Care Home: Greenfields

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What the care home does well Greenfield`s provides young people who come for short breaks with a warm, friendly and well maintained environment. There are a number of communal rooms that have been set up for different activities, such as a sensory room, soft play area, small kitchen and arts and crafts rooms. This gives the young people opportunities to spend time in different areas and to take part in a variety of activities. One family spoken to said that the only thing they could think of to improve the service was to provide a larger main lounge as this can get congested due to the amount of people who use wheelchairs. Other than this comment they said `` Greenfield`s is a lovely environment, xx loves going there and enjoys the fact that they can get out and about to town.`` The staff group are committed and caring and provide excellent quality care and support to individuals in a person centered way. This is supported by a good training programme and an open and inclusive management approach. Care and support is well planned to ensure that a consistent approach is used and individuals are supported in a way that honours their preferred routines of daily living. Plans are regularly reviewed to ensure that all ongoing and any changing needs can be met and the manager has asked families to be involved in the reviewing and development of these plans. Greenfield`s makes sure that the young people who use the service are kept safe, by ensuring that all new staff have checks to show they are suitable to work in the home, and provides training to ensure staff are aware of what to do if they suspect abuse. Good records are kept to show the home makes sure medications are given correctly, monies are kept safe and any incidents of accidents are recorded. What has improved since the last inspection? The home now have their own specialist bus that enables access to the local community to be more readily accessed. The range and amount of activities and trips to ensure individuals are getting out and about has improved. The home now employ a chef to prepare the evening meal. This enable the service to provide a greater range of choice and frees up care staff time to spend quality time with individuals. What the care home could do better: Plans of care should include all aspects of how individuals are supported including any agreed actions in terms of restraint used to ensure the safety of an individual and that of carers. This should be part of the plan to ensure that it is reviewed regularly and agreed by all stakeholders involved in the individuals care package. Key inspection report Care homes for adults (18-65 years) Name: Address: Greenfields Derby Road Barnstaple Devon EX32 7EZ     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: Joanne Walsh     Date: 2 1 0 5 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 29 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 29 Information about the care home Name of care home: Address: Greenfields Derby Road Barnstaple Devon EX32 7EZ 01271343709 01271329121 paul.jellicoe@devon.gov.uk http/www.devon.gov.uk Devon County Council care home 11 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 sensory impairment Additional conditions: Caters for young people and adults between the ages of 16 and 25 years Current service users over the age of 25 or under the age of 16 will be allowed to continue to use the service On the termination of the placement of either of the named young persons, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 26th July 2004 or as appropriate The maximum number of persons accommodated at the home, including the named young persons, will remain at 11. To admit one named person aged under 16 as detailed in the notice dated 5th August 2004 and one named person aged over 25 as detailed in the notice dated 10th September 2004 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 0 11 11 11 Brief description of the care home Greenfields provides planned respite care and accommodation for up to 11 young adults and some children with severe learning disabilities and physical or sensory impairment, aged 14 to 25 plus years (male and female), whose families live within North Devon and Torridge District Councils boundaries. Services are sometimes provided to young people and adults from outside these catchments areas. Some service users who reach the age of 25 years continue to use the service for a further 10 years. Usually the maximum number of children, young people and adults staying at the home at any one time is nine. However, in certain circumstances, up to 11 children, young people and adults are accommodated. Emergency admission for unplanned respite is provided, for those service users already using the facility for planned respite care. The home has nine bedrooms. The home now only accomodates two children, and does not plan to offer this service to any further children. The home also provides day care for young adults, Mondays to Fridays, 9 am to 4 pm with various activities on offer. Greenfields is owned and managed by Devon County Council. Devon County Council can provide the range of fees on request. This report is made available at the home by ensuring a copy is left in the main entrance hall. Care Homes for Adults (18-65 years) Page 5 of 29 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: This inspection took place during a week day in May and lasted for approximately six hours. During this time 5 care staff were spoken to as well as the administrator and registered manager. Individuals who use the service have complex needs and are not always able to express their views easily so time so spent observing care practice and how staff supported people throughout the day. Prior to the inspection taking place the home were asked to complete an Annual Quality Assurance Assessment (AQAA), which provides us with information about how the service ensures a safe environment, tells us what policies and procedures it has and what it has done to improve the facilities and services offered over the last 12 moths. This helps to inform the inspection process. Surveys were not used on this occasion, but we did speak to 4 parents of individuals who use the service on a regular basis, following the inspection. Their views have been Care Homes for Adults (18-65 years) Page 6 of 29 included in the main body of the report. Care Homes for Adults (18-65 years) Page 7 of 29 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. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 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 10 of 29 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. Individuals are only admitted following a through assessment of needs to ensure that Greenfields can meet these needs well. Evidence: Greenfields have not admitted any new people for respite/short breaks for over two years now. It continues to provide services for the same individuals who have complex care and support needs, and who use the service in different ways depending on their needs and wishes. Files looked during this inspection show that individuals who use the service have ongoing input from a range of multidisciplinary services. The manager said that should they consider any new admissions, they would work closely with the individual, their family and other professionals who know their needs so that they could gain a full picture of how best the service could support and care for the individual. Care Homes for Adults (18-65 years) Page 11 of 29 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. The home ensures that care plans detail individuals assessed and changing needs, so that staff can provide consistent care. Evidence: Four plans of care were looked at in detail and discussed with the registered manager and staff on duty. The plans are clearly set out and give staff good detailed information about the assessed needs of individuals and how these needs should be met. Most people have complex physical needs and there are photos to help staff understand the correct positions for individuals to be comfortable, to ensure that they are hoisted correctly and that they are free from risk of pressure areas. The home also ensure that they keep detailed body maps of individuals so that they can track if and when a bruise or sore area may have developed. This is especially important for individuals who are so dependent on staff for moving and handling. Plans are divided into different sections and include all aspects of daily living such as food and fluid intake, sleep patterns, communication, personal hygiene and Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: community inclusion plans. Risk assessments are in place and where risks have been identified the plan sets out how these risks should be minimised. One area that needs to be included in one persons plan is agreed actions for restraint and sanctions. Although any actions by staff to restrain or give the individual time out is fully documented, this still needs to be included as part of their overall plan of care, so that it is reviewed and agreed by all stakeholders as part of the ongoing care planning process. Discussions with staff helped us understand how the home tries to enable young people who use the service to make decisions and choices in their everyday lives. Examples given were assisting individuals to make choices about what they want to wear, giving choices about snacks and drinks. Staff have a good rapport with the young people they support, many of whom they have known for a long time and they have a good understanding of individuals body language and are able to use this knowledge as cues to help them to understand if an individual is happy with a choice. As the home offers respite/short breaks and day care, their role in enabling independence is limited, but where possible individuals are encouraged to be independent as much as possible. Four families were contacted by phone and asked their views about the service people get at Greenfields. All gave very positive views about the care and support provided and comments included xx loves it there, staff are always very good and do a brilliant job. Without this regular respite I would not be able to cope, they are a very good staff group and I do not want to lose them. The (staff) understand xx and are always helpful and kind to us all. Care Homes for Adults (18-65 years) Page 13 of 29 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. Greenfields offers individuals a choice and range of activities that mostly meet their needs. Evidence: There has been some significant improvements in these outcome groups since the last inspection. The home now has its own specialist bus that enables them to more readily access the local community. They have worked hard to ensure that individuals are given regular opportunities to go out and about and access community resources. All of the families spoken to said that they were impressed with the level of commitment from the staff in ensuring people went out on trips. One parent commented I have noticed that over the last 12 months or so there have been outings and xx always loves trips to the shops and local cafes. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: Staff spoken to during the inspection said that having their own bus had made a big difference to being able to access activities outside of the home, and that they have worked as a team to ensure that everyone who uses the service is included in trips and outings as well as trying to look at what they can provide in house. The registered manager said that they are now also looking at how they can utilise the amenities fund to buy in activities that individuals or groups may be interested in trying, such as music therapy and massage. The daily routines are flexible and staff have a good understanding of individuals preferred daily routines and try to honour these so that care is person centered. One individual for example enjoys a lay in until later in the morning, another person prefers spending time in their own room and one person settles well when classical music is played. All these routines were actioned by staff. One of the key elements of why individuals settle well for their short breaks at Greenfields is that staff have built up an in depth knowledge and understanding of individuals needs and wishes and their preferred routines of daily living. The home now employ a chef to cook the main meal of the day, which is normally served at tea time. Currently they are still using the meals on wheels service to deliver the lunchtime meal, but hope to use the chef for additional hours so that he can help with meal preparation for lunchtimes as well as tea. The meal was served in a relaxed and unhurried manner and individuals were supported in a kind and respectful way. Special diets are catered for and a choice offered as far as possible. Care Homes for Adults (18-65 years) Page 15 of 29 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. Personal and health care needs are well met. Evidence: Plans of care give very good information as to how staff support individuals in personal care and how health care needs are monitored. Staff keep daily records and monthly reports to record individuals physical and emotional well being and plans clearly evidence that other health care professionals are consulted and are involved in planning care. The physiotherapist and occupational therapist have involvement and this is well recored. The four families spoken to said that they had no concerns about personal and health care needs and all said that staff met these well. Staff spoken to and care practice observed shows us that staff have a an excellent understanding of individuals needs and how best to support them. The homes medication procedure was observed and discussed with the senior carer. The home has appropriate storage facilities for all medications and records are well Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: maintained for administering of medications. Only staff that have completed training in safe handling and administering of medications are able to take on this role. None of the current service users are able to self medicate. Care Homes for Adults (18-65 years) Page 17 of 29 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. The views of individuals and their carers are listened and acted upon. Evidence: The home has a simple complaints procedure that is part of Devon County councils key policies. Complaints are recorded and followed up with actions taken to resolve issues. Carers spoken to said they were comfortable in makning their concerns known to staff. There have been no complaints made directly to the Commission since the last inspection, and Greenfields have kept good records of all complaint issues and how these have been resolved. The registered manager said they try hard to ensure that they check with families on a regular basis whether they are happy with the care and support provided as a measure to ensure issues do not become complaints but are dealt with as they arise. Staff have training in the protection of vulnerable adults and are aware of what to do should they suspect abuse. The home has stated policies and procedures in place and staff when asked were aware of these. Any incidents of physical or verbal aggression is recorded and copies are sent to CQC. Policies and guidance is in place for staff to refer to. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The home has a robust system in place for ensuring that individuals monies is kept safe and records kept of all transactions. Theses were checked and found to be accurate and well maintained. The records are independently audited weekly and staff check amounts daily. Care Homes for Adults (18-65 years) Page 19 of 29 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. Greenfields provides individuals with a clean, safe and homely environment. Evidence: During this inspection a tour was made of all parts of the home, which was found to be clean and comfortable. One or two areas are in need of redecoration, but it is clear staff have made great efforts to ensure the environment is as homely and comfortable as possible. Young people who use the service are encouraged to bring items in to personalise their rooms The home has a good range of communal spaces upstairs for a number of activities. One room has been converted to a sensory room with specialist lights and another is a soft play area. The home also has a craft room a quiet garden room and a playroom. Down stairs there is a large lounge and dinning area as well as the bedrooms. The garden area is accessible to wheel chair users and has been made attractive with shaded areas. One parent commented that it the environment could be improved by having a larger communal lounge as this can get crowded with so many wheelchair users. The home completed the AQAA, which evidences that all equipment and facilities are serviced and well maintained to ensure that the home is a safe environment. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: Policies and procedures are in place to ensure that good infection control procedures are in place and domestic staff are employed to ensure that the home is kept clean. Staff were observed to wear gloves and protective aprons when handling food or providing personal care. Care Homes for Adults (18-65 years) Page 21 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and supported to do their job. Evidence: Many of the staff group have worked at the home for a number of years and have built up a good relationship with the young people who use the service. This is key to providing good quality care, as most individuals are unable to communicate their needs verbally, so rely on people understanding their facial expressions and body language. This knowledge and experience is enhanced by a good training programme that covers all aspects of health and safety as well as some specialist training that enables staff to have a better understanding of the needs of those individuals who use Greenfields for short breaks. Five Staff were spoken to during this inspection and all said that they had good opportunities for training. Staff continue to work toward the Learning Disability Award Framework which is nationally regnognised. This training looks at specific issues relating to working with those individual who have a learning disability and enables staff to check their every day practice is in line with ensuring individuals are treated with respect and dignity. The home have exceeded the 50 ratio of staff achieving NVQ training, which is a Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: nationally recognised training programme in care. This helps staff to better understand their role. Three staff files were looked at to check that all relevant checks and references were in place. This helps to ensure that those who are suitable to work in care are not employed and so young people who use this service are protected. Care Homes for Adults (18-65 years) Page 23 of 29 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 run and in the best interests of the people who use the service. Evidence: The registered manager is qualified and experienced to run the home. Staff spoken to said that the management approach was open and inclusive and staff felt their opinion was listened to. Staff reported during face-to-face interviews that the staff team worked well and supported each other. The manager stated that the homes quality assurance continues to be well implemented in terms of external audits looking at specific areas such as the kitchen, finances and the general environment. DCC ensures that someone appointed on behalf of the responsible individual completes monthly-unannounced visits. Reports of these visits are made available to CQC and include information about the premises as well as views of staff and where possible service users. The manager has now extended the quality assurance programme to include seeking the views of the carers of those young people who use the service. Surveys continue to be used to regularly check that the quality of care is what the carers expect and their views and comments are used Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: to help make any improvements to the service offered. The manager now plans to also survey health care and care management staff that refer people to use the service. This will help to make sure that the home includes the views of all those involved in the planning of care and support of the young people who access services at Greenfields. The home ensures that staff have key training in all areas of health and safety. This ensures staff are able to do their job safely. The AQAA evidences that the home ensures all safety checks are completed, that equipment is serviced and policies and procedures are in place for all health and safety matters. The registered manager is qualified and experienced to run the home. Staff spoken to said that the management approach was open and inclusive and staff felt their opinion was listened to. Staff reported both in the surveys returned and in face-to-face interviews that the staff team worked well and supported each other. The manager stated that the homes quality assurance has been well implemented in terms of external audits looking at specific areas such as the kitchen, finances and the general environment. DCC ensures that someone appointed on behalf of the responsible individual completes monthly-unannounced visits. Reports of these visits are sent to CSCI and include information about the premises as well as views of staff and where possible service users. The manager has now extended the quality assurance programme to include seeking the views of the carers of those young people who use the service. Surveys are now used to regularly check that the quality of care is what the carers expect and their views and comments are used to help make any improvements to the service offered. The manager now plans to also survey health care and care management staff that refer people to use the service. This will help to make sure that the home includes the views of all those involved in the planning of care and support of the young people who access services at Greenfields. The home ensures that staff have key training in all areas of health and safety. This ensures staff are able to do their job safely. The AQAA evidences that the home ensures all safety checks are completed, that equipment is serviced and policies and procedures are in place for all health and safety matters. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 7 Plans of care should detail all agreed actions including any agreed restraint used to prevent harm to the individual or staff providing care and support. Care Homes for Adults (18-65 years) Page 28 of 29 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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