Care Home: Grizedale

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up detailed plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere in the home, with appropriate social activities inside and outside the home. Service users are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users are very complimentary about the food, and there is a balanced diet, with a choice included. Complaints and concerns are now taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? The home has a new manager, and the home is run in the best interests of the service users. Service users are supported and encouraged to make decisions about their own lives. Staff can demonstrate how individual choices have been made: and record instances when decisions are made by others, and why. Service users receive personal support for achieving independence, and live ordinary and meaningful lives. Service users have a choice of entertainment, leisure activities and are supported and encouraged to pursue their own interests and hobbies. The daily routines promote independence, individual choice and freedom of movement. What the care home could do better: No requirements or recommendations were identified during this inspection visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Grizedale Pont Head Road Leadgate Consett Durham DH8 6EL     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: Jim Lamb     Date: 1 9 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 30 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 30 Information about the care home Name of care home: Address: Grizedale Pont Head Road Leadgate Consett Durham DH8 6EL 01207583708 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): newlife.care@btinternet.com Newlife Care Services Limited (wholly owned subsidiary of Minster Pathways Limited) Name of registered manager (if applicable) Mrs L A Ross Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 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 category: Learning disability Code LD, maximum number of places: 7 Date of last inspection Brief description of the care home Grizedale is a registered care home that provides accommodation for seven adults with learning disabilities. Most of the people who live there have been at the home since it opened. 1 4 0 4 2 0 0 9 7 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home Grizedale is a large detached house situated in Leadgate. The house is surrounded by colourful well-kept gardens and is within easy walking distance of all the local shops and amenities. The original building has been extended and adapted to provide five single bedrooms and one double bedroom. The home also has a large comfortable lounge, dining room and kitchen with one ground floor bathroom and one first floor bathroom and shower. There are also two additional toilets. Ramps provide access to the house for wheelchair users. Both inside and out, the house is well maintained and homely. To stay at this home it would cost from £421.00 to £784:00 a week. Fees are negotiated on an individual basis and are reviewed every year. Additional charges are made for the following: Aromatherapy sessions, Chiropody, Haircuts, personal items and some outings are also charged for. These fees are current at the time of this report. Up to date fees or charges should be checked with the manager. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Adults (18-65 years) Page 6 of 30 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, staff, the manager, and the area manager, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? The home has a new manager, and the home is run in the best interests of the service users. Service users are supported and encouraged to make decisions about their own lives. Staff can demonstrate how individual choices have been made: and record instances Care Homes for Adults (18-65 years) Page 8 of 30 when decisions are made by others, and why. Service users receive personal support for achieving independence, and live ordinary and meaningful lives. Service users have a choice of entertainment, leisure activities and are supported and encouraged to pursue their own interests and hobbies. The daily routines promote independence, individual choice and freedom of movement. 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 9 of 30 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 30 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 are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: People who come to stay here are given an information pack, called a Service Users Guide, which includes useful information about what they can expect from the service. Everyone is encouraged to come and have a look around the home before making a decision. In this way people have good information to make a decision about whether to move to this home. There are clear records to show that the needs of the service users were assessed before they moved in so that the home knows whether those needs can be met here. Care managers of the Social Services Department carry out most assessments and these are provided to the home. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: The manager also carries out assessments of prospective new service users, to make sure that the home can meet their individual needs. The assessments are holistic and also include details of peoples spiritual and social care needs so that the home can plan to support them in these areas. All are provided with an easy read contract that explains the terms and conditions of the service, and the fees to be paid. Intermediate care is not provided. Care Homes for Adults (18-65 years) Page 12 of 30 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 care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: Service users Plans and Independent Living Plans contain a great deal of information about their individual needs and preferences. Detailed and specific information is recorded of peoples care needs, how help and support should be delivered and information about routines and other issues important to the person. Evidence from care plans examined, discussion with staff members and observation during the inspection showed that service users are regarded as individuals with different personalities and needs, they showed that care is flexible and individual. Care plans are very person centred. Discussion and observation also showed that the home has good links with external professional services needed by the service users to make sure that people get the help they need. Care plans contained a great deal of information about each persons holistic needs Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: and how these needs are met and how health is promoted. Files contained evidence of visits to doctors, occupational therapists, physiotherapists, dentists and opticians. It was clear that service users receive regular health care check ups. Files also showed that service users are helped to receive any more specialist health care they may need including, assistance with their mental and emotional health as well as their physical needs. Risk assessments were detailed and comprehensive about service users health and social care needs, providing clear guidance to staff. They were subject to regular review and evaluation, involving service users, relatives and social workers where appropriate. To be sure that all concerned are fully aware of the identified risks, it would be better if they were agreed and signed by all concerned. Care Homes for Adults (18-65 years) Page 14 of 30 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. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: Each person has an individual timetable of activities, tailored to their likes and interests. They are supported to take part in a range of activities in a variety of settings. Outings and activities are organised daily. There are meals out, visits to cafes, shops, day centres, supported work schemes, pubs, trips to a local theaters etc. The service users enjoyed a holiday last year, and more are planned for this summer. Most of the people who live in the home have involvement with their families. The degree of contact is decided by the wishes of each individual, and it can be in person Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: or by phone. Friendships are encouraged and supported. They can use their bedrooms to entertain guests. Staff were seen to respect and safeguard peoples right to privacy, and asked two of the people if they minded showing the inspector their bedrooms. They kindly allowed this and took an obvious pride in how well they had personalised their rooms. Service users confirmed that staff respected their privacy. One person said,I love living here, the staff take good care of me, and i enjoy going out with them. Another said,i like working in the garden and helping with jobs around the house. The people living in the home have unrestricted access to all areas of the Home other than each otherhs bedrooms. They all helped with household tasks such as helping to prepare meals, clearing up after meals and cleaning their bedrooms. Throughout the inspection staff were observed talking to and engaging appropriately with the service users. The daily routines in the home were seen to support the independence of the people who live in the home, rather than restrict them. Negotiation and consultation appeared to be the normal methods of communication. Each person has agreed a goal plan regarding his or her responsibility for housework, and promoting their independence. They receive their mail unopened, and they are addressed by their preferred name. People living in the home are fully consulted as to the weekly menu, and have a genuine input. Staff provide guidance and parameters with regard nutrition, where this is deemed necessary for the ongoing health of the service users. Peoples food likes and dislikes are known and are recorded, but staff will also actively try to extend the options available and introduce new culinary experiences. If, however, an individual does not want the agreed meal, then alternatives are offered. A cooked breakfast is available on request. Staff promote healthy eating and aim to provide the advised five portions of fruit and/or vegetables every day. Fresh fruit is available at all times, and is popular. All staff have received basic food hygiene training. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: Special diets are currently limited to one person who suffers from Diabetes. Proper guidance regarding this is available to staff and a care plan is being drawn up. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The promotion of health care is taken seriously, and service users have their personal needs fully met. Evidence: People using the service are given sensitive personal support by the staff to promote each individuals independence, dignity, privacy and choice. Each person has an individual assessment of his or her personal health care needs, and has a care/goal plan in place to meet those needs. Plans are person-centred, sensitive and thoughtful. They stress the strengths of the individual, and are positive in terms of seeking to develop the skills and abilities of the person. Privacy is given a high priority. Plans are reviewed every month, and amended as necessary, to reflect the progress made by the individual. Each person has his or her own Personal Health Information file. This contains professional health assessments, correspondence, records of contacts with health professionals. It demonstrated that all aspects of a persons physical and mental health are taken seriously and are properly met. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Medicines are ordered monthly, and these are delivered in blister packs. This is working well, and there are policies and procedures in place to minimise any risk of a medication error. The Medication Administration Records (MAR) was checked. This was found to completed properly, with no gaps. Senior staff do a weekly audit of the prescribed and non-prescribed (homely medicines) medications. Medicines are safely stored. All staff have had training on how to use the medication system. They have also had external Safe Handling of Medicines training. Care Homes for Adults (18-65 years) Page 19 of 30 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 complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: There is a complaints procedure. It contains details of how to contact the CQC to make a complaint, if complainants are not happy with the homes investigation and response. The procedure is written in a way that ensures service users fully understand its contents. Copies are displayed throughout the home. For those service users without capacity, advocacy arrangements are in place.(imcas) Independent mental capacity advocates. Since the last inspection visit, there has been no complaints received. The home has a Whistle Blowing policy, a copy of the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping in the homes safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: of evidence of personal spending. Receipts are obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. Care Homes for Adults (18-65 years) Page 21 of 30 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. The home provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The grounds were highly attractive, tidy, safe, and accessible to all service users. The rear garden has a mini putting green, and this is regularly used by the service users. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. The bedrooms are all highly personalised. Radiators and pipes were guarded. There was emergency lighting throughout the home. The kitchen was spotlessly clean and very well organised. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are well organised. The washing machines have the specified programme to meet disinfection standards. Care Homes for Adults (18-65 years) Page 23 of 30 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 is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 6 service users. In addition to the manager, the required numbers of staff were on duty across the day: 3 from 8am to 10pm. There is 1 waking night staff and 1 sleep-in between 8pm and 8am. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. The homes training programme meets the National Training Organisation requirements for the first six months. All statutory training was up to date and all of the staff team has completed NVQ level 2/3. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: The personnel records of two staff were examined. Both had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. Both had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. All staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have individual training needs analysis on their personal file. These have recently been revised to cover developmental as well as mandatory and core training. The manager said that, mental capacity and deprivation of liberty training will be arranged during the next 6 months. Care Homes for Adults (18-65 years) Page 25 of 30 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 manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The new manager has applied for registration. She is well qualified and experienced in senior roles within social care settings. Service users, and staff described her as being approachable and caring. She is working to wards the Registered Managers Award at National Vocational Qualification (NVQ) level 4. She confirmed that all staff are regularly supervised (bimonthly) and have an annual appraisal. Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving service users personal monies, such as pocket monies, clear individual accounts and records are maintained. Service users have ready access to their money, even at short notice. Comments received from staff and management confirmed that there are good health and safety policies and practices Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: that promote the health, safety and welfare of service users and staff. All relevant staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered providers written policies on Health and Safety. Health and Safety issues are also discussed at staff meetings. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, as does fire safety training. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. Service users and staff expressed satisfaction with the way the home was run. Service users and staff said they enjoyed living and working at the home and believed the home was safe and run in the best interests of the service users. The manager said she will routinely invite comments and suggestions for improvements from both service users and visitors to the home, via regular meetings, surveys and consultations. An annual development plan is in place. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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