Care Home: 29-29a Shrewsbury Road

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What the care home does well The service provides a welcoming and friendly atmosphere and provides a well maintained, comfortable and environment for people living there. At the time of this visit good interaction was observed between people and staff who were caring, attentive and respectful. People living in the service told us that they were happy living there . Comments included, " I am happy and I have a Nice room", "The staff are nice", "Lovely food" and "I am happy with everything". Each person has a person centred care plan, which has been discussed with them. These contained detailed information about "Things that are important to me" and "Things that I enjoy". People living in the service participate in a wide range of meaningful vocational, educational and social activities , which meet with their needs and preferences. At the time of this visit some people left to go shopping and visit the cinema. People told us about some of the activities that they participate in including, college, music, gardening , going to the pub and attending clubs. People are able to choose their preferred holidays. A person told us, "I went to Egypt". The service is run by an experienced registered manager and people are supported by a stable staff team some of whom have worked there for many years who had a good knowledge of people`s needs and preferences. What has improved since the last inspection? There were no requirements made at the last key inspection What the care home could do better: No requirements were made as a result of this visit Two good practise recommendations were made Key inspection report Care homes for adults (18-65 years) Name: Address: 29-29a Shrewsbury Road 29-29a Shrewsbury Road Redhill Surrey RH1 6BH     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: Lisa Johnson     Date: 0 9 0 4 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: 29-29a Shrewsbury Road 29-29a Shrewsbury Road Redhill Surrey RH1 6BH 01737778572 01737778574 shrewsbury@prospectha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prospect Housing and Support Services Name of registered manager (if applicable) Mr Jack Bacciarelli Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 16. The registered person may provide the following category/ies of service only: Care home only - (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). Date of last inspection Brief description of the care home 29/29a Shrewsbury Road is situated in a quiet residential area close to local amenities in Redhill. The service, which is operated by Prospect Housing Association, provides care and accommodation for up to 16 people with a learning disability. Accommodation is arranged in two self-contained units, one at ground floor level and the other at first floor level. A stairlift is provided to assist access to the first floor unit. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 16 Brief description of the care home Each unit has a separate entrance and can accommodate up to eight residents. Each unit also has its own lounge and dining room, as well as kitchen and laundry facilities. The two units share a large garden at the rear, and off-street parking is available at the front and side of the property. The fees at the home are £1,061.44 per week. 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 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 unannounced site visit was part of a key inspection. We arrived at 9:05am and left at 4:10 pm The last key inspection was carried out 29th May 2007. We have also carried out two annual service reviews. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment(AQAA). This is a self assessment that focuses on how well outcomes are being met for people using the service. We received the AQAA by the expected date, which was clear, detailed and gave us all the information we asked for. Reference is made to this assessment throughout this report. During this visit we met with five people that live in the service Discussion took place with the registered manager and five members of staff . Comments are reflected in this Care Homes for Adults (18-65 years) Page 6 of 28 report. During this visit we spent time observing activities and staff interaction. We sampled staff recruitment, and training records, care plans, risk assessments, menus, complaint, accident/ incident records, quality assurance systems, medication administration procedures, health and safety records and policies and procedures. We also reviewed other information that we have received since our previous visit including notifications. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 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 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 are provided with accessible information that they need to know about the home and their needs are assessed prior to admission. Evidence: During this visit we looked at the information provided to people who use the service to see whether it is able to supply everything that they or their representatives need to know. The service provides a statement of purpose and service guide, which is made accessible to people with pictures and symbols. This document contained current and detailed information about the services they are able to offer and provide. The service operates a structured pre admission procedure. When the service receives a referral an assessment is carried out by the manager that involves gaining information from the person, relatives, current placement, care managers and other professionals. During this visit we sampled a pre admission assessment that had been completed by the service. This was seen to be detailed and comprehensive covering peoples health, personal, emotional, mobility, social, culture and faith. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Over the last year four people have been admitted into the home. Three of the people admitted are females. Prior to these admissions the home was only occupied by males. People were provided with the opportunity to make visits to the home to meet the other people living in the service and were able to make transitional visits and stays, which has been successful During this visit the three ladies appeared settled in their new home and one person told us they were very happy living there. 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. Each person has a plan of care that they have been involved in making. Peoples needs and goals are met and they are able to make decisions about their life. People are able to take risks as part of an independent lifestyle. Evidence: Each person has a person centred care plan in place, which they are consulted about. Two people told us that they attend review meetings. During this visit we sampled four peoples care plans, which included information about their health, personal, daily living skills, communication, social and cultural needs. Information seen demonstrated that care plans are regularly reviewed. Annual reviews also take place where the person,their key worker, care manager and invited guests attend. Each person has a key worker and staff spoken with during this visit told us that they had been involved in the development of the care plan and demonstrated their understanding of peoples needs. