Care Home: Fern Lodge

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What the care home does well Service users live in a comfortable environment that is decorated and furnished to an excellent standard. The service has a dedicated team of staff, most of whom have achieved NVQ level 2, or above in care. From obsevation staff demonstrated that they had the skills to do their work, having received a good level of training; they also expressed that they were well supported, both by their manager and by each other. People get out, and do lots of activities that they enjoy. The staff team aim to be flexible, and provide `what people who live in the home want.` This is achieved by clear, individualised care plans that are regularly reviewed, to provide consistent care and support. The complaints procedure is clear and easy to to see, and if Service Users are unhappy or concerned, then staff want people to tell them. They will listen and try to help. If you feel that your key worker cannot help, the Manager is also available. What has improved since the last inspection? Recording has improved. Keyworkers write down any information that is important when meeting to talk to service users. The home has been extended, a large conservatory has been built onto the front of the home. It is accessed through the dining area, and overlooks the garden and entrance to the home. What the care home could do better: A recommendation has been made that there must be one service user guide that clearly states the service people will receive. Key inspection report Care homes for adults (18-65 years) Name: Address: Fern Lodge 108 Broad Road Bocking Braintree Essex CM7 9RX     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: June Humphreys     Date: 1 2 1 0 2 0 0 9 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) 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 28 Information about the care home Name of care home: Address: Fern Lodge 108 Broad Road Bocking Braintree Essex CM7 9RX 01376550432 01376342928 braintreehcltd@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Braintree Health Care Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability Additional conditions: Persons of either sex, aged 65 years and over, who require care by reason of a learning disability (not to exceed 8 persons) Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 8 persons) The total number of service users accommodated in the home must not exceed 8 persons Two persons, under the age of 65 years, who require care by reason of a learning disability and dementia, whose names have been made known to the Commission Date of last inspection Brief description of the care home Fern Lodge is a care home registered to provide accommodation, personal care and support to eight people with a learning disability. The service supports people primarily who are under 65 years of age at admission, but does continue to care for people living in the home once they reach the age of 65 if their needs can continue to be met. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 2 8 Brief description of the care home Fern Lodge is owned by Braintree Healthcare Ltd, and the Registered Manager is Mrs Jenny Woolliams. Fern Lodge is a purpose built bungalow situated in pleasant secluded surroundings, in a semi rural location on the outskirts of the town of Braintree, in the county of Essex. All bedrooms are of single occupancy and offer spacious accommodation with a small lounge area, kitchen facilities, en suite bathrooms and patio access to the garden. The home also has a dining room, lounge and an attractive garden. The inspector was advised that the current fees ranged between £877-14 to £2,200-83 per week, at the time of the inspection. 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 quality rating for this service is 3 stars. This means that the people who use this service experience excellent quality outcomes. One Inspector June humphreys visited the home unannounced on Monday 12th October 2009. They looked around the home, to check that it was safe, and a comfortable place to live. Paperwork like care plans, staff files, supervision records, staff rotas, complaints, medication and accident records were looked at to help gather evidence for this report. The Manager completed and returned the Annual Quality Assurance Assessment / AQAA which is an important document that tells us how well the home is doing. As part of the inspection there was the opportunity to speak with service users, relatives, staff, and the registered Manager. staff were observed supporting service Care Homes for Adults (18-65 years) Page 6 of 28 users, and a number of postive surveys were received from proffessionals and relatives who visit the home. 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 service users can be assured that a thorough assessment will be completed, and admission to the home will only be agreed if their needs can be fully met. Evidence: The manager showed several different service users guides, which over a number of years had been updated to show prospective service users what it is like to live at Fern lodge. The information was informative and outlined how different people of different ages would be supported to live in the home. It is recommended that one accurate service user guide, be produced which clearly reflects the service that is provided. The care records for the one new service user admitted since the last inspection evidenced that a full needs assessment had been carried out by the manager. This was prior to the person being invited to visit the home.The manager showed a good awareness of the needs that the home is able to meet, and clearly took this into account when considering prospective admissions. A number of visits of increasing Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: duration were then made, leading to a stay over night. Staff said that they had access to detailed assessment information from the health & social care professionals involved with prospective service users. A picture of the individual person and their care needs is built up during contact when them when they visit the home, and with their families and friends. 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. People living at Fern Lodge receive good quality care based on their assessed and identified needs. Evidence: The two care plans looked at had been regularly reviewed and updated, following a clear person centred approach i.e. due to the range of age and ability of people living in the home each persons plan was individual to them. Good descriptions as to individual care needs were recorded along with suggested or proven methods of communication, as a number of people did have limited speech. One Care plan identified the need for consistency in care because this helped in relation to responding to known behaviours. A staff member told us we work hard to look after people, and try to ensure that by getting to know them we can help them in the way they like, making them happy to stay here, we follow the care plan at all times. The records of service users meetings were not able to evidence the number of meetings which the manager said had taken place. However there was evidence that Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: service users are involved in decisions concerning the running of the home. Service users choose what food they would like to eat on a weekly basis, and the menus are devised from the things that have been chosen. In addition to this each service user has a regular individual meeting with their key worker . The manager stated in the AQAA that the Keyworker books in service users rooms has changed the way in which staff can liaise with service users, and the allocation of a member of staff to ensure that regular keyworker meetings are held. The keyworker role is all encompassing with family and friends being involved. It was evident from the records, discussions with staff and from observation, that the staff had the skills, knowledge and experience to communicate effectively with people and to support them when necessary to take risks as part of an independent lifestyle. Risks identified are closely monitored and so far as possible reduced. 