Care Home: Bungalow, The

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bungalow, The 35 Grosvenor Avenue Crosby Liverpool Merseyside L23 0SB 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: Date: Paul Kenyon 1 1 1 2 2 0 0 8 Care Homes for Adults (18-65 years) Page 2 of 39 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. They reflect the things that people have said are important to them: 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 3 of 39 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 Crispin’s, 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. 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 4 of 39 Information about the care home Name of care home: Address: Bungalow, The 35 Grosvenor Avenue Crosby Liverpool Merseyside L23 0SB 01519288318 F/P01519288318 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): North West Community Services (GM) Limited Name of registered manager (if applicable) Mr Thomas Robson Ritchie Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 Care home 3 Learning disability Additional conditions: The registered provider may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the homes are within the following categories: Learning Care Homes for Adults (18-65 years) Page 5 of 39 disability - Code LD The maximum number of service users who can be accommodated is: 3 Date of last inspection 1 6 0 1 2 0 0 7 A bit about the care home 35 Grosvenor Avenue is a detached bungalow located in a residential area of Crosby. It is situated close to local amenities and all forms of public transport. The home is registered to provide care and support for three people who have a learning disability. The service provider for the home is North West Community Services. The organisation has other similar homes in the North West region. The house is owned and maintained by LHT a local housing association. Care Homes for Adults (18-65 years) Page 6 of 39 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 Care Homes for Adults (18-65 years) Page 7 of 39 How we did our inspection: The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This was a key inspection held at Grosvenor Avenue. The service had no prior notice that the visit was to take place. National Minimum Standards for Younger Adults were used to measure the quality of support provided by the agency. The visit took place during the morning and part of the afternoon. A tour of the building was undertaken as well as an examination of records relating to the support provided by the service. In addition to this, discussions were held with both individuals who use the service as well as an interview with a member of staff and a student nurse who was on placement at the service. The Manager was not on duty during the visit yet the Service Manager was present in order Care Homes for Adults (18-65 years) Page 8 of 39 to outline any developments that the service was undergoing. Comments made during the inspection included: staff are nice they look after me I am happy here They let me have my say It is ok The Manager is approachable The Manager is the right person to do the job It is a brilliant place, I have been enlightened by how people are supported, people are treated as individuals and stereotypes have disappeared What the care home does well The service meets the needs of those who use the service through the manner in which it identifies the needs of people before they come to live at Grosvenor Avenue. The service further meets the needs of individuals through the way in which their needs Care Homes for Adults (18-65 years) Page 9 of 39 are summarised in care plans. Those who use the service are able to make decisions about their lives and any risks arising from these decisions are taken into account by the risk assessments adopted by the service. Those who use the service are able to pursue the activities they wish to in the wider community and benefit from being involved in community life. Those who use the service are able to maintain contact with their families and friends and benefit from having their rights respected. The nutritional needs of all are met. Those who use the service are supported in a manner in which they are happy with and have their health needs met. Their health and safety is promoted through the safe management of medication. Those who use the service are protected from abuse. Care Homes for Adults (18-65 years) Page 10 of 39 Those who use the service live in a comfortable and hygienic environment. Those who use the service are protected by the manner in which staff are recruited and have their needs met by staff who are trained to meet their needs. Those who use the service benefit form receiving support form a service that is managed by an experienced and qualified individual and are able to influence the running of the service by the manner in which the service examines the support it provides. The health and safety of all is promoted by the practices of the service. Care Homes for Adults (18-65 years) Page 11 of 39 What has got better from the last inspection The service has now ensured that medic administration records have been completed appropriately so that the health and safety of individuals is promoted. The service has now ensured that the broken fence has been repaired to ensure that those who use the service live in a well-maintained environment. Care Homes for Adults (18-65 years) Page 12 of 39 The service has now ensured that staff have received specific training, which meets the needs of those who use the service. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Paul Kenyon Unit 1 3rd Floor Care Homes for Adults (18-65 years) Page 13 of 39 Tustin Court Port Way Preston PR2 2YQ 01772 730 100 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. 