Care Home: Jude House

What the care home does well `I came here to meet people before I lived here`. Comment from a resident. `We have meetings to talk about what`s happening and the staff help me if I want to do something`. Comment from a resident. `The staff here help me to make sure I stay well`. Comment from a resident. `I`m safe here`. Comment from a resident. During this visit we found that the provider had excellent systems for assessing potential new residents to make sure their care needs could be met in the home. Residents were fully involved in planning and reviewing the care and support they received. Residents told us that they felt well supported and safe in the home and that any concerns they might have would be treated seriously by the staff, manager and provider. The home provides good standards of communal accommodation and residents` bedrooms were very individual, well decorated and furnished. The home is well managed and the provider has clear policies and procedures to make sure that people living in the home experience excellent outcomes. What has improved since the last inspection? When we last inspected the home in October 2007 we made three requirements to improve the management of residents` prescribed medication, improve the home`s bathroom and maintain a record of staff training. The manager told us when we did an Annual Service Review in August 2008 that all three requirements had been met. During this visit we saw that residents` medication was well managed, the bathroom had been refurbished and a good record was kept of staff training. What the care home could do better: Following this key inspection our judgment is that the home is providing excellent outcomes for residents. We have made one requirement to make sure that fire doors in the home are not wedged open at any time. Key inspection report Care homes for adults (18-65 years) Name: Address: Jude House 92 Randall avenue Neasden London NW2 7SU     The quality rating for this care home is:   three star excellent 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: Tony Lawrence     Date: 3 1 0 7 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: Jude House 92 Randall avenue Neasden London NW2 7SU 02084520336 02088307258 rc.homes@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Lucille Rabor care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 4 The Registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Jude House is a four bedroomed home on a quiet residential street close to the North Circular Road and local amenities. It is a registered home for four adults whose primary needs are mental health. It has three floors, with one bedroom on the ground floor, two bedrooms on the first floor and one bedroom on the top floor, this bedroom has its own en-suite facilities, with a toilet and shower. On the first floor there is a bathroom and a small separate shower room. There is parking to the front of the house and a garden and patio area to the rear of the home. The Registered Provider owns three other registered care homes in the same area and Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 Brief description of the care home some staff work between these homes. Details of the weekly fees can be obtained from the homes manager. 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: three star excellent 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: This unannounced key inspection took place on Friday 31st July 2009 from 10:00 14:00. During this visit we reviewed outcomes for residents against the key National Minimum Standards for care homes for adults. We did this by spending time talking with residents, staff and the homes manager. We also checked care records kept in the home and saw all communal parts of the home and residents bedrooms, with their permission. The manager also sent us the Annual Quality Assurance Assessment (AQAA) when we asked for it in May 2009. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service.The AQAA was clear and gave us all the information we asked for. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Significant time and effort is spent planning to make admission to the home personal and well managed. Prospective residents are treated as individuals and with dignity and respect for the decisions they need to make. Evidence: I came to see the house a couple of times before I moved in. Comment from a resident. I came here to meet people before I lived here. Comment from a resident. All potential service users are given a copy of the Service User Guide and brochure to help them make an informed choice. We only admit clients who weve assessed and feel that we could provide a good quality service to meet their needs. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we spoke with two people who lived in the home. They told us that they had been given information and visited the home before deciding to move in. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: They said that they had met other residents and staff and stayed overnight as part of their moves. We saw that the homes Service User Guide gave people clear information about the home and the services provided, their rights and responsibilities. We saw from the three peoples care plans we checked that staff from the home completed a detailed Assessment Portfolio. The assessments were completed with the potential residents and people involved in their care and covered all areas of each persons personal and health care needs. Each of the care plan files also included discharge summaries, nursing reports, psychology and occupational therapy reports from the hospitals people had moved from. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The key principle of the home is that people using the service are in control of their lives and they direct the service. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. Evidence: I talk to the staff about my care plan and what I want to do. Comment from a resident. We have meetings to talk about whats happening and the staff help me if I want to do something. Comment from a resident. Based on a thorough assessment, review and reevaluation process together with service users, we develop care plans and risk assessments based on need. We support clients in managing their independence and maintaining their dignity. Extract from the providers Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: During this visit two people told us that they had worked with staff to write their care plans. They said that they were able to agree goals with staff that covered areas where they wanted to develop more independence. We looked at the care plans for three people and saw that each plan included a current care plan. We saw evidence that people were involved in agreeing their own care plans and the goals that were included. The plans were person-centred and covered all aspects of personal and health care, including physical and mental health; medication; daily living skills and building relationships. Each care plan area included clear guidance for staff on the support they should provide. We saw that staff reviewed each care plan area every month. When agreed goals were met, the care plan area was closed and signed off by the resident and staff. We also saw that each of the care plans included detailed risk assessments. The assessments covered potential risks identified in risk screening assessments completed as part of the care plan agreed by all agencies supporting each resident. We saw that the assessments focused on maintaining each persons independence and included clear guidance for staff on minimising identified risks. Each risk assessment was reviewed and updated by staff each month. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a strong commitment to enabling residents to develop or maintain their skills, including social and independent living skills. Individuals are supported to identify their goals and are supported to achieve them. Evidence: Im going on holiday to the Isle of Wight soon and Blackpool later in the year. Comment from a resident. I enjoy the food, theres always plenty. Comment from a resident. We encourage service users to access mainstream community facilities. We support and encourage families and friendships where these are in the best interest of the service user. Extract from the providers Annual Quality Assurance Assessment (AQAA). Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: During this visit we looked at the care plan files for three people living in the home. We saw evidence that staff supported people to take part in a range of community activities. These included maths, English and computer classes at the local adult college, art therapy sessions at the day hospital and information technology and Working Life Skills courses at a local drop in centre. Residents told us that staff talked to them about things they wanted to do and supported them to identify and apply for appropriate activities. As well as educational opportunities, they told us that they went to the cinema and bowling and on holidays each year, supported by staff. Two residents told us they were able to take part in leisure activities they chose. Both people had a TV in their room and one person showed us his music system and collection of DVDs. One person told us that he could go out whenever he wanted and sometimes went out on his bike. Another person told us that he went out regularly with staff support. The providers Service User Guide clearly detailed the rights and responsibilities of people living in the home. Residents told us that they were registered to vote in local and general elections. The care plans we saw included details of residents relatives, friends and other significant people, together with their contact details. We saw that staff always recorded visits by these people and asked them to write any comments in the persons care plan file. The comments we saw from relatives were all very positive about the care and support provided in the home. The manager told us that an Occupational Therapist (OT) was employed to work with people living in the providers four care homes. The OT carried out assessments of each persons daily living skills and supported individuals with cooking skills, if needed. Two residents told us that they enjoyed the food provided in the home. They told us that meals were varied and nutritious. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive effective personal and health care support using a person centred approach, based on the rights of dignity, equality, fairness, autonomy and respect. The home fully respects the rights of people in the area of health care and medication. Evidence: Staff help me if I need to see my GP or go to hospital appointments. Comment from a resident. The staff here help me to make sure I stay well. Comment from a resident. All medication interventions are documented by staff. We have annual health checks where clients have blood tests, blood pressure and weight taken during this time. Clients who have diabetes are supported through regular health checks and monitoring of sugar levels on a regular basis. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we reviewed the personal and health care records of three people living in the home. We saw that the ways people preferred to be supported with their Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: personal care were well recorded and reviewed regularly as part of their care plan. residents told us that any support they needed with their personal care was provided with respect for their dignity and privacy. also We also saw clear evidence that staff from the home worked well with clinicians and other professionals to make sure that individuals health care needs were assessed and reviewed regularly. We saw that the home made sure detailed reports and assessments were provided by hospital staff and other agencies before people moved into the home. The manager and staff told us that this information was used to develop person-centred care plans to make sure identified health care needs were met in the home. For one resident this meant that staff had supported them over a period of time to lose weight, as recommended by their GP. All three files we checked included a good record of all health care appointments, including GPs and hospital clinics. We saw that realistic goals were identified with individual residents and agencies supporting them and staff supported people to work towards meeting these goals. The home used a monitored dosage system provided by a local pharmacist for each residents prescribed medication. The manager told us that this system worked well and the pharmacist delivered medication each week. We saw that medication was securely stored in a lockable cabinet in the homes office. We checked the records of medication given to each person in the home and saw that these were well kept. Staff also kept very good records of any non-prescribed medication given to residents. The manager also told us that she met annually with the pharmacist, GP and practice manager to discuss and resolve any issues concerning peoples health care or medication needs. 