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. Service Users benefit from personalized care plans that enable them to undertake activities, both personal and social in the way they choose. Evidence: Each persons care plan provides information about their interests, abilities and expectations. The staff on duty stated that they organize events, activities and trips out, according to the preferences of the service users. Daily recordings in the home showed that routines in the home are flexible, and varied according to individual choices, and needs. The manager stated in the AQAA All Service users have their own rooms where well trained staff ensure that they are always treated with dignity. The spacious rooms with kitchen facilities enables service users to be supported with meals in their own rooms if they wish without using the communal areas. This allows individuals to be as independent as possible and maintain basic living skills. All Service users get up and go to bed at the times of their choice, bathing and showering is Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: assisted by well trained staff who carry out these duties according to the care plan. Service users are encouraged to choose their own clothes and are assisted to carry out personal tasks such as shaving, putting on makeup and doing their hair so as to allow them the freedom to be individuals. Sensory lights and equipment is provided in communal and private areas for service users with sensory, cognitive and mobility needs. Observations was that people were confident and relaxed and enjoyed a positive and supportive relationship with staff. Staff spoke with service users in a positive and friendly tone using appropriate language and communication methods. The home has a well-equipped domestic style kitchen. A wide range of food stocks were available, and staff spoke of ensuring that people at the home are able to participate in the buying of food for the home in local shops. Menus are devised by service users on a weekly basis with the support of staff. This is usually undertaken on a Sunday. Staff spoken with considered the quality of food and the variation of meals provided is good. 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. The care plans are active working documents, which provide staff with the information they need to make sure that service users health, personal care and social needs are met. Evidence: Information was recorded on care records to indicate the way each person preferred to be supported when receiving personal care. Each person has an en suite facility so that they may be assured of privacy. The home employs a mix of male and female staff, and this enables service users to have choice about who supports them. Observations on the day of the inspection confirmed that staff provide care discretely and with consideration to ensure peoples dignity is maintained. A health professional who completed a survey for us stated, During my visits to the home I have observed the staff providing care to a high standard, respecting the service users dignity and privacy at all time. Service users care plans examined provided evidence that appropriate health care services are available, accessed, and fully recorded. Records showed that service users had access to a range of health care professionals including: district nurses, Dentists and Chiropodists. There was good evidence that Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: peoples health care needs are given high priority. The manager and staff spoken with all were able to demonstrate a good awareness of individual needs, around health and well being. A number of staff had attended peg feed training as a service users needs had changed and now required this assistance. As part of the inspection this was observed. The staff member completed the task competently, and at ease, and the service user was relaxed, responding well to any requests made. A robust medication storage and administration system is in place to which there have been no changes since the last inspection. All staff who administer medication have been trained to do so. The recordings on the two MAR (medication administration record) sheets were properly made with no omissions. Service users medication is stored in each persons bedroom, and the manager advised that medication is usually administered within the individuals personal space. 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. Service users views are regularly asked for, listened to and when ever possible acted upon. Evidence: The service has a comprehensive complaints procedure in place, which staff are aware of and able to talk about how they would respond. One member of staff said we encourage people to speak out, we want them to tell us if they are unhappy or concerned. A relative said we have no concerns about the home, they listen to you here, and so if we were unhappy about something we could openly talk to the manager. The record of complaints maintained within the home was seen, which recorded the actions and outcomes as necessary. All service users have been informed about the complaints procedure. This is also on display in the home. There had been one complaint since the last inspection. A service user had made a complaint about another person living in the home. The manager responded by suggesting that the service user was supported to use their bedroom should noise levels be of a concern. The manager said this does seem to have helped, and the service user is much happy with the outcome. Recording of staff training confirmed that Staff had received training in issues and procedures relating to safeguarding adults. Staff spoken to were able to explain how they would deal with any concerns they observed. Since the last inspection the manager could evidence that two incidents had Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: been properly investigated by the service to ensure the safety of the service users concerned. 