process as this is a small home where people live quite closely together. This process ensures that, as far as is possible, all parties are compatible and any new placements will not have a negative impact on the lives of people already living in the home and will enhance the quality of life for the person looking to live at the home. Linkage employed a professional support team made up of qualified social workers, psychiatrist, clinical psychologist, speech and language therapist, visual impairment specialist and a registered nurse who can support the ongoing assessment process and provision of professional support. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Very detailed care plans had been developed with the person using the service. Peoples needs were met and they were supported in their development towards maximum independance Evidence: Three care plans were examined as part of the inspection process. Each file contained a focus page which gave staff a quick overview of a persons needs, dietary requirements, information on advocacy services and a personal history. In addition very detailed care plans had been developed with the person using the service which described peoples care needs, daily routines and preferences. Person centered plans which focused on the individual and their continuing development towards maximum Independence were developed where people had agreed to these. Records evidenced how staff supported them to work to wards their identified aims and objectives. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The home was in the process of developing the way they present their care planning to make them more understandable for people taking into account their communication skills. The manager was putting together care plans using pictures and on discussion with one of the people living in the home it was clear he had gathered some level of understanding of the content of his care plan using the pictures. Very detailed daily diary records were maintained by staff. Observations of these records evidenced that care needs were met and independence promoted in many ways. Peoples physical and emotional well being was recognised and met by very attentive staff. Risks to peoples health, safety and welfare had been identified, assessed and were being minimised by the production of risk assessments that staff were familiar with and followed. A number of these related to measured risk taking which allowed for people to develop and maintain their independence. For example risk assessments were in place for one person who regularly goes out alone and often travels on public transport and for another developing their road safety skills. Care plans were kept under review to ensure they remained relevant to peoples needs. Care plans were evaluated monthly and formally reviewed and retyped every 3 months. There was evidence that care plans had been updated when needs had changed. We observed people being offered opportunities to participate in the day to day running of their own home. They had house meetings once a week and every person living in the home had a house day when they changed their bed, cleaned their room and did their laundry, with as much or as little support as was required by the individual. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assisted to continue their personal development and have access to the community for a range of leisure and educational pursuits. Family contact and personal relationships are maintained and all people enjoy a healthy diet. Evidence: Evidence in care files showed that people were supported to achieve a lifestyle of their choice and engage in a range of activities to continue their opportunities for personal development. This included attending activities such as football matches or going to a work placement. One person had had their work placement arranged by the the Linkage Trust employment services and they used public transport to reach their job in a nearby Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: town. They said they really enjoyed this work. The care files evidenced how the staff supported and encouraged him to maintain this placement. Emphasis was placed on people taking an active role in household tasks and they all had at least one day at home to change their beds, clean their rooms and do their laundry with staff support as required. Some people attended the Linkage occupational and recreational services during the day and took part in activities such as drama, IT, art, communication skills and horticulture. The sessions were tailored to individual need, which was assessed by the instructors. Some people attend the day services provided by the local authority and some attend the education centres for literacy skills. Activities and outings are planned by people living at the home at their fortnightly meetings. People told us that they enjoy going to the cinema, football matches, discos, and visiting the pub. In surveys one person said I like all of the trips out like chartdales. An annual holiday is arranged for the people who lived in the home and they have input into the choice of destination. People who live in the home all either visit their parents/relatives homes or are visited by them at Abbey drive and contact is welcomed. The manager and staff promote a healthy eating menu but try to balance this with peoples likes and dislikes and special treats on occasions. People living in the home have input into the menus at weekly meetings and those in the home at the time of the inspection stated they liked the meals and were observed to be offered choices for their lunch. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and health care 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. Peoples physical and emotional needs were met and a caring and professional team of staff promoted their privacy, dignity and respect. Evidence: Discussion with people, families and staff and observations confirmed that the staff promoted peoples privacy and dignity and supported individuals preferences and likes and dislikes. Records examined confirmed that peoples health needs were met by GP, dentist, chiropody and that they had access to a wide range of other health professionals for example psychiatrist and psychologist, speech and language therapist and visual impairment specialist if and when required. Health action plans had been produced and had been regularly updated. Linkage have robust medication policies and procedures that include the receipt, storage, administration and disposal of medication. People who wished to self medicate were encouraged to work toward this with a graduating self-medication programme. The manager and staff made an assessment of the persons skills prior to Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: commencement and a risk assessment was also undertaken. Facilities were made available for people to lock their medication away in their room. The medication systems were examined as part of the inspection process and found to be well managed and robust. All staff are given medication administration induction training which includes an exam to ascertain competence. Regular medication audits were undertaken by the management to check policies and procedures were being followed. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were protected from harm by the homes policies and procedures and staff training. Evidence: The home had a well developed complaints procedure. This contained contact details for the Commission and the ombudsman and gave an assurance that people would not be victimised for making a complaint. The timescale given for responding to complaints was 21 days. The complaints procedure was also available in Makaton symbols and on audio cassette. More recently the home had developed a DVD copy of the procedure. In addition to the above the home also had a specific complaints policy for people living in the home. Each person living in the home had been given a copy of the complaints policies in written and Makaton format, and Social Services Right to Complain leaflet. These were kept in peoples individual files. All minor issues were dealt with through the house meetings. More serious issues were taken to the manager and a mechanism is in place for responding to these areas of concern and complaint. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: There had been six complaints since the previous inspection, the records showed that these were all taken seriously, investigated and resolved appropriately. The records were held in a bound book and the manager was advised that these should be held individually to meet the requirements of DATA Protection legislation. The manager checked the complaints log on a regular basis. The home had a copy of the Local Authorities procedure with regard to safeguarding vulnerable people and an in house abuse policy and procedure that linked with this document. This gave information in respect of alerting, referral and investigation of allegations of abuse. All the People living in the home had been given a copy of the leaflet from the local authority on abuse and this was kept on their individual file. The home has a separate whistle blowing procedure which advises staff on their responsibilities for reporting issues of concern. There was evidence from the homes recruitment and selection processes, staff training records, complaints log and the use of risk assessments that the manager ensured that people were protected and safeguarded from abuse. Training records evidenced that staff had received training on safeguarding vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a well maintained home that is safe, homely and comfortable and meets their assessed needs. Evidence: 22 Abbey Drive West is a large house in the heart of the local community in Grimsby. It is close to Peoples Park and all local amenities. All the people who lived in the home have a single room that is personalised to their own taste, providing them with a private area to their liking where they can spend private time or receive visitors. Two of the people who lived in the home showed the inspector their rooms. They confirmed that they had input to the choice of decor in their room. They were encouraged to keep their home clean and tidy and spent one day per week each on these tasks with staff support were necessary. People also had access to a secure, private and pleasant back garden area with seating. Furnishings and fittings were of good quality. The home was well maintained, clean, tidy and free from offensive odours throughout. The accommodation was comfortable and homely with personal items on display. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The home has a maintenance book that recorded day to day work and a plan for the ongoing redecoration of the home. Two new ensuites have been added to the acommodation since the last inspection which means only three people share the main bathroom. Policies and procedures were in place to support infection control and all staff had received training in infection control. The laundry was situated in an outbuilding sited away from food preparation or eating areas and accessed through the back door. The laundry was kept locked when not in use. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing was provided in sufficient numbers and with the competence and qualities to meet peoples needs. A robust recruitment and selection process protects people from the risk of harm. Evidence: The home is fully staffed with a permanent and consistent staff team. The staffing was arranged to ensure there were two staff on duty when all five residents were at home. On the day of the inspection there was one staff member for two people plus the manager. All the other residents were at day services. An additional twenty nine staffing hours were provided to enable one person to access social activites. The staff team were supported by a wide range of health professionals e.g. psychiatrist and psychologist, speech and language therapist and visual impairment specialist for advice and support. Linkage recruitment policies and procedures were robust and all staff had CRB disclosures, identity checks as required by regulation and references obtained prior to commencement of employment. One staff member had two written references but references had not been obtained from their most recent employers where they had worked with vulnerable people. the manager was advised to do obtain these Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: references. Staff were subject to a six month probationary period following appointment. A detailed induction programme was undertaken which included principles of care and safe guarding vulnerable people. Ongoing training was provided which included mandatory training such as fire safety and first aid and regular refreshers were provided to keep staff up to date in these areas. Training to assist staff to meet peoples specific needs and keep them safe was also provided. For example staff had received training in non violent crisis intervention, challenging behaviour and communication skills such as Makaton.Training for National Vocational Qualifications (NVQ) in care was provided and three of the six staff employed had achieved NVQ level 2 and one of these had also achieved level 3. The manager had a training and development plan for the staff team that clearly identified staff training needs and all staff had an individual training and development action plan that was completed annually. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that is part of a creditable organisation that is well run and managed from the top down and the service at Abbey drive is managed by a very competent manager. People living in the home are at the heart of the organisation and their views are taken into account by the quality monitoring scheme, house meetings and reviews that promote their involvement. Evidence: Mrs Jane Manning is the registered manager at 22 Abbey Drive West and is also the registered manager at another Linkage home called The Limes. Mrs Manning has worked for Linkage since 1998, She has undertaken various training courses in working with people with learning disabilities and management training. She states she has completed NVQ level 4 and the registered managers award. Regular house meetings that include staff and service users and the key worker system ensure that staff and people living in the home have the opportunity to Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: influence the way the service is delivered. Records from the meetings showed that people living in the home are able to bring up topics which were then openly discussed. One person living in the home said in a survey staff listen to me when I have issues. Staff said in surveys the home is well organinsed, I really enjoy working for the company. Linkage have a Corporate Quality Monitoring system (EFQM) and a Quality Manager who co ordinates and leads on quality issues. A year long calendar is produced that provides the framework for QA activity including surveys, audits and appraisals. Comment cards had been translated into makaton symbols to aid people living in the home to participate in the process. Linkage produces an Annual Review document and regular newsletters. We examined recent surveys responses which showed good levels of satisfaction with the service provided. As part of the inspection all maintenance records were seen and were up to date and in order ensuring that people live in safe environment. The fire alarm system had been checked and the responses from people living in the home to the alarm were recorded. Whilst these checks had been completed regularly weekly checks had not always been maintained every month, this is recommended as good practice. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 34 To obtain references from previous employers where staff have worked with vulnerable people to ensure that the person is fit to work with people living in the home. The fire alarm should be tested weekly to ensure that any faults are identified and the equipment is maintained in full working order. 2 42 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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