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 14 of 39 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 15 of 39 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. Those who come to live at Grosvenor Road have their needs met through the assessment process adopted by the service. Care Homes for Adults (18-65 years) Page 16 of 39 Evidence: One person was due to be admitted on the day of the visit. Two other individuals have used the service for some time. The person coming to live at Grosvenor Road was know to the staff and the other individuals given that they had lived in another service operated by the same organisation. Information on the persons needs had been provided to the staff team. In addition to this, a report completed by an advocacy service involving all the individuals related to this persons life. This was centred on a move to another service given the changing needs of this person. The report provided a view of the needs of the person and concluded that Grosvenor Road could meet the person’s needs. Another assessment from an Occupational Therapist was viewed and this again indicated that the persons needs would be best met by the service. Care Homes for Adults (18-65 years) Page 17 of 39 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. Those who use the service have their needs met through the manner in which the service devises care plans. All are able to Care Homes for Adults (18-65 years) Page 18 of 39 Judgement: make decisions about their lives and have any resulting risks identified and reviewed which is turn promotes their health and safety. Evidence: One care plan relating to an individual living in the service was viewed. This care plan came in two parts. The first document outlined all the daily needs of the person and included the action that staff needed to best support the person. The second document is presented as an essential lifestyle plan. This plan outlines the personal preferences of the person as well as routines and those things that are of main importance in their daily lives. All care plans had been reviewed within the past six months. While the essential lifestyle plan outlined a detailed account of the daily life of the person, there was no evidence that the details of the plan had been confirmed with the person. This is raised as a recommendation in this report. There was evidence that the two individuals who had lived at the service for some time were invited to monthly staff meetings. This was confirmed through minutes of the meeting from the past two months. While the minutes included their names and one person stated that staff listened to them, there was no evidence that the individuals were active participants by having their views obtained. This is raised as a recommendation in this report. As mentioned, advocacy services had been involved in the assessment of the individual who was coming to live at Grosvenor Avenue given that their needs had changed. A report had been produced and was viewed. This suggested that the advocacy service had contributed greatly in facilitating the move to the service for this person. All individuals have their own bank Care Homes for Adults (18-65 years) Page 19 of 39 Evidence: accounts and are able to access their personal monies when needed. Measures have been put into place to safeguard their finances with the Manager being a signatory to these accounts. Risk assessments for one person were viewed. This included reference to all those daily activities pursued by the individual and the support they received with the risks associated with these identified. The risk assessments had been reviewed in the past twelve months. Risk assessments identified the risks faced by the person and the action needed by staff to minimise them. There was no evidence that this person had been asked to contribute to the assessment. This is raised as a recommendation in this report. Care Homes for Adults (18-65 years) Page 20 of 39 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. Care Homes for Adults (18-65 years) Page 21 of 39 Judgement: Those who use the service are able to pursue structure occupation during the day when they wish and benefit from being able to access the local community. Individuals are not isolated given that they are able to maintain contact with their families and friends and benefit from being treated with respect. The nutritional needs of all are met. Evidence: Interviews with two individuals who use the service were interviewed. One attends a local day centre and was able to give an account of the activities he is involved with there. He stated that he enjoyed it. The other individual does not attend day service through choice but prefers to use her time for leisure purposes during the day. Both confirmed that they use local facilities within the community and need assistance to go out. The service has access to its own transport yet both individuals confirmed that they also have bus passes. The interviews confirmed that both needed staff support at all times yet enjoyed the activities they went to. Both were able to outline the activities they pursued in the community and had forged links with the local community. Both individuals confirmed that they were able to maintain contact with their families and friends. One person received visits from their relation on a weekly basis and maintained contact by telephone. The other stated that while they had no immediate family, there was able to maintain contact with friends. There was evidence in the case of one person that links remained between the staff team and the family member. One individual was being admitted into the service on the day of the visit. Evidence suggested that despite having no immediate Care Homes for Adults (18-65 years) Page 22 of 39 Evidence: family, she was well known to the other two individuals and had used advocacy services during her transition form her previous accommodation to Grosvenor Road. Staff practice was observed during the visit. It was clear that consideration was given to individuals’ privacy when they were in their own rooms. The Inspector was on arrival that both individuals were in their bedrooms and in this way privacy was maintained. Staff were also observed knocking on bedroom doors before entering. The preferred terms of address for both people are included within their individual care plan. The Inspector was introduced to each person and given the option to speak with the Inspector if they wished. There was evidence in care plans that both people are willing to assist in some domestic tasks. One person was able to outline their involvement in preparing meals and this was confirmed by the persons care plan. Throughout the inspection there