Care Home: Inglewood House

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What the care home does well The home provides a good service to the service users living at the home. Contact with family and friends are encouraged and service users are able to entertain their visitors in the privacy of their bedroom if they so wish. The registered manager complies with given requirements under the Care Homes Regulations 2001 within the given timescales. Service users spoken to indicated they were happy at the home and liked their activities. All service users at this home enjoy a full active lifestyle. The documentation of individual care plans are easy to read, the assessments gave the reader a full picture of the service users likes and dislikes, communication needs and risk assessments. The home has demonstrated that the care needs of the current service users living at the home are well catered for and met. Observations of care staff interaction with service users indicated that service users are treated with dignity and respect. It was also observed that great care was taken in respect of the service users personal belongings and standard of cleanliness in bedrooms ensured service users lived in a well-maintained environment. The home has demonstrated its capability to cater for service users from ethnic minority by ensuring staff have the knowledge through training to meet the diverse needs of service users. Currently, all service users at the home are British and Caucasian. However, the manager told us that the staff mix at the home represents the cosmopolitan nature of the community in which the home is situated. The home has an Equality and Diversity policy, which the staff reassured us they use in their daily work with service users. They also have an equal opportunities policy, which they use in selecting inducting and preparing carers from overseas to work within the British culture. We were told the manager had a good grasp of Equality and Diversity and uses it in her daily work with the staff and service users. What has improved since the last inspection? The manager has complied with all the given requirements at the last inspection. The home seeks to promote the independence of the service users, using a good degree of in house therapists and comprehensive day facilities. They help service users to identify and own their goals, visions and needs by becoming involved in their person centred care planning. Service users are encouraged and enabled to create their own health action plan to promote their physical and mental health. What the care home could do better: The home has purchased a computer for the use of service users. They have also bought a new user friendly soft ware suitable for service users with learning disability. They should speed up the training of staff in the use if this equipment so that service users can start to use the computer. Key inspection report Care homes for adults (18-65 years) Name: Address: Inglewood House 56 Middle Gordon Road Camberley Surrey GU15 2HT     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: Mavis Clahar     Date: 1 0 0 8 2 0 0 9 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: Inglewood House 56 Middle Gordon Road Camberley Surrey GU15 2HT 0127664776 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: inglewood@regard.co.uk The Regard Partnership Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 12. The registered person may provide the following category/ies of service only: Care home only - (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 (LD). Date of last inspection Brief description of the care home Inglewood House is a semi detached house situated in a residential area of Camberley, and is within a few minutes walking distance from the town centre. The home is registered to provide care for up to 12 individuals in the category of younger adults. The accommodation is provided over two floors, with communal areas on the ground floor and bedrooms on the ground and first floor. All bedrooms are single, with a wash hand basin. There is a pleasant rear garden, which is accessible to all individuals. Parking is mainly on-street parking. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 12 Brief description of the care home The current fees range from £1200 to £1503 per week. This does not include personal toiletries. 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 health care 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 for this service was completed on 8TH August 2007. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection, (CSCI) was undertaken by Mrs. Mavis Clahar on 10th August 2009 and lasted for five hours and forty minutes commencing at 09:20 hours and concluding at 15:00 hours. The registered manager Mrs. Elizabeth Hayes assisted on this visit. The Care Quality Commission (CQC) Inspecting for better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) that is to be completed by the service, which includes information from a variety of sources. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CQC (us) and is referred to throughout the report. The registered manager of the home articulates her responsibilities for the clinical guidance and supervision of all staff and for the Pre assessment of proposed service users wishing to enter the home. Care Homes for Adults (18-65 years) Page 6 of 27 The first part of the inspection was spent speaking with service users and their carers. This was followed by discussion with the registered manager, when an outline of how this visit would be conducted was discussed and agreed. The registered manager was present throughout the inspection visit. A partial tour of the home and gardens was conducted. Each service user bedroom is personalised by the service user to suit their likes and taste. Generally the home is clean and tidy. The home has a good size garden, with easy access by the service users. Time was spent reviewing