Care Home: 62 Bradgate Close

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What the care home does well We found that service user plans had been reviewed and updated so that staff had written information about how to meet peoples day to day needs. We found that the routines at Bradgate Close were flexible and staff are responsive to the requests and desires of the people living at the home. We saw that effective personal and health care is provided, and that physical health care needs are met in full. We found that the service promoted the emotional wellbeing of people by ensuring that staff are able to spend time getting to know people and working with people as individuals. We found that the physical environment provided sufficient and flexible space so that people can complete different activities at the same time. We found that the manger and staff working at Bradgate Close are able to learn new skills and keep up to date through the training offered by the organisation. We found that staff suitable for working with vulnerable adults are employed through a robust recruitment and selection process. We found that people frequently got out and about and had pleasant lifestyles. What has improved since the last inspection? This is a new service. What the care home could do better: The registered person should ensure that all staff understand the information in the Mental Capacity Act and the Deprivation of Liberty Safeguard guidance, this is so that staff understand when these rules apply and so prevent peoples rights from being infringed. The registered person should ensure that methods are developed that enable people to make an informed choice about the meals they have this will demonstrate that people are given choice in as many aspects of their life as possible and so enhance their feeling of self worth and promote their independence. The registered person should ensure that identified needs in relation to behaviour management are assessed and planned for in keeping with best practise guidance, this is so that people are supported to independence in a consistent manner that is in keeping with the philosophy of enabling and empowerment. The registered person should introduce a quality assurance process that will elicit the views of the people using the service so that these can be incorporated into any developments planned for the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 62 Bradgate Close 62 Bradgate Close Manchester Lancs M22 4LX     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: Michelle Haller     Date: 0 7 0 5 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 30 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 30 Information about the care home Name of care home: Address: 62 Bradgate Close 62 Bradgate Close Manchester Lancs M22 4LX 01619455810 01619455810 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): North West Community Services (Greater Manchester) Ltd Name of registered manager (if applicable) Christine Flanagan 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 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 - Code LD. The maximum number of service users who can be accommodated is: 4. Date of last inspection Brief description of the care home 62 Bradgate Close is a four bedded house situated on an ordinary housing estate in Northenden South Manchester. Communal areas include a large lounge, medium sized kitchen and enclosed back garden. Each person has their own bedroom. There is parking at the front of the house and public transport to Manchester and Northenden is within walking distance. Bradgate Close is staffed on a 24 hour basis. Care Homes for Adults (18-65 years) 4 Over 65 0 Page 4 of 30 Brief description of the care home People mostly access the service at Bradgate Close through a referal process that is lead by the Manchester Learning Disability Partnership. The total cost of each placement is dependant on the complexity of the individuals assessed package of care. Care Homes for Adults (18-65 years) Page 5 of 30 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 health-care support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We conducted this inspection by visiting the home without informing the manager before hand, and we looked at all of the most important or key Care Homes for Adults (18-65) National Minimum Standards (NMS). This is called a Key Inspection. The inspection involved looking at the information we had received about the service before visiting the home. This included notifications or events that the manager has told us about, information from other sources such as social services, health workers or people using the service. This is a new service and so no previous Care Quality Commission (CQC) have been conducted. We received one completed Care Quality Commission (CQC) survey from staff. Care Homes for Adults (18-65 years) Page 6 of 30 We visited Bradgate Close, we looked around the home and checked through written information, including service user care files. We read through policies, guidelines and other documents concerned with running the home. We observed the interactions between service users and staff at the home. We talked briefly to staff. We interviewed manager and talked to the registered provider. The manager returned to us the CQC Annual Quality Assurance Assessment (AQAA). The information requested included data about staff training, development of policies and procedures and compliance with health and safety checks when applicable. The information also influenced the outcome of the inspection. We visited the offices of North West Community Service (NWCS) to examine staff records. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The registered person should ensure that all staff understand the information in the Mental Capacity Act and the Deprivation of Liberty Safeguard guidance, this is so that staff understand when these rules apply and so prevent peoples rights from being infringed. The registered person should ensure that methods are developed that enable people to make an informed choice about the meals they have this will demonstrate that people are given choice in as many aspects of their life as possible and so enhance their feeling of self worth and promote their independence. The registered person should ensure that identified needs in relation to behaviour management are assessed and planned for in keeping with best practise guidance, this is so that people are supported to independence in a consistent manner that is in keeping with the philosophy of enabling and empowerment. The registered person should introduce a quality assurance process that will elicit the views of the people using the service so that these can be incorporated into any developments planned for the home. Care Homes for Adults (18-65 years) Page 8 of 30 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 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health-care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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 referred to Bradgate Close will go through an admission process that ensures that their needs will be understood so that they can be confident that the service will meet their requirements. Evidence: Bradgate Close is a small residential home which has provided support to the same people for a number of years. We found that North West Community Service (NWCS), the company that owns Bradgate Close, has a policy that will be used when new admissions are planned. This policy includes the manager attending meetings and spending time with the person, their social worker, family and others who know the person well. The assessment includes gathering information about communication needs, accommodation, activities and leisure, family and social involvement, managing or supporting risk, income and finances and cultural needs. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The policy states that proposed clients are able to spend gradually more time at Bradgate Close to assist with getting to know new staff and environment. This also assists with managing and assessing the dynamics and compatibility with the people already using the service. We assess that if the NWCS referral and admissions process is used in full then all concerned can be confident that peoples needs will be net at Bradgate Close. Care Homes for Adults (18-65 years) Page 12 of 30 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. We found that there are systems in place that will support people using the service to make choices and and have their individual needs met. Evidence: We looked at the service user plans for people living at Bradgate Close. These had recently been updated and reviewed. The manager told us that they were changing over to the system used by NWCS. We saw that information had been transfered across and updated, describing each persons current needs. We noted that people involved in this process included the person, their key worker from Bradgate Close, the persons relatives, if they were involved, and the social worker. We noted that the service user plan provided sufficient detail to inform staff about how to work with people each day. We noted through the information in the care plans and risk support plans, that peoples preferences were identified and how they made Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: choices was recorded. There was information about how to support with activities, going to bed, getting dressed, going out, and family contact. We saw, through the daily records, that the routines at Bradgate Close were flexible and that people were able to make choices about where they spent their time in the home. We also found that people were free to choose whether to participate in activities offered by staff. Records were written respectfully, however entries needed to be completed in more detail. This matter was discussed with the registered manager and the registered provider. We noted that care plans and risk assessment were individualised and person centred. Risk assessments provided a description of the risk and the actions needed to minimise the impact of the activity. We discussed risk management with the registered provider. She stated that the company are to reassess the current risk management strategy for people using the service. She stated that the philosophy they wanted to introduced was to support risk. The expected outcome will be to enable people to complete the activity they want with support. We concluded that there were different types of risk management protocols available in social care and that the least restrictive should be used depending on the situation and potential outcome. We discussed Mental Capacity Act and Deprivation of Liberty Training. We were informed that senior members of staff had attended a course provided by Manchester Learning Partnership and this information will be cascaded to junior staff, however there was no planned date for this to commence. We assess that Mental Capacity Act and Deprivation of Liberty safeguard training should be made a priority and added to the current NWCS training plan for 2010. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are processes in place at Bradgate Close which enable people to lead the lifestyle they choose. Evidence: We looked at the information available about peoples leisure, educational and occupational interests. We noted that this had been documented. We noted, however, that activities arranged by staff centred very much around Bradgate Close, shopping and going for drives out. The daily records indicated that people enjoyed these activities and during the inspection we noted that people responded positively when a shopping trip was arranged. We noted that staff included the resident when arranging the shopping trip, and staff made a shopping list through discussion with the residents. It was noted that people were able describe, using single words what was needed and pictures were used to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: assist. The activity and daily record also indicated people used the local community facilities such as going to the pub to watch a football match or the local swimming baths. This outcome in this area would be improved if more steps were taken to introduce people to regular groups and activities that would assist them in developing a wider circle of friends and acquaintances. We saw that the importance of family contact was highlighted when relevant. We noted that staff developed close and effective