Care Home: 58 Hermitage Way

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 58 Hermitage Way 58 Hermitage Way Madeley Telford Shropshire TF7 5SZ     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: Becky Harrison     Date: 0 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 29 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 58 Hermitage Way 58 Hermitage Way Madeley Telford Shropshire TF7 5SZ 01952586224 01952432209 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Self Unlimited care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 7 Date of last inspection Brief description of the care home 58 Hermitage Way is registered with the Commission for Social Care Inspection as a care home for up to 7 adults with a learning disability. Self Unlimited (West Midlands) own and manage the service. The house is purpose built and is situated on a residential estate close to the towns of Madeley and Ironbridge. The building contains a self contained flat. The Homes Statement of Purpose states that The services provided are designed in consultation with the people who live here and respond to the needs of the individual. People who use the service and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home our website at www.csci.org.uk The fees charged range from £437.62 - £527.85 per person per week. One person has an additional support package. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We were at Hermitage Way for eight hours, we did not tell people that we were coming. A range of evidence was used to make judgements about this service to include discussions with six people who use the service, a member of staff, a relative, the manager and the training coordinator. We looked at some parts of the home, reviewed the homes quality assurance processes and sampled a number of records to include complaints and protection, staff training, recruitment and health and safety records. The manager completed an Annual Quality Assurance Assessment (AQAA) document for us as requested. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for Care Homes for Adults (18-65 years) Page 6 of 29 people using their service and is an opportunity for them to share with us areas that they believe they are doing well. The AQAA was very detailed and provided us with lots of information about the service. Two people who live at the home were case tracked this involves establishing individuals experience of using this service, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. We looked at the outcomes for people living at the home and reviewed the requirements made at the last inspection. Information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. What the care home does well: What has improved since the last inspection? The last key inspection of this service was undertaken on the 1st August 2007. The manager has done all of the things that we asked her to do therefore outcomes for people living at Hermitage Way are much improved. One person told us that he helped redecorate the lounge and dining room and is very happy with his achievement. People said they chose the colours and were also involved in purchasing new blinds for the lounge and dining room. Care Homes for Adults (18-65 years) Page 8 of 29 The assistant managers hours have increased providing greater assistance to the management of the home. Support plans have improved and now provide staff with detailed information ensuring peoples health and personal care needs are met. 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.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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with clear information about what the service provides. The currently has no vacancies however the home has a detailed admissions procedure in place and individuals would only be admitted following an assessment of their needs. This would ensure the service is appropriate for them. Evidence: Information about the service is readily available in the Statement of Purpose and Service User Guide. Each person has been provided with their own copy of the guide and both documents provide people with information to help them understand the service that Hermitage Way provides. There have been no new admissions to the home since 2004, however the home has appropriate admission procedures in place in the event of a vacancy occurring. Discussions held with the manager clearly evidence that she would obtain the necessary information to ensure they are able to meet the needs of prospective residents prior to admission. Prospective residents would also have the opportunity to Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: meet staff and people who live at the home. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have a detailed support plan, which informs staff about their individual needs and how they prefer these to be met, providing an individualised service. Individuals are provided with good opportunities to make decisions because staff promote their rights, choices and empower them. People are supported to take risks to enable them to develop their independence and lead the life they choose. This is because the staff have appropriate information on which to base decisions. Evidence: People living at Hermitage Way can be confident that their needs are met because they have detailed support plans in place, which inform staff about their assessed needs, and how they wish to be supported. Individuals contribute to the development Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: of their support plan and attend their meetings with people close to them to review their needs and the progress that they have made. Although people currently do not receive the service of an independent advocate, most people have active family involvement and everyone has a designated key worker to act in their best interests. Discussions with people use the service and records seen clearly evidence that peoples views are listened to and acted upon and that key decisions are taken only after full consultation with them and people close to them. Risks are managed positively, which enables people to lead the life they want based on an assessment of risk. For example the files of the two people we case tracked contained risk assessments covering activities in the community, trips, finances, transport, household tasks and an assessment for being home alone. Risk assessments have been reviewed and updated since our last visit and those seen evidence the involvement of individuals using the service. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Hermitage Way maintain contact with people close to them and are provided with varied opportunities for personal development, so that they can lead their life in a chosen way. People are provided with a choice of meals in accordance with their own preferences and dietary needs. Evidence: Two of the people we spoke with told us about their part-time jobs which include cleaning and working in a cafe. Discussions with them clearly evidence that they enjoy their work. Other people shared their leisure and learning experiences. One of the people we case tracked has successfully commenced an art, design and media studies Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: course at the local college. Discussions with him and his relative clearly indicate that this is a huge achievement for him. His relative stated We are thrilled about our son attending college, it is down to the staff who discovered his abilities and supported him to apply for the course. Daytime provision is not static and people are given loads of initiatives. People are provided with a variety of opportunities to develop their social and independent living skills and lead very active lifestyles and