service users care notes and sampling care workers records, which were all up to date. The information contained in this report is gathered mainly from, service users notes and records kept by the home, along with observations of the interactions of the seven service users and their carers, discussions with all service users and with care workers present on the day of the visit. No requirement or recommendations of good practise was made on this visit. The final part of the visit was spent giving feedback to the manager about the findings of the visit. The inspector would like to thank the service users and staff who spent time speaking with us on the day of the visit. Care Homes for Adults (18-65 years) Page 7 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 Care Homes for Adults (18-65 years) Page 8 of 27 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 health care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 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. Admissions to the home are not made until full needs assessment has been undertaken to ensure the home can meet the needs of the service user. Evidence: Review of service users files demonstrated that the home has established a good process of assessing service users needs. This has been enhanced by the joint development of service users care plans with service users. The home uses the Person centred approach to care. It was noted that no two service users assessment of needs were identical. We were told the service users and their relatives or representatives and social services are involved in their assessment and so are able to make decision with support about their care and leisure pursuits. The service user or relatives and representative signatures on the care plans and also on the records of review meetings for the service user evidenced this. There is no new admission to the home since the last Key inspection. The Service User Guide and the Statement of Purpose have both been reviewed, and are now in a format, which is suitable for people diagnosed with Learning disability. The AQAA informs assessment is conducted professionally and sensitively and involves the service user and their family or Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: representative. We observed where the assessment is undertaken by social services, the home obtains a copy and a copy of the care plans also. Current and prospective service users are able to make informed choices about the suitability of the home and its ability to meet their needs. The Statement of purpose now contains information about fees the home charges and how these are to be paid. Care Homes for Adults (18-65 years) Page 12 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. Service users are involved in the review of their care, and agreed changes are documented in their care plans, thereby ensuring all care workers have access to this new information. The home encourages service users to make decisions about their daily lives, and to take risks as part of their independent lifestyles, with assistance from the key worker when necessary. Evidence: Random review of service users files demonstrated that service users assessed needs are documented in the care plans and the reviews demonstrated that changing needs are recorded. Three service users files were reviewed and it was apparent their aspirations and goals were documented with outcomes for each. All of the service users were present during the visit and each one introduced themselves to the inspector. We are of the opinion that the service users are aware of their likes and dislikes, their goals and aspirations as they were able to discuss quite openly with the inspector different aspects of their week day pursuits. It is obvious from the information contained in the care plans that the service users were involved in Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: planning their changing needs, and achieving their personal goals. One service user has demonstrated an interest in gardening, and is being actively supported by the staff team in achieving this goal. Care workers spoken to say the assessment of needs is carried out consistently, and that the service users and their families are very involved. Full review of care needs is carried out on a yearly basis with the service user, the care manager and the relatives and all present are required to sign the agreed care plans. It was apparent that service users made decisions about their lives. Review of randomly selected service users files during tracking revealed that service users can and have changed their minds about a decision they had made and have decided to do something different on the day. In discussion with the deputy manager, we were told the homes documentation on service users choices is based on Respect, Independence, Community participation and Community presence. In discussion with care workers the inspector was told service users are involved in the care of their home. They told us lunch menus are not really planned, as they are able to have what they want, but dinner menus are planned on Mondays for the week following which they do the food shopping. The deputy manager told us service users are out of the home every day of the week doing their chosen activities. Household duties are planned around the service users personal activities and their free time. Review of the service users documents revealed service users are encouraged and supported to take risks to enhance their lifestyles supported by suitable risk assessments in place. Care Homes for Adults (18-65 years) Page 14 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 service has a strong commitment to enabling service users to develop their skills, including social, emotional, educational, cultural communication and independent living skills. They are encouraged and supported to identify their goals, and aspirations and work to achieve them. This