relationships with the people using the service and their families. We found that action was taken to try and re-establish and maintain positive family relationships. And people are supported to take a part in family life. We noted that the daily routines were flexible and in keeping with the information provided in care plans. We saw that staff speak to the service users and listen to what they said. We found that staff had developed a long list of food preferences for each person living at Bradgate Close. We looked at the menu and saw that people were generally offered a light lunch and a cooked tea. The meals were varied and included quiches, pies, stews, roast meals, sandwiches, fish meals and, on occasion, take away meals. We noted that people were not given a choice at mealtimes. We discussed this with the manager and with the registered provider. We saw that people were able to communicate with staff in relation to the drinks and a food preference list available. We therefore conclude that people will be able to make a choices about the menu if the information is presented in an accessible way. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and health-care support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience 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 Bradgate Close benefit from systems which ensure that their personal and health care needs are met. Evidence: We found that people living at Bradgate Close had their personal care skills fully assessed and so were supported in a way that promoted their independence and encourage the development of new skills. As previously identified peoples preferences were highlighted and daily records indicated that these were respected at all times. We also found that specialist input had been sought in respect of working with someone whos behaviours drew attention to themselves when in the community and challenged staff. Despite this and the guidance provided, a behaviour management care plan and guidelines had not been developed. Neither were staff recording incidents in a manner that would assist in monitoring and therefore devising an effective care plan. It was not possible to confirm, therefore, that a consistent approach was been used and neither was it possible to assess the progress in reducing the impact of the behaviour. We observed that staff sometimes used inappropriate prompts in order to achieve the desired outcome with service users. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: We also noted that staff recording was inconsistent in that they would provide clear and detailed information about an incident, but no description of the steps taken to resolve the situation or evidence of followup actions. These matters were discussed with the registered manager and the registered provider. We observed the interaction between the people using the service and staff. We noted that people were very relaxed, smiling and communicated their preferences in relation to what was happening for them at Bradgate. We saw that people were supported to achieve a high standard of personal cleanliness and general grooming. People looked smart and had been supported to dress fashionably. Records about health care visits and other correspondence confirmed that people received support to attend out patient appointments and routine health checks. We noted that people had been examined by the podiatrist, dentist, and optician. We also saw that in January 2010 each person received a Annual Health Check, the result of this was followed up and treatment given if required. We examined the medication record sheets for people living at Bradgate Close and saw that all medication had been signed for. There were no unexplained gaps. The medication in the house is provided by Booths the Chemist in a metred dosage system. The packaging also prompts staff about ordering additional medication before it runs out and the process is followed. Medication is kept securely in a locked cupboard and the records confirm that staff working at Bradgate Close have received medication training. Care Homes for Adults (18-65 years) Page 18 of 30 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. Policies and procedures are in place to enable people to make their concerns known and promote the safety of vulnerable adults. Evidence: We examined the complaints policy used by the service and found that it provided information about how people can complain and what to expect in relation to the investigation and the outcomes. We noted that this policy was provided in picture format so that it was more accessible. We found however that there was some inaccurate information in relation to the contact information for CQC and the change in ownership of the organisation. The registered person informed us that the company was in the process of updating all of the policies and procedures and so this information would be amended as the process was completed. We looked at the homes complaints record and no complaints had been recorded. The manager told us that there had not been any adult protection investigations at the home. We discussed adult protection matters with the manager and she was clear about the behaviours and omissions that could be considered as abuse. She confirmed that all Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: staff had recently completed an induction program related to working for the new organisation and adult protection and safeguarding had been a topic that was covered. She also stated, and this was confirmed when the training plan was examined, that staff had also been booked onto an in-depth safeguarding adult course. Staff who returned the CQC survey confirmed that they were aware of advocacy and how to deal with any concerns about the treatment of people. Care Homes for Adults (18-65 years) Page 20 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Bradgate Close benefit from an environment that meets their needs however inadequate steps are taken to promote infection control. Evidence: We found that the home is in an ordinary housing estate and blends in with the properties around it. The building is easy to access. There is a garden that is secure and safe so that people can spend time in this space alone. The hallway and other areas in