was evidence of individuals assisting in dealing with their personal laundry and the other person confirmed that they help to clean their rooms at times. Meals are prepared in a kitchen, which is domestic in scale. Both individuals are reliant on staff to cook meals yet as stated, are involved to a degree with the preparation of meals. A menu is available yet this serves as a guide to the provision of meals and covers a four-week cycle to include breakfast, lunch and tea. A dining room area is available and one person used this during the visit. No assistance is required by either individual in eating and no one has any specific dietary needs although preferences are recorded in care plans. Breakfast was noted to be provided as and when people rose. One person was noted to be eating their breakfast and was done in an unhurried manner. Care Homes for Adults (18-65 years) Page 23 of 39 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. Those who use the service have their wishes and preferences met by the care practices adopted by the staff team. Those who use the service are able to maintain their health again through the interventions of staff. The health and safety of all is promoted through the safe management of medication. Care Homes for Adults (18-65 years) Page 24 of 39 Evidence: Interviews with two individuals noted that they satisfied with the support provided by the staff team. One stated staff are nice and they after me. Discussions with the staff team noted that there was an emphasis in the service with supporting people to do things for themselves rather than doing things for them. Both individuals have some issues relating to mobility yet it was noted that both people were able to move around the building independently and this was encouraged by the staff team. This was included within risk assessments relating to manual handling. Health records relating to each person were viewed. In the past, appointments were recorded with details of any progress in respect of their health. Appointments have included visits to the Doctor, Chiropodist, Dentist and Optician. Recently, Health Action Plans have been developed and these contain a summary of the health needs of people written in a format which is individual. Given that these had been introduced of late, they were still being completed. Training records suggested that staff had received training on their use. One individual confirmed that she was well and that she could see a Doctor when she was not well. The other person had a cold. A Doctor had prescribed them antibiotics and staff asked about his welfare and gave him general advice to maintain his well-being. This person was able to confirm that he had been given medication to aid his recovery. Medication is stored securely in two purpose built cabinets; one for each person. No controlled medication is prescribed at present. Training records suggested that staff had attended medication training and that their competency to do this was tested from time to time. Medication records were viewed and were found to be completed appropriately. No individual self medicates at present. All medications received are recorded and records are in place for the recording of medications returned to Care Homes for Adults (18-65 years) Page 25 of 39 Evidence: the pharmacy. Each care plan includes the medications which have been prescribed to each person. Care Homes for Adults (18-65 years) Page 26 of 39 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. Those who use the service and their families are not able to fully influence the running of the service through the complaints procedure. Those who use the service are protected from abuse. Evidence: A complaints procedure is available. The procedure for families outlines the manner in which complaints will be investigated and includes details of the Commission For Social Care Inspection. Each person has an I Have Rights document, which again outlines the manner in which the service will investigate any Care Homes for Adults (18-65 years) Page 27 of 39 Evidence: complaints. The service manager of the service stated that no complaints had been received and the Commission For Social Care Inspection has not received any complaints. No complaints record could be produced during the visit. A copy of the Local Authority procedure for the reporting of allegations of abuse is available and staff have signed to acknowledge their awareness of this. No allegations have bee made regarding the service since the last key inspection. The service has a number of policies and procedures relating to the protection of vulnerable adults. A policy is in place, which prevents staff being involved in the financial interests of individuals although the Manager acts as a signatory for bank accounts, and this is seen as a safeguarding measure. The service has a whistle blowing procedure although this was limited given that there was no reference to the role of the Commission For Social Care Inspection. This is raised as a recommendation in this report. An interview with a staff member confirmed that they were to attend abuse training in the near future and training records suggested that staff had already attended this. Risk assessments include a section on physical and verbal abuse although this is not an issue within the service at present. The service manager was present during the visit. She confirmed that she was aware of the procedure for the referral of staff to the vulnerable adults register although there had been no need to refer anyone to this. Care Homes for Adults (18-65 years) Page 28 of 39 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. Those who use the service benefit from living in a wellmaintained and hygienic environment. Evidence: A tour of the premises was undertaken. The building is a dormer bungalow although all facilities on located on one floor. This is suitable for the mobility needs of each person living there. Care Homes for Adults (18-65 years) Page 29 of 39 Evidence: Ramps are located to the exterior of the service and this enables access for people to the outside. Individuals’ interviews confirmed that they were happy with their bedrooms and had been able to place all their personal items in these areas. Some