Care Home: Brookland House

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What the care home does well Brookland House provides a friendly and homely environment in which people can develop their independence skills and confidence enabling them to make decisions and choices about all aspects of their lives. People living in the home are encouraged to actively be involved in developing and reviewing their care plans. Brookland House has a staff team that relates well to the people living in the home and are able to demonstrate a good understanding of the needs of each person and the support they require. Individual`s rights are promoted and they are supported to develop their independence and to take part in activities of their choice. Recruitment policies and procedures are in place and the staff receives induction and training to meet the complex needs of people living in the home. One staff member said, "This is the best place I have ever worked". What has improved since the last inspection? The recent improvements to update the home have included upgrading and repairing all the necessary repairs to one person bedroom as highlighted in the previous inspection report. This included a new radiator cover, holes in the walls filled and replacing the bedroom door. New curtains were being hung during the inspection in the lounge area and the dinning room curtains had already been replaced with suitable closing curtains. Windows have been fitted with safety glass and repaired to ensure they now close securely. What the care home could do better: Medication record sheets written on by staff should be checked to ensure errors to not occur. No Requirements were made during this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Brookland House 2 Watson Place St Judes Plymouth Devon PL4 9QN     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: Kim Fowler     Date: 2 0 1 1 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 27 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 27 Information about the care home Name of care home: Address: Brookland House 2 Watson Place St Judes Plymouth Devon PL4 9QN 01752690684 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Nicholas Simon Troke,Mr Nigel Bruce Troke Name of registered manager (if applicable) Mr Philip Arthur Hummel Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users that can be accommodated is 3. The registered person may provide the following category of service only: Care Home only (code PC) to service users of either gender whose primary care needs on admission are within the following category: Learning Disability (code LD) Date of last inspection Brief description of the care home Brookland House is a end of terraced property conveniently positioned in a residential area in the centre of Plymouth. There is easy access to a bus route and all local shopping and social facilities. The home is registered for three adults who have a learning disability and who may have behaviour that will challenge the service. Brookland House is owned by Westlake Care who have another home in Cornwall. The Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 0 9 1 2 2 0 0 8 Brief description of the care home current fee levels are £3358 to £4050 but may vary based on individual need. Care Homes for Adults (18-65 years) Page 5 of 27 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: The unannounced inspection took place over 1 day and started at 10:00am and finished at 2:15pm. The Registered Manager, Mr Philip Hummel, was available and assisted throughout the inspection. We made a tour of the building and spoke to the people living at the home. Documentation relating to the care planning process and the management of the home were examined. We also spoke to the deputy manager and the staff members on duty during the inspection. Surveys were sent out before the inspection and two staff surveys were returned. Any comments received during the inspection are in the relevant section of the report. Care Homes for Adults (18-65 years) Page 6 of 27 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. Care Homes for Adults (18-65 years) Page 7 of 27 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 27 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 27 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. Future admissions that maybe referred to the home can be assured that they will be provided with sufficient information for them to make an informed choice about living at this care home. Evidence: The home has not had any new admission for a number of years. Though the home is registered for three people the owners currently only plan for two people to live in the home. A discussion with the registered manager confirmed that the company have a preadmission process in place that would ensure trial visits are offered and a preadmission form to hold all the information on an individuals care needs. This included arranging meeting with any prospective new admission, current carers and other professionals involved. Previous inspection reports record that the present occupants had a pre-admission completed and had undertaken trial visits before moving in. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: This information is important so prospective admissions are assured that not only can their health care needs but also their physical needs are managed and met by the home. This is particularly important if people have limited communication. The homes AQAA returned to the Commission said, During the summer of 2006 both of our new service users under went a transition process. This involved short visits to the home first and went onto record, These visits gradually progressed to include mealtimes and an overnight stay. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be encouraged and supported to make daily decisions about their own lives as much as possible to help promote and maintain their independence. Evidence: The files for both people living at the home were examined. Both files examined held individual care plans in place and the details held on these files are needed by staff to meet individual needs. These care plans show a breakdown of the services and facilities provided by the home as well as current needs, specialist input and guidelines for staff to manage individuals. Each individual plan provides staff with the information on how to care for each person and ensure continuity in care and have been completed to enable staff to carry out their duties. All plans ensure that all aspects of health, personal and social needs will be met. The homes files and care plans were supported by a PCP (Person Centered Plan) Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: completed by the home. Each file showed that they had been reviewed regularly and updated when needed. Individuals and their families, who act as advocates, are invited to attend review meetings and participate as much as possible. Any restrictions and limitations of individuals freedom are detailed in each care plan and shows outside agencies are in agreement with these arrangements. A staff survey returned to the Commission wrote under what the home does well, Given good choice and encouraged to be involved in decision making where able. Each file held a handover sheet which included what each person was wearing on that day in case of emergencies, and what each person ate, drank and if any incidences had taken place. Observations