Care Home: 6 Durlands Road

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What the care home does well Service users have many opportunities available to them to have community participation. They are supported to have valuing friendships with people and have social,educational and leisure opportunities available to them. Their development needs are identified and care plans and risk assessments underpin how these are met safely. Staff are recruited safely and ongoing training ensures that current care practices are used to provide support. Service users have good relationships with staff and are able to have their non verbal communication understood by staff. Staff have a good awareness of safeguarding adult polices and know how to raise any concerns they may have. A complaint procedure is in appropriate format for service users to make their concerns known. Access to health care professionals is good and staff have received training to ensure service users receive their medication safely. A quality assurance programme is in place and this included obtaining the views of service users,their relatives and staff. What has improved since the last inspection? A training plan is in place and now all staff receive a comprehensive induction and ongoing training. Half of the staff team have attained NVQ`s (National Vocational Qualifications) in Care, which means they have additional skills and knowledge which may mean they can provide an improved delivery of care and support. A refurbishment programme has taken place and new furniture is in place in the lounge and dining area. New carpets have been fitted throughout the house and all areas have been redecorated. This means that service users have more comfortable surroundings to live in. What the care home could do better: The service will be complying with the necessary legislation when they have a manager in post who has been registered with the Commission. By streamlining all of the records held regarding service users it will be clearer to identify what are the current care plans and risk assessments for service users so it will be easier to use this information when supporting service users. Key inspection report Care homes for adults (18-65 years) Name: Address: 6 Durlands Road Horndean Waterlooville Hampshire PO8 9NT     The quality rating for this care home is:   two star good 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: Kathryn Emmons     Date: 1 1 0 8 2 0 0 9 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 26 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) 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. The material should be acknowledged as CQC 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 26 Information about the care home Name of care home: Address: 6 Durlands Road Horndean Waterlooville Hampshire PO8 9NT 02392591915 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robinia Care Group Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 4 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 4. 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 6 Durlands Road is a large, detached care home providing personal care, accommodation and support for four young adults with learning disabilities and complex needs. The home was opened in August 2004 and is set in a residential area on the outskirts of Horndean, on the A3 between Guildford and Portsmouth. The home is one of many owned and run by Robinia Care, a national company based in the South of England. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 4 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 visited the service on Monday 10th and Tuesday 11th August 2009 from 9.30am until Midday on Monday and 2.30pm until 4.15 pm on Tuesday. The AQAA (Annual Quality Assurance Assessment) was received when we requested it and this provided us with a lot of information about the service.We were able to use the information this contained to help us prepare for the inspection visit. We request a completed copy of this document every year. We saw all four of the service users during our visits and spoke to three staff and the manager. Prior to the inspection visit we sent out comment cards to the service for the four service users and we received one back on the first visit. We have used the comments these contained to help us gain information about the service and have reproduced some of these comments in the main part of the report. Care Homes for Adults (18-65 years) Page 5 of 26 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 6 of 26 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 7 of 26 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. Service users and their representatives are given information in an appropriate format to help them decide if they want to use the service. Preadmission assessments provide the service with information so they can to ensure they can meet the service users needs. Evidence: We looked at the admission details for two service users . One of the service users had lived in the service since it opened in 2004 and the other service user had moved into the service since our last visit. There was an assessment from a care manager and details recored by the member of staff who had carried out the assessment. The new manager confirmed that the level of details that would be obtained for any future admissions would be in more detail to ensure the service users needs could be met and any other resources such as community learning disability team support was in place. The two documents in place for service users and their representatives to use to help them make decisions about moving into the service are called the statement of purpose and service user guide. These have been updated since our last visit and were Care Homes for Adults (18-65 years) Page 8 of 26 Evidence: in pictorial format and with (Makaton) signing symbols so they were more appropriate for service users to use. Care Homes for Adults (18-65 years) Page 9 of 26 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. Service users choices and decisions form the base for all activities they