Care Home: Ashford House

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What the care home does well This home makes sure that it can meets peoples needs before they admit them to the home. People who are considering moving into the home can visit and stay overnight to help them make a decision. People are involved in planning their own care and are made aware of any restrictions imposed on them whilst living at the home. The people who live here are supported to live the lifestyle they choose and lead active lives. One person spoke to us about a very specialist holiday they had been supported to go on last year and how much they enjoyed it. People are able to take part in the running of the home if they choose and are supported to prepare their own food. People are supported to become independent and to gain the skills they need to move out of the home into a more independent setting. Staff recruitment practices are safe and staff are trained to be able to meet the needs of the people who live in the home or are going to move into the home. The management make sure that the home is run in the best interest of the people who live there. Staff are supported and there is a low staff turnover. The health and safety of the people who live and work here are protected. What has improved since the last inspection? Since the last Inspection improvements have been made and requirements made have now all been met. Care plans have improved and now provide staff with more detail as to what support people may need to keep their rooms hygienic. Records in relation to the food people have eaten are kept to make sure that people are being offered and eating a varied diet. All staff are now provided with training in the local safeguarding procedures to ensure that people are protected from abuse. More preventions are now in place to help protect people from tripping and falling round the home. What the care home could do better: Although some shortfalls were seen as this is a good 2* service we have confidence in the service to put these thing right. One of these shortfalls was that some areas of the home were cold and the manager must make sure that all areas of the home are kept warm and comfortable including the area of the home that is designated for smoking. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ashford House 9-11 Winchester Road Worthing West Sussex BN11 4DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elaine Green     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Ashford House 9-11 Winchester Road Worthing West Sussex BN11 4DJ 01903202595 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ashford House Limited care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 10 The maximum number of service users who can be accommodated is: 10 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 Ashford House is a care home registered to provide accommodation for up to ten service users aged between 18 and 65 with a learning disability, and one of whom may be over the age of 65 with a learning disability. The accommodation is located in a residential area in the west part of Worthing, where there is access to local bus and train services. The registered provider is Ashford House Limited, for whom the responsible individual is Mr Aslam Dahya. The registered managers post is currently vacant. As of the 12th January 2009 the fees range from £683 to £1,589 per week. Fees are assessed on an indiviual basis and cover basic hotel costs and the cost of an annual holiday. Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: An Unannounced visit was made to this home on the 16th December 2008. Before the visit to the home we looked at all the information we have received from the home since we made our last visit on the 19th April 2006. This information included an Annual Quality Assurance Assessment (AQAA) which is a document completed by the home. This document gives the home the opportunity to say what it does well and provide evidence of that. It also gives them the opportunity to say what they feel they could do better and what their future plans are, how it dealt with any complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of the people who live there, their relatives, staff and other professionals who visit the service. Care Homes for Adults (18-65 years) Page 5 of 28 During the visit we talked to people who live in the home, the staff and the manager. We looked at information about the people who live in the home and how well their needs are met. We looked at other records that must be kept and checked that staff had the skills, knowledge and training to meet the needs of the people they support and care for. We also looked around the building to make sure it was clean, safe and comfortable.We checked what improvements had been made since the last visit and before we left we told the manger of the home what we had found. 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 set out on page 4. Care Homes for Adults (18-65 years) Page 7 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents needs are assessed and they are provided with the information they need to decide whether or not the home would be right for them. Evidence: This home helps prospective residents to identify whether it will be able to meet their needs and preferences. It has developed information to help them understand what specialist services the home can provide. This includes a pictorial service user guide and a statement of purpose and everyone who lives in the home is provided with a copy of these documents. Documents and records seen confirm that admissions are not made to the home until a full needs assessment has been undertaken. These assessments involve the person and their family or representative and other people who support them where appropriate. Records seen also show that the home only offers someone a place at the home if they are confident that the staff have the skills, ability and qualifications to meet the assessed needs of anyone considering moving into the home. The manager Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: stated that additional staff training is provided to meet people needs when needed and an examination of records confirmed that the staff have had training in alcohol abuse awareness and the in the behaviour of offenders. Any person considering moving into the home is given the opportunity to spend time in the home including being able to stay over night and a member of staff or key worker is allocated to them give them information and to help them understand how the home is organised and run. On the day we visited the home there was a person staying there on such a trial visit. This was their third such stay and they had been there for 5 days. They were seen interacting with the staff and other people who lived at the home and appeared to be settling in well. Records confirmed an assessment had taken place and discussions with staff on duty confirmed they had been made fully aware of the needs of this person and how they should be met. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home make their own choices, are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: Records seen confirms that each person who lives in the home has a plan of care that they have agreed to. These are written with the individual and look at all areas of the individuals life, however they are very large documents and are not very easy to understand. One person had made an album of photographs that told their life story and illustrated their likes, dislikes and preferences, this was very easy to understand and gave the reader a real insight into the person. The manager stated that the support staff were going to be working with everyone who lived in the home to produce plans which were more person centered like this. The care plans detail the support each person needs from staff to live the life they choose. These plans are kept up to date and are written with the individual. The Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: people who live here are encouraged to make choices on a daily basis with regard to what to eat, how to spend leisure time, when to go to bed, what to wear. Staff were seen to be supporting people to make these choices throughout the day of the visit to the home. One person decided to have a lie in and have a late breakfast, another person was supported to go into town to buy a budgie cage and told us of their plans to go out and choose a budgie another day. In order to take account of peoples safety and wellbeing there are occasions when choice has been limited. For example, some of the people who live here are unable to go out safely on their own so have to be accompanied by staff which means that spontaneous outings are not always possible. Another example is that some kitchen cupboards are locked and so staff support is required to access them which limits peoples access to some food stuffs unless staff are available. Any such limitations or restrictions are recorded in peoples care plans. A key worker system allows staff to work on a one-to-one basis with people who live in here and this helps them get to know each other well. When people are ready to, they are are supported to move out of the home to live more independently. One person is in the process of moving out of the home into supported living and another person said that they will be moving out soon. This person stated they were now ready to move on and said Im looking forward to it. The information provided by the home states that Regular meetings are offered with the with the people who live in the home to discuss their issues and ideas. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home are able to make choices about their life style and supported to develop their life skills to live the life they choose. Evidence: People who live here are supported to develop their skills, including social, emotional, communication and independent living skills. Individuals are supported to identify their goals, and work to achieve them. One person is supported to go to work at a local day center and others attend college courses whilst 2 other people are working toward moving out of the home into a more independent setting. People who live here have the opportunity to develop and maintain important personal and family relationships. Two of the people who live here spoke about their relationships and how they stay in touch with their family and Friends. People are Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: supported to phone Friends and family on the house phone or their own mobile phones. We saw 2 people using the phone to contact family, 2 people went out shopping with staff support twice during the day, one person told us they were going to the cinema that evening and another was going to the get a burger before going to a local club. Another person was going to Karate. Each person is provided with the opportunity to go on holiday every year. One person spoke avidly about their experience on holiday last year where staff had supported them to go on a very specialist holiday. They said that they had found out about this type of holiday by using the researching it on the Internet using the homes computer. They also spoke about their plans for the next years holiday and that other people were interested in joining them this year. The staff team help with communication skills and we saw staff supporting people with communication by encouraging and prompting when needed. Staff appeared to have a good understanding of how people are feeling by reading their body language and responded appropriately when needed. People who live here are involved in the running of the home and each person takes responsibility for their own room. They can be involved with menu planning and cooking meals, if they choose and are able to enjoy the food they prefer and like. The menu is varied with a number of choices including a healthy option. It includes a variety of dishes that encourage individuals to try new and sometimes unfamiliar food. The meals are balanced and nutritious and meal times are flexible. One person told us how much they enjoyed preparing food with staff support. Three people were seen using the kitchen to make hot drinks independently and two people were seen preparing food with staff support. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people who live in the home receive is based on their individual needs. People are treated with dignity and respect and their privacy is protected. Evidence: Personal health care needs are clearly recorded in each persons care plan and in the health plan for those who have them. This makes sure that staff are aware of what support each person needs and how this should be provided. Personal support is responsive to the individual needs and preferences of the people who live here. Staff respect privacy and dignity and are sensitive to changing needs. People are supported and helped to be independent and can take responsibility for their personal care needs and staff will prompt and encourage people when needed. Residents have access to health care services when needed and are supported to access them by the staff team. Records seen included a clear record of medical appointments made to health care services such as peoples GP. This also includes a record of the outcome of the consultation and any treatment to be provided. One Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: person was in hospital when we visited the home and they rang to speak to the manager when we were there. The manager arranged to go to the hospital to visit this person so that she could assess whether this persons needs had changed so that she could make sure the home could meet this persons needs when they were discharged from hospital. The people who live here have access to a councilor with whom they can talk to in confidence. Everyone who lives in the home is introduced to this person and is able to meet with them on a regular basis. These meetings are flexible and are tailored according to the persons needs. Information received from the home in relation to admissions to hospital etc confirms that they act responsibly and appropriately when health care support is needed and that they support the people who live in the home to access the sort of treatment they need. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records seen were fully completed, contained the required entries, and were signed by staff. The manager stated that staff complete an appropriate medication course and as assessment to ensure they are competent to handle, record and administer medication properly prior to them administering medication. Some medication, for example creams, are only needed as and when. Staff were able to explain to us when individuals needed such medication and stated that people will ask for it when they feel they need it, however the details of when this medication should be given or applied was not written up in the medical records. This was discussed with the manager who gave assurances that written guidance would be provided once advice had been sought from the prescribing GP. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The home has a complaints procedure that is clearly written and easy to understand. The complaints procedure is supplied to everyone living at the home and is also displayed in the entrance hall. Two people who we asked that live in the home, told us that they understand how to make a complaint and are clear about what will happen if a complaint is made. Records show that the home keeps a full record of complaints, including details investigation and any actions taken. The policies and procedures for safeguarding adults are available in the home and give clear specific guidance to those using them. Staff working at the home know when incidents need to be referred to the local authority. The home understands the procedures for safeguarding adults and has attended meetings and provided information to external agencies when requested. Records show that staff training in safeguarding is regularly arranged by the Home. Other training around dealing with physical and verbal aggression are made available to staff as needed. External trainers visit the home to provide this training and put intervention packages in place as and when needed and requested by the manager. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: All staff have had the relevant identity and security checks prior to them starting work in the home and have all received some training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home provides people who live here a safe environment which encourages independence, however not all communal areas of the home are warm and homely. Evidence: We visited the private accommodation of two of the people who live in the home. These rooms were both decorated to reflect the personalities of the people whose rooms they were. Both people stated that they had been involved with choosing the decoration for their rooms and one person had decorated their room with their own art work. One of the people whose bedroom we saw showed us around the home. The homes lounge is large, homely and comfortable. The decoration and furnishings have been provided to a good standard and this provides the people who live here with a comfortable and safe environment. There is a dining room on the ground floor which can seat everyone who lives there. On the walls are some collages made from photographs of the people who live here and the staff who work here. There is a games room in which there is a pool table. The manager and staff confirmed that this room is used regularly by the people who live in the home. The games room and some Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: other areas of the home were very cold. The manager explained that this was because some of the radiators needed replacing. The manager must make sure that all areas of the home are kept warm and comfortable. We also visited bathrooms, toilets, the kitchen, hallways, games room and the utility room. Neither the upstairs bathroom or shower room had blinds at the windows, the over the bath shower was missing from the bath room and there were unguarded pipes in the shower room. The flooring of the whole of the ground floor apart from the lounge area is laminate flooring and this was scuffed and marked in