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 has a complaints procedure that is clearly written and easy to understand. The policies and procedures for safeguarding adults are available and give specific guidance to those using them. Training of staff in safeguarding is regularly arranged by the home. Evidence: Im safe here. Comment from a resident. If I was worried about anything Id talk to the staff or (the manager). Comment from a resident. Ive had adult protection training and Id talk to the manager if I had any concerns. Comment from a member of staff. We will take all complaints seriously and will proactively seek to reduce any cause for complaints or dissatisfaction by talking and getting feedback regularly from our stakeholders and service users. We strive to understand that our clients feel restricted and out of control of their personal destiny by the mere position of living in a care home and this is often reflected in their attitudes towards each other and staff. Extract from the providers Annual Quality Assurance Assessment (AQAA). During this visit we saw that the home had a clear complaints procedure that was Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: given to residents as part of the Service User Guide, before they moved into the home. Residents told us that they would talk to staff if they had any complaints and they were confident they would be dealt with appropriately. One resident also told us that regular house meetings could be used to talk about and resolve any disagreements. We checked the homes record of complaints and saw that there had been one formal complaint from a neighbour since our last inspection. We saw that this had been well managed and the manager told us the person who complained was happy with the outcome. We also saw that the home had a copy of the local authoritys safeguarding adults policy and procedures in the office for staff to use. The manager told us that she had completed safeguarding training with the local authority and there had been no safeguarding referrals or investigations since our last inspection in 2007. The manager also told us that all staff working in the home had completed in-house safeguarding training. The manager demonstrated a good knowledge and awareness of the Mental Capacity Act and Deprivation of Liberty Safeguards and the implications for people living in the home. We saw good evidence that she had worked well with the local authority to make sure that capacity assessments were completed for 2 people living in the home and actions taken as a result were recorded and agreed by all agencies working with the person. 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 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 a very pleasant, safe place to live. People are encouraged to personalise their bedrooms and the home promotes the privacy, dignity and autonomy of residents. Evidence: Im happy with my room, I have my music and TV here. Comment from a resident. Its a good room, Ive got what I need. Comment from a resident. The environment is clean, tidy and free from odour. We have a maintenance book in place for any identified problems which arise and are signed off on completion. All repairs are brought to the attention of the manager and dealt with ASAP. A smoking shelter has been erected at the back of the house and is well used. Extract from the providers Annual Quality Assurance Assessment (AQAA). Jude House is a four bedroomed home on a quiet residential street close to the North Circular Road and local amenities. It has three floors, with one bedroom on the ground floor, two bedrooms on the first floor and one bedroom with ensuite shower and toilet on the top floor. On the first floor there is a bathroom and a small separate shower room. The lounge and kitchen are on the ground floor. There is parking to the front of Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: the house and a back garden and patio, with a covered smoking area. During this visit we saw all private and communal parts of the home. Communal areas were well decorated and comfortably furnished. Residents bedrooms were very individual, well furnished and decorated. We saw that all parts of the home were clean and hygienic and residents told us they were very happy with the accommodation provided. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the staff who care for them. All staff receive relevant training that is focussed on delivering improved outcomes for residents. People who use the service are regularly involved in the recruitment of staff. Evidence: The staff are good, they will all help me if I want them to. Comment from a resident. The staff all have relevant experience and training in the mental health field. Potential new staff are introduced to service users at the 2nd interview stage where possible and we observe how they interact with clients naturally before making a decision to employ. Extract from the providers Annual Quality Assurance Assessment (AQAA). When we arrived for this unannounced visit there was one person on duty, supporting two residents. The homes manager and administrator arrived shortly after. The manager and staff told us that there were usually two staff on during the day and one person on call in the home overnight. This was confirmed by the homes rota. During this visit we saw that staff worked well together to make sure that residents were supported promptly and appropriately. Staff told us they had good access to relevant training. 90 of staff had completed Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: their National Vocational Qualification (NVQ) Level 2 training. The manager confirmed that an annual training report had been completed for all staff, to identify training that was needed. Staff and the manager told us that all staff had formal supervision every six weeks and an annual appraisal of their work. The manager also confirmed that references and Criminal Record Bureau (CRB) checks were carried out as part of the homes recruitment processes. A record of CRB checks was kept in 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 has the required experience and qualifications and is competent to run the home. The manager has a clear understanding of the key principles and focus of the service. They provide an increased quality of life for residents with a strong focus on equality and diversity issues and promoting human rights. Evidence: Management and staff are qualified and receive training to regularly update their knowledge and practice through proactive continued professional development. Extract from the providers Annual Quality Assurance Assessment (AQAA) During this visit the manager told us that she had worked in social care since 2002 and was appointed to manage the home when it opened in 2007. She also told us she had completed her National Vocational Qualification (NVQ) Level 4 training and a degree in psychology. We have registered the manager as a fit person to manage the service. During our visit the manager showed us she had a good knowledge of current best practice in social care and mental health, including the Mental Capacity Act and Deprivation of Liberty safeguards. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The manager sent us the Annual Quality Assurance Assessment (AQAA) when we asked for it in May 2009. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the home. The AQAA was well completed and gave us all the information we asked for. Residents and the manager told us that a satisfaction survey was completed twice a year and residents meetings were