participate in. Staff have a good understanding of knowing service users choices. Comprehensive risk assessments ensure service users are kept safe whilst participating in activities and enable them to be an independent as possible while remaining safe. Evidence: During our visit we saw many examples of service users being given choice. This varied from where they wanted to be in the house, to what they what they were going to wear, have to drink and what activities they were involved in . We also saw in care plans evidence of being able to decide where to go on holiday and for one service user they were involved in choosing the theme to the annual family B-B-Q- held at the service. The AQAA states that all service users are given choice regarding how they spend their days. When we visited the service we could see that staff were able to understand how the service users indicated their choices. This was through verbal Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: communication and through signing and non verbal gestures. One service user we spoke with said I like going to the grove and I go all the time because I like it. Each service user has a Person Centered Plan and additional care plans and risk assessments. We were not able to assess if service users were aware these plans were in place. We saw that goals and aspirations were known and photographs were used to indicate the activities service users had been involved with, which evidence their goals had been achieved. Each shift a record is maintained of what activities the service user had been engaged with and how they had responded to the activity. This information is used to also assess if the activity is something the service user enjoyed and would want to repeat. Risk assessments are in place and these were in very comprehensive detail. Staff we spoke with were aware of these working records and used them when planning activities with service users. Any need a service user had was also linked into a risk assessment to ensure that if there were any restrictions on an activity taking place it was clear why this would happen. Risk assessments are discussed with relatives and supporters as part of the review to ensure that service users rights are upheld. Care Homes for Adults (18-65 years) Page 11 of 26 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. Service users have many opportunities for personal development and social inclusion. Staff support service users to have their rights known and acknowledged. Systems are in place for service users to be supported to have their rights upheld. Dietary preferences are catered for and this is also service user led. Evidence: Service users are able to participate in educational activities either by attending the local college or by attending the organisations resource centre.We saw in one service users file they had attainment awards in place for organised activities they had attended. Where possible support workers will work with service users to assist them in developing new skills. While many of the service users will move to Durlands road with the view that this will be their home the ethos of the service is also to provide opportunities for service users to move on to more suitable accommodation such as supported living schemes if this is more appropriate. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: From looking at the AQAA and reading daily records we could see that service users are often in the community accessing activities. These included going out for lunch, bowling cinema, swimming , horse riding, social clubs and discos, aquarium and at the time of the visit all of the service users and staff had gone to he organisations resource centre for lunch. Staff were clear on the importance of service users being part of the local and wider community and from looking at records it is evidenced that this is achieved. We spoke with staff regarding how they managed to support service users in the community and what action they would take if their was an issue while out with service users. The responses were appropriate and evidence that staff understand service users rights to be valued members of the community . The staff we spoke to were clear of the importance of service users to be able to engage in friendships and relationships where this was appropriate. The service enable service users to invite friends to the house and the manager told us of an occasion where they tried to arrange for a couple of service users who were friends to holiday together. All of the service users are going on holiday and three had chosen to go abroad and through the staff and supporter assistance service users also chose which staff would support them. There was evidence in records and from speaking with staff which tells us that service users have good access to advocates, supporters and family members who can help them make decisions about their lifestyle, when service users need this support. This means that they are assisted to have their rights upheld and to make decisions in their own best interest. Service users are involved in meals preparation at the service . We saw photographs illustrating one of the service users picking the menus with a support worker . The menus are picked using photographs of the meals, and support workers guiding service users to make menus which provide a varied and balanced diet. There are cookery and baking sessions held most days and the kitchen had photographs on the doors of the cupboards so service users can see what each cupboard contains . These arrangements mean that service users are able to lean new skills and to move to wards being more independent in daily living skills. Care Homes for Adults (18-65 years) Page 13 of 26 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. Care plans evidence that service users receive their personal care in their chosen way and with the right level of support. Service users have good access to health care professionals and are supported by key workers to have their health care needs met. Medication systems keep service users safe and ensure they receive their medication