are encouraged and enabled to partake in daily living tasks and also access the community on a daily basis. Discussions held clearly evidence people enjoy leading independent lifestyles. People are supported to maintain relationships that are important to them for example family are invited to attend any meetings held and regular contact is maintained, if desired. People have also developed positive relations with neighbours as evidenced in a Christmas card received from local neighbours and their support during recent events concerning antisocial behaviour. The AQAA states The service and the people who live here have a positive profile in the community as good neighbours. People are provided with good opportunities to meet up with their friends through the day service, college, employment and leisure clubs they attend and are able to make full use of a computer with e-mail access. Peoples preferences in relation to choices, routines, likes and dislikes are well documented as evidenced on the files of the two people we case tracked. Discussions indicate routines are flexible and observations made evidence that people have access to all areas of the home and can choose when to spend time on their own or in the company of others. People living at Hermitage Way are provided with a choice of food which is balanced and caters for their dietary needs. The people we spoke with said they get together and choose and plan menus for the forthcoming week and take it in turns to help prepare and cook the meals as observed during the inspection. One person shared their action plan for cookery with us, which details all the things she has made. People no longer eat their main meal at the day service on the main site but now prepare sandwiches for lunch and enjoy their main meal in their own home. They told us they much prefer this arrangement which provides greater opportunity to plan, shop, prepare and cook the meals they choose. The evening meal looked healthy and well balanced and people told us alternative choices are made available if someone changes their mind. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of individuals living at Hermitage Way are closely monitored and regularly reviewed ensuring their good health and well being. Evidence: People can feel confident that their health and personal care needs are monitored because staff have access to good information about them ensuring their needs are met. The support plans we looked at detailed the level of support individuals require to maintain their personal care and self-image. Although peoples healthcare needs are documented in their support plans we advised the manager to include information concerning significant health events that individuals have experienced. This will ensure new staff are aware of previous events so they can detect any changes at the earliest opportunity ensuring continued good health. The annual quality assurance states We have worked extensively and well with a range of physical and mental health professionals to develop and action plans to support the reintegration of an individual into the service. This was also evidenced in discussions held with the person concerned and a relative who stated The home Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: definitely meets the changing needs of people with a learning disability and staff must be given credit for this. People spoke with said they are supported to attend health appointments and entries in the health records of the people we case tracked evidence that individuals are provided with access to healthcare professionals to meet their assessed needs including routine checkups and treatment. Health action plans have also been introduced, this is an individualised plan about what the person must do to stay healthy. Staff receive training to ensure they are competent and confident to administer medication to individuals who require assistance. Two people are supported to self administer their row medication based arm a risk assessment. Since we last visited the home there has been one medication error relating to a person who self medicates however procedures have been reviewed and additional measures put in place with the person concerned to prevent a reoccurrence. Records evidence that medication reviews are regularly held to ensure individuals are on the correct medication and dosage required to maintain their health. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Hermitage Way can be confident that if they or people close to them have concerns with their care, their concern would be looked into and action taken to put things right. The service safeguards people from abuse by ensuring staff are trained in adult protection and that the necessary action is taken to follow up any allegations, ensuring their well-being. Evidence: People living at the home have access to a complaints procedure and discussions with them evidence they know who to speak to if they are not happy with the service they receive. They also told us that they have regular residents meetings to air any concerns or share ideas for improvement. The AQAA states Due to the positive inclusion of the service users in the running of the house . . . and the open culture here, issues tend to be brought to light and dealt with at the early stages, so it is very rare that people feel the need to invoke the formal complaints procedure. We have not received any concerns or complaints about the service since our last inspection. The home has received one verbal concern from a relative and this has since been resolved. Records evidence that concerns are now logged so that trends can be analysed and complaints records are retained, as recommended by the previous Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: inspection. The annual quality assurance states A culture of respect for the individual is fostered in the home and there is the Rome tolerance of abusive behaviour. How to treat people is readily discussed in service users and staff meetings and person centred planning methods ensure the service users wishes are respected. Staff have access to local policy and procedures in relation to adult protection, and these have also been developed in an accessible format for people using the service. Staff have received training on safeguarding adults who are vulnerable so they know how to recognise signs of abuse and report this so that people they support can be safe. Both the manager and the deputy manager have received training on managing the referral process. Since we last visited the home two referrals have been made under safeguarding adult procedures and one investigation held in relation to one person. Records seen evidence the home has cooperated with a safeguarding adults team and the issues have been concluded. The individuals involved have been supported by the team and other agencies to include the police, neighbours and health and social care professionals. Additional measures have also been implemented in peoples best interests. People living at home manage their own money and discussions with them clearly evidence they enjoy this responsibility. A member of staff spoken with considered procedures in place safeguard people from potential financial abuse. The manager has attended training in the Mental Capacity Act and Deprivation of Liberty Safeguards and therefore understands how this legislation may affect people in her care. Staff have received training in physical intervention as evidenced on the training records seen. This identified that some require refresher training, although none of the people living at Hermitage Way require physical restraint. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Hermitage Way are provided with a homely, clean and comfortable place to live where they feel safe and secure. Evidence: People told us they enjoy living at Hermitage Way and that they feel safe and secure. We looked around the communal areas of the home and the two people we case tracked were happy to show us their rooms, which are very personalised and furnished appropriately for their needs. One person said that staff had recently supported them to change their room around. People are provided with a range of spaces to share with others to include a large lounge, dining/kitchen and well maintained gardens. Since our last visit the lounge and dining room have been redecorated and new blinds purchased and fitted. People told us that they chose the colour schemes for the communal areas and also choose the decor for their own rooms. One person said he was involved decorating the lounge and dining area and also looks after the gardens. The home was clean, warm and comfortable and free from offensive odours. Staff have received training in infection control procedures and people using the service are assessed to use any cleaning products hazardous to health. Care Homes for Adults (18-65 years) Page 21 of 29 Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff work positively with the people they support and receive good training opportunities to equip them with the skills and knowledge to meet the individual needs of the people living at the home. People have confidence in the staff at the home because the checks have been done to make sure that they are suitable to care for them. Evidence: The AQQA states Our strength is a motivated staff team with sound values and commitment to the service users here, and we put a lot of effort into maintaining that so that the team can then put the effort into providing good support to the people who live here. People living at Hermitage Way are supported by a trained and motivated staff team who have a clear understanding of their individual needs. People using the service looked relaxed in the company of the manager and staff on duty and told us they like the staff and the manager. All but one member staff has obtained a care qualification known as NVQ at level 3 and above and one person is due to commence the award shortly. This exceeds the national minimum standards. We spoke with a member of Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: staff on duty who was very positive about her role and stated Im very happy here, the home meets the needs of service users. The manager stated that the homes ethos is to support service users to live independently, as reflected in the staffing levels currently available. One person currently receives additional support although following a significant improvement in his health this is due to be reviewed. The manager stated staffing levels remain under constant review based on peoples changing needs and this is also acknowledged in the AQAA which states Changes in service uses needs will need to be monitored for their implication in accessing resources. The staffing ratio is one member of staff to support the seven people using the service although additional staffing is made available to cover trips out, health appointments etc. We looked at the files of the two staff employed since our last inspection to make sure that checks are undertaken so staff are suitable to work with vulnerable adults. The files were well presented and evidenced that all of the checks that we require had been undertaken for example a Criminal Records Bureau check and two written references. We advised the manager to ensure a full history of employment is obtained and any gaps in employment discussed as part of interview process. People receiving a service are supported by a well trained staff team. The Annual Quality Assurance Assessment states We have a comprehensive rolling training programme managed by the training coordinator. . . the coordinator works with the home manager to ensure that staff access appropriate training. We met with the training coordinator and reviewed the training matrix, which identifies the training staff have undertaken. The manager stated We have an absolutely superb training coordinator...and the best trained staff team in the area. The member of staff spoken with considered she is provided with very good training opportunities to include training specific to the needs of the people she supports in addition to training in safe working practices, ensuring people are kept safe. New staff receive induction training and the learning disability qualification (LDQ). Training needs are discussed as part of staff supervision, in team meetings and in organised staff team away days. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in Hermitage Way because it is managed in the best interests of the people living and working there. Evidence: People living at Hermitage Way benefit from a manager who is experienced, qualified and demonstrates a good understanding of their needs. The manager has over 12 years experience in managing residential services and has attended numerous training courses relevant to her role. Since the last inspection both the manager and the assistant manager have obtained their NVQ level 4 awards. People we spoke with said they like the manager and that Jayne is very approachable. The organisation is currently restructuring and the manager has kept people fully informed of the proposals. The AQAA completed by the manager was detailed and reflects the strengths and areas for improvement and states The people who live and work here are actively Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: involved in making decisions about how we run the service in their interests, as well as decisions about their personal lives. Views are gained through regular residents meetings, reviews, staff meetings and satisfaction surveys. Monthly audits are undertaken as part of regulation 26 visits, as required. This helps assess how the service is currently performing and evaluates outcomes for people and aids future planning. Discussions with six people indicate they are happy with the service they receive. The home has received a number of compliments from health and social care professionals, the Housing trust, relatives and the police. These include: The incredible support provided to a service user promoting their recovery from major health issues. The consistent and effective support provided to their relative promoting their recovery of their lifestyle after a difficult period. Supporting service users to develop their confidence and skills. Prompt action taken in response to an incident with a service user that resulted in involving police. People told us that they feel safe living at the home. We looked at a variety of health and safety records and the checks that staff do to prevent people from being placed at risk of harm. We found that checks are generally in undertaken at the required frequency and equipment serviced to ensure that it is safe and protects people. Training records evidence that staff receive training in safe working practices for example food hygiene, fire, infection control, health and safety which helps to keep people safe. The manager stated she has complied with the recommendations made by the fire officer following their last visit to the service in 2007. The environmental health department have not visited since our last inspection. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 19 Information concerning significant health events should be included in peoples support plans. This will ensure new staff are aware of previous events so they can detect any changes at the earliest opportunity ensuring continued good health. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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