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. Fern Lodge is a well maintained and attractive home that meets the needs of the people who live there. Evidence: The home has been purpose built, and provides level access ground floor accommodation to all of the service users that live in the home. All service users has their own individual bedrooms, which were spacious and well equipped, and include evidence of people being surrounded by their own personal possessions. The home presents as a light, modern and cheerful place to live. The quality and standard of furnishings are excellent. Sensory areas, made up of various coloured lights and textures were set up in private and communal areas of the home to enhance stimulation for those service users with sensory needs. Moving and handling and specialist equipment was in place and maintained in safe working order. Communal areas included a lounge and separate dining room. These are small compared to the size of individual bedrooms. To extend the space a large conservatory has been built onto the front of the home.It is accessed through the dining area, and overlooked the garden and entrance to the home. The kitchen was maintained to a good standard of hygiene and cleanliness, and Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: service users are encouraged to help with tasks i.e. clear away after meals. 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. There are sufficient numbers of appropriately trained and skilled staff employed to support the people who use the service, and to ensure the smooth running of the home. Evidence: Rotas examined on the day of the inspection showed that there was sufficient staff on duty during the day and night to meet the needs of people living at the home. A range of different staff work at the home, some of which have been in post for many years, and therefore have got to know the service users and understand how to meet their care needs well. All the members of the care staff spoken with during the inspection were enthusiastic about their work in the home, and one said, Its a really nice place to work, we all know the residents so well. The response from the surveys received, discussions with relatives and professionals was overall positive about staff, and the care provided. One person said, My brother is well cared for. Another person said, Management and staff actually care about the people they care for, they listen and if necessary make changes. There was evidence of good communication within the staff team in relation to service users changing needs by the recording on daily notes, handovers and the updating of care plans. Observation of staff on the day of inspection again confirmed that staff were confident and knowledgeable about the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: people they assist. Staff spoke warmly about service users and saw their qualities beyond any challenging behaviour that they may present. This positive approach from staff appears to promote positive relationships with the service users, and it was apparent that this easy going approach worked well. The manager, and deputy has a hands on approach to managing the home. They frequently work alongside care staff providing practical supervision through daily contact. This is particularly important in the management of one service users behaviour. Both staff spoken to, and surveys received from staff provided evidence that not all staff feels confident in working with this person. The manager stated that a member of staff is on duty at all times to support those staff ,who is confident. On occasions the manager has come into work to assist when off duty. Virtually all of the staff at Fern Lodge have received various training in management of Challenging Behaviour and Dealing with Aggression in the Workplace, including a full accredited training on Non Abusive Psychological and Physical Intervention.The service users care plan continues to be regularly reviewed and updated when necessary. The home generally provides a good level of core training for staff. Training completed by staff this year since the last inspection as included fire safety, moving and handling, medication administration, dementia care, and health and safety. One new staff file was looked at contained evidence that the current induction used within the home had taken place. The manager had met with the staff member several times, and the staff member stated that the experienced staff had been very supportive ensuring that they new where things were. Braintree healthcare is a small company, but despite this the manager reported that funding for care staff to undertake the N.V.Q in care has been high. The manager stated in the service the AQAA we are able to offer a very high specification of training to ensure that we meet the needs of the service users living at Fern Lodge. Nearly all staff have now achieved either an NVQ2/3/4 and other staff are either trained nurses or undertaking nurse training to further their careers. The files of two staff members were inspected for evidence of the homes recruitment practice. All of the files contained evidence of all of the required information and checks necessary being carried out before staff commenced working in the home i.e. evidence of employment history, medical questionnaires, declarations of criminal record, and of identification. 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. The manager has a clear understanding of the principles, and focus of the service provided, and is committed to ensuring the home is run in the best interests of the people living there. Evidence: The registered manager is experienced in the care of people with learning difficulties and demonstrated an interest in keeping uptodate i.e. training relating to the mental capacity Act. The home is well managed, and systems and procedures have been organized and established regarding recruitment, training and supervision. Feedback from service users and staff, about the manager and deputy was positive; with comments received about them being supportive, approachable, and always available for advice.Personnel records contain supervision agreements between the member of staff and the management. Each member of staff has six supervisions a year as well as observations and a yearly appraisal. The Supervisions are two members of staff were looked at and recorded, including what was discussed and any agreed actions. Good informal monitoring takes place through the manager regularly talking to service Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: users. Keyworkers also regularly meet and record conversations each month. The manager had completed an Annual Quality Assurance Assessment (AQAA) for the Care Quality Commission which demonstrated an ability to evaluate the service and to identify areas for improvement. All of the records required by regulation are kept correctly. The home had a clear health and safety policy statement, and additional information and guidance on various aspects of health and safety. Staff interviewed were aware of policies and procedures and felt confident that the manager would update them when necessary. Records looked at showed that appropriate servicing and checks were carried out on facilities and equipment.The fire logbook provided evidence that regular fire alarm checks, extinguisher checks and emergency lighting checks took place. The manager reported that fire drills were under taken on a 3 monthly basis. Two service users cash transaction records were inspected and all were correct. Wherever possible staff take service users out to buy new items of clothing, and personel things for their bedroom. 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 1 1 The manager must ensure that there is only one uptodate service user guide which clearly outlines the service provided. 2 35 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. 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