Care Home: Homestead

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What the care home does well The people have their own bedrooms.The people like the food.The people help with cooking the food.The people are helped to make decision about things that they would like to do.The people go to college to learn new skills.The people are involved in their care plans and information is written in easy words and pictures so they know how their needs are met.The people go on holiday with staff and enjoy this.The people like the staff.The people have meetings with staff so they can tell them things that they would like to do.The staff do training to help them to look after the special needs of the people.The staff have meetings to discuss how the peoples needs are being met.The staff say the new manager is supportive and listens to them. What has improved since the last inspection? The home has a new manager.The manager visits the people in the home.Care plans are written in easy to understand format. Information available has been improved.The home has more staff on duty.The staff have done more training.Medication is now safe and a new medication cupboard and fridge were bought. What the care home could do better: Complete all the peoples care plans in easy words and pictures.Provide staff more supervision to find out how they are meeting the needs of the people they look after.Ensure that the people who belong to the Board of Trustees of the home have the special checks carried out to ensure that they are safe to visit the people in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Homestead 7 Bedford Road Yardley Hastings Northants NN7 1HJ 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: Ansuya Chudasama Date: 1 9 0 1 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 38 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 © (2010) 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 38 Information about the care home Name of care home: Address: Homestead 7 Bedford Road Yardley Hastings Northants NN7 1HJ 01604696782 01933664333 postmaster@oakfieldjm.force9.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Oakfield (Easton Maudit) Limited care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: Date of last inspection 1 5 0 3 2 0 0 9 A bit about the care home Homestead provides care for people who need help and support. The home is in the village of Yardley Hastings. Care Homes for Adults (18-65 years) Page 4 of 38 The home has a computer area with access to the internet. All the people have single bedrooms. There is a small kitchen with a dining table. There is a lounge that the people can relax and watch TV. Care Homes for Adults (18-65 years) Page 5 of 38 The people who live at the home have a learning disability. The people can visit the home and meet the staff and other people to find out if this is the right home for them. The basic fee cost about £947 per week to stay at the home. The people are given information about the services the home provides to meet the needs of the people they look after. Care Homes for Adults (18-65 years) Page 6 of 38 The home tells us about the things that has happened and how they look after the people and keep them safe. The information is recorded on a report called the Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 7 of 38 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 Care Homes for Adults (18-65 years) Page 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home We spoke to the manager to find out how they were looking after the people. We spoke to some of the people to find out how their needs were being met. We spoke to some of the staff to find out how they were meeting the needs of the people. Care Homes for Adults (18-65 years) Page 9 of 38 We checked that the home has safe policies that tell them how to do things properly. We looked at the care plans to see how the people are being looked after by the home. We looked at the training that the staff do to help them understand the needs of the people better. Care Homes for Adults (18-65 years) Page 10 of 38 What the care home does well The people have their own bedrooms. The people like the food. The people help with cooking the food. Care Homes for Adults (18-65 years) Page 11 of 38 The people are helped to make decision about things that they would like to do. The people go to college to learn new skills. The people are involved in their care plans and information is written in easy words and pictures so they know how their needs are met. The people go on holiday with staff and enjoy this. Care Homes for Adults (18-65 years) Page 12 of 38 The people like the staff. The people have meetings with staff so they can tell them things that they would like to do. The staff do training to help them to look after the special needs of the people. The staff have meetings to discuss how the peoples needs are being met. Care Homes for Adults (18-65 years) Page 13 of 38 The staff say the new manager is supportive and listens to them. What has got better from the last inspection The home has a new manager. The manager visits the people in the home. Care Homes for Adults (18-65 years) Page 14 of 38 Care plans are written in easy to understand format. Information available has been improved. The home has more staff on duty. The staff have done more training. Care Homes for Adults (18-65 years) Page 15 of 38 Medication is now safe and a new medication cupboard and fridge were bought. What the care home could do better Complete all the peoples care plans in easy words and pictures. Care Homes for Adults (18-65 years) Page 16 of 38 Provide staff more supervision to find out how they are meeting the needs of the people they look after. Ensure that the people who belong to the Board of Trustees of the home have the special checks carried out to ensure that they are safe to visit the people in the home. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 17 of 38 If you want to speak to the inspector please contact Ansuya Chudasama CQC East Midlands Citygate Newcastle Upon Tyne NE! 4PA TEL: 03000616161 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 18 of 38 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 19 of 38 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 using the service are assessed to ensure that the service can meet their needs. Evidence: On the day of the inspection, the home had one vacancy and three people staying at the home. The three people were having a day back doing their personal chores. The home has not had any new admissions since 2001. Prior to moving to this home, the people had lived at the other sister home. The people told us that they wanted to come and live at this home and they were very happy. We were told by the manager that all new admissions to the home would be assessed and visits to the home to meet the people living in the home would be encouraged. This was to ensure that the peoples needs can be met by the home. It was also said that all potential users of the service would have an extended Community Care Assessment from Social Services prior to admission. There is on going reassessment of people living at the service to highlight changing needs at which time appropriate action is taken to provide the support. The Service User Guide and Statement of Purpose have been updated in a format the people can understand the information. Page 20 of 38 Care Homes for Adults (18-65 years) Evidence: At the key inspection of the sister home we discussed with the manager and the finance manager on the use of contracts for people that live at the home. It was agreed that no additional contract between the home and families in relation to fees should be made. The contract between the home and funding authorities is the appropriate contract to be in place for this. The contract between the home and the person living in the home should have the information stated in Standard 5 of the National Minimum Standards for younger adults. All additional costs in relation to activities and personal purchases should be met by the personal income of people using the service. The Statement of Purpose and Service users guide were not clear on these issues. The AQAA says what we could do better is to improve on details in the contract and discussion/agreement with the client. Care Homes for Adults (18-65 years) Page 21 of 38 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. Care plans are in place and demonstrate involvement of people using the service. Evidence: All the people have care plans in place and evidence shows that they have been reviewed on a regular basis to ensure that staff are updated with changes. The plans seen had information about how the peoples personal and health needs were being met by the home. There were risk assessments in place for activities the people undertook. The peoples daily activities undertaken were put in a format the people could understand. The plans were signed by the person and the staff member to demonstrate that people were being involved in their care planning. The plans are reviewed with the person and other parties at review meetings. We were told that the people were soon to have person centered planning meetings with all the people in the home. It was observed that there is good communication between staff and people that use the service with confidentiality being maintained. Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: In observation of practice and discussion with staff it was evident that they are very knowledgeable about the needs of the people they support. Staff spoken with confirmed that they had undertaken induction training that included a period of working alongside an experienced worker until they had demonstrated that they were competent and confident in meeting peoples needs. The AQAA says that our plan for improvements in the next 12 months is to have on going training for staff. Auditing tools for care plans and related documentation. Reviews to be undertaken in Person Centered Format. Care Homes for Adults (18-65 years) Page 23 of 38 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. A wide range of personal, educational and social options are available and promote individual development. Evidence: The day centre that the people attended at the sister home was now closed down. The people now have a weekly activities programme. This includes attending external day care activities and developing daily living skills in which individuals are supported to develop skills in meal preparation, shopping and home management. On the day of the inspection all the people were observed cleaning, polishing and hovering their room with support from staff. The people spoken to tell us that they help with food shopping and meal preparation. One person said yes like cooking and this was observed when they were helping with lunch preparation. All the people said that they liked the food that they ate. The people choose the meals on a weekly basis with staff support. They had meetings in the home and it was said that they told the staff of the things that wanted to do in the home and in the Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: community. Since the last inspection we observed that the people did more activities and they were being more involved in the running of the home. This was helped by having two staff on duty so they could spend more time with the people. It was also noted that several people have external day care opportunities and are supported to experience community facilities. The people told us that they like living at the home. One person said nice like it here and its a home. All said that they were happy. It was also said that the staff is nice because they help them to do things. The AQAA says our plan for improvements in the next 12 months is to have on going plans for clients to have more choice and Independence within the home. Staff to have training in day to day living skills for clients. Develop a system for assessing the success of activities. An anti institutional project to be launched to reduce institutional practices. The manager informed us that a news letter about the home was being started and the families would get a copy of this. The manager also said that the key workers of the people will regularly update families of what has been happening with their relative. Care Homes for Adults (18-65 years) Page 25 of 38 