Care Home: Halcon House

What the care home does well Halcon provides permanent care to a small group of people and respite care to over 100 people who require assistance with personal care because of a physical disability. The home has been well adapted to meet the needs of people with all levels of disability and there is adequate specialist equipment available. There is a good training programme for staff and people using the service said that staff were knowledgeable and supported them in a way that promoted independence and dignity. Staff observed during the day were well motivated and professional in their approach. Throughout the inspection it was noted that there was constant interaction between people staying and working at the home. All staff spoken with had a genuine commitment to providing a high quality person centred service. Some people said that staying at Halcon was like being part of a large extended family. People have access to healthcare professionals and staff have received specific training to meet the specialist needs of some individuals. People said that routines in the home were flexible to enable them to make decisions about their day to day lives. People staying at the home take an active role in reviewing their care plans and risk assessments. Appropriate systems are in place to monitor the quality of care and maintain the health and safety of people living and working there. What has improved since the last inspection? Although Halcon House is a long standing residential home it was re registered in September 2009 and the registered provider is now Somerset Care Ltd. This is the first inspection of the home since the company took over the registration. What the care home could do better: No requirements have been made as a result of this inspection but two recommendations for good practice have been made. Although there are three people who live permanently at the home there are no organised activity programmes for these people and they currently do not attend any regular activities or educational courses. These people are able to join in with activities arranged for people receiving respite care. The home needs to continue to explore recreational and leisure activities to ensure that they have regular opportunities for social stimulation outside the home and are able to learn and develop skills. There is a weekly menu in the home and, although people said they were able to ask for an alternative to the meal on the menu, there is only one specified option for each meal. The home should ensure that there is at least two choices at each meal to make sure that anyone who is unable or uncomfortable to ask for an alternative is able to make a choice about the food they eat. People spoken with were extremely positive about the care and support provided by the home but made some suggestions for small improvements. These included: Extra night staff, as it was felt by some people that two staff was not enough to meet the needs of the people at the home. Employing a cook so that care staff were able to concentrate on their care role and the quality of cooking was consistent. Installing more automatic doors to make it easy for people using wheelchairs to access outside areas. More organised outings. Key inspection report Care homes for adults (18-65 years) Name: Address: Halcon House Halcon House Hamilton Road Taunton Somerset TA1 2EP     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: Jane Poole     Date: 0 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Halcon House Halcon House Hamilton Road Taunton Somerset TA1 2EP 01823353447 01823353447 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Somerset Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 17 The registered person may provide the following category of service: care home only Code PC, to service users of either gender whose primary care needs on admission to the home are in the following category: Physical Disability - Code PD Date of last inspection Brief description of the care home Halcon House is registered with the Care Quality Commission to provide care to up to 17 people under the age of 65 who require support due to a physical disability. The home currently provides permanent care to three people and all other rooms are used to provide respite care. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 0 17 Brief description of the care home Halcon is a single storey home within close proximity to Taunton town centre. All areas of the home are wheelchair accessible and all rooms have en suite facilities. The home is owned by Somerset Care Ltd. Current fees (06/03/10) range from £837.52 to £1292.92 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out over a one day period. During this time We, The Commission, were able to speak with people using the service and staff and observe care practices. We were also able to tour the building and view records. At the time of the inspection there were three people living permanently at the home and 12 people receiving respite care. Prior to the inspection the acting manager Care Homes for Adults (18-65 years) Page 6 of 28 completed an Annual Quality Assurance Assessment (AQAA) and some information from this assessment has been used in this report. We were given unrestricted access to all areas of the home and all records requested were made available. The manager and area manager were available throughout the day. 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: No requirements have been made as a result of this inspection but two recommendations for good practice have been made. Although there are three people who live permanently at the home there are no organised activity programmes for these people and they currently do not attend any regular activities or educational courses. These people are able to join in with activities arranged for people receiving respite care. The home needs to continue to explore recreational and leisure activities to ensure that they have regular opportunities for social stimulation outside the home and are able to learn and develop skills. There is a weekly menu in the home and, although people said they were able to ask for an alternative to the meal on the menu, there is only one specified option for each meal. The home should ensure that there is at least two choices at each meal to make sure that anyone who is unable or uncomfortable to ask for an alternative is able to make a choice about the food they eat. People spoken with were extremely positive about the care and support provided by the home but made some suggestions for small improvements. These included: Extra night staff, as it was felt by some people that two staff was not enough to meet Care Homes for Adults (18-65 years) Page 8 of 28 the needs of the people at the home. Employing a cook so that care staff were able to concentrate on their care role and the quality of cooking was consistent. Installing more automatic doors to make it easy for people using wheelchairs to access outside areas. More organised outings. 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 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 10 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. Anyone wishing to stay at the home has their needs assessed to ensure that it is the right place for them. Evidence: The home are in the process of up dating their service user guide and statement of purpose. They have also produced a new colour brochure that can be given to people who are interested in using the service. Three people live permanently at the home and the other rooms are used for people for respite care. Before anyone is offered a respite stay the home obtains a copy of their full assessment of needs. If the assessment indicates that Halcon maybe a suitable place then they carry out their own assessment. The homes own assessment covers all areas of physical need and scores needs according to the level of assistance required. It also takes account of the needs of the persons usual carer. This enables the home to identify the staffing levels that are required by the person and the amount of respite weeks per year that can be offered. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: There is evidence that when arranging stays for people the home look at the needs of the group who will be staying in any one week to ensure that they have adequate staffing and equipment. People are able to visit the home before deciding to make use of the service. Care Homes for Adults (18-65 years) Page 12 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. Everyone staying at the home has an up to date care plan that gives guidance about how people wish to be supported with their personal needs. Risk assessments are in place to ensure that people are able to take part in activities with minimum risk to themselves and others. Evidence: Everyone staying at the home has a care plan which is reviewed with them at every stay. This ensures that any changes in need are identified at the beginning of a stay. 3 care plans were looked at during this inspection. 1 for a person who lived permanently at the home and two for people receiving respite care. The care plan for the person who lived at the home was more comprehensive and there was evidence that it was reviewed on a six monthly basis. All care plans seen gave clear guidance for staff about how people liked to be assisted with their care. The home are planning to change their care plan system to a computerised system in Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: the near future. Everyone asked said that they were able to make decisions about all aspects of their day to day lives. Care plans are signed by the person and a member of staff to demonstrate that the plan has been agreed by both parties. Throughout the day it was observed that people made choices about what they did, what they ate and who they spent time with. For some activities risk assessments have been completed to ensure that people are able to maintain independence with minimum risk to themselves and others. People spoken with during the inspection were aware of the risk assessments in place and the reason for them. Care Homes for Adults (18-65 years) Page 14 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. Routines are flexible and people are able to make choices about their day to day lives. There are limited opportunities for people who live at the home to take part in regular ongoing activities. Evidence: Everyone asked said that daily routines in the home are flexible to enable people to make decisions about what time they get up, when they go to bed and how they spend their day. Many people said that they booked their respite stays together as they enjoyed each others company and liked to socialise. During the day of the inspection people were seen socialising in communal areas, going out to town and interacting with staff. Many social events are organised by volunteers who are allocated to the home and Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: supported by a permanent member of staff. Volunteers assist people to take part in activities within the home such as games, arts and crafts and they also support people to access community facilities. Some people who stay at the home are able to access the community without support and on the day of the inspection one person said that they go out most days, sometimes with other people staying at the home and sometimes alone. There is a evening activity one night a week when people are supported to go out for meals, bowling, cinema or other places of their choosing. People who live permanently at the home have limited access to ongoing activities and join in with events organised for people staying on respite. None of the three people who live at the home have a weekly activity programme or attend college or work outside the home. College courses were arranged for these people but the courses have now ended. The manager stated that they will be looking into regular college courses for people when the new term begins. The home has two computers which people are able to access the internet on and some areas of the home are wi-fi enabled for people who bring lap tops with them. In the lounge area there is a large TV with a sky package. The main meal of the day is in the evening in line with peoples wishes. There is a lighter meal at mid day. Care staff are responsible for preparing and cooking the meals in the home, meaning that one member of staff is in the kitchen for a large part of the day. People spoken with said that the food was generally good but it depended on who was cooking. It was noted that the kitchen was well stocked with good quality products including fresh fruit and vegetables. There is a weekly menu which gives a variety of food. Although there is only one option on the menu people are able to ask for an alternative if they would like to have something different. This relies on people being comfortable and able to ask for an alternative and it is recommended that there is a choice of meal each day. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported with personal care in a manner which promotes independence and dignity. People have access to health care professionals according to their individual needs. Evidence: Halcon supports people with a wide range of physical needs and staff receive training to ensure that they are able to meet individual needs. Everyone asked felt that staff had a very good understanding of their needs and supported each person in a way that promoted their independence and dignity. The home employs both male and female carers meaning that people are able to have some choice over the gender of staff who support them with intimate personal care. All rooms have large en suite facilities with level access showers where personal care can be carried out in private. There are also two bathrooms with assisted bathing facilities to enable people to have a choice of bath or shower. People living at the home are registered with local health care professionals according to their individual needs. Currently appointments with health care professionals are Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: recorded in the persons running records making it difficult to see when they have attended appointments and any advice given. People staying at the home for short periods are able to access health care professionals on a temporary resident basis. Some people have completed advanced directives/living wills and these are kept in care plans to make sure people are aware of the care and treatment that people wish to receive if they become very unwell. People staying at the home are encouraged to self medicate and lockable facilities are provided in all bedrooms for people to store medicines safely. For people living at the home there is a Monitored Dosage System for medication and printed administration charts are available. For people staying on respite a variety of systems are in use and the home is continually looking at ways to standardise and improve systems. Medication Administration Records were viewed. All medication is signed for when it enters the home, when administered or refused and when returned to people at the end of their stay. This gives a clear audit trail. There are adequate storage facilities for controlled drugs and a controlled drugs register is kept. Records seen correlated with medication stored on the day of the inspection. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are comfortable to raise any worries or concerns and are confident that they would be listened to. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. A complaints log is kept and this showed that one complaint has been made since the home was registered in September last year. There was evidence to shown that the complaint was handled and resolved to the satisfaction of all parties. People spoken with said that they would be comfortable to raise any worries or concerns with a member of staff. All felt that they would be listened to and action would be taken to address any issues raised. People also said that the home had a suggestion box if they wished to raise any issue anonymously. Throughout the day it was noted that people had unrestricted access to all communal areas and their personal rooms. Staff have received training on safeguarding vulnerable adults and the AQAA states that further training in this area is planned. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Halcon House provides a comfortable, well adapted, environment for the people who live and stay there. Evidence: Halcon is a single storey purpose built home within close proximity to Taunton town centre and other local amenities.All areas are fitted with a fire detection and call bell system. All bedrooms are for single occupancy although some rooms would be large enough for people to share if they chose to. All rooms have large en suite shower rooms and 10 of the 17 bedrooms have ceiling tracking systems in place. The pre admission assessment looks at the equipment needed by the individual and this is put in place before people arrive at the home. People who live at the home have been able to personalise their rooms to give them a homely individual feel. There is ample communal space. There are three lounges and a large lounge/diner. One lounge has been designated as a smoking area and people are also able to smoke in the garden area. Throughout the home there are wide corridors and doorways making all areas Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: wheelchair accessible. There is a laundry that is adequate for the home and all areas seen were reasonably clean. Some refurbishment has taken place in the home; lounges and corridors have been painted and new soft furnishings have been put in place. The AQAA states that this is ongoing. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and staying at the home are supported by a well motivated and trained staff team. Recruitment policies and procedures minimise the risks of abuse to people using the service. Evidence: The home employs 21 care staff, 10 (48 ) have a National Vocational Qualification (NVQ) in care at level 2 or above The home has a stable staff team and people are offered opportunities for ongoing training in line with their job role. As part of their career development some staff have taken on additional responsibilities to enhance their skills and confidence. In addition to the manager there are three senior staff and a group of staff who take on the shift leader role. There is always a senior member of staff on duty giving clear lines of responsibility and accountability. There are regular staff meetings and all staff receive formal recorded supervision with a member of the senior staff team. Senior staff receive supervision from the homes manager. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: People living and staying at the home felt that there was generally enough staff on duty although two people commented that they thought the home was not well staffed at night. During the night there are two staff on duty and one person said that if the two staff were assisting someone there was no spare staff to respond to the needs of other people in the home. People spoken with were extremely complimentary about the staff. People said that they were always ready to help and were extremely patient. Throughout the day it was observed that there was constant interaction between people living and working at the home. Interactions were friendly and warm and more than one person said that staying at the home was like being part of an extended family. All staff spoken with, and observed, were enthusiastic about their jobs and demonstrated a true commitment to providing high quality person centred care. The recruitment file of the most recently appointed member of staff was viewed. This demonstrated that there is a robust recruitment procedure in place which minimises the risks of abuse to people using the service. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of the people who use the service influence the management of the home. There are quality assurance systems in place to monitor the quality of care and plan ongoing improvements. Evidence: The long standing registered manager has recently left the home, a new manager has just commenced work and was available on the day of this inspection. The newly appointed manager is in the process of applying to be registered with the Care Quality Commission. During the short period that the home has been without a manager the company, Somerset Care Ltd, put in a temporary manager to ensure ongoing management support. As previously mentioned there is a clear staffing structure and clear lines of accountability and responsibility. The home has some quality assurance systems in place and there formal and informal Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: ways of seeking the views of people who use the service. There are regular meetings for people living and working at the home. Minutes of meetings seen showed that a wide variety of subjects are discussed and people are able to share opinions and make suggestions. The area manager stated that they are planning to carry out 6 monthly satisfaction surveys to ensure everyone who uses the service has an opportunity to express their views. In addition to the homes own quality assurance system the company has robust systems in place which include monthly visits by the provider and regular audits. Everyone spoken with demonstrated a commitment to providing a high quality service and making continual improvements in line with the wishes of people who use the service. The home reports all significant incidents to the Care Quality Commission. The building is well maintained and there are contracts in place to ensure that equipment is regularly serviced. All lifting equipment was serviced in December last year. There are certificates in place to demonstrate the safety of the gas and electrical installation. A fire risk assessment has been carried out. Alarms and emergency lighting are regularly tested and staff receive training in fire safety. Up to date certificates of registration and insurance are displayed. 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 2 12 17 The home should continue to look at ongoing, regular activities for people who live permanently at the home. There should be a choice of meal on the menu each day. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!