Care Home: Coombes House

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What the care home does well People have information about the home and opportunities to visit, before moving in, so that they can be confident their needs will be met there. People are supported to make choices and decisions so that they experience a meaningful lifestyle. The home is good at supporting people to keep in touch with their friends and relatives so that they do not lose relationships that are important to them. Records that describe people`s personal care needs are well written and staff understand how to offer care to people in a way they they need and like. People told us that they enjoy their meals and mealtimes and that when they make suggestions for changes to the menu, they are listened to. There are good systems to recruit staff so that people are protected from possible harm. Complaints are taken seriously and people are confident that staff will listen to them should they have any concerns. Staff have regular training to help them care for people more effectively. Health and safety is promoted to protect people from possible risk of harm. What has improved since the last inspection? This was the home`s first inspection since becoming newly registered with the commission. This means that although the details for the responsible individual have changed, the service at Coombes House remains the same as at our last visit in July 2008. What the care home could do better: Sometimes records about people`s health, the food they eat and the medicines they take are not completed which could lead to their needs not being met. There are areas of the home which do not look pleasant because repairs have not been made. People have limited opportunities to prepare and cook food so they could lose skills that promote their independence. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Coombes House 1360 Yardley Wood Road Solihull Lodge Solihull West Midlands B90 1JT     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: Julie Preston     Date: 1 5 0 1 2 0 0 9 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 31 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Coombes House 1360 Yardley Wood Road Solihull Lodge Solihull West Midlands B90 1JT 01214303677 01214208240 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) : Solihull Care Trust care home 22 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 22 The maximum number of service users who can be accommodated is: 22. The registered person may provide the following categories of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: - Learning Disabilities - Code LD Date of last inspection Brief description of the care home Coombes House is a twenty two bedded home that provides care and accommodation to people with a learning disability. There are four places for people who may require respite care and eighteen places for people who live at the home on a long term basis. Separate accommodation is provided to people who use the home for respite care. All bedrooms are single and those on the first floor have en suite facilities. There are shared bathrooms with adapted bathing equipment which meets the needs of people currently living at the home. Fees are variable. The home can provide further information. Care Homes for Adults (18-65 years) Page 4 of 31 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: We spent a day at the home. The people who live there and the staff did not know that we were coming. Before our visit we looked at information that the home had sent to us including notifications of events that impacted on the health and well being of people who live there and details of any complaints or safeguarding issues. We case tracked three people who live in the home. Case tracking includes meeting people and talking about the care they receive or watching staff supporting them, looking at their care records and medicines and the way that they are helped to make choices and decisions. This assists us to understand the experiences of people who live Care Homes for Adults (18-65 years) Page 5 of 31 in the home. We looked at records of staff training and recruitment, health and safety records and the food people are offered. Time was spent talking to the management team and three members of staff as well as five people who live at Coombes House. We looked around the building to make sure that it was clean, warm and comfortable. There were no immediate requirements made as a result of our visit. This means that there was nothing urgent that needed to be done to protect people who live in the home. 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 31 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 31 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 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given information about the home before they move in and their individual needs are assessed so that they can be confident their needs can be met there. Evidence: There have been no new people move in to the home since the last time we visited in July 2008. Coombes House provides respite care to a number of people who have short breaks away from their regular place of residence. This group of people also remain the same as at our last visit. There is a procedure in place for assessing the needs of people who may wish to live in the home. We looked at this in July 2008 and found that it was clearly written, including information about how people should be supported to visit the home before deciding whether or not to live there. We were told that there had been no changes to the pre admission assessment procedure. The home has a statement of purpose and service user guide that are made available Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: to people who live there and a copy given to their families. The service user guide has pictures and photographs that give information about the services and facilities provided in the home. We were told that this makes the content more accessible to people who may have difficulty reading. Care Homes for Adults (18-65 years) Page 11 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems of care planning and risk assessment which should contribute to peoples individual needs being understood and met. People are supported to make choices and decisions about their everyday lives. Evidence: We looked at care plans and risk assessments for three people