correctly. Evidence: We could see from reading three sets of care plans that personal care was planned to be delivered in the service users preferred way. A few care plans we saw contained a lot of information and some of this was a couple of years old. The manager stated that a new format was being introduced and that eventually the older information would be archived so the most current information was in the plan and that this would make it easier for support workers to follow. Each service user has a key worker and photographs are displayed in the hall ways so service users can remember who their key workers are. Key workers are responsible for updating care plans and holding reviews with the manager. All of the service users are registered with the local doctors surgery and from reading Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: notes and speaking with the manager we established that service users have good access to the community learning disability team, psychologists, practice nurses, epilepsy nurse specialists and dentists. We saw a care plan for one service users health support needs when visiting the dentist. This was in pictorial format which enables the service user to have more of an understanding about visiting the dentist. Each service user had an individual health care plan called My Health Plan. This document also identifies the level of understanding and insight each service has into their heath needs. Each of the staff we observed had a good rapport with the service users and could understand the service users emotional state through their non verbal communication. One service user had a care plan in place for staff to follow when they completed information regarding this particular service user as they became distressed when they saw staff writing information about them. Staff told us and we saw from staff records that all staff involved in administering medication have received training. Medication records we looked a had been completed correctly and each medication was given and witnessed by two support workers. We could see an audit trial of medication ordered and what was returned back to the chemist. Any medication that was given when necessary had a comprehensive care plan in place so that staff would only give medication when it was needed and not at their own individual discretion. This means that service users receive their medication in a safe way. Care Homes for Adults (18-65 years) Page 15 of 26 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 who make complaints can be confident that these will be responded to promptly. Systems are in place for identifying adult abuse and reporting any concerns regarding care practices that may be placing service users at risk of abuse. Evidence: We discussed with the manager how concerns, complaints or comments were dealt with. We were told, and we saw a complaints log which is held at the service and is available for staff to complete. The manager confirmed that this document is checked during monthly quality meetings from one of the organisations senior managers. This means that any issues raised are addressed and actioned appropriately. We could see that the issues raised in the last twelve months had been responded to within the organisations agreed timescales. The information about complaints and concerns which was recorded in the AQAA matched the complaints log. Staff gave us examples of how they could tell if service suers were not happy or satisfied with any aspect of their care. There is also a complaints procedure produced by the organisations for service users to use. This is in pictorial format to assist service users in using the procedures. We could see from staff training records that all staff had received training in safeguarding adults and protection of vulnerable adults. The manager confirmed this training was also provided yearly as refresher training. A policy is in place and is used in conjunction with Hampshire County Councils safeguarding adults procedure. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: Through speaking with staff we evidenced that staff had a very good working awareness of understanding care practices and how to ensure that any element of abusive practice did not slip into agreed care practices. Staff were clear on who to speak to if they had any concerns and this included taking concerns to higher levels of management in the organisation . There is an openness surrounding alerting other staff and challenging staff if there were any concerns regarding practices. Care Homes for Adults (18-65 years) Page 17 of 26 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. Service users live in comfortable surroundings which they have been able to personalise. Staff support service users to have ownership of their bedrooms and have received training to ensure safe working practices at the service. Evidence: Since our last visit there has been a major refurbishment programme at the service. As we walked around the service we could see that new carpets and furniture had been purchased for the lounge and dining area. The AQAA informs us that new windows had been fitted throughout the house. Three of the bedrooms have en suite facilities and one of the upstairs bedrooms is next to a bathroom which is for a sole service users use. One of the service users allowed us to view their bedroom. They indicated they had chosen the decor themselves and had been able to personalise the room with their paintings and drawings and other personal possessions. The front door has a key pad in place to prevent unauthorised people entering the building. When people call at the house service users are supported to open the door with a member of staff. This means that staff acknowledge that the service users have ownership of their home. The kitchen is spacious and as mentioned earlier this is laid out with pictures on cupboard door so the facillities are easier for service users to use. There is a sensory room which we viewed. This provides space and a comfortable area Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: for service users to relax and spend some time by themselves, or with support if this is their choice. The garden is enclosed and well maintained. We saw service users walking around the service and understanding it was not acceptable to go into other service users bedrooms without permission. Staff support service users to ensure they can keep their bedroom private by supporting other service users to not go into other peoples bedrooms. Staff told us, and we saw that gloves and aprons were available for personal care. Staff received training in basic food hygiene and the AQAA indicated that staff have received training in infection control. There is a maintenance book for any repairs and these are carried out by the organisations maintenance team. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be confident that the right people are employed to support them. Recruitment procedures are robust and induction enables staff to be clear on the job role they are expected to perform. Ongoing training provides staff with the knowledge and skills to continue to meet service users changing needs. Evidence: Since the last visit a recruitment drive has taken place. All apart from one support worker role have now been appointed to. The manager advised us that two staff were due to start work the following week and one new staff a few weeks later. At the time of our visit interviews were being held for a senior support worker post. Agency staff is still used occasionally but the same staff go to the service to provide consistency and continuity of care for service users. We looked at the recruitment records for three staff. We could see that all of the necessary checks had taken place and staff were not able to start work until the organisations human resources team had confirmed that all information had been received. This included two written references, application form, evidence of identification and a Criminal Record Bureau check(CRB).We saw interview notes were maintained and details of when staff were due to start work. There is an comprehensive induction programme in place and staff we spoke with confirmed that they had carried out an induction before they were able to work Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: unsupervised at the service. We saw a duty rota and saw that there were at least four staff on each shift and if activities planned required ,five staff and the manager. The manager confirmed that on occasion they would provide care rather than call in agency staff. The AQAA provided us with details of the training provided and this included Safeguarding Adults , epilepsy training ,autism, first aid and training in how to manage potential challenging behaviors.The AQAA also records that nine of the ten care staff had completed an induction course at the nationally recognised level and that half of the staff had a NVQ in care. This means that they have the necessary skills and knowledge to provide safe care to service users. We observed many interactions between staff and service users. It was clear that staff had very good communication skills with the service users and could understand how service users were expressing their needs through non verbal communication. Staff spoke to service users in a valuing and appropriate way and we could see that all of the service users had a good rapport with staff. We received one comment card from a service user and this states that one of the things the service does well is I like the staff a lot, we get to go out lots. We saw evidence that supervision sessions take place every couple of months and an annual appraisal also takes place. The manager provides supervision to senior staff and senior staff provide supervision to support workers. This means that staff have a formalised system for having their training and development needs identified. Care Homes for Adults (18-65 years) Page 21 of 26 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. The manager needs to make application to the Commission to be considered for registration as the manager. Health and safety arrangements keep service users and staff safe. Quality assurance systems are in place which provide direction for the service to continue to improve and provide good outcomes for service users. Evidence: Since the last visit a new manager has been recruited into the managers post. The manager has been in post since mid April and has not yet made an application to be registered by us as the manager. We discussed this and on our second visit the manager had downloaded the relevant application forms and confirmed that they were going to make an application within the next couple of weeks. Staff we spoke with said they had a good rapport with the new manager and felt that a good service was provided for service users. We saw the manager interacting with the service users and there was a good rapport between the manager and service users. The manager confirmed that all policies and procedures had been updated regularly and that they were reviewed as part of the services quality assurance system. The manager received monthly visits from one of the organisations senior managers who looks at various Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: record and speaks with staff and assesses how service users feel about the service they receive. The manager was able to tell us about health and safety measures that are in place and provided evidence of up to date fire safety tests and training. Staff we spoke with were clear on the need to maintain a high level of health and safety throughout the home and said that the manager was receptive to any work that needed to take place to ensure the home remained a safe place to live and work. The organisation ethos includes a culture of inclusion and openness. Staff have regular staff meetings and service users have service user meetings monthly. Minutes of these are then provided and action plans are produced to evidence that issues raised are actioned. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 Care Homes for Adults (18-65 years) Page 25 of 26 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!