Care Home: Applelea

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What the care home does well Residents enjoy varied lifestyles, undertake activities of their choice and are able to participate in a wide range of opportunities and that the social activities,. Family contacts are well managed and reflected residents wishes and choices. The home provides a good reliable service to residents by a well managed, stable, well trained, supported, committed and qualified staff team who are recruited in a manner that protects residents. Both of the outcome areas mentioned above were assessed as excellent. What has improved since the last inspection? Areas dealing with the residents lifestyle and staffing previously assessed as good are now considered to be excellent. What the care home could do better: There were no areas of concern noted or requirements and recommendations made as a result of this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Applelea The Harrow Way Basingstoke Hampshire RG22 4BB     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: Peter McNeillie     Date: 0 3 0 9 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 29 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 29 Information about the care home Name of care home: Address: Applelea The Harrow Way Basingstoke Hampshire RG22 4BB 01256364044 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: a.rayner@liaise.co.uk Liaise Loddon Ltd 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 Applelea a care home owned and managed by Liaise Loddon Ltd (who are also responsible for a number of similar services in Hampshire) is registered to provide accommodation, support and personal care for up to four adults aged 18-64 years with a learning disability. The service is designed for individuals who require 1:1 support to access the community, and who may have additional needs associated with epilepsy and sensory impairment. The property comprises a detached two-storey house close to Basingstoke town Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 4 Brief description of the care home centre, community facilities,shops, transport links, including bus routes, a main line station and the M3 motorway. All residents are accomodated in large single bedrooms with personal ensuite bathing and toileting facilities or the sole use of their own bathroom. There is space for parking up to eight vehicles on site and additional unrestricted of road parking off in a nearby lay-by. 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: This report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, previous reports, examining service users and staff records, talking with staff, management, and responses to a pre inspection CQC satisfaction survey by staff and health care professionals. No responses were received from residents or their representatives. Additional information was provided by the manager in her responses in the homes pre inspection Annual Quality Assurance Assessment. (A.Q.A.A.). During this inspection which took place on 03/09/09 between the hours of 08:45am and 12:30 pm all of the designated key standards for younger adults were inspected. As a result of this visit no requirements or recommendations have been made. The results and findings contained in this report which we discussed with the manager Care Homes for Adults (18-65 years) Page 6 of 29 at the conclusion of our visit and the Director of ccare for Liase Loddon (by telephone) will determine the frequency and type of future inspections. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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. The home has a well-developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. Evidence: There have been no admissions since the last inspection. We were told by the registered manager that all admissions are carried out in accordance with a corporate admissions policy and procedure that requires that no resident is admitted without a full assessment of needs their and attendant risks being carried out. This was confirmed in the homes AQAA which told us: We have a thorough and comprehensive pre-placement process which includes visits to the individuals in their familiar surroundings; completing a through needs assessment with the persons circle of support group; inviting the individual and family to visit the home, if appropriate. Pre-placement Needs Assessment 100 Successful transitions into our service. Most individuals who come to live in a Liaise home settle and remain living in the home for Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: many years. To confirm the above and ensure the standards were being complied with, we viewed four residents files chosen at random. All included, an initial assessments covering a number of topics including housing related support, personal care support, daily living skills, looking after their physical and mental health as well as areas of risk. External health and social care professionals also contributed to the assessments process including a pre placement review where appropriate. All assessments of need and risk were reviewed on a regular basis. As there have been no admissions since the last inspection our assessment of this outcome area remains unchanged at good. Care Homes for Adults (18-65 years) Page 11 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. There is a clear and consistent care planning system in place which ensures residents needs are met within a risk management policy that involves residents in decisions that affect them. Evidence: None of the residents were able to read and fully understand the complexities or the meaning of a care plan and understand the concept of risk and risk taking. To ensure compliance with the standards and regulations we viewed all of the residents records. These indicated that all of the plans were reviewed on a regular basis to ensure all they reflected the current needs of the resident. In the absence of agreement by the resident, their representative had been involved in and consulted when the plan was formulated. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: All plans viewed were based on an initial assessment of needs and risk ( The previous section of this report refers) which took into consideration residents needs, wishes, choices, aspirations, risks, abilities, details of any health care professional involved, communication methods, dietary needs , help required with eating and drinking and number of staff required to safely deliver the plan. Residents right, and the opportunity to take risks is seen as fundamental, however it was clear from records and our observations all of residents would have difficulty in totally understanding the concept of risk and risk taking. Despite this, residents were encouraged and supported by staff to make decisions for themselves within a risk assessment framework. This process identified individual risks and how they were to be managed, enabling residents to take part in activities in a safe manner. Where restrictions were in place these were clearly recorded in the care plan. Staff demonstrated to us that they had a good understanding of the contents of the care plans and risk assessments and were able to explain how this was translated into day-to-day practice. To promote equality and diversity and to ensure that race, gender identity, disability, sexual orientation, age, religion and belief are promoted and incorporated into what they do, in their AQAA the home told u we do the following: Thorough polices, intensive induction and continued training for all staff. Liaise supports service users from several ethnic backgrounds and of different religions. Ensure that all service users have their own individual plan that supports them to have the lifestyle they seem to choose. Where appropriate and possible service users are supported to actively pursue their religion and beliefs. Menu planning to include service users cultural and religious beliefs Approraiate music e.g Greek In the future they intend the Further development of cultural Days Care Homes for Adults (18-65 years) Page 13 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. The social activities family, contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: Any decision taken that affects individuals always seeks to empower the individual by taking into consideration the individual residents choices,wishes,aspirations and independence however limited. These were reflected in the manner in which the home is run and day to day life conducted. Residents are free to conduct their day to day life at a pace that suits them i.e. bedtimes, mealtimes, choice of clothing etc. This is in line with the staffs perception of themselves as enablers first and carers second. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: We observed staff staff interacting with residents in a positive, respectful nonpatronising manner. It was evident that caring for the residents was more than a job for the staff who expressed and demonstrated a total commitment to the residents. Despite the high care needs and unpredictability of the residents, they are are encouraged and supported to use of community based facilities. These include, local shops, pubs, swimming pool, restaurants, bowling horse riding, bowling, parks, walks and holidays. In house a number of activities are also available including, television, art, music, sensory, gardening, etc. Residents activities are viewed as very important to the individuals development and general wellbeing, consequently, apart from employing an activities coordinator, staffing is arranged to ensure residents are supported by staff familiar to them and whenever possible no activity is cancelled due to lack of staff. The home is also very much aware of any religious and spiritual needs a resident may have. In the case of one resident they had discussed this with residents relatives who had accepted responsibility for this aspect of the individuals life. Continued and regular contact with family and friends (If the resident wishes) is actively encouraged and supported. Residents families and friends are encouraged to visit at any time. To facilitate a particular resident, we were informed two staff take a resident home monthly and collect them later. This requires a journey of some hours and demonstrates the homes commitments to ensuring family ties are retained. A daily menu in a written format based on residents likes and dislikes was displayed in the kitchen. This also reflects any special dietary needs and in the case of one resident acknowledges and promotes their cultural and religious heritage. The homes staff and management recognised that alternatives to a written menu is of great importance for some residents who may find the addition of pictures are beneficial to their understanding of the food available, however we accept that should such an item be displayed it would be of little value and probably quickly be destroyed. Despite the absence of a menu in a format that all residents could understand we are satisfied that residents choose the menu as we observed residents choosing their breakfast using objects of reference, pictures and photographs as previously advised by the manager. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: 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. Satisfactory arrangements are in place,ensuring the personal,emotional,health care and medication needs of residents are met. Evidence: Details of the personal care, support and health care needs of residents need were clearly recorded in very detailed and well presented individual health care action plans ( Section Individual needs and choices of this report also refers) with which staff demonstrated a clear understanding and familiarity with. Details recorded apart from giving a comprensive picture of the residents past and current health care needs including current medication, height, weight, foot care, eye care, hearing, allergies, sleep paterns, dental care, continence and mobility etc. Records indicated that any special medical, health or social care needs would be provided following consultation with the appropriate professional. These might include the local; doctors, district nurses, physiotherapists, occupational therapists, speech language therapists, care managers and any other specialist required including the community learning disability team. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Residents were unable to confirm that they had exercised choice with regard to their doctor,however we were informed by the manager that should a resident indicate a wish to see a doctor of the same gender or showed signs of not liking a paticular doctor they would ensure an alternative G.P from the same practice was consulted Records were kept of appointments with all health and social care professionals and included details of any advice and treatment given. Medication records confirmed that all prescribed medication, (which was seen to be securely stored) was administered in accordance with a medication policy and procedure by trained staff. The record of medication administered to residents and unwanted items disposed of were complete and accurate. A procedure that ensures residents can assume responsibility for their own medication was in place. Records viewed confirmed following a risk assessment no resident was responsible for their own medication. 