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The service is demonstrating that they are supporting people to make decisions and choices about their lives and providing assistance where this needed. The service holds regular consultation meetings with people to gain their views. A majority of people living in the service are able to communicate verbally. Where people are unable to express their views or they are unable to fully participate in making decisions the service has identified families or other advocates on their behalf. We were informed two people living are participating in the organisations working party on staff recruitment and policies and procedures. The service has implemented a range of risk assessments which have been discussed with people. Members of staff told us that they are expected to read peoples risk assessments, which are signed by them to confirm their understanding. Risk assessments sampled included, community access, mobility and risk of falls. These had been reviewed and were up to date. 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. Peoples vocational, educational, social, cultural, diverse and religious needs are met. People maintain contact with their family , friends , representatives and the local community. People are supported to exercise choice over their lives and are provided with varied and well balanced meals. Evidence: The service is demonstrating that people living in the service participate in an extensive range of meaningful and appropriate vocational, educational and social activities, which are documented in their person centred care plan and in Things I enjoy. During this visit some people were leaving the service to go to the cinema and shopping. People spoken with during this visit told us about some of the activities that they participate in including,I go to a club,college;;gardening;shopping;I have Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: been on holiday to Egypt;I go to music;and I go to the pub with my friend. Two people choose to visit the local town independently each Saturday to go to the bank and make their own purchases and two people attend a camera club and they have purchased their own cameras and have exhibited their work in the local shopping mall and published a calendar. Another persons care plan identified that they receive aromatherapy. Photographs were seen during this visit of people away on holidays at their chosen destinations. The service holds a range of social events including Christmas parties and barbecues. Peoples cultural and religious needs are supported and respected. Some people attend the local church and they have facilitated one person to receive weekly communion at the home. Another person is supported by staff to attend their synagogue. Information supplied in the AQAA states that relationships with family and friends are promoted. People receive visits in the service and they also facilitate visits to their families. A person told us that they talk to their family on the telephone. People were observed to have access to all areas in the home and some people like to assist with household tasks, which we observed at the time of this visit such as making tea, hovering and loading the dishwasher.At the time of this visit good interaction was observed between people and staff who were seen offering people support and choices and spending time with each other. The home facilitates people to have pets. Two people own a cat and they are supported with its care. Another person has Guinea pigs and looks after them independently. People are involved in choosing their preferences for the homes monthly menus, which is discussed as part of the homes meeting agenda. Information provided in care plans documented peoples food preferences. Meals provided focus on healthy eating. However meals are decided on a daily basis and it was recommended as good practise that a written record is maintained of all meals that people have received, which the manager said that they would implement. People spoke positively about their meals including, Lovely meals; I have a cooked breakfast if I want and I can choose what I like. Care Homes for Adults (18-65 years) Page 15 of 28 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. Peoples health and personal care needs are met and their preferences for support are respected. The home supports people with their medication in a safe way. Evidence: Peoples care plans contained information including, Things that matter to me, their likes and dislikes, preferred name of address and preferred routines such as times of getting up and going to bed.One persons care plan identified that they like to have a lie in, which was seen to be respected by staff at the time of this visit. Health care plans are in place outlining each persons health and personal care needs and detailed how these are to be supported.The service supports both younger and older adults and some people also have physical disability. Specialist baths have been installed to meet individual needs , a remote controlled stair lift has also been provided for people who who may find difficulty in accessing the bath and a tracking system and hoist is in place. Suitable handrails have also been provided. Health plans sampled indicated that people have received regular health screening checks and appointments, which was confirmed by records maintained including, visits Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: to the General Practitioner, practise nurse, chiropodist, optician and dentist. Referrals are made for specialist advice through the GP and the home has had involvement with the dietitian, speech therapy, psychology and physiotherapy. During this visit staff were observed to be attentive, caring and addressed people respectfully. Two people spoken with said that staff respect their privacy by knocking or ringing their door bell before entering their room. People spoken with during this visit told us that that were happy living in the home. Comments included, The staff are very nice, I am happy here and I have a nice room and Everything is good. During this visit we looked at the medication practises in the service. Medication was stored safely. Medication is dispensed by a local chemist using the monitored dose system (MDS). Systems were in place for the receipt and disposal of medication. Medication administration records sampled were maintained in good order and contained a photograph of the person for identification. We saw two medication administration records that had items that had been hand transcribed by staff and it was recommended that these should be checked and signed by two members of staff. The pharmacy visits the service to carry out medication audits, which we sampled during this visit. Staff receive medication administration training. Currently there are no people living in the service who are able to self administer their medication, although some people are supported to apply their own creams and ointments. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a robust complaints procedure in place and people are protected from abuse. Evidence: During this visit we looked at information provided to people, which tells them about how they can make complaints. This information has been made accessible with pictures and symbols. The service also maintains a complaints register, which we viewed during this visit. No complaints have been received by the service since our previous visit. People living in the service are told about how to raise concerns and complaints and through house meetings they have the opportunity to raise any issues which are recorded. These are monitored through the organisations internal reporting and monitoring systems. Three people spoken with during this visit said that they would know who they could talk to if they were unhappy or if they had any concerns such as their key worker or the manager . The service has safeguarding vulnerable adults from abuse and whistle blowing procedures in place. The manager informed us that they also have the local authority safeguarding vulnerable adults from abuse procedures, although the manager was unable to locate this at the time of this visit. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Information supplied in the AQAA states that all staff attend safeguarding vulnerable adults from abuse training. Staff training records sampled and discussion with four members of staff confirmed this. Discussion with members of staff indicated that they were aware of their responsibilities should they ever witness or be made aware of any incident where the safety of people is compromised. Staff also told us that they are expected to read and sign procedures that are in place. Since our last visit there have been no matters that have required referral following the local authority safeguarding vulnerable adults from abuse procedures. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is safe, comfortable, homely and clean. Evidence: Accommodation is provided in two self contained units. The service provides a homely and comfortable place for people,which is decorated and furnished in a modern style. There is a continuous decoration, furnishing and maintenance programme in place. Over the last few years the service has undergone major refurbishments to all bathrooms and kitchens. In the last year most of the bedrooms, both lounges, dining rooms and the downstairs corridor were redecorated. Monthly health and safety checks are also carried out and servicing and maintenance of equipment was up to date. There is a well maintained and accessible garden at the rear of the property, which now contains a large patio area, which people were using at the time of this visit. Equipment is available for people with mobility difficulties including grab rails and accessible bathrooms. Information supplied in the AQAA states that people have been supported in purchasing new bedroom furnishings. Two people invited us to see their bedrooms, Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: which were comfortable and personalised reflecting their gender and preferences. A person showed us their memorabilia of their favourite football team. During this visit the home was seen to be clean and hygienic and cleaning schedules were in place.The service has received two positive visits from the environmental health officer and staff receive infection control training. 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. People using the service are supported by staff that are competent and trained to meet their needs and they are protected by the homes recruitment policies and practises. Evidence: At the time of this inspection there were three members of staff on duty in both living units. The manager was also working supernumerary to this. At night time people are supported by two waking and a sleep in member of staff. People living in the service benefit from a stable staff some of whom have worked there for many years and have a good knowledge of peoples needs. Recently the home has gained some more members of staff,which means that the home is now fully staffed. Five regular bank staff are also allocated to the home to cover any absences. The duty rota sampled indicated that the agreed staffing levels are maintained. There is a mixed staff gender team, which meets the needs of people living in the service. Information supplied in the AQAA states that fourteen out of twenty care staff employed in the service have obtained National Vocational Qualifications (NVQ) (level 2)or above,which is still rising. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: New staff receive induction training and complete further in house induction. Within the team there are four members of staff who hold assessor qualifications to support staff with their NVQs and they mentor new staff completing the induction award (LDQ) Staff receive both statutory and specialist training, which meets the needs of people living in the service. Training schedules were sampled during this visit, which confirmed this. All staff have also attended values training and Equality and Diversity and Discrimination training. Staff recruitment is based on equal opportunities. During this visit we sampled three members of staff personal files, which contained the required information including, completed application form, two written references and enhanced criminal records bureau checks We were informed that no members of staff are employed until this information is received. Staff receive regular formal supervision and appraisals, which was confirmed during discussion with staff. 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. The home is well run in the best interests of people living there. Peoples wellbeing and safety is promoted and protected. Evidence: The service continues to be run by an experienced registered manager who has gained the Registered Managers Award (RMA). During this visit the manager was observed to have an open approach and was accessible. Discussion held with four members of staff indicated that they enjoy working in the service and spoke positively about management support and the training that is provided by the organisation. Staff also confirmed that regular staff consultation meetings take place. Comments included, Good team work and Supportive team. The Annual Quality Assurance Assessment (AQAA) provided to us by the manager contained clear information about the current situation in the home and areas where they have improved and where further improvements and developments have been identified. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The organisation has implemented a quality assurance framework. Monthly quality monitoring visits are undertaken, which are carried out by the organisations quality assurance manager or another senior manager. These reports were available in the service which we sampled. These were detailed and comprehensive and it was evident that the views of people using are gained as part of this process. The quality of the service is also audited annually both internally and externally. Surveys are also carried out to gain the views of relatives and staff. The outcomes of these audits are fed back to the manager and staff. The manager has attended training on the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). This information has been cascaded to the staff team. Information and guidance was available in the service and the manager has a good understanding of this. Systems were in place ensuring the safety and well being of people living in the service including, regular health and safety checks. The manager ensures that health and safety policies and procedures are adhered to. Staff records sampled and through discussion with members of staff confirmed that they all receive statutory training including moving and handling, first aid and health and safety. During this visit we observed cleaning substances that could pose a risk to people were locked away safely. Accident or incidents are recorded and maintained in the service. 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 2 17 20 It is recommended as good practise that a record is maintained of all meals consumed. It is recommended that two members of staff check and sign the medication administration record when medication is hand transcribed. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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