Care Home: Fen Road

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What the care home does well Comments from the surveys included the following, `The care is superb and the staff (are) content, diligent and motivated` and `I am very happy with the care my (relative) receives. (They) seem happy and content.` Both of the health care professional surveys said that that the people`s social and care needs were fully met in a dignified way and that the home, `Provides excellent holistic care to the residents.` In March 2008 the home was inspected by the Environmental Health Officer who awarded the home four stars i.e. `very good` for its standard in food hygiene. The home continues to provide, overall excellent outcomes for residents due to the excellent management of the home. What has improved since the last inspection? There were no requirements or recommendations made following our last inspection. Improvements made include those to the environment; to the care records and the standard of in-house activities. What the care home could do better: No requirements and no formal recommendations have been made although some deficiencies found include the following: The medication administration records could improve to include the signing, dating and witnessing of hand written entries. This is to ensure that such entries provide a clear audit trail, that they are accurate and are verified for their accuracy. The quality of any staff interaction with the residents needs to be of a consistently good standard to reduce the risk of possible negative outcomes for any of the residents. Key inspection report Care homes for adults (18-65 years) Name: Address: Fen Road 71 & 73 Fen Road Cambridge Cambridgeshire CB4 1UN     The quality rating for this care home is:   three star excellent 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: Elaine Boismier     Date: 0 6 0 4 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: Fen Road 71 & 73 Fen Road Cambridge Cambridgeshire CB4 1UN 01223425634 01223515960 FenRoad@grantahousing.org.uk www.grantahousing.org.uk Granta Housing Society Limited care home 10 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) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category 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: Physical Disability, Code PD Learning Disability, Code LD Date of last inspection Brief description of the care home 71 & 73 Fen Road provides accommodation, support and care for up to 10 people below 65 years of age with profound learning and physical disabilities. The home is arranged in to two separate bungalows: number 71 provides accommodation for up to six places and number 73 provides accommodation for up to four places. Each bungalow provides individual communal seating and kitchen areas; laundry facilities are provided in both bungalows. The home, owned by Granta Housing Society Limited, is situated in a quiet residential area, approximately three miles from Cambridge City centre. The bungalows are surrounded by large gardens with a vehicle parking space to the front of the complex. Two minibuses are available to transport service users to Care Homes for Adults (18-65 years) Page 4 of 28 10 10 Over 65 0 0 Brief description of the care home day care services, visits and outings. Current fees range from£1172.24 to £2038.39. Additional costs include those for holidays, meals and drinks out and clothing. Further information about the fees can be obtained via the home. A copy of the CQC inspection report is available at the home or via the CQC website at www.cqc.org.uk 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: three star excellent 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 last key unannounced inspection took place on the 7th May 2007. Since then we have carried out Annual Service Reviews of the home. During these reviews we collated and analysed information about the home and concluded that we were satisfied with the standard of care and standard of the service provided and would continue with our inspection schedule, which resulted in this inspection of the 6th April 2010. We, The Care Quality Commission (CQC), carried out this unannounced key inspection between 9:15 and 14:30 taking four hours and fifteen minutes to complete. Before the inspection we received surveys from six of the residents (these were completed on their behalf by their relatives) and from ten of the staff. We also received surveys from two health care professionals. We looked at information that we have received about the home since our last key unannounced inspection. Care Homes for Adults (18-65 years) Page 6 of 28 The home sent us, as requested, an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. During this inspection we looked around the premises and looked at some of the documentation. We case tracked one of the current ten residents. Case tracking means speaking and observing the resident and visiting their room. It also includes speaking with some of the staff who were looking after them. We compared what we saw and heard with the persons individual records. We also spoke with and watched other people who were not part of our case tracking. We spoke also to some of the other staff, including the Manager and Deputy Manager. For the purpose of this inspection report people who live at the home are referred to as people, person, resident or residents. 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. Prospective residents and their represenatatives can be confident that they will have access to information about the home. They can also be confident that their needs will be assessed before they move in to ensure that that the home is able to meet their assessed needs. Evidence: Since our last inspection the home has received, in January 2010, an amended certificate of registration and this was on display. The six residents surveys were completed on their behalf. All of these said that the person had received enough information about the home before the resident moved in. According to the AQAA With a recent new admission the Management team and senior staff went to see the prospective tenant and discussed the tenants care plan in depth. Senior staff also met the tenant involved. The tenants social worker/care manager came to Fen Rd to assess Fen Rd as well. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: As part of our case tracking we looked at a persons care records and we found that the home had received information about the person from the previous care provider and from the persons care manager. There was also recorded evidence that the home had carried out its own assessment of the persons full needs and this assessment was completed before the person moved into 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they are cared for and valued and supported by wellinformed staff. Evidence: As part of our case tracking methods we observed how the staff were caring for the person: we spoke with the staff, including the Manager and Deputy Manager, and we compared with what we saw and heard with the contents of the persons care records. It was clear that the staff were aware of the persons special needs and there were ongoing assessments to determine the needs, including the complex communication needs, of the person. Their care records demonstrated that there was ongoing evaluation and reviews of the care records as the home came to understand and know the persons individual needs. Within these records we also found that advice from a health care professional was transferred into the persons care plan, including how the person was to be helped with their nutrition and how they were to be helped to move about. The staff we spoke Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: with indicated that the care records were referred to and were knowledgeable in how to meet the planned care needs of the person. Since our last inspection the home has introduced a health action plan: this provided clear guidance about the special health needs of the person and how these were to be met. From our observation of other residents, discussion with the Manager and from our case tracking, we noted that the people are able to live a full life, based on a framework of assessed risk, to include travelling in the mini-buses and taking part in activities such as swimming. According to the AQAA We have recently improved our monthly tenant reviews to include more clearly defined goals that can be linked to identified needs for the tenants. This will include perceived views of the tenants. The AQAA also told us that that there have been improvements made, during the last twelve months, within the care records as there are Lots of pictures to show staff how to provide the correct care. Updated and introduced new risk assessments to include safeguarding. Due to the complex communication abilities of the residents, according to the AQAA The tenants dictate what time they would like to go to bed. Staff observe whether a tenant is falling asleep or dozing. The tenants have complicated health care needs along with a busy activity plan, we often find that the tenants are very tired in the evenings. If a tenant is going out in the evening the tenant often has a rest before going out. This tells us that peoples choices are valued and that they are able to live a life in a flexible way. Where completed the residents surveys indicated that peoples choices are valued. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they have access to an excellent range of social activities and are supported in keeping contacts with families, friends and the community. Evidence: According to the AQAA there have been ongoing improvements in the range of day to day activities provided, We have introduced a more rigorous approach to week end activities and evening activities. This approach means that each tenant has at least one week end activity per month. For example cinema trip and meal or bowling. The Manager said that that due to the closure of a day service, the home has taken innovative action to replace this service provision with the introduction of an in-house day service that is in the development stage. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: As part of our case tracking we saw that the person had enjoyed aromatherapy, music sessions and the home had introduced them to the activity of swimming. The record of reviews indicated that the person had enjoyed taking part in these activities. The Manager explained, and we found that this was the case when we visited the place, that there were no residents at one of the bungalows, as the majority of these were attending their day services, with the support of the care staff. The staff, unsolicited, said that some of the residents went for a short holiday to the coast, in 2009, supported by the care staff and plans were in place for some of the residents to go away and spend time, with support from some of the staff, at a holiday camp. We saw, during our case tracking and from examination of the visitors record, that people have access to their family and friends and we found additional evidence of this from the surveys that we had received, as all of the residents surveys were completed on their behalf, by their families. Staff were seen to include residents in discussions and decision making and the persons preferred way of how they like to be called was used by staff. Examination of the three-weekly menus indicated that people have a range of choices of food to include, for example, roast dinners, baked potatoes, garlic mushrooms, mild chili con carne and pasta dishes. We saw that the staff were helping some of the people with their food and drink in a manner that encouraged, where possible, their independence, and supported other people with eating and drinking in an individual way; this told us peoples dignity was valued by the staff. Some of the residents were unable to take their food and drink by mouth and we saw how the staff were giving these peoples nutrition via other means. This was done in a hygienic and safe way. From speaking with some of the staff and from examination of their training records we found evidence that these staff had attended training in safe food handling and how to give people their nutrition via artificial means. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they receive an excellent standard of safe health care. Evidence: All of the residents surveys said that the person always received the right care, including medical care, and support that they needed. Added comments included that The care is superb and the staff (are) content, diligent and motivated and I am very happy with the care my (relative) receives. (They) seem happy and content. Both of the health care professional surveys said that that the peoples social and care needs were fully met in a dignified way and that the home Provides excellent holistic care to the residents. As part of our case tracking we observed the standard of care provided to the person: we found the persons care needs, including physiotherapy, was carried out according to their care plan. Their treatments were provided by the staff in their own room, behind a closed door. People who live at the home have complex physical needs and we saw, from our case tracking, that the persons physical needs were well met: this included their nutrition, Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: with a positive gain in their weight and how staff were to reduce the risk of harm, posed by a medical condition, by safe moving and handling of the resident. The persons care records indicated that they had an assessment by a physiotherapist and staff were clearly aware of the prescribed physiotherapy advice that they were to follow, when treating the person. These treatments were to prevent illnesses and to promote health. Continuing on with our case tracking we examined how the persons medication was stored and recorded. We found that medication was stored in a secure manner and that the temperatures of where any medication is stored, was recorded each day and these were satisfactory, indicating that the quality of the medication was preserved. There were no omissions of recording when the person had had their medication and this was given in accordance to their care plans. Speaking with a member of the staff and looking at the residents medication records it was evident that there was a risk of excess of two of the prescribed medications being in the home. The Manager said that she would take action to reduce this risk. We noted, from the medication administration records, that the person was prescribed nutritional supplements: these were recorded as given in other care records. We advised that a note should be made, on the medication administration records, where the other records of administration of this prescribed medication, were to be found. This would ensure a clear audit trail of the medication. Two hand-written entries were made on the medication administration records although none of these had been signed, dated and witnessed. To do so would ensure that there is a clear audit trail and that such entries are accurate and verified for their accuracy. The Manager said that she would take action to improve this. Although we found these shortfalls, we found no poor outcomes for the resident. 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 can be confident that if they were unhappy about something they would be truly listened to. They can also be confident that they are safe from the risk of harm. Evidence: All of the surveys that we have received indicated that the person knew how to make a formal complaint if they wished to do so. According to the AQAA All staff are giving yearly refreshers for SOVA (safeguarding of vulnerable adults against abuse). The AQAA noted that the home has received no complaints and we have received no complaints against the home. We looked at the record of complaints and found that there were no new entries since our last inspection. This tells us that people should be satisfied with the standard of service and standard of care provided. We have received no allegations of abuse against any of the residents and the AQAA also noted that no such safeguarding events have taken place. We saw, from speaking with the staff and from their training records, that they had attended training in safeguarding awareness. They told us what they would do if they suspected any abuse against any of the residents; we were satisfied with their response. This tells us that the residents have been safe from the risk of harm. As part of our case tracking we saw that the home had assessed the persons mental capacity to make decisions about their care, ensuring that where the person could not Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: give their consent, care was provided in their best interest. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, well-maintained and clean home. Evidence: Some of the staff surveys provided positive views about the home environment, saying the home does well as the residents and staff (Have) the best equipments (sic) to work with....maintaining a good safe environment both for the service user and staff and The home provides a safe and secure environment for the people who work and live here. We looked around the premises and found that, since our last inspection, improvements have been made to the flooring of one of the bungalows and a pergola had been installed in the rear garden area. Both of the kitchen areas have been upgraded with replacement cupboards and ovens. Bedrooms continue to be individually decorated and there were items in all areas of the home, including the gardens, to stimulate peoples visual and auditory senses. The Manager and Deputy Manager acknowledged that certain areas of the garden needed some tidying, to include attention to a broken swing, for example, before the weather became more clement, allowing the residents to visit these areas, for longer periods. We found that all of the areas of the home were clean and fresh. All of the six Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: residents surveys said that the home was always or usually clean and fresh. 