throughout the inspection were staff assisting people to make decisions about everyday issues. This can be difficult due to each person living in the home having complex needs and a 2:1 staffing ratio. Decisions included any trips out that day and the choice for lunch and shopping. One person choose to stay in bed late on the day of the inspection. The manager stated that due to individuals needs each person normally has day trips arranged but one person visits and stays with family and weekly holidays are not always suitable. Further observation showed that the staff in the home have an excellent relationship with the people who live in the home. No one is able to manage their own money and clear information is recorded into individuals care plans on who and how each persons money is managed. This included one persons money being managed by family members; however the home held clear records of income, expenditure and receipts held for both person. The money held was checked and found to be correct with two signatures required on each transaction. The homes AQAA states that, We have various documents within the home which detail the services and facilities provided by the home and any restrictions on choice, services and facilities. All care plans held risk assessments to cover all aspects of risk. These risk assessments included independent living skills and trip out into the community. This information is important to minimise risk and each risk assessment is drawn up with input from other professionals involved with an individual care including the Challenging Behaviour team. Care Homes for Adults (18-65 years) Page 13 of 27 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 staff working in Brookland House promotes and provides support for people living in the home to access the local community and leisure activities as much as possible. Evidence: Both people living in the house were at home at different times during the day and the staff on duty, who were spoken with, was able to confirm that the home arranges activities and day trips with peoples choice and preferences in mind. Each person has their own transport and are encourages to visit the local community whenever possible. Observation during the inspection was one staff member discussing with one person what their plans were for the day and included going to the shops and items that needed purchasing. Other activities undertaken included swimming and bowling with Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: pictures displayed of one person living in the home assisting painting the main lounge area. Due to the complex needs of people living in the home they are unable to hold down employment. The homes AQAA records under what they do well, When planning activities we take into account each individual interest and went onto say, Staff actively promote the independence of each service user. A staff survey returned tot he Commission stated under what the home could do better, Could improve on communication a little. Evidence was recorded in the files examined of input from relatives and friends. The staff confirmed that both people have regular visits from family members and one person visit the families at home. Staff were observed arranging with a family member an overnight Christmas visit. These visits are supported by the homes risk assessments. Observation throughout the day was people living in the home participating in daily routines including preparing meals. Information held on files is used to promote the respect, privacy and dignity of each person living in the home and the home and the grounds are assessable for all. The manager stated that a menu is drawn up weekly and each person has recorded what they have eaten to ensure people have a varied and nutritional diet. Pictures are taken of different meals to encourage individuals to help draw up a weekly menu. Both people have weekly routines that they have been involved in planning as much as possible with picture format to assist. These include were to visit, visits to relatives and housekeeping tasks. A staff survey returned to the Commission wrote under what the home does well, High quality food and a variety of meals. Care Homes for Adults (18-65 years) Page 15 of 27 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 staff on duty were observed promoting individuals independence and providing good personal support promoting privacy and dignity at all times. Brookland House has access to health care to promote and maintain the wellbeing of both people living in the home. Evidence: Personal support is clearly recorded into both individual care plans and these are easily accessible for staff and both rooms are single. No one current requires assistance with moving and handling however input from the Occupation Therapist had been sort for one person with a support plan drawn up to assist staff in managing this persons care. Both care plans show that they are based on individual assessed needs and both showed they had been regularly reviewed and signed by the staff. Guidance on personal care is clearly recorded into each persons file and this ensures that the staff are fully aware of a persons needs to promote consistency in care. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Other professionals are involved in the home and include the Learning Disabilities team, Dietitian and continence advisors. The homes AQAA states on what they could do better wrote, Service users are encouraged to assist with their own personal care and went onto say, Both our service users have an up to date Health Action Plan. The manager, who has been in post for a year said of the staff team, the staff team were excellent and supportive to each other and both people living within the home. The medication system was checked during this inspection and found to be mainly well recorded and documented. The home uses the blister pack administration system. Staff designated to administer medication have received medication training and several staff members confirmed that they had received medication training with Medication training certificate held on staff files examined during this inspection. However the home currently writes out the medication record sheet by hand and this showed that all staff who has administered one particular medication over the last few weeks has signed for an incorrect dose. The medication prescribed is 500mgs and staff has been signing to say that they have been administering 300mgs. Errors in medication place people at risk. Care Homes for Adults (18-65 years) Page 17 of 27 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. Any concerns or complaints raised by people at Brookland House will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: The home has a complaints procedure in place and is clearly displayed on the homes notice board and is also available in the homes Statement of Purpose and Service Users Guide. This information included how to contact the CQC and the process of how a complaint is dealt with including timescales. Neither the home nor the Commission have received any complaints. Neither person living in the home is able to make a complaint however the home meet with family members on a regular bases and family are welcome at any time and staff observe for any changes in behaviour. The manager confirmed that most staff have now completed the Safeguarding training provided by a local