who live in the home. These records describe the support that people need in their day to day lives and the safeguards in place to protect them from possible harm. Each care plan had been reviewed within the last six months to make sure that the information was relevant to individuals needs. The care plans that we looked at clearly described how people need and like to be supported and included details of the skills they have so that their independence could be maintained. For example, one person had been supported to travel independently so that he could make his own way to and Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: from work, which he told us, was important to him. People told us that they thought they had good care at the home and that the staff team knew them well. We were told that people make choices and decisions as part of their regular routines. House meeting records showed that people had made suggestions about menus, activities and day trips, which had been listened to and acted upon by the staff team. House meeting minutes had been taken and we saw that plain language and pictures had been used so that the information was accessible to people who may have difficulty reading. People that we spoke to gave examples about the choices they make such as how to spend their money, when to go to bed at night, meals and activities. Care Homes for Adults (18-65 years) Page 13 of 31 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 are supported to take part in a range of activities that meet their needs and preferences as part of a meaningful lifestyle. People enjoy their meals and mealtimes. Some information about the food people eat is not maintained consistently which could lead to individuals needs not being met. Evidence: Part of the ground floor of Coombes House is used as a day centre, which is attended by people who live at the home during weekdays. The day centre is staffed by a designated team, who are not employed as residential staff. People that we spoke to said that they enjoy attending the day centre and doing activities such as cooking, arts and crafts and going on trips to places of interest. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: We looked at activity plans and daily records for three people to see if they had regular opportunities to do things that they enjoy. Each person had a record of the activities they like and those that they dont like. The daily records showed that people were taking part in their preferred activities. One person told us that they went out to the local pub each week, which they really enjoyed. Another person said that they were doing a college course and had learned a lot from the experience. The home supports people to keep in touch with their friends and families. Care plans that we looked at described how people should be supported to maintain this contact. One person told us that he regularly received visits from family members and that he could use the telephone to call them when he wanted to. The home has a visitors procedure which is made available to people when they move in. There are no restrictions to the times that family and friends visit, other than late at night and the home recommends that a phone call is made prior to the visit to ensure that the person is available. We looked at menus and the records of food that people eat to make sure that a varied and healthy diet is offered that meets peoples needs and preferences. People do not cook for themselves (other than as part of their day centre experience) and food is ordered in from a range of suppliers, then delivered to the home. There are two cooks employed who plan a three week rolling menu, based on their knowledge of peoples expressed food preferences and from information gathered as a result of house meetings. We were told that people are asked to choose what they would like to eat for the evening meal earlier the same day and from observation of the records of food eaten it was evident that alternatives are made available. A senior member of staff explained that some diets are provided for people with specific health care needs and that records are kept of the food they have eaten. We looked at the records for one person needing a soft diet, however they had not been consistently maintained which would make it difficult to monitor their food intake and ensure they were eating healthily. Food records only described the main meal on offer (ie) roast chicken or shepherds pie. There was no information about vegetables or other accompaniments, desserts or snacks so that staff could accurately monitor what people are eating and take action to address any concerns. People told us that they enjoyed the food at Coombes House and that when they made Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: suggestions about new items to go on the menu they were listened to. Care Homes for Adults (18-65 years) Page 16 of 31 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. There are effective systems to meet peoples personal and health care needs although some records do not always contain sufficient detail about monitoring peoples health. Medicines are usually well managed so that people receive their medication as prescribed in order to maintain their health. Evidence: We looked at personal and health care plans for three people. The plans varied in terms of detail. For example, some health action plans plans had been fully completed, whilst others had been left blank. A health action plan is a document that explains the support a person needs to stay healthy and well and the services they may need to access to achieve this. This means that information relating to the way peoples needs regarding their health and personal care were not up to date, which could lead to individuals needs not being met. We did, however talk to three members of staff, who demonstrated effective knowledge of individuals needs. The staff members told us that although some health Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: action plans had not been completed the relevant information was contained elsewhere in peoples records. The home has systems in place to monitor peoples ongoing health such as food, weight and epilepsy charts. The charts that we looked at were up to date and accurate with the exception of one weight record. This showed that the person had not been weighed each month (as stated in their care plan) and that this had not been followed up to make sure that the person was maintaining a consistent body weight. Some people have specific health care needs such as epilepsy, diabetes and mobility difficulties. From looking at staff records it was evident that awareness training had been provided for each of these areas. Moving and handling assessments had been completed. There was clear information to describe how to support the movement of people with mobility difficulties to reduce risks to their health and well being. Personal care plans were detailed, containing information about peoples preferences such as whether they liked a bath or shower, morning and night time routines and the support needed to choose clothing and hairstyles. One person told us that he enjoyed staying up late on a Saturday night and a lie in on Sunday mornings. Another person said that she often went out to buy her own clothes and other personal items. It was evident from meeting people during our visit that they had received good support to manage their personal care. Some of the women who live at Coombes House were taking part in a beauty session with staff , having their nails painted and make up done. It was evident that this was a very popular activity. We looked at the way medicines are managed within the home to ensure that a robust system was in place for the well being of people who live there. The home has a newly refurbished room that is solely used for the storage and dispensing of medicines. The room is lockable with locked cabinets and hand washing facilities. From discussion with the manager, we were told that only senior staff administer medicines and that all senior staff have completed accredited training in the safe handling of medicines. Certificates were seen to support this. This should ensure that people receive their medication in a planned and safe manner. We looked at the records and supplies of three peoples medicines. Each record had a Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: photograph of the person and a description of how they prefer to take their medicines. The majority of the records showed that medicines had been given as prescribed. There were written protocols in place to explain when to offer as required medication to people according to their specific health care needs. There were some gaps in one persons medication record, although from looking at the supply of tablets in place, the medication had been given to them. Another record showed that the amount of tablets received into the home had not been entered onto the administration record. These issues had not been identified by staff at the home although we were reassured that action would be taken to investigate why (for some people) this had taken place. The Commission received no notifications since the home was newly registered that any errors in giving out medicines had occurred. This demonstrates that, despite the administrative issues identified for two people at our visit, medicines are being well managed for the well being of the people who live there. Care Homes for Adults (18-65 years) Page 19 of 31 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. There are effective procedures in place to listen to peoples complaints and safeguard them from possible harm. Evidence: There have been no complaints, either to the home or to the commission since our last visit in July 2008. The home has a complaints procedure which is made available to the people who live there and to their families. Three people told us that they were confident that staff would listen to them if they were not happy. Another person said that the staff were good at listening. We looked at the training matrix for the staff team, which showed that they had taken part in safeguarding training in 2008, with more planned for 2009. The staff that we spoke to told us that they understood the importance of the training so that people could be protected from potential harm. There have been no safeguarding issues raised within the home since our last visit. Some people demonstrate behaviour that sometimes challenges others who live with them. We saw that there were behaviour management guidelines in place which had been written and reviewed by psychologists. A member of staff told us that the Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: guidelines were important to ensure that people were offered consistent support and to reduce the risk of harm to them or to others. It was evident that the staff team were taking safeguarding issues seriously for the ongoing protection of people who live in the home. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, warm and well furnished with adaptations that meet peoples needs. There are limited opportunities for people to retain and develop some independent living skills due to the size and layout of the building. Evidence: Coombes House is a twenty two bedded building which clearly looks like a care home and differs from other properties in the area. The home is situated near to public transport routes, shops, pubs and places of worship. This is important to the people who live there as they make regular use of these facilities. The home consists of twenty two bedrooms (the majority of which have en suite facilities), a shared lounge, which leads directly into the dining area with an industrial style kitchen leading off the dining room. There is a smaller lounge on the ground floor and kitchen, bedrooms and lounge facilities in the area used for respite care. We were told that the kitchen in the respite care unit is not used as people tend to eat in the main part of the house. The respite kitchen could be used by people to practice their cooking and independent living skills, however this has not been utilised. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: The bedrooms that we looked at were, in the main, well furnished, decorated, clean and warm. People had clearly been supported to personalise their rooms with furniture and other items of their choice. People told us that they had keys to lock bedroom doors so that they could keep their space and belongings private and secure. One bedroom had a damaged window ledge which looked unpleasant, however we were told that there is a rolling programme of maintenance for the building, so this would be addressed. Other parts of Coombes House are not so homely looking due to the size and layout of the building. For example, there are shared toilets on the ground floor which, in our opinion resemble those that would usually be found in a school. These toilets were not in a good state of repair with damaged plaster work and rusted radiator covers, which would not look pleasant for anyone using them. There are adapted bathing facilities, which meet the needs of the people who live at the home. We saw that there were recent certificates in place to confirm that equipment had been serviced so that it remained safe to use. The home has a passenger lift so that people with mobility difficulties can move safely between floors. The home was clean when we visited with no unpleasant odours that may indicate poor cleansing routines. Care Homes for Adults (18-65 years) Page 23 of 31 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 are supported by a trained team of well established staff who have good understanding of their needs. The home operates a robust system of recruiting staff for the ongoing protection of the people who live there. Evidence: We asked people about the qualities of the staff who work with and were told that the team are good and friendly. Some people who live in the home were not able to express how they felt about the staff team due to complex communication needs. We saw that people spent a lot of time with staff, choosing to sit next to them and stand with them. This indicates that people are comfortable with the staff who work with them. The staff that we spoke to at this visit were knowledgeable about peoples needs and clearly know them well. We looked at staff recruitment records for a new worker. The records showed that checks had been made of the persons suitability to work within the home, prior to Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: appointment. This contributes to the ongoing safety and protection of people that live at Coombes House. Solihull Care Trust provide a rolling programme of staff training so that the staff team have regular opportunities to advance and refresh their knowledge of social care. From looking at the staff training matrix and talking to staff it was evident that mandatory training had taken place as well as sessions more specific to the needs of people at Coombes House, such as epilepsy and diabetes awareness training. The three members of staff that we spoke to said that training opportunities at the home were frequent and well organised. This should contribute toward people being supported by a competent and knowledgeable team of staff. Care Homes for Adults (18-65 years) Page 25 of 31 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 home is being well managed and peoples health and safety is promoted and protected. Evidence: The home has a registered manager, who has been in post for eighteen months. The manager has qualifications that are relevant to her work and completes regular updates in mandatory training. Four assistant managers support the manager and from looking at the staffing rota it was evident that an assistant is on duty at every shift, including sleep in shifts. We were told that this means a senior member of the staff team is available at all times to respond to any emergencies that may arise and to offer support and guidance consistently. Throughout our visit the manager and an assistant answered our questions confidently and were knowledgeable about their roles. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: There are systems in place to review the quality of care and service provided within the home. Solihull Care Trust has appointed a member of staff (who does not work at the home) to visit on a regular basis in order to report on the quality of care and service provided at Coombes House. From looking at reports of these visits it was evident that peoples views had been sought as part of the process. We saw records which showed that regular health and safety audits take place as well as care plan and risk assessment reviews. House meeting records demonstrated that people are contributing towards the running of their home and that their suggestions are being acted upon. People told us that they were confident that they would be listened to by the staff team. This indicates that the home are taking quality issues seriously for the benefit of people who live there. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The fire alarm system had been tested and serviced on a regular basis to make sure that it was working properly. People had taken part in fire drills so that they had opportunities to practice leaving the building in the event of an emergency. Certificates were in place to evidence that moving and handling equipment had been serviced to ensure it was safe to use. There was a certificate of service for the passenger lift and records to show that it was being regularly maintained. Training records showed that staff have taken part in health and safety, fire safety and infection control training. This should contribute towards promoting peoples health and safety. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 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 17 Food records should record the full meal eaten, including desserts so that peoples food intake can be accurately monitored. Food records should be reviewed to consistently reflect the food eaten by people who require specific diets in order for any concerns to be acted upon promptly. Records that monitor peoples health and well being should be checked on a regular basis to ensure a planned approach to promptly identifying and responding to potential concerns. Consideration should be given to reviewing the way in which peoples health care needs are recorded so that information is kept in the same place and to avoid confusion for anyone reading the records. The system of auditing medication records should be reviewed to ensure that records reflect medicines received and dispensed to reduce the risk of errors and possible harm to people who live in the home. The ground floor toilets should be included in the homes maintenance programme so that they are more pleasant for people to use. Page 29 of 31 2 17 3 19 4 19 5 20 6 24 Care Homes for Adults (18-65 years) 7 24 Consideration should be given to using the kitchen in the respite care unit as a facility for enabling people to practice their cooking and independent living skills. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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