will enable the service users of this home to make choices in accordance with their abilities and develop usable independent living skills. Evidence: The observed interactions between care workers and service users were relaxed and friendly creating a warm and friendly homely feeling. Documented evidence kept at the home demonstrated service users are encouraged to live a full life and to partake in age related activities such as going to the pub, having meals out attending college of further education, participate in various sports, go shopping and going to the cinema. Their religious beliefs are documented and acknowledged. In discussion with Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: service users we were told their spiritual needs are being met by the home in agreement with the service users. Review of service users records and in discussion with care workers it was documented that Service users are encouraged to make friends outside of the home and to keep in touch with their friends and families as they wish. Service users are enabled to entertain their guest in the privacy of their bedroom if they so wish. On the day of the Visit there were no visitors to the home. Records also indicated and supported by the AQAA and also in discussion with service users, that service users attend college of further education, enjoy suitable work experiences for two days of the week. The manager told us the home is run on the basis that it is a family home where each member is allocated tasks within their capabilities and sometimes tasks are allocated that will stretch the service user, who is always supported and enabled by their key worker and service users, achievements are always acknowledged. Completed risk assessments were observed for service users where it is assessed as necessary to the development of the service user. We were told care workers aided by the service users provide catering service for all at the home. The inspector did not sample the mid-day meal but the service users indicated it was delicious, and the amount was right. The inspector noted a good amount of dry, frozen and fresh food in the home. We observed Service users are allowed to make drinks as they wish with assistance from their key worker if needed. The manager told us that at their weekly menu-planning meeting they discuss the advantages of healthy diet and aid the service users in making healthy choices. They discuss the meals for the week with each service user encouraged to make at least one choice of main or evening meal. The service users on a weekly basis do food shopping. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and health care 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 homes delivery of personal care and support is highly flexible, consistent and reliable ensuring that service users receive personal care and support in the way they prefer; and that their emotional and health needs are met Evidence: Discussions with the Manager, two service users and care worker, indicated each service user received the agreed personal care and support as directed in the care plans. Physical and emotional needs identified in the care plans are also met. The care plans are reviewed on a regular basis, visits to the doctor dentist, and dietitian are carried out on an as required basis. Daily care notes are documented dated and signed by the key worker or other care worker as necessary. We were told service users are offered and encouraged to use their right to choose what to do, when to do it, what clothes they buy and wear. The AQAA informs service users are actively encouraged to be involved in making choices in the way the home is run. Review of randomly selected service user files revealed that no service user at the home is risk assessed as capable to self-administer their medication. Staff trained to do so administer medication; thereby service users are being protected by the Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: homes policies and procedures on administration of medication. A review of the medication records demonstrated that medication is being administered within the homes policy and guidelines of administration of medicines. We observed medicines are being stored correctly and records of all medication received, administered and returned are kept and are available for review. Care Homes for Adults (18-65 years) Page 18 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 operates in a manner that supports service users to air their views and concerns, which are acted upon before they can become complaints. Robust safeguarding policies are in place to protect the service users from abuse neglect and self-harm. Evidence: The Annual Quality Assurance Assessment (AQAA) revealed no complaints made to the home since the last inspection. During the inspection visit we were told the home has since the submission of the AQAA received one complaint which is being dealt with along the lines of the care homes policy on managing complaints. Included in the service users personal folders is the homes complaints policy and service users guide, developed in pictorial and widget symbol format. We were told issues raised by service users are dealt with instantly before they can become complaints. Random sample of care workers files and in discussion with the manager and care worker it was evidenced that care workers are being trained to recognise and report any act or suspicion of abuse to service users. The manager supported this by the production of the staff training record. The manager produced a copy of the Surrey Multi-agency Protection of Vulnerable Adults Scheme dated 2008. In discussion with Care workers they were knowledgeable about whistle blowing and Safeguarding Adults procedures within the home. Care Homes for Adults (18-65 years) Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical layout of the home enables service users to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The