the home would benefit from been redecorated, however the furniture, fittings and fixtures were clean and domestic in nature. We were informed that staff and the service users carry out cleaning duties, and the organisation employs a gardener. There is a good bus network close to the house. We checked the fire safety records and found that all checks had been completed frequently and in keeping with fire safety regulations. Fire safety equipment was Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: strategically placed around the home and these had been recently checked by fire fighting equipment specialists. We found that the house was clean and free from unpleasant odours. During the tour we found that there were no soap, towels or hand cleansing equipment in the toilets or bathrooms. This is unacceptable because hand-washing is one of the most important actions in preventing the spread of infection. This omission was discussed with the registered manager and the registered provider. Care Homes for Adults (18-65 years) Page 22 of 30 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. Staff at Bradgate Close are employed using a robust recruitment process and receive training and support to enable them to carry out their jobs effectively. Evidence: We observed staff as they went about their work. We noted that, in the main, staff approached people with courtesy and sensitivity. The training matrix confirmed that since the start of the new service staff have been offered the following training courses: Moving and Handling; Food Hygiene; Protection of Vulnerable Adults; Epilepsy Awareness; Equality and Diversity; Medication; Dementia Care; Diabetes; health and safety for carers and First Aid. In the information returned to us the manager stated that four of the seven staff had achieve the National Vocational Qualification level 2 in care. We looked at the recruitment record for a member of staff who has been employed since North West Community Service took over ownership of Bradgate Close. We saw that this file held a check list of the documents that needed to be received before employment commenced. We found that this file contained a completed application form, notes made during the interview, two references, additional proof of Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: identification and a completed Criminal Record Bureaus check. We saw through signed off sheets that people were enrolled onto an induction course that covered the subjects stipulated by the Skills for Care council. We noted that staff meetings we held and the minutes showed that matters were discussed that provided staff with guidance and information about completing their jobs effectively. Topics discussed included the progress of people using the service, staff training and health and safety matters at Bradgate Close. Care Homes for Adults (18-65 years) Page 24 of 30 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 at Bradgate Close benefit from a services that is managed by a qualified person who promotes safe working practises. Evidence: We interviewed the registered manager for Bradgate Close. She has worked at the home for a number of years under the previous ownership. The manager informed us that her qualifications and training included: the Registered Managers Award, National Vocational Qualification (NVQ) level 4 in care, NVQ assessors award and Adult Protection training. In the information provided by the manager we were informed that all health and safety equipment and services checks had been completed by qualified professionals. We looked at the health and safety records which confirmed that fire safety equipment was checked in April 2010. Water safety checks and electrical checks certificates were also looked at. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: We found records confirming that the NWCS organisation carry out quality audits. This had been conducted in March 2010. This audit looks at Care plans and assessments, personal risk assessment and finances. We saw that this audit identified improvements to be made in relation to record keeping. We saw that currently there is no system in place for regularly recording the opinion of the service users, however comment is made on a daily basis about peoples general demeanour and contentment with the service. Care Homes for Adults (18-65 years) Page 26 of 30 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 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 23 The registered person must ensure that suitable hand washing and drying equipment is available to in the toilet and bathroom areas at all times. This is so that the risk of spreading infection is reduced through encouraging people to hand wash which is one of the most effective infection control measures. 11/06/2010 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 7 The registered person should ensure that all staff understand the information in the Mental Capacity Act and the Deprivation of Liberty Safeguard guidance, this is so that staff understand when these rules apply and so prevent peoples rights from being infringed. The registered person should ensure that methods are developed that enable people to make an informed choice Page 28 of 30 2 17 Care Homes for Adults (18-65 years) 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 about the meals they have this will demonstrate that people are given choice in as many aspects of their life as possible and so enhance their feeling of self worth and promote their independence. 3 18 The registered person should ensure that identified needs in relation to behaviour management are assessed and planned for in keeping with best practise guidance, this is so that people are supported to independence in a consistent manner that is in keeping with the philosophy of enabling and empowerment for the service user. The registered person should introduce a quality assurance process that will elicit the views of the people using the service so that their views can be incorporated into any developments planned for the home. 4 39 Care Homes for Adults (18-65 years) Page 29 of 30 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. © 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. 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