refurbishment has either taken place or has been identified. This mainly included carpeting through the building. One person confirmed that they had had a new carpet placed in their rooms and plans were in place to replace carpeting in the dining room, lounge and hallway areas. All areas were appropriately decorated. A system is in place for identification of repairs. All furnishings are of a good quality and no Close circuit television cameras are in use. The building is located in a mainly residential area, which is close to local facilities. The building blends in with the local area and cannot be identified externally as a care home. Those who use the service are involved in some domestic tasks and were witnessed doing these. The staff team maintain the cleaning in the building. The building was noted to be clean with no offensive odours present in any part of the building. A laundry is available and this is located separately from food storage and preparation areas. This is a well-organised facility with an impermeable floor in place and contains a mix of industrial and domestic appliances. Care Homes for Adults (18-65 years) Page 30 of 39 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. An effective staff team who understand and do what is expected of them supports people. 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. Those who use the service are protected by the recruitment of new staff and are supported by staff who are trained to meet their needs. Evidence: A personnel file relating to an individual who had come to work at the service was examined. This contained all the information needed to assess the suitability of the person to work there and Care Homes for Adults (18-65 years) Page 31 of 39 Evidence: complied with national minimum standards and regulations. Checks made by the service during recruitment included the obtaining of a criminal records check, two references and proof of the persons identity. Training records for staff were viewed. These indicated that staff had received training in mandatory topics such as manual handling, first aid, food hygiene and fire awareness. This was confirmed during an interview with a member of staff during the visit. Training records also confirmed that staff had received induction through common induction standards as well as training in medication, person centred planning, equality and diversity, abuse awareness, health action plan and dementia awareness. Care Homes for Adults (18-65 years) Page 32 of 39 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. Those who use the service benefit form receiving support form a service that is managed by an experienced and qualified individual. The best interests of individuals are served by the manner in which the service examines its own practice. The health and safety of all is promoted through the practices of the Care Homes for Adults (18-65 years) Page 33 of 39 Judgement: service. Evidence: The Manager was not present during the inspection although the Service Manager was. The Managers training records confirmed that he had received mandatory training as well as training in topics linked to his role as Manager. This training included Annual Quality Assurance Assessment training, mental capacity act training, common induction standards and the Registered Manager Award. The Manager is registered with the Commission For Social Care Inspection and has managed the service for a number of years. Staff interviews confirmed that the Manager was approachable and was the right person to manage the service. Quality assurance in conducted in a number of ways. The service issues questionnaires to those who use the service, their families and staff on an annual basis. The results of these are then used during a two day development sessions and an action plan is then devised outlining the response to the questionnaires. The Inspector was able to conduct the inspection with the assistance of the staff team and was able to interview those who use the service in private. All requirements from the previous inspection have been addressed. The service manager conducts inspections on a regular basis and provided evidence of these. One such inspection was to take place on the day of the visit. Training records were viewed and evidenced that staff receive health and safety training appropriately. Evidence was available during the inspection of health and safety checks on the service on a monthly basis. Any resulting issues are actioned. Evidence was available during the visit that portable appliances have been tested, fire systems are checked on a regular basis, accidents Care Homes for Adults (18-65 years) Page 34 of 39 Evidence: are recorded appropriately, risk assessments are available and testing of water temperatures. A certificate of registration is on display as well as a certificate confirming that insurance had been obtained. Window restrictors are not needed given the nature of the building with low surface radiators in use and the use of thermostatically controlled water valves. Care Homes for Adults (18-65 years) Page 35 of 39 Are there any outstanding requirements from the last inspection? Yes No X 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 36 of 39 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 Description 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 Description 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 1 Refer to Standard 6 Good Practice Recommendations Those who use the service should be able to confirm their agreement with the contents of their essential lifestyle plan so that they benefit from being able to influence the Page 37 of 39 Care Homes for Adults (18-65 years) support provided. 2 9 There should be evidence that those who use the service are able to contribute to their risk assessments so that they benefit from being able to make decisions about their lives. The whistle blowing procedure should include reference to the contact details of the Commission For Social Care Inspection so that those who use the service can be further protected form abuse. 3 23 Care Homes for Adults (18-65 years) Page 38 of 39 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. 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