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. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: A record of complaints, which included time scales within which complaints must be dealt, is maintained. No complaints have been received by The Commission for Social Care Inspection (CSCI the previous regulator) or CQC since our last visit. Due to the problems of communication we were unable to ascertain how residents felt about discussing any concerns they had with the homes manager. Staff told us should any resident by their behavior exhibit signs of being was unhappy or distressed they felt confident in raising the issue with management and were certain any issued raised would be dealt with promptly and fairly. A whistle blowing and Adult Protection Policy and Procedure based on the No Secrets publication had been implemented to work in tandem with the multi agency procedure produced by Hampshire County Council. All management and staff spoken with and staff training records viewed confirmed all had received training in recognizing various types of abuse and were aware of and were able to demonstrate the procedure to follow should they witness or suspect the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: abuse of a resident. 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. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: The home comprises a large two storey detached property set in its own grounds with a small amount of off street parking is sited in a residential area close to Basingstoke town centre, community facilities, shops, transport links, including bus routes, a main line station and the M 3 motorway. From the outside there is nothing to distinguish the home from its neighbours, there are no discriminatory signs and nothing to indicate it is a care home. All areas of the home were clean and free from unpleasant odours and obvious hazards. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs. All communal areas were accessible by residents including the large, established and safe garden. As previously mentioned in our introduction, all residents are accommodated in their own single rooms to which if they wish they are issued with a key. We highlighted that at present, the locks fitted to residents bedroom doors do not meet current standards Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: as they cannot be unlocked from the inside unless a key is used. A verbal undertaking was given by the Director of Care for Liaise Loddon by telephone all locks would be replace within the next three months. In view of this assurance no requirement is being made on this occasion. An infection control policy and procedure was in place as were disposal aprons, gloves, antiseptic hand soap and a washing machine fitted with a high temperature and sluice programme. 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. Residents needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The residents currently being accommodated all have high care needs and require at least one member of staff and on occasions two staff to be with them at all waking times to ensure their safety. In our view, at the time of the inspection staff numbers and the deployment of staff was sufficient to meet the residents needs. The manager informed us the planned staffing level for the home is a minimum of four staff at all times at all times plus management, a cook and an activities coordinator (for part) during the day and evening and two waking staff at night plus telephone back up for emergencies. She also informed us staffing levels could be raised if residents needs increased or a particular days programme required additional staff. As part of this inspection, we viewed four staff recruitment and training files selected at random. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: All files viewed included evidence that staff who all receive regular one to one supervision from the manager are employed in accordance with a robust equal opportunities recruitment, and selection procedure, which is designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, very comprehensive records seen confirmed that all staff are subject to an in house and Learning Disability qualification (LDQ) induction training that include first aid, handling medication, food handling, moving and handling, safeguarding and infection control. Following completion of their induction programme All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided by the Manager indicated that 68.8 of staff had been trained to NVQ level two, of these 11.8 had also qualified to NVQ level 3 with a further 5.9 staring level three and 5.8 starting level two. In addition 11.8 of staff has appropriate and social work related degrees. 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. he management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought through their representatives. Evidence: The manager who has been in post since the home was first registered in October 2006 has many years of experience working with persons with a learning disability holds an NVQ level four in care and s about to start a Care leadership in management course. In talking with staff we were satisfied that the home has a clearly defined internal and external management structure and that staff were aware all of their responsibilities and the limits of their authority. Staff described the management both internal and external as supportive, approachable, accessible and encouraged them come up with ideas and suggestions for the improvement of the service.. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: As part of the corporate and homes quality monitoring system, residents and residents representatives staff and health /social care professionals will shortly be invited to participate in satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention for the future development of this service. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health/ safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling, infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents, and procedures to follow in the event of fire (including evacuation). 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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