home has a suitably maintained environment, and service users are encouraged and enabled to personalise their bedrooms. The home presents as a safe place to live with bedrooms that meet the National Minimum Standards for Younger People. The management has a good infection control policy: they seek advice from external specialists, e.g. infection control, and encourage their own staff to work to the homes policy and procedures to reduce the risks of infection. It was noted in care workers file that they attend regular training sessions on Health and Safety issues. Care workers spoken to were knowledgeable about suitable storage and disposal of waste, and the need to keep all dangerous substances in a locked cupboard to prevent risk of harm to service users. The home presents as comfortable with large kitchen living room and dining room. All service users have their own bedroom with en-suite facilities. There is a large garden, which is laid mainly to lawn with garden furniture strategically placed for the use of the service users. The atmosphere in the home on the day of the visit was friendly and relaxed. Requirements issued on the last Key Inspection on this outcome have been carried out in a timely fashion. 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. Care workers employed in the home are trained, skilled and in sufficient numbers to support the service users who live at the home, and to support the smooth running of the home. Evidence: Review of service users care plans indicated their named key worker supports service users. Review of care workers training files indicated the manager encourages and enables carers to undertake external qualifications beyond the basic requirements to enable staff to assist the service users achieve the agreed care and social needs identified. In discussion with the manager we were told the home employs their own trainer, from a private company who identifies and fulfil the identified training needs of the care workers. The home is also updating their training based on the Learning Disability Framework Awards as a sound introduction to care practises for staff caring for service users with learning disabilities. The home keeps an up to date training matrix which enable management to see at a glance that training has been accessed in a timely fashion. Review of the staff rota indicated that adequate numbers and skill mix of care workers are on duty over any twenty-four hour period to meet the needs of the service users. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: In discussion with care workers it was verified that normally the home provided training and regular updates for them. The home has a new and improved recruitment policy and procedure, based on their equal opportunities policy that has the needs of the service users at its core, which is adhered to. Care workers were very pleased to inform us of their strength in caring for service users at this home based on each service users assessed equality and diversity needs. It was noted that all members of staff were recorded as having had an application to the Criminal Record Bureau (CRB). Review of staff files demonstrated Schedule 2 of the Care Homes Regulations 2001 (Amended) was being observed by the home. 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. The manager ensures that care workers follow the policies and procedures to maintain the health, safety and welfare of the service users. Evidence: The registered manager assisted with the inspection. The manager is registered with CQC [CSCI] as the manager for the home. There is a strong ethos of being open and transparent in all aspects of the running of the home. The home is service user focused and the manager leads and supports a strong staff team who have been recruited and trained to a high standard. In discussion with service users they were able to discuss their care plans and how they were involved in the planning and evaluation. One service user in particular was very able to discuss changes they had instigated and areas they felt they needed increased to ensure their care needs are fully met. From the evidence gathered we came to the conclusion that some service users in this home are confident their views underpin self-monitoring, review and development by Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: the home to ensure their personal and diverse needs are met. All service users spoken to answered questions when asked and they appear to be very confident with a stranger in their home. We were told that residents and staff meetings were held and that service users and care workers opinions were listened to and acted upon. The manager provided minutes of these meetings to support this claim. Service users are encouraged and supported to make choices even when these choices might involve some degree of risks, for which appropriate risk assessments are completed. Each service user is registered with the local GP practice, which they access as required. Chiropody service and dental service is also accessed as required. Service users have access to the wider primary health care services and the manager said she is aware of whom to contact if the need arises. The manager ensures that at all times the health, welfare and safety of the service user and care staff are promoted and protected by having suitable numbers of trained care workers on duty at all times to meet the assessed needs of the service users. The management and administration of the home is based on openness and respect, has effective equality and diversity and quality assurance systems to ensure service users views are obtained and acted upon. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R 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 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 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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