Care Home: Cottage Farm

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What the care home does well This home provides people with a safe, clean and homely environment to live in. People benefit from having personalised bedrooms that reflect their individuality and enable them to express themselves. Adaptations within the home help to promote independence. People`s personal and everyday care support needs are clearly identified and written up into care plans that provide step-by-step instructions regarding the level and type of support needed with various care needs. This is especially important, as people living at the home are often unable to verbally communicate their needs. This also helps to make sure that people can maintain their independence. People living at the home are supported to make choices about their life style, to take part in various activities and to keep in contact with friends and family. What has improved since the last inspection? The one outstanding requirement from the previous inspection has now been met. The home now has a full time manager who has made a registration application to the Care Quality Commission. The home has sustained the improvements as reported in the previous inspection report of December 2008. This has contributed to the change in the home`s quality rating. What the care home could do better: There are no requirements as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Cottage Farm Southampton Road Hythe Hampshire SO45 5TA     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: Chris Johnson     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 28 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Cottage Farm Southampton Road Hythe Hampshire SO45 5TA 02380840661 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.macintyrecharity.org MacIntyre Care Name of registered manager (if applicable) Mrs Alina A Conway Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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). The maximum number of service users to be accommodated is 5 Date of last inspection Brief description of the care home Cottage Farm is registered to provide accommodation to five younger adults with a learning disability, physical disability or sensory impairment, although the home currently accommodates three residents over the age of 65. The home is a large spacious bungalow in a semi-rural setting, on the outskirts of Hythe town centre and the New Forest. Accommodation is provided within individual rooms, with communal facilities including a large, comfortable sitting room, spacious kitchen dining room, one assisted bathroom, walk in shower room, separate WC and utility room. At the front of Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home the property is a large parking area, with the garden area at the rear mainly laid to lawn, with small shrubs, a patio area and an adjacent fruit orchard. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess how well the home is doing in complying with regulations, previous requirements and to assess what the outcomes are for people who live at this home. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out over one day on 18 January 2010. During this visit we looked at all key standards. The person managing the service completed an Annual Quality Assurance Assessment (AQAA) prior to the inspection and this forms part of the evidence for this report. Any regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Care Quality Commission and the predecessor organisation the Commission for Social Care Inspection. Care Homes for Adults (18-65 years) Page 6 of 28 During this visit we looked at the physical environment including, peoples bedrooms and all communal areas of the home. We examined records, policies and procedures. We talked to people who live at the home and some members of staff. We observed staff during their day-to-day interactions with people living at the home. We also sent surveys to staff, people living at the home,relatives and social and health care professionals. Due to the communication needs of the people living at the home we were not able to hold discussions with them. However we did talk to people briefly, interact with them and spend time observing the care being given to them. The person managing the home was present during the visit to answer questions and discuss issues and verbal feedback was provided at the end of the inspection. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are fully assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the persons needs. Evidence: The home has a history of providing people with good outcomes in this area. We have not had any concerns from previous inspections. Since our last visit there had not been any new admissions to the home. The annual quality assurance assessment (AQAA) provided us with evidence that the home continues to carry out an appropriate assessment of peoples needs before considering offering them a place at the home. From discussion with the person managing the service we were told that they were currently assessing someone with a view to them moving in. The assessment process was unchanged since the last inspection. This included the opportunity for prospective residents to visit the home prior to moving in, spending time at the home such as overnight stays, the gathering of other professionals assessments as well as completing their own. The person managing the home demonstrated a clear understanding of the assessment process and placed an emphasis of the importance Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: of making sure that the needs of the people currently living at the home were taken into account before offering someone a place at the home. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide clear instructions for staff to follow and enable them to provide support and care in a way that people prefer. Evidence: At the previous inspection on 19 December 2008 quality in this outcome area was judged to be good. On this occasion we looked at the care plans of two people who live at the home. Our findings were similar to as the last inspection. All staff who returned a survey were of the opinion that they were given up to date information about the people living at the home. Relatives surveys returned to us stated that in their opinion the home met the needs of their relative and provided the support and care that they expected. The annual quality assurance assessment (AQAA) stated, We ensure that each person Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: we support is supported in the way they want to be. Examination of care plans during the visit substantiated this. Both care plans looked at were person-centred and were written in the first-person. Sections within each care plan examined included, what people say about me, My essential information, Things I like, Things I really do not like, Whats important to me / for me, How I communicate, Snippet of my day and My achievements. Care plans demonstrated that peoples independence is promoted and highlighted peoples abilities as well as their needs. Peoples personal care and daily support needs were clearly identified and care plans provided clear guidance regarding the level and type of support needed with various care needs. Daily records maintained at the end of each shift provided recorded evidence that care was being provided as per the care plan. All care plans looked at provided evidence that people had been consulted and involved in formulating their plan. Care plans provided guidance for staff for anyone who may exhibit challenging and risk assessments and risk management plans were in place for any identified risks. We