training company. The home has assistance from the Challenging Behaviour team to draw up any guidelines on restrictions for individuals with input from the home, other professionals and family members. The home AQAA states, All employees complete POVA (Protection of Vulnerable Adults) training. Care Homes for Adults (18-65 years) Page 18 of 27 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. Brookland House has updated and upgraded areas of the home highlighted in the last inspection report to provide a suitable environment for its stated purpose and for people living in the home to have a comfortable home that is regularly maintained. Evidence: The last inspection report highlighted areas of concern and a full tour of the premises showed that the requirements made have now been met. This included one individual bedroom having a new radiator cover, repainted walls with holes in the walls repaired, the broken window repaired and with safety glass inserted and the main bedroom door replaced to ensure the privacy of this person is maintained. The other bedroom has new furniture on order to upgrade this room. Curtains that close have now been fitted in the lounge, dining room and one persons bedroom as required in the last inspection report. The lounge area has benefited from being decorated with a new fireplace, ornaments and curtains providing a warm homely environment. The front door of the house has Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: been replaced with a spy hole to assist with security of the home and the manager stated that new carpet has been ordered for the main hall and stair way. Both bedroom doors now have locks fitted; however one person is unable to hold a key and risk assessments are held on individual files reflecting these choices. Other staff confirmed that the home provided disposable aprons and gloves for their protection. And the manager confirmed that all staff has completed an infection control course and the premises were clean, hygienic and free from offensive odours and the laundry facilities were separate. One staff member file held a completed certificate on Infection Control. The homes AQAA under how we have improved in the last 12 months recorded, We have had safety glass fitted in all the lower windows, a new carpet in the lounge, and one of the service users has had their bedroom re-decorated. Care Homes for Adults (18-65 years) Page 20 of 27 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. People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training is carried out regularly for all staff to ensure that all assessed needs of the people living at the home are met. Evidence: On the day of the inspection there were 3 staff on duty for the two people living in the home with a fourth staff member coming on duty later that day so both people ere able to access the community. All the staff were observed responding sensitively and respectfully to both people living in the home and were able to use their knowledge of individuals to encourage choice and independence as much as possible. The staff were observed to be friendly, good-natured, courteous and respectful at all times. They interacted well with the people living in the home and some of the activities sessions observed being planned showed that the staff and the people living in the home being relaxed in a friendly atmosphere. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The staff spoken with were able to confirm that there was sufficient staff on duty to meet the current needs of people living in the home. The home also provides sleep in staff and an on-call system for the management. Observation showed that the staff members on duty were aware of individuals needs and how best to support them. The interaction observed between the staff and the people living in the home showed that the staff team were very good and it was evident that there was a good rapport between everyone living and working in the home. Examination of staff files showed that staff had most of the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. However one completed CRB checked was not available for examination and the manager confirmed it was held at the companys head office. The homes AQAA returned to the Commission states. We have started to recruit bank staff for the home cutting down the need to use agency staff. Discussions with the manager and the staff showed that all staff participate in and update training course when needed. The training recorded in individuals files show that induction, adult protection, first aid, health and safety, fire safety, medication, food hygiene, National Vocational Qualifications (NVQs) and courses related specifically to working with people with learning disabilities is regularly undertaken. Some people have already completed the Mental Capacity Act and the Deprivation of Liberty course with the remaining staff team training planned. All the staff on duty were spoken with during this inspection and all confirmed regular training was offered. These staff also felt that they were able to express their view at staff meetings held in the home. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. One staff member said of the staff team, Good staff team and supportive. Staff and the manager confirmed, with records held, that supervision and appraisals are regularly undertaken and staff confirmed they are well supported. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of this home is very good and ensures that records are effectively maintained. And the staff team are well trained to meet the needs of people living at the home. Evidence: The Registered Manager, Mr Phillip Hummel, has been in post for a year and is now registered with the Commission. Mr. Hummel is in the process of completing the Registered Managers award and holds a NVQ 4 in care and has over 20 years experience of working with people with a learning disability. At the previous inspection it was raised by the staff that the manager would be working 2 days a week on the care rota and 2 days a week as manager. Mr. Hummel felt this was working well most of the time, however one staff felt that at times it could be difficult if the manager was called away it could leave a shortage of staff working with both people living in the home. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The staff spoken with were able to confirm that the manager is approachable and is highly thought of by all spoken with. Several staff also praised the deputy manager and commented on how approachable and supportive the deputy was. With one staff saying, Best place I have every worked. Neither of the people living in the home is able to complete a quality assurance survey; however the home sends surveys to family and professionals. The returned surveys from family members were examined and showed positive comments. The AQAA returned to the Commission recorded, I carry out quality assurance work in the form of bi-annual Quality of Life Questionnaires That is sent to service users families. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment ensuring all have been checked. Gas and electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 All hand written medication added or discontinued onto the medication record sheet should be signed and checked to ensure errors do not occur. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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