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. A trained staff team ensures that people using the service are supported in meeting their health care needs. Evidence: People using the service are supported to access local or specialist health care services and good rapport is being established with the local health care teams. People using the service are supported to have regular health checks and there is evidence on files that health care appointments are made. The people tell us that the staff take them to visit the GP when they are not feeling well. The AQAA confirms that the PCP contain details of how a client likes to be supported with their personal care. A detailed policy on support with personal care is in place. PCPs contain details of all general and specific health care needs. All medical appointments are documented on other medical details sheets and any follow up appointments are noted and put into the handover diary. We have robust procedures in place for all aspects of medication. All staff receive accredited training in medication. We use a consultant psychiatrist to review medication along with our local G P. The home has a new medication cupboard and a new fridge. The records checked were satisfactory. All the staff who administer medication have received the accredited Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: training. All medicines that requires cold storage are now stored in an appropriate facility and at the correct temperature range The people tell us that the staff knock on their door and they are able to get washed by them selves but staff help them when they want help with any thing. How personal care is delivered is recorded in the persons file. The staff spoken to had very good understanding of the needs of the people and they spoke to the people in a dignified manner. Care Homes for Adults (18-65 years) Page 27 of 38 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 staff have good understanding of the peoples behaviours to ensure they are protected from any abuse. Evidence: The home has a complaints policy, and the procedures for making a complaint is recorded in the Service User Guide. A copies of the complaints procedures is displayed in the home in a format the people can understand. We were told that the home has not received any complaints since the last inspection. The people spoken to tell us if they are not happy, they would tell the staff. Management also monitors the home to ensure the people are happy. The staff spoken to told us that they had completed the safe guarding of vulnerable adults procedure training. They had good understanding of this and understood the peoples behaviours to know if they were unhappy or not feeling well. The information in the AQAA says that the manager has developed a pack for POVA training in house for all staff. The home has not had any safe guarding incidents referred to the SOVA team of social services. A poster about adult abuse in picture format was displayed at the front entrance of the home. We were told that the people understood this information. We were told that all the people in the home have separate bank accounts. The people open their own bank statements and staff helps them to understand the information. The Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: manager informed us that all the people in the home have their own money tins. This was to help the people to learn to manage their money with support from staff. One persons finances checked was correct and had the signature of staff and the person. Care Homes for Adults (18-65 years) Page 29 of 38 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people live in a safe and comfortable environment to ensure their needs are met. Evidence: Homestead is situated in the village of Yardley Hastings. The home has one bedroom downstairs and 3 bedrooms up stairs. A bathroom with toilet is also on this floor. There is a computer area and the old computer was being replaced with a more modern version for the people to use. A kitchen with dining table and a utility room with a toilet are downstairs. A tour of the home showed that the home was clean and pleasantly decorated. This was confirmed by talking to the people and staff on the day of the inspection. The bedrooms seen were individualised to the people and they tell us I like my bedroom and some people enjoyed spending time in their rooms. The people told us that they had picked the colour for their bedroom. One person was looking forward to moving back to their room when it was completely decorated. We were told that this was going to be soon and the person was happy with the colour they had chosen for their room. The people liked sitting in the lounge as it was relaxing and homely. The people are supported by staff to choose any furnishings bought for the communal areas. Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: The manager informed us that since the last inspection the utility room was painted and the new medication cupboard was kept in the utility room with the new fridge. The sink was also replaced in the utility room and the toilet was replaced with a new one. A new door was put between the kitchen and utility room to separate the rooms and make them more homely. Another wooden rail was put up the stair case to give the people more support when going up and down the stairs. Meals temperatures were being undertaken, and items in the fridge were also being all labeled. The manager said that the lights in the kitchen were being replaced with better ones to provide more brightness in the room. There were also going to be more light switches being put in the kitchen. The flooring was also being painted in the kitchen. The back of the home was having a decking area with a raised garden with a pergola for the people sit in the summer months. We were also told in the near future the people were going to be provided with a small fridge in their rooms so they could keep their drinks and small snacks in the fridge. An extractor fan and sensory lights were also being put in the bathroom. The Environmental Health Officer had visited the home and awarded the home 3 Stars for food hygiene, which is good. The AQAA says our plan for