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. People can be confident that they are cared for by a well trained and consistent team of staff. Evidence: Ten surveys were received from the staff: all of these said that there was always or usually enough staff on duty to meet the needs of the residents. One of these surveys added that the service could do better regarding recruitment although there were no additional comments provided to elaborate this view of the respondent. According to the Manager there is current active advertising for new staff, including qualified nurses. Continuity of care is maintained by the use of bank staff and by the use of staff, supplied by agencies, who have previously worked at the home. We spoke with an agency member of staff who was able to tell us how peoples food was prepared and, according to the Manager and Deputy Manager, this was done in the correct and safe way. We saw that there were enough staff on duty to provide 1:1 individual care. This level of staffing also allowed people to be taken, by the care staff, to their day services. The interaction of the staff with the residents was observed. We found the standard of this varied from some of the staff telling the residents what they were going to do, Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: step by step, such as moving them in their wheelchair, and engaging in social conversation when helping them with their food and drink. We saw, however, that such good interactions were not always carried out: we saw some of the residents being moved in their wheelchairs without the staff telling them what was happening. We also saw that the staff missed opportunities, to engage the person, when providing them with their food and drink, due to limited conversation from the staff to the resident. We found no negative outcome expressed by any of the residents during these occasions. The Manager and Deputy Manager were aware of these issues of staff communication and said that these would be formally addressed. All of the ten surveys from the staff said that the person was satisfied with their induction training, their ongoing training and the support that they received from their Manager. Added comments included (There is a) strong motivated staff team. The standard of care given, the physical environment, level of day services, outings etc. (is) very high People should be in safe hands as, according to the AQAA, there is more than 50 of the care staff who have a National Vocational Qualification in Care, level 2, or equivalent. We examined three staff recruitment files and all the required information was made available for inspection. This tells us that people should be safe from unsuitable staff. The AQAA informed us that twenty-three of the staff have attended training in the prevention and management of infections; seventeen of the staff have attended training in malnutrition and helping people with their food with fifteen of the staff having attended training in safe food handling. We examined two staff training records and found evidence that they had attended training in topics to include managment of, for example, people with epilepsy; management and prevention of pressure sores and the management of continence difficulties. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live and work at the home benefit from an excellent standard of management. Evidence: The Managers training file was examined and we found evidence that she has attended training in topics, such as Meaningful Activities and caring for people with visual impairments. Residents continue to receive an excellent standard of care and services which tells us that there is an excellent management of the home. The AQAA was completed in detail and it told us that there is a good quality assurance system in place as the home continues to make improvements in the standard of service provided. Examples of this can be read within this inspection report. In 2008 and 2009 the home carried out the annual quality assurance reviews, called Quartz and copies of these reports were seen. It was noted that Fen Road was viewed, by the respondents of the surveys, included in the Quartz exercise, as fairing very favourably, in the majority of the areas reviewed. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: People should live in a safe place as, according to the AQAA, Fire risk assessment carried out by an external organisation yearly and recommendations actioned. Staff have annual refresher training. All the tenants have individual fire evacuation plans. Fire checks continue weekly. The AQAA also informed us that the service checks are in date for items such as fire detection and fire fighting equipment, hoists and portable appliance equipment. Records for fire alarm tests and emergency lights checks were seen and these were satisfactory. Service tests for portable appliance equipment and hoists were recorded as in date. The last fire drill was carried out in November 2009 and, according to the homes fire risk assessment, was due in February 2010: the Deputy Manager indicated that the next fire drill would be carried out imminently. The staff told us that they had attended training in safe moving handling, first aid and fire safety and their training records indicated that this was the case. In March 2008 the home was inspected by the Environmental Health Officer who awarded the home four stars i.e. very good for its standard in food hygiene. 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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