places. Rubbish was seen to the front, rear and side of the building which was unsightly but that the manager stated staff were going to take to the local refuse tip. There is a small space were people who live in the home can go to smoke. Albeit this is a covered area it is not really a room and it is neither ventilated or heated and has no floor covering. The suitability of the use of this space as a designated smoking area was discussed with the manager who stated that she would look into the possibility of either converting this space to make it appropriate or providing an alternative area for smokers. We were informed cleaning schedules are in place to ensure all areas are cleaned on a regular basis to ensure hygiene is maintained to a good standard. Information supplied by the registered provider confirmed that appropriate steps have been taken to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly and that the maintenance plan will be up dated. Other improvements that the home states they are planning to introduce in the next 12 months are that new flooring will be purchased for the lounge and downstairs corridors, the garden will be replanted and a new seating area will be provided. New work tops, doors and draw fronts will be acquired to replace the old kitchen units. Other areas will be refreshed by painting and the purchase of pictures and rugs to give a more homely inviting feel. They also plan to redecorate and carpet the upstairs of the home in the following 12 months. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who live there, in line with their terms and conditions, and to support the smooth running of the service. Evidence: We examined the recruitment records of four staff who had been appointed within the last 12 months. We found that all appropriate information and checks were in place to ensure vulnerable residents have been protected. This included three written references, proof of identity and criminal record checks (CRB). We looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents rights, independence, choice and dignity. We looked a the training program that demonstrated the type of training all staff will receive over the coming months. Training that staff will receive includes mandatory training that covers manual handling, first aid, abuse awareness, fire safety and health and safety and specialist knowledge in areas pertinent to the needs of the people who Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: live in the home including the behavior of offenders. There was also evidence that demonstrated they receive regular support and supervision from a senior member of staff. Staff also told us they found the management does provide staff with the support they need. They were also able to clearly explain their role within the care home and what was expected of them when working with residents. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well managed and run in the best interest of the people who live here. Evidence: The manager has been in post since October 2008 she has the required qualifications and experience and is competent to run the home. An application has not yet been received for the manager to become registered and it is expected that this application should be made in the very near future. The manager leads and supports a strong staff team who have been recruited and trained to be able to safely support the people who live here. The manager ensures staff follow the policies and procedures of the home. This was evidenced when spot checks on night staff resulted in staff being disciplined for not following the homes policies and procedures. Management processes ensure that staff receive feedback on their work. Staff receive supervision and the frequency of this has increased since the new manager has been Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: in post. Staff also receive an annual appraisal. People are supported to manage their own money where possible and individuals have access to their records whenever they wish. All the people who live in the home have their own bank accounts and are supported to manage their finances as required. Seven of the people who live at the home have their benefits paid directly into their own bank accounts. The manager gave assurances that she would look into the reason why the other two peoples money is paid into the company account first and change this if possible and document the reasons if not. Regular meetings are held with the people who live in the home and these meetings are documented. The senior management undertake unannounced visits to the home to check on the homes performance. As part of these visits the people who live in the home and the staff have the opportunity to give their opinions. A record of these visits is held in the home and where shortfalls are identified and action plan is put into place with a timescale for this to be completed. Records confirmed that the manager had completed everything she had been required to do. The home now has a development plan in place and this identifies areas of improvement required to the building and grounds. The home has an annual questionnaire which is sent out to the people who live in the home and their relatives. These were seen and showed that generally people were happy with the services provided by the home. However, the home has not as yet made the questionnaire itself available in a format accessible to everyone who lives there and the outcome of the questionnaire is only available in the form of a bar chart which would not be easily understood by everybody who lives there. In addition to this although the results were published as a bar chart the relating questions were not which makes the bar chart meaningless. This was discussed with the manager who stated that she understood the need for the home to be able to make this accessible to all and also stated that she would ensure the outcome of future questionnaires will be published in an accessible format for all and included in the service user guide. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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