improvements in the next 12 months is to achieve 4 star rating on food hygiene and get food hygiene training for all clients. Care Homes for Adults (18-65 years) Page 31 of 38 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. Staff receive support and training to ensure that the peoples needs are met by competent staff. Evidence: The staff recruitment files were looked at in detail at the sister home. Evidence showed that the relevant staff information required was undertaken and the files were well organised and information was easy to find. The Director and the board members of the organisation do not all have CRB checks. We discussed this with the Director and the manager at the last inspection carried out at the other sister home. It was agreed by them that this was to be done for all the board members who visited the home. The manager assured us that the board members would be accompanied by staff until the CRB checks were received. The staff spoken to say that they enjoy working at the home and with the people. One staff said its their home and we are here to help them. It was said that a more permanent staff team that work at the home would be more beneficial to the people. This was said to bring more continuity to the people. The staff were observed to be getting on well with the people and each other. We were told that they had completed the induction and all the statutory training, and all training provided at the home was said to be good. The manager informed us that she has booked training on mental health for staff. Other training on bereavement, getting old and dementia care was also being booked for staff to attend. It was said by staff spoken Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: to that support is good from the manager and she listens to them. The home did not use agency staff and we were told that there were enough staff on duty to meet the needs of the people. The home has two staff per shift and one sleep in night care staff. Staff and management told us that at present the home was retaining a lot of their staff and this provides continuity to the people. We are told that team meetings now take place on a monthly basis. It was said by staff that they discuss the peoples needs, health and safety information and other issues about the home. The AQAA says what we could do better is to have Managing stress training and Makaton Training. Care Homes for Adults (18-65 years) Page 33 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of the people to ensure their needs are met. Evidence: The manager of the home has been working for the home since July 2009. The manager is qualified and competent and has worked with the client group in other residential settings. The manager has completed their application form to register with CQC as the registered manager for the home. They were in the process of waiting to undertake their fit person interview with CQC. The staff tell us that the manager is very supportive and approachable and works well with the staff. It was said that the manager has made many positive changes in the home. The peoples activities and environment had also changed for the better when the new manager started monitoring the home. We were informed by families and staff that the board members of the home did not understand the National Minimum Standards that the home had to meet. We were told that the manager had provided one day training to the board members of Oakfield home about the National Minimum Standards that the home has to meet and the work the home was doing to meet these standards. We were told that the board members found this training very helpful in understanding Care Homes for Adults (18-65 years) Page 34 of 38 Evidence: the homes role in meeting the standards. Evidence showed that the manager had only received one supervision since they started work at the home. This was discussed with the manager and it was said that they will ask for this to be undertaken on a monthly basis and this would be recorded. The manager of the home informed us that the finance manager discusses how the homes budgets and peoples finances are managed so they have a better understanding of this. The accident and incident records show that none were recorded and discussion with staff and the people showed that no accidents or incidents had occurred since the last inspection. The organisation carries out regulation 26 monitoring visits of the home to find out how the peoples needs are being met. The home had undertaken a service user, staff and family representative questionnaire surveys. There was some positive feed back about the care the people received and there was information about things the home needed to improve on. These surveys were undertaken before the new manager had started work at the home. Discussion with the manager showed that another survey will be undertaken and the analysis will be produced in a format the people will be able to understand and separated from the other sister home. The AQAA says for what we could do better and how we are going to do this is by developing different formats of The Quality Questioners as not may people participated on the last issue, so we were unable to collate useful information. A new format using BILD Quality Indicators will be sent out in January 2010 this will produce better information enabling us to improve our service. The water temperatures were undertaken and this was satisfactory. Monthly emergency lighting and weekly fire alarm testing was done. There were general risk assessments of the home being undertaken. Fire drills were undertaken and the people were involved with this process. Care Homes for Adults (18-65 years) Page 35 of 38 Are there any outstanding requirements from the last inspection? Yes  No  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 36 of 38 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 Description 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 Description 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 37 of 38 Helpline: Telephone: 03000 616161 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 © (2010) Care Quality Commission (CQC). 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