Care Home: Haslewood Avenue (1)

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What the care home does well The home very clearly belongs to its service users and staff ensure a high standard of care delivery. Care was observed to be being given in a kind and patient manner and it was evident that the staff knew the service users very well and that this assists them with the anticipation of their needs. There is a stable experienced and very well motivated staff team whose calm approach to their work contributes to the relaxed and friendly atmosphere in the home.The staff are enthusiastic about their work and are very committed to the welfare of the people who live in the home.The staff are well supported with a good standard of training and management. What has improved since the last inspection? The requirement made at the last inspection has been met. The care plans are been reviewed and are now presented in a more person centered format so that the care provided meets the specific needs of each individual in a person centered way. Further improvement work on the care plans is planned. An ongoing rolling programme of training continues to be given good priority in the home with more staff having attained NVQ qualifications. The home and garden have benefited from various works of refurbishment,( both bathrooms have been refitted), redecoration and the provision of new equipment and furnishings all these improving the overall appearance and comfort of the home for its service users. What the care home could do better: The key standards are met and the manager is aware of the areas where further quality developments can be made. The home should continue with the planned improvements to the person centered care plans. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Haslewood Avenue (1) 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Greaves     Date: 1 7 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 27 Information about the care home Name of care home: Address: Haslewood Avenue (1) 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT 01992479171 01992479171 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hightown Praetorian & Churches Housing Association care home 8 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Physical Disability - Code PD Date of last inspection Brief description of the care home Haslewood Avenue is a purpose-designed bungalow in the centre of Hoddesdon built in 1995 to accommodate 8 adults with learning disabilities who had formally lived together in a long stay hospital. It is an attractive, compact building, surrounded by a small garden that provides eight single bedrooms, two assisted bathrooms, three wheelchair accessible WCs, a laundry, lounge, kitchen and dining room and offices and Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 0 8 8 Brief description of the care home storage areas. The home has a very homely appearance and feel. The facilities of the local town are easily accessible by foot from the home, as are the local transport services. The home, which is run by Hightown Praetorian Housing Association, a voluntary organisation, provides full care services in an integrated and safe environment for its residents who all have learning and physical disabilities and who may present a moderate degree of challenging behaviour. The Statement of Purpose is available and each individual has a copy of the Service Users Guide. The Local Authority sponsors all the people who currently use the service. The weekly fees range from £1115 to £1143. Care Homes for Adults (18-65 years) Page 5 of 27 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 last key inspection of this service was made on 22nd August 2007, and an ASR (Annual Service Review) report was completed on 5th August 2008. An annual service review is an review made by the Commission of information about the service given to us through the year and includes information given in questionnaires completed by service users and staff. This inspection took place over seven hours on a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Adults. The report is written using accumulated evidence gathered prior to the inspection visit including information contained in the AQAA ( Annual Quality Assurance Assessment) completed by the manager, information given in any pre inspection questionnaires and also takes account of statutory notifications sent periodically to the CQC ( Care Quality Commission ) by the home. We made a tour of the building had discussions with the staff on duty and spoke with the homes manager. We met and spoke with all the Care Homes for Adults (18-65 years) Page 6 of 27 service users. Spot checks were made on a number of the homes records and care plans. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 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. People who use this service have a full assessment of their care needs and are able to visit and test drive the service before having to make any decision about admission. The home has a Service Users Guide and an up to date Statement of Purpose and prospective residents have all the appropriate information to enable them to make an informed choice. Evidence: There have been no new admissions to Haslewood Avenue since the last inspection. The service currently has one vacancy and although a number of referrals have been received and pre admission assessments made none of the prospective applicants referred have so far chosen to move into the home or have had suitable care needs that the home can fully meet. Being a very small home any new applicant must also be compatible with the existing resident group. The manager told us that the homes Statement of Purpose is currently being reviewed. Care Homes for Adults (18-65 years) Page 10 of 27 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 people who use this service have person centered care plans which provide an up to date record of their needs how these may be changing and how they will continue to be met. Risk assessments are regularly reviewed to accommodate changing ability need and risk. Evidence: The care plans examined gave a wealth of information about each service user with their needs clearly identified also how these needs are to be monitored managed and met. With the benefit of there being both a stable staff team and long standing group of service users the staff know them and their needs very well and have built up a close rapport with each of them. The care plans are recorded using a person centered format and gave good evidence of the residents involvement with the compiling of their plans; signatures and identification marks were seen where the service users were able to make these. Staff explained that all the care plans were currently being Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: reviewed and reformatted using better person centered language this action being taken following additional care plan training that some of them have attended. The plans evidenced the regular one to one talk time meetings that key workers have with all the residents these meetings are to ensure that they are all regularly consulted in an individual manner by staff who know them well and can overcome any difficulties that may other wise arise from their lack of or limited speech. It was noted during this visit that individual gestures or behaviour patterns of individual residents were understood and being interpreted by the staff in a manner which supported their independence and wishes in a dignified manner. The care plans seen all contained risk assessments which gave guidance of the known risk how it may be avoided and if it arose how it should be managed. Staff were heard to encourage the residents to express their choices and to support them in having as independent a life style as is safely possible for them to so do. One service user has a monitor to ensure their safety when they choose to be alone in their bedroom. Another carries a mobile phone when they are away from the home at their day activity classes as this enables them to feel more safe and secure. Information about the service users is kept securely locked in secure office facilities and during this visit the staff demonstrated a good awareness of maintaining a confidential manner at all times. Even if a resident had no speech anything spoken concerning them was always individually explained to them first. Care Homes for Adults (18-65 years) Page 12 of 27 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 people who use this service participate in a range of activities to meet their individual needs and choices. They are supported appropriately by staff to use local community facilities and to maintain communications with their families and friends. A healthy varied diet of freshly prepared food is provided in a manner which meets their individual needs. Evidence: Since the last inspection the range of activities has increased and now all the people who use this service have an individually planned day activity programme encompassing several weekdays as well as some regular weekend and evening activities. The Guide Post Activity organization leads most of the day activities and several of the service users were seen to be being taken out to participate in various activities during the duration of our visit. One service user who has the ability to Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: undertake more active and communal activities enjoys attending classes at a local day centre and at college. They told us that they enjoy the cookery and art classes along with music and the new computer classes. A certificate evidenced that last year they were awarded the student of the year award from the College. The manager explained that as the care needs of several of the service users had increased so their day activity needs and abilities had also changed and along with social services a review of the current day activity needs for them all was being undertaken. Staff were seen to assist one service user to take their cat to the vet for treatment and another was accompanied to visit their GP for a test. Staff regularly accompany some residents to the local bank and all are accompanied to take lunch in the town at least once a week. Staff explained that all the service users enjoy eating out so this is encouraged. During our visit preparations for one service users birthday party were being discussed and staff accompanied one service user out to shop for party food and decorations. Another service user was heard to be discussing the colour of a new cardigan that they intended to buy during a visit the following day to a local super store. An individual activity plan was seen to the service user who is now largely bedbound this is mainly a musical or visual programme offered by several of the staff individually. Staff told us that they however still very much enjoy participating in all of the homes in house shows or activities and could sometimes enjoy an outing as well. All the service users have a staying away holiday each year and the home also enjoys taking day outings and they also have in house entertainment. Last summer visits were made to Euro Disney in Paris and to Lowestoft and several enjoyed staying in a cottage by the sea on the South Coast. Staff took another service user to Cornwall to visit a previously long lost relative who had arranged a big family reunion party. A weekly menu is chosen by the residents with staffs assistance using a pictorial menu guide. It was seen that this included a good range of choices and that the special dietary needs of some service users were being appropriately met. Lunch was taken by some of the service users during our visit and it was noted that a number of different dishes to meet individual wishes were enjoyed. Care Homes for Adults (18-65 years) Page 14 of 27 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 health and personal care that people receive is based on their accessed individual needs and they are treated with respect and dignity. Evidence: Personal care is provided for the people who use this service in a way that meets their needs and takes account of their own preferences and expressed or known wishes. One service user who is now very frail and spends much of the time in bed was heard to be consulted as to whether they wished to get up before or after lunch and preparations for their forth coming birthday celebrations were also being discussed with them. Service user records seen had visits to and from doctors and hospitals clearly documented. Staff said that they had now built up good liaison relations with their local GPs who were knowledgeable about learning disability conditions and who always responded promptly and would refer for specialist help when ever it was required. The staff explained how they had been assisted by the GP and the district nursing team to meet the extra care needs of one service user who is now largely bed bound. A special bed and pressure relieving equipment had been supplied and comments seen from the medical team were complimentary about the quality of care that was being delivered to this service user who was clearly very content and happy Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: and communicated this warmly to us during our visit. The care plans evidenced that regular eye testing, dental checks, chiropody and hearing checks are accessed by all the residents. Their weights are regularly monitored with the GP giving advice concerning special thickened drinks and how to overcome any swallowing problems. Service users who had needed to spend time staying in a hospital had been accompanied there by staff from the home who stayed with them throughout the twenty four hour period to ensure that their needs were fully met. Two service users who suffer from epilepsy are being monitored by specialist medical services from the Chalfont Centre and several of the home staff have recently completed training on this subject. An Occupational Therapist had made an assessment for specialist walking equipment for one service user and the home now has two hoists and a special chair to meet their needs. Since the last inspection End of Life Care had been provided for one service user with assistance and training given by the local Hospice. Staff said that following this they had all attended further end of life and bereavement training and explained how the home had arranged the funeral and refreshments for the bereaved with which all the home residents joined in. The home continues to use a MDS (monitored dosage system ) for the storage and administration of medication. All the staff have attended medication training and the MAR ( medication administration record) sheets were seen to be completed accurately. The home stores its medication in a wall hung purpose designed medication cabinet in a small separate office which combines as a room used for private supervision and other meetings. The room provides adequate space and is a safe and secure working environment for the handling of medication and is a space where a stable temperature can be maintained. The GP makes six monthly checks on the homes medication arrangements and staff said that the supplying Pharmacist is also accessible and helpful. The home has a Controlled medication cabinet and register which it has not yet had to use as no controlled medication has ever been prescribed for any service user in the home. Care Homes for Adults (18-65 years) Page 16 of 27 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 who use this service are able to express their concerns, have access to an effective complaints procedure and they are protected from abuse. Evidence: A comprehensive complaints policy and procedure is in place and is well published in the home and to the service users. A copy of the visual complaints procedure was seen on all the care plans files examined. Staff spoken with were familiar with the homes whistle blowing procedures which they said they would have no hesitation in using as they had previous experience that in the past when this had been done improvements had been made by the homes management. There have been no complaints since the last inspection. A number of complimentary letters have been received by the service. There have been no adult protection issues in the home since the last inspection. All the staff have attended training on the protection of adults and staff spoken with showed a good awareness of their roles and responsibilities in protecting such vulnerable service users and of how and when they may need to make notification to the local authority safeguarding team and to the Care Quality Commission. The homes keeps the Care Quality Commission informed of changes and other required management matters through the notification process. The manager and some senior staff have attended training concerning the Mental Capacity Act and further training about this is being arranged for all the staff. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: One service user has an Advocate and since the last inspection the services of an IMCA have been called upon on two occasions. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home is excellent and enables people who use this service to live in a safe well maintained and comfortable environment which encourages their independence. Evidence: The home which was purpose built some fourteen years ago is very well appointed and well maintained. It is spacious provides individual bedrooms for all the service users and has a very homely atmosphere. Since the last inspection many works of refurbishment and improvement have been carried out. Both the bathrooms have been refitted one providing a new fully assisted bath and the other forming a wet room. Both are very attractively decorated and provide an inviting environment for the service users. Redecoration and re carpeting works have been carried out in the main corridor and the lounge has also been redecorated and had some new furnishings. The bedroom carpets have all been replaced with laminate flooring which gives a modern fresh and clean look to the rooms. Each of the bedrooms has been furnished with modern attractive furnishings to meet the likes and requirements of the individual service user and also to reflect their interests. Works to the garden have included replanting of some old overgrown shrubs giving better access to the patio area where new garden furnishings have been provided. Hanging baskets have been planted these giving the front entrance a welcoming and well kept appearance and a small garden Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: area created where one service user is intending to grow carrots. The greenhouse has been decluttered and refurbished and the staff plan to further develop this area during the summer months. On the day of this unannounced visit the home was found to be very clean and tidy and to be free from any unpleasant odour. Staff were seen to be being giving appropriate attention to infection control measures themselves and to be reminding and assisting service users to wash their hands. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are cared for by experienced and trained staff who are themselves well supported and have sufficient skills to support the people who use the service. The recruitment policies and practices provide adequate safeguards to protect the service users. Evidence: The service which is virtually fully staffed retains a stable group of very dedicated staff who are well trained and who work very well together as a team thereby ensuring the smooth running of the service. Many of the staff said that they would be willing to work extra shifts or accept a change to their normal working pattern this to provide cover for sickness and other unexpected absences and because of this the home only rarely has to use agency staff.The home has a number of Bank staff who are known to the service and who also know the service users and understand their needs and they can usually assist by filling in with any staff gaps and the manager explained that this ensures good continuity of care for the service users. She also said that she is trying to recruit more suitable carers for this bank pool. Since the last inspection an additional waking night staff member has been employed to ensure that the needs of all the service users can be fully met at all times. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff spoken with confirmed that training continues to be given high priority in the home and that they are encouraged to develop their knowledge and skills and to achieve NVQ awards. One staff member has since the last inspection completed NVQ at level 3 and is to commence training for the Assessor Award. No new staff have been recruited since the last inspection. The recruitment records examined at that time found that all the required checks had been made before the new staff commenced their duties. New staff complete a full induction period before they are expected to work unsupervised. All the staff spoken with were very positive about their work and in maintaining the homely family like atmosphere of the home and had meeting the needs of the service users as their top priority. They confirmed that they received regular supervision and felt that they were well supported by their managers at all times. One said this is a good happy place to work we all have the same aim which is to enable the service users to have the best possible life style. Another staff member confirmed that they had been well supported through the period of management change caused by the maternity leave absence of the manager but did add that it would have been better if more management replacement time had been provided to cover this absence. Care Homes for Adults (18-65 years) Page 22 of 27 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. People who use this service benefit from living in a well run home where their views are listened to and acted on and where the welfare of both residents and staff are promoted. Evidence: At the time of this inspection visit the registered manager was away taking maternity leave and the service was being managed by the homes senior carer deputy manager who had been appointed by the company to be the manager during this period. They have worked at the home for several years and are experienced with the care of learning disability persons and with the management of this small service. They hold an NVQ qualification at level 3. They operate an open door management policy and work shifts on occasions this to ensure a good insight into the service users needs whilst balancing the management requirements of the home. They told us that they are well supported by their company managers and the service is subject to regular Regulation 26 visits. The home gives good priority to promoting the health safety and welfare of the service Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: users and staff through the regular maintenance of safety checks, training and record keeping. The records relating to fire testing and the monitoring of water temperatures were found to be regularly completed along with risk assessments for the environment. The home has developed an evacuation plan to be followed in the event of a fire or other incident and stocks of warm woollen hats and thermal blankets are kept available for the service users protection. It was seen from the records that regular evacuation practices are carried out the last being done in December 2008. Since the last inspection the home had to be evacuated for one night because of the danger of an explosion in a near by building the whole area was evacuated following Police orders. This event enabled the home to test that its evacuation plans to house the service users at another Hightown home near by worked successfully. The minutes of staff and residents meetings evidenced that these were planned and held regularly and that every effort was made to keep the service users informed about their service to seek their views and to enable them to influence the planning of their lives in the home. The home has a policy and procedures to ensure the protection of the service users finances and spot checks made on three of these during this visit found that the amounts and the records and receipts kept did all tally. The service has a Quality Assurance Programme and regularly sends questionnaires to the residents, staff, relatives and other professional stakeholders in the service.The results of these questionnaires are analyzed by the company and the information shared with the staff so that the service can be continually improved. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!