Care Home: Hillside House

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What the care home does well The service has a long-standing staff team who provide support to the residents on a flexible basis. The residents are supported to attend a range of meaningful activities of their choice. Health professionals said "the service provides a secure environment for residents to live life to the full; provides high quality of care that is tailored to meet peoples needs". The homes AQAA also states the homes does this well and this was confirmed during the inspection. Have positive attitudes and enthusiasm. Support people and meet their individual "holistic" needs. Support people to be happy and healthy. Ensure people are included and access their community. Provide every opportunity to be as autonomous as possible - "White paper 2001/valuing people." Listen to how the residents want to live their lives. Provide day care through college, social services and in-house activities daily Keep people safe and healthy. What has improved since the last inspection? A number of requirements were given at the previous inspection, which have been met. All parts of the care home are to be kept clean and steps have been taken to ensure they are reasonably decorated and in a good state of repair. There is evidence of the home`s quality monitoring system in place based on reviewing and improving the overall quality of care in the home including the quality of nursing where nursing is provided at the care home. Residents have end of life plans, which ensures residents wishes with regards to aging; illness and death are handled sensitively. What the care home could do better: Management must complete its programme of decoration and finish make the property more homely for the residents. Key inspection report Care homes for adults (18-65 years) Name: Address: Hillside House 1/2 Hillside Cotham Hill Bristol BS6 6JP     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: Kath Houson     Date: 1 7 1 2 2 0 0 8 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Hillside House 1/2 Hillside Cotham Hill Bristol BS6 6JP 01179735784 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: ramanihillside@hotmail.co.uk admin@aspectsandmilestones.org.uk Aspects and Milestones Trust care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Manager must be a RN on Parts 5 or 14 of the NMC register Staffing Notice dated 15/11/2001 applies Date of last inspection Brief description of the care home 1 & 2 Hillside House is a listed Georgian house that provides accommodation, which is arranged over three floors for 17 adults with learning disabilities and mental health. The home has domestic style facilities such as, a kitchen, dining area, lounge, bathrooms, toilets and bedrooms. The home is located in Cotham Hill and is close to many of the amenities that central Bristol has to offer. The home can be found in a busy residential position and can be readily accessed by car or public transport. There is a shopping centre close by on Whiteladies Road with local shops and coffee houses, pubs and restaurants within walking distance of the home. The home is staffed by a core of nursing staff supported by care support workers. 17 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home The fees arranged according to residents individual assessment. Social services pay £688 per week for the total care package. This information was obtained at the time of the inspection. The provider is Aspects & Milestones and Western Challenge is responsible for all repairs of the building. 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 Visit: An unannounced visit was made on 17th December 2008. During the visit we: Talked with people who used the service, the staff team and the deputy ,manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records, such as their polices and procedures, staff files and their rotas, the medication policy and complaints book. Undertook a discussion with the staff to assess their knowledge, skills and training to meet the needs of the people who use the service. Looked around the building to make sure it was clean, safe and comfortable. Discussed, any improvements that had been made since the last visit and if any requirements had been met.we provided feedback to the deputy manager. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 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 8 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. Potential users of the service and their referrers benefit from sufficient information in accessible formats to allow them to make informed decisions about their future placement. People can be confident that they will only be admitted where the home is able to demonstrate that it is able to meet their assessed needs. Evidence: There have been no new admissions into the service since the last inspection; therefore this standard has not been fully assessed. The homes Statement of Purpose (SoP) has sufficient information in an accessible format. The home fully understands the importance of having sufficient information made available to potential residents and the home SoP contains this information. This would help people to make an informed decision about their place of residence. The SoP is in pictorial and text format with Makaton signs included. The pictures and photographs are realistic in content and of good quality. People said, We received enough information about this home. Another resident said, I stayed for a few days trial to try out the home. Other residents said we came to visit Hillside on more than Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: one occasion, with the same staff. This document was made readily available during the inspection. Residents were asked, Were you asked if you wanted to move to this home? Many residents were part of the community NHS hospitals and as a result were moved in to residential care. Residents made additional comments such as, I was at Cleve hospital for several years then it closed and many of us all moved together. Closure of the previous care home meant had to visit on many occasions to get used to it here before I moved in permanently. Residents currently in the home were fully assessed; this is to ensure the service can meet their needs. Potential residents would have their goals and aspirations planed with a number of multidisciplinary team. Correspondence from other agencies was seen in the current residents files. This shows the residents were fully assessed before admission into the service. 