saw evidence that people are supported to make their own decisions, with assistance where necessary and that identified risks posed to each person are managed appropriately. Both of the care plans looked at had been written from two perspectives, firstly from the individuals point of view and that of staff and other professionals, whats important to me and What is important for me. This section included assessments from staff and other professionals of the risks posed to the person. A recent assessment of individuals with sight impairments by the Royal National Institute of Blind People (RNIB) had been completed and this was being incorporated into peoples care plans. Where appropriate friends and family had contributed to and been involved in the care planning process. The person managing the home had reorganised the staff team into link teams whereby a team of staff have responsibility for overseeing the care and support of named individuals. We saw evidence that monthly meetings had been held with each individual to review their care plan Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to make choices about their life style, and are supported to develop life skills. People are supported to engage in activities and to keep in contact with friends and family. Evidence: Each person living at the home receives funding for one to one support in the community and this is delivered by an outside agency and funded by social services. On the day of the visit one person went out with the agency while others were observed to engage in their own activities, spend time in their rooms, communal areas and engaging with staff. Evidence recorded in care plans detailed peoples individual lifestyle choices and their Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: interests. The home environment reflected this with personalised bedrooms and photographs and prints around the home of the people who live their taking part in their chosen activities, outings and holidays. The home maintains activity diaries for each person and these provided recorded evidence that people were supported to take part in a variety of activities. The diaries also provided us with evidence that people could exercise choice as whether to engage in an activity and choice regarding meals. One relative stated that their relative had recently gone on holiday with staff from the home and commentated, The fact that he was taken on holiday to Butlins a few months ago I see as very positive and the album of photos that were produced for him shows care and understanding of his likes and needs. The home has its own transport and can take people out. This is normally on an informal basis taking two or people out at a time. We saw evidence that people can receive visitors and are encouraged and supported to keep in touch with family and friends. This was supported by responses to surveys completed by relatives. We saw a sample of menus and discussed menu planning. People indicate to staff their menu choices and records are maintained and were available for inspection to demonstrate that people are offered a healthy and varied diet. We reported at our last visit to the home that they planned to introduce pictorial menus. These had now been produced and menu choices for the day of the visit were displayed in this format. In addition to this the home had also introduced, object boxes to specifically meet the needs of one person with sight impairment, enabling them to make their own menu choices. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are fully supported with their health care needs and have access to a range of specialist health care support. People receive personal support in the way they prefer and according to their needs. Evidence: From evidence recorded in the annual quality assurance assessment (AQAA), care plans and from observations and discussion it was evident that people were receiving support with their personal care needs in line with their needs and preferences. The How to support me section within care plans provided a detailed description of how the person liked to be assisted with their personal care needs. Care plans and associated documents provided us with enough information to demonstrate that health care needs are being met and that people have access to a range of health services. Each person had a separate health file and these provided plenty of evidence that referrals to a wide range of health care specialists had been made and that people were being supported to attend appointments. Health care plans contained plans to reduce and manage specific illness, systems for monitoring health and goals to improve health. A summary of each appointment had been maintained and there were also health appointment information sheets that are taken to each appointment Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: whereby health care professionals are requested to sign the sheets detailing the reason for any intervention, the diagnosis and any outcome or advice . The last inspection of the home on 19 December 2008 found there to be an improvement in the management of medication. Evidence collated during this inspection demonstrated that this improvement has been sustained. Care plans described the level of support required with medication. The How I like to take my medication section within both the care plans that we looked at provided a detailed description of how the person liked to be assisted with their medication support needs. The medication administration records were checked for two people during the visit. From examination of these records it was evident that staff were following correct administration recording procedures. The home has a written medication policy and clear procedures. This included a procedure for place for checking in medicines received into the home, procedures for logging any medicines returned to the pharmacy and regular auditing of the records. The records examined during the visit had been maintained in line with the homes written procedure. The person managing the home reported that the home was not holding any controlled medication, however there was written guidance and appropriate storage procedures should the need arise. Evidence was seen to demonstrate that staff undergo training before being able to administer any medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home are protected by the homes policies and procedures. Evidence: The home reported that they had not received any complaints in the last twelve months. We looked at the complaints log during our visit and can confirm that none were recorded. The last inspection of the home found this outcome area to be good. The annual quality assurance assessment (AQAA) stated, All our staff receive training in protecting people from abuse and on their duty to report concerns and allegations. We verified this by looking at a sample of staff training records. All nine staff who completed a survey told us that they knew what to do if someone had concerns about concerns about the home. The home had a talking photo book providing a recorded audio description of the different stages involved in making a complaint, what will happen and whom people can speak to if they are unhappy. There is also a pictorial version. Due to the communication needs of people living at the home we were unable to ascertain from them whether this had aided their understanding of their right to complain. Within both care plans looked at there was information describing the way each person communicated whether or not happy with anything. The home supports people to manage their finances. Each person is risk assessed as to their ability to manage their own finances. We examined the records of two people all transactions had been recorded and receipted as per the homes policy and the Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: storage facilities were safe and secure. A shift check is undertaken of peoples money looked after by the home as part of each shift handover. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well furnished, comfortable and homely. The home is clean and tidy and good standards of hygiene are maintained throughout the home. Improvements continue to be made to the physical environment to promote independence and to meet peoples changing needs. Evidence: The previous inspection of the home found this outcome area to be excellent. This most recent inspection provided us with sufficient evidence to demonstrate that the home continues to sustain these high standards. During the visit to the home we saw all communal areas and a selection of peoples bedrooms. On arrival at the home it was found to be clean and tidy and smelt pleasant. All bedrooms seen were highly personalised as was found at the last inspection. The home had one vacant room and the person manging the home stated that this would be decorated to the persons taste. We found that the home had installed more adaptations since our last visit. Several people living at the home suffer from some degree of visual impairment. Recently the home had arranged for people to be assessed by the Royal National Institute of Blind Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: People (RNIB). The results of these assessments had been incorporated into care plans. Alongside this adaptations had been made to peoples individual rooms and communal areas according to individuals needs. Aroma sprays had been installed for one person to assist them with locating their room independently. Other recent additions included, talking buttons providing people with help in orientating themselves and tactile, objects, signs and symbols. Photographs and tactile objects were placed on kitchen cupboards to assist people to find food preparation items, plates and cups etc. From observation people were relaxed and at home in the environment and free to access their rooms and other areas as they so chose. The home continues to replace furnishings and update the decor. Communal areas of the home provided a lot of evidence and a feel that the home is designed, furnished and decorated to reflect the needs and tastes of the people who live there. This is helped by the display around the home of lots of personal photographs of peoples holidays, photographs in general and peoples art work. The AQAA told us that the home plans to develop a sensory garden with raised flower beds and a fountain. The laundry room, kitchen and bathrooms were all seen and it was evident that infection control procedures were being followed. Health and safety other guidance were displayed in the laundry room with procedures for infection control such as colour coded cloths for different tasks. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are employed in sufficient numbers to meet the needs of people living at the home. They are well trained and undergo a thorough recruitment process. Evidence: We looked at the staff rota for the day of the visit and this proved to be a true reflection of the actual staff on duty. Staff were asked whether there were enough staff to meet the individual needs of all the people who live at the home. Two people responded Always, three said, Usually, and four said, Sometimes. The person managing the home explained that there was a degree of flexibility with staffing numbers and that the rota could be adapted to meet the needs of those living at the home. We saw evidence to support this from examination of the rota. We asked staff whether pre employment recruitment checks had been undertaken before they were able to start work at the home. They all responded that they had been. The annual quality assurance assessment (AQAA) stated, We have rigorous recruitment and selection procedures to protect the people we support and to appoint the best staff. During this visit to the home we looked at the files of two members of staff who had been recruited since our last visit. These confirmed that an appropriate recruitment Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: process had been followed and that this included; the submission of an application form, an interview, the receipt of two written references and that both Criminal Records Bureau and Protection of Vulnerable Adults checks had all been completed prior to them commencing work at the home. Evidence was seen to verify that both members of staff had been inducted into the home and that they had completed an induction programme that was linked to the Skills for care induction standards. This was consistent with our findings at the previous inspection. We know from previous inspections that staff receive training appropriate to their role. When asked whether they considered that they received relevant training all staff who responded to the questionnaire said that they did. We looked at the training records for the two newest members of staff and saw that they had undertaken a range of training courses relevant to their role. The AQAA stated that,Cottage Farm has 55.5 of the staff team with an NVQ level 3 and above, three more staff are currently undertaking NVQ Level 2 and 2 new staff are currently completing the LDQ (learning disability Qualification). Our observations with staff were that they were friendly and supportive toward the people living at the home. Staff and people living at the home were observed to be relaxed in each others company. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. Safety is promoted within the home. Evidence: The last time that we inspected this home on 19 December 2008 this outcome area was judged to be adequate. There was one outstanding requirement that the home Must appoint an individual to manage the home and arrange for this person to submit an application for registration. The home had complied with this requirement. At the time of this visit a full time manager had been in post since July 2009 and they had applied to become registered with the Care Quality Commission. This is as an improvement on the previous management arrangements. The person managing the home is contracted to work at the home for thirty - eight hours a week. Half of this time is dedicated to purely managing the home and the rest of the time they are on shift. The person managing the home stated that this was flexible to meet the demands of the role. The last inspection found a number of improvements had been made in the running of Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the home. Evidence from this inspection found that these improvements have been sustained and there are not any outstanding requirements. Examination of a sample of policies and procedures during the inspection demonstrated that these are kept under regular review. We saw that a representative from the organisation visits the home on a monthly basis to monitor the effectiveness of the service. Records showed that during these visits people living at the home were consulted and spoken to staff were interviewed, the environment and upkeep of the home was monitored and records were examined. We saw documented evidence during our visit to the home that maintenance checks, tests and servicing of equipment are carried out regularly. Examination of the fire logbook confirmed that weekly fire alarm checks are undertaken. We saw recorded evidence that regular fire drills take place. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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