Care Home: Cornview

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What the care home does well When we asked people what the service does well they said the following: Staff said "The home is excellent at risk and needs assessing, setting monitoring and evaluating objectives for service users. The home is good at communication. It does well in meeting the service users needs following their preferences. It promotes choice well and suited activities. Staff training is also good as well as relations with family and advocates and other agencies." "The home always works hard to make sure that it meets the service users needs either individually or otherwise." "What the home does is give the service users the best quality of life as possible and try to fulfil their every need." "Looks after them to make sure they have a good diet and see to all their personal needs. Generally the house and the house manager working very hard to make sure the relevant service is in place". A relative said "Everything. I am extremely happy with all the services that x is provided with here at Cornview. X has benefited enormously from the supportive and caring environment The staff provide a continuity of care and work hard to ensure x needs are being met at all levels. It has been a great joy to see how relaxed and happy x is." The health care professional described the care as "generally good" The findings of this inspection support these views We found in addition that: The service is very good at supporting staff to achieve their NDQ qualifications. The service is very quick to adapt to service users changing needs. Managers are good at monitoring and evaluating the quality of the service provided and make changes where necessary. Managers and staff are always looking for ways to improve, for example, more ways for staff to communicate effectively with service users. What has improved since the last inspection? There is a formal process whereby any restrictions to service users rights or freedom of movement can be carefully evaluated to ensure that any such restrictions are, and continue to be, in the persons best interest. The medication system has been improved to ensure that medication administered is being properly recorded and that medication is being stored at the correct temperature. Communication has improved between the management team and the staff. What the care home could do better: Although service users are not prescribed any controlled drugs at present, current storage facilities for this medication are not in line with guidance. The service has already taken steps to address this, The communal areas of the home would benefit from being extended to provide service users with more space. The need for this has already been identified by the service. Key inspection report Care homes for adults (18-65 years) Name: Address: Cornview 124 Roman Road Basingstoke Hampshire RG23 8HS     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: Kathryn Kirk     Date: 1 8 0 1 2 0 1 0 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: Cornview 124 Roman Road Basingstoke Hampshire RG23 8HS 01256350827 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: cornview@liaise.loddon.co.uk Liaise Loddon Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Cornview is a care home providing personal care and accommodation for up to four young adults who have autism and associated complex behaviours within the category of learning disability. The home is owned and managed by Liaise Loddon Ltd. The home is a four bedroom detached bungalow with a communal lounge and dining room that opens out to a paved patio and enclosed rear garden. The home is in the heart of Basingstoke and is close to all the local amenities, which are regularly used by service users. Service users are supported by the homes staff to access the community and engage in meaningful activities. 0 5 0 3 2 0 0 9 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: We carried out a key inspection for Cornview. A key inspection focuses on National Minimum Standards that most affect the quality of life experienced by service users. We gathered evidence for this report in a number of ways. These include: A visit to the home by one inspector, Kathryn Kirk. This took place on 18 January 2010. We spent time with service users and staff and spoke with the manager and senior managers We looked at some records, relating to service users and regarding some practices and procedures in the home, for example the complaints log and medication records. We also saw bedrooms and the communal areas of the home. Four staff members, one health care professional and one relative completed surveys. An Annual Quality Assurance Assessment (AQAA) was returned to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met. It also gave us some numerical information about the Care Homes for Adults (18-65 years) Page 5 of 27 service. We also looked at the information that the service had sent to us about significant events since the last inspection. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? There is a formal process whereby any restrictions to service users rights or freedom of movement can be carefully evaluated to ensure that any such restrictions are, and continue to be, in the persons best interest. The medication system has been improved to ensure that medication administered is being properly recorded and that medication is being stored at the correct temperature. Care Homes for Adults (18-65 years) Page 7 of 27 Communication has improved between the management team and the staff. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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. A lot of information is gathered about peoples needs and wishes before a move to the home is considered. This helps to ensure that the service will be able to deliver a service which will be appropriate. Evidence: There have not been many times when a new service user has been admitted to the service owing to the number that the home can accommodate (up to four) and the long term nature of the placement in general. There are however procedures in place to ensure that any new service user would only come to live at Cornview after very careful consideration and a judgement that the service could meet their assessed needs. The AQAA says that when selecting potential new service users we consider the needs of the existing service users. We have a thorough and comprehensive pre placement process which includes visits to the individuals in their familiar surroundings completing a thorough needs assessment with the persons key people inviting the individual and family to visit the home if appropriate. The most recent person to move to Cornview did so at short notice. However, records Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: and discussions with staff demonstrated that they had a lot of information about this persons needs and wishes before they moved. Staff at Cornview were able to continue with the aims and objectives set as part of the care planning process at the persons previous placement. The process was further helped by staff from the persons previous home working at Crornview for a few days to help the new service user to settle in. Staff we spoke with said that this person had settled very well and this was endorsed by relatives. The manager said that the home had obtained both a health and social care assessment of the persons needs in addition to all the information gathered by the service itself. 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. Detailed Care plans are followed to ensure that as far as possible peoples needs and wishes are respected. Any decisions taken on behalf of service users are documented and reviewed regularly to ensure that people are given as much choice as possible. Evidence: The AQAA says each service user has an individualised care plan. We found this to be the case when we visited. The support plans we saw provided information about peoples known choices and preferences, sets short term objectives and monitored progress towards achieving these objectives. Staff were provided guidance in how to communicate with the person, how to manage any challenging behaviour and how to support them in their daily living tasks. Any risks identified were clearly documented. Since the last inspection the service has introduced a Rights Restriction form which helps the managers to evaluate any restrictions that have to be put into place to keep a person safe, for example, the lock on the kitchen door., These are reviewed regularly. This ensures that any such action Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: continues to be necessary and that it is the least restrictive method of supporting people effectively. The support plan is continuously monitored by staff who record peoples reactions to, for example, each activity. This helps to ensure that the plan reflects peoples wishes and enables amendments to be made if necessary. Staff surveyed were asked Are you given up to date information about the needs of the people you support or care for? All 4 answered Always. A health care professional surveyed said that the care service always responds to the diverse needs of individual people, and relatives agreed that the service supports people to live the life they choose. The family member surveyed also said that the care service always meets the needs of their relative We observed that service users were able to make decisions, for example, what type of hot drink they wanted and whether they wished to take part in a planned activity or not. We observed that staff had a good understanding of peoples wishes and facilitated these choices well. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff work hard to ensure that service users maintain appropriate and fulfilling lifestyles in and outside the home. Evidence: Each day service users follow an individualised schedule which is drawn up from the information that has been gathered about peoples needs and wishes. Against each activity is the name, or names of the staff member who will support each service user. We observed that this system meant that staff were clear about their responsibilities and that each activity was supported by the appropriate number of staff. The programme for the day of our visit showed that the activities arranged included outings and in house events. For example, a farm walk, music therapy, karaoke, massage, a walk to the shops and football in the garden. We observed that staff followed the programme although they were prepared to adapt it when a service user indicated that they did not want to go out. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The AQAA says that the service supports people to visit their families and this was confirmed by a relative in a survey. Despite some restrictions of movement within the house service users were observed to be included in daily routines, for example a service user who indicated that they wanted a drink was included in its preparation. Staff were also observed to respect the privacy of one service user who was in his bedroom, whilst ensuring from a discrete distance, that he remained safe. Staff said that there is a four week menu which has been assessed by a nurse to ensure that service users have a healthy diet. We observed that staff used different communication methods, for example, photographs to help service users to choose what they wished to eat. Staff we spoke with described how the use of photographs is going to be extended to enhance peoples choices in general. 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 service provides appropriate personal and health care support for people Medication systems have improved to better protect service users. Evidence: The AQAA says that Each service user has a supporting x document which outlines preferred method of support and includes a proactive plan of action to ensure continuous monitoring and promotion of health and wellbeing. We saw these documents when we visited and found a lot of information which would help staff to support people effectively and consistently, for example one persons notes said that they cooperate more with male staff when anxious We saw that peoples health care needs are documented in a health action plan and evidence that staff assist people to attend visits to medical professionals such as GP, optician, dentist and psychiatrist. Staff surveyed and spoken with all felt that the service always seeks advice and acts upon it to meet peoples health and social care needs. A health care professional generally agreed that peoples needs are properly monitored, reviewed and met. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: At the last inspection, two requirements were made relating to the management of medication. These were; that an accurate record must be kept of all medication administered, and that daily records must be kept of the temperatures where medication is stored to ensure that it is kept within the recommended range. Since the last inspection the system for managing medication has changed and the service now uses a monitored dosage system for the majority of medicines administered. We found during our visit that temperatures are now recorded. We checked the medication administration record for one service user. This had been fully completed without any unexplained gaps and the record tallied with the medicaiton held. Topical cremes were clearly labeled and the date that they had been opened was recorded. Both requirements have therefore been met. We saw evidence that the medication system is audited by senior staff as part of the services quality monitoring process. Records we saw showed that staff have been provided with training in medication management and all staff surveyed and spoken with felt that the service always supports people to manage their medication correctly. The manager confirmed that no service users currently are prescribed controlled drugs. There is however storage available for this medication should such a need arise. It was discussed that these storage arrangements do not meet with current guidance. Senior managers took immediate action to rectify this, ordering an appropriate controlled drugs cupboard during our visit. 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. Robust complaints and protection procedures are followed to protect service users. Evidence: The AQAA says that one complaint has been received in the past twelve months. This had been documented appropriately in records that we saw and there was evidence that the concern had been responded to thoroughly in line with the services own procedures. The AQAA says also that each service use has the complaints procedure in a format which will encourage their understanding. Relatives surveyed confirmed that they knew how to make a complaint should the need arise and relatives and visiting professionals surveyed confirmed that the service had always responded appropriately if any concerns had been raised. All staff surveyed said that they know what to do if someone expresses concerns about the home to them. The AQAA says that there is a policy and procedure in place for the safeguarding of adults. Staff said that this is discussed as part of the homes induction training. The homes own audit confirms that all staff have had training in safeguarding in 2009, apart from one person, who had completed it in 2008. Evidence of such training was seen in staff files that we looked at and evidence that training would be ongoing was seen in the learning and development programme for 2010. 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. Service users live in a safe environment which is regularly reviewed to ensure that it best meets their needs. Evidence: We looked around the home. The accommodation was furnished to meet peoples needs and staff spoken with showed a clear understanding of the importance of making the environment as homely as possible whilst ensuring peoples safety. The home was in a fair state of repair. Proposed redecoration and improvements were discussed both by senior staff and contained in the homes audit review form, for example, there are plans to build a conservatory onto the back of the building to provide more communal space. We observed that some furniture and areas of the home were kept locked, for example peoples wardrobes and the kitchen area. This meant that service users only have access to these under staff supervision. Records we checked showed that these restrictions had been carefully documented and reviewed by senior staff to ensure that peoples freedom of movement around the house was not compromised unless it affected their safety or wellbeing. The laundry area was clean tidy and provided washing machines with sluice facilities. All potentially harmful chemicals coming under the COSHH categories were locked away safely. There was liquid soap and disposable towels available for handwashing to Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: reduce the risk of spread of infection. 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 are supported by well trained, properly recruited staff, in sufficient numbers to meet their collective needs. Evidence: We spoke to staff and saw daily rotas which showed that service users are supported by sufficient staff to support them in their daily tasks and activities. In addition to the support staff the home employs a cook and a cleaner. The registered manager said that he works 50 of his time directly with service users, which, he said, enabled him to support and guide staff more effectively . Senior managers said that they are also involved on a regular basis and are responsible for arranging training, ensuring that recruitment processes are thoroughly followed and by auditing the quality of the service. The AQAA says that service users are also supported by specialist health care professionals for example speech and language therapist and clinical psychologists and records we saw during our visit supported this. We observed that staff were provided with very clear information about who they should support and for what activity. They appeared comfortable around service users and used different forms of communication for example maketon and picture prompts Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: to enhance this process. Staff surveyed were asked Are there enough staff to meet the individual needs of all the people who use the service? two said always and two said usually. Staff also said that they had enough support experience and knowledge to meet the different needs of people who live at the home. The health care professional and relative surveyed agreed. Staff surveyed were asked Did your employer carry out checks such as your CRB and references before you started work ? All replied Yes This was confirmed in one record that we checked . The AQAA says that all workers have a comprehensive induction plan, an ongoing learning and development plan and that they are allocated on average 5 hours a month which is dedicated to personal development. Staff surveyed confirmed that their induction had covered everything they needed to know to do their job and also said that they were given training that is relevant, helps them to understand and meet the individual needs of people and keeps them up to date with new ways of working. . We saw the learning and development programme for 2010 and this showed that a rolling programme of training has been devised, giving staff regular opportunities to attend such courses as PROACT-SCIPr,( which helps staff to manage challenging benaviours) abuse, fire safety, understanding Learning Disability, autism, food hygiene, 1st aid, communication and infection control. We spoke with the training officer who described how the service supports all staff to obtain their LDQ. The Manager said he has has completed LDQ 3 this year. The management team described how they are supporting two staff members whos first language is not English to study the language and explained that people are able to complete courses again if they have not understood the content of a course the first time around. 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 service is well managed. Evidence: The AQAA says the registered manager has a degree in social work and has completed the NVQ level 4 and Registered Managers award. There is always a senior member of staff on site. At the last inspection a requirement was made that The home must ensure that the managers skills and experience are adequate to meet care needs of service users and care staff. This was made because at that time we judged that there were some problems in communication between the managers and the staff team . Since this time the manager has continued to develop his skills and knowledge, for example, by completing NDQ level 3 and he continues to work alongside staff. Systems have also been put in place to improve communication, for example, a newsletter is available every week to let people know what is happening in the service, and in the organisation. Staff we surveyed for this inspection all said that the manager gave them regular support and met with them to discuss how they were working. We judge that the Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: requirement has therefore now been met. As mentioned in previous sections, senior staff complete a thorough audit , the most recent one we saw clearly identified minor shortfalls and explained how these shortfalls were being put right. Records we saw showed that the home works closely with relatives of service users. They are involved, for example, in the review of care planning. A senior manager also said that they are planning to arrange parents afternoons as a forum for relatives to discuss any general issues or concerns. The AQAA says that all policies and procedures were reviewed and updated where necessary in 2009. It also confirms that electrical, gas and fire safety equipment has been serviced in 2009. We saw that the service protects the health and safety of service users in a number of ways. Risk assessments we saw were thorough and the service had involved specialists to help them to assess risk where necessary, for example, a fire risk assessment we saw had been compiled by an external consultant. As discussed in the previous section, staff are provided with a range of training to help to keep service users, and themselves, safe. 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 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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