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. People benefit from having their individual needs and choices are reviewed regularly and this is reflected in their care plans. People are supported to take risks and are encouraged to make decisions about their individual choices. Evidence: Selected care plans were looked at and were found to be recorded well. The care files showed good monitoring of peoples complex needs. The care plans include, medical and clinical records, where information is recorded concerning peoples healthcare. For instance those with epilepsy and who are susceptible to many seizures are monitored. This ensures peoples changing needs are regularly reviewed and involves individuals in the planning of their care. Signatures of residents involvement in their reviews shows signs of their involvement. The service maintains the personal centred plans which looks at peoples care in a holistic way. They include information on peoples mental health and other healthcare needs and well being, significant others and family, their physical needs, social life and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: educational goals. They include daily recording sheets. The documents seen were accessible and showed for example, peoples individual goals and how they develop their skills and future aspirations. This service promotes and encourages the residents to develop their care plans. One relative said, thank you so much for the care especially given to my son and to all his mates. The care plans are written in plain language with signs and symbols, for improved accessibility. The staff team support residents to make decisions about their lives. For example, residents who wished to find employment such as shop work or providing assistance to the local community would be appropriately supported including from a distance. Residents responses when asked, do you make decisions about what you do each day? Residents said usually some other residents said, always with additional comments I chose to go to Lawrence link day centre, I chose my college courses, I choose activities I like to do. Each care plans looked at contained comprehensive risk assessments, which, are regularly reviewed. This ensures residents independence are maintained and promoted. Residents were asked, can you do what you want? many responded they could do what they wanted during the day the evening and at the weekend. Additional comments include, I like to go shopping at the weekends, I am able to go out on my own so I regularly go to the shops, clubs and pubs. 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. People are involved in a wide range of meaningful activities and are supported according to their individual choices at the home and in the community. The meals are balanced with a choice of healthy options. Evidence: People are supported to take part in meaningful activities in and around their community. For instance, most of the individuals were out during the day of inspection; their activities plan was seen and found to be structured. Many residents were at college; another was out shopping, others also went out to the local coffee shop. Residents daily placements and activities include; Lanercost, ShireLink, Lawrence Weston farm, Ashley Down College, Workmates, a number of drop in centres and horse riding. People that live in the home take part in the workmate scheme often receive gifts Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: from the neighbours they help. People that live in the home take part of their local community. Many go out to the local pubs and do their shopping at the local shops and supermarket, which, is close by. The deputy manager states many of the residents access the local community as they are out all the time and the each have their bus passes. A couple of the residents bus passes were seen. Residents are encouraged to maintain relationships with family and friends. This is reflected in their care plans with letters from their relatives arranging planned visits. Residents are also supported to take part in domestic routines and take responsibility for their own rooms. The few residents and staff who were in the home at the time of the inspection were spoken with respectfully. The atmosphere in the home was one of calm and quiet. The staff team were preparing to take the remaining residents out for coffee. The kitchen was seen and found to be very organised. There was plenty of fresh fruit and vegetables seen and the chef takes pride in making sure the residents have a varied and balanced menu. There is a list, which shows the residents, likes and dislikes to help ensure residents preferences for their choice of food have been taken onboard. The menu seen shows a number of healthy options and a good range of foodstuffs. 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. People benefit from receiving personal care and support in the manner they prefer and from having regular access to specialist health care. Residents are supported to be independent in medicating and the support provided is flexible and proactive. People are protected from medication errors by effective practices supported by procedures and guidance. Evidence: People are supported with their personal routine. For instance, residents choose when to get up in the morning especially if they do not have to attend college and choose to get up later in the day. Care plans looked at showed to have several input from other healthcare professionals such as, the District Nurse (DN) the chiropody, and visits to the dentist are recorded. The service has adopted the use of OK health records where residents emotional, physical needs are recorded well. Healthcare needs are regularly monitored. For example, if there are any radical changes to their healthcare needs these are documented with guidelines for the staff team to follow. For instance, if they have recently been discharged from hospital. New risk assessments are written and relate Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: to changes in healthcare needs. This shows the service recognise information are accurate and up to date which helps the staff team to provide care according to residents changing needs. People who self medicate are risk assessed and given support to manage their own medication. The residents are trained with support of the staff. This is reflected in their medication sheet. All the residents medications sheets were looked at and no omissions had been detected. The home uses the pharmacist dosage medication system; where monthly deliveries of medicines are made into the home. There have been no drug errors; this shows the home is compliant with its own administration of medication practices and procedures. One healthcare professional said, They are obsessive about checking and coping well. 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. The home keeps a full record of complaints and this includes the details of the investigation and any outcomes achieved. People benefit from staff receiving appropriate training to help ensure that they are protected from potential neglect or abuse. Evidence: The home has an easy to read complaints procedures; which contains text, pictures and is user friendly. The residents are given support are able to use the complaints procedure to voice their concerns. The culture is open and residents are encouraged to express their views and concerns in a safe environment. For instance, there were several previous entries in the homes complaints log. At the time of the inspection the home has not received any recent complaints. The complaints log showed the date, the nature of the concern the complainant and the outcome of each entry. Each complaint had been dealt with in a timely manner, which promotes confidence in the homes complaints procedure. Residents said when asked, do you know who to speak to if you are not happy? the response from many residents was yes with additional comments, I like to speak to the home manager and my family, I would speak to the manager, I would speak to one of the staff. Another resident said, I have been told by the staff members how to make a complaint and watched a DVD. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: The service receives compliments from relatives who said to all the staff thank you for the invitation to the Christmas party and for putting the invitation on such pretty note paper. The homes policies and procedures for the safeguarding of adults were made available. The home pays particular attention the no secretes documentation. This document was made available during the inspection, is accessible to all staff in the home and contains information and clear guidelines for staff to follow to ensure the safety of vulnerable adults is maintained. The staff team, actively listen to the residents and this was observed during the inspection. The homes Annual Quality Assurance Assessment (AQAA) made reference to the staff having attended the vulnerable adults training. This has been complied with from the previous inspection, which recommended staff attend such training. The deputy manager commented on how positive the training was provided at Bristol 6000. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not able to benefit from a home that fully meets their needs, as the required refurbishment that will allow the building to achieve its full potential has yet to be completed. Evidence: 1 & 2 Hillside House is a large substantive sized grade II listed Georgian house. The property is domestic in style and has several large bedrooms, 4 bathrooms, kitchen and dinning room and 4 lounges. One of the bedrooms are shared because the residents wish to share this is made via special arrangements. To the rear of the house there is a garden with additional space for car parking for several vehicles. The service has a part time gardener. The property can be found in Cotham Hill, which is close to a number of amenities, which central Bristol has to offer. The home is close to Whiteladies road, which has supermarket, local shops, bars clubs and coffee houses. Public transports are accessible to a number of places in the area of Bristol city. Western Challenge is responsible for all the maintenance of the property owns the building. Aspects and Milestones are the service providers. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: There have been a number of improvements made to the property since the last inspection, such as: The ceiling in the lounge had been cleaned and repainted. The result has produced a stunning ornate ceiling, which makes the lounge areas more homely for the residents. The lounges has been repainted with new curtains has produced positive results and added to the homely. The carpets are being replaced. A detailed correspondence was seen to confirm that these plans are taking place. Much of the decorating is yet to be completed; the deputy manager said they are started making improvements to the property which would be much better for the residents. Historically, the refurbishment was to commence in April 2006 this had not happened and the environment continued to deteriorate which added to the institutional appearance of the home. There are elements of the home still looks institutional; however this is being addressed and the home is beginning to look and feel more homely. The deputy manager and manager recognise the property requires more work in particular the basement areas and bathrooms. They were able to produce the plan for the refurbishment for the property and this was also confirmed in the homes AQAA. There were a number of photographs, paintings and wall hangings around the house, which added to the homely feel the service is aiming to achieve. The residents made many of the paintings, which were seen, around the house. The future plans for Hillside House as mentioned in the previous inspection report dated 17th & 18th December 2007 have been shelved; the plans for decorating the home are going ahead. The home was clean and fresh and no offensive smells were detected. A relative said,Its like one big happy family and a lovely atmosphere when I come to visit. 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. An effective staff team meet the needs of the residents and they have confidence in the staff that cares for them. The residents are protected by the homes recruitment and selection procedures and practices. Evidence: The home has a long-standing staff team who supports the residents on a flexible basis. The home has a low staff turn. Staff comments that they like coming to work and working with the residents. The staff team consists of nursing and care support. The staff duty rota shows good skill mix; with sufficient staff available to meet residents needs. The staff qualifications include; Nursing, National Vocational Qualifications levels 1,2,3 and 4. Healthcare professionals and the residents made complimentary comments about the staff team. For example, a GP said they make an effort to support people to lead the lives of their choice but give guidance when it maybe unsafe or harmful to peoples welfare. Residents said, The staff treat me really well. The staff files show regular training take place. The training and development include; first aid, fire training, and food hygiene. The deputy manager said, I have completed the level 4 in management and was awaiting my certificate. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The service has a good recruitment procedure, which clearly defines the process to be followed. For instance, staff files looked at contained; a job description, an application form, terms and conditions, two references, the request for criminal records check and enhanced Criminal Records Bureau response (CRB), POVA first response, health questionnaire with occupation health input and identification documents such as passport. This practice shows the service recognise the importance of effective recruitment practices and the delivery of a good quality service which protects the residents. Supervision notes were also seen as they are contained in the staff files although this was not assessed staff said, Regular supervision takes place. 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. Residents benefit from a service that is managed well with effective communication and use of policies ensuring that people living in the service continue to have good quality of life. Evidence: The manager has the qualifications and experience to manage this service and has been running the home for several years. The health professionals have been complimentary about the service. The GP said, Hillside provides a secure environment for residents to live life to the full and provides high quality care that is tailored to each persons needs. This is evident in residents care plans, their medical and clinical records and their risk assessments. Their activities charts show their favourite hobbies of choice, which they are involved with during the day. The homes diary and communication book show how staff communicate to meet residents needs. This shows a service, which is structured to meet the needs of the residents and provides care according to their care plans and risk assessments. A resident said I am happy at Hillside and have many friends. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The home has evidence of self-monitoring system. Regular monthly visits carried out by the providers inform the Commission (CSCI) of any changes with the service. The residents survey captures any concerns they may have with the service which help management to monitor standards of care. This shows management continuously work towards maintaining a good standard of care for the residents. The service has effective policies and procedures, which help to ensure clear health and safety practice in the home. For instance, the 2008 health and safety audit which was conducted by Bristol City Council environmental health service, shows the home had a positive outcome. The risk assessment for wheelchair use, the portable appliance testing, the gas and the fire appliance certificates were looked at and seen to be in good order. 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 1 24 23 the registered person must ensure that all parts of the home are kept clean and reasonably decorated. paying particular attention to the refurbishment programme which has started in the home. This is to ensure that the programme of decoration is complete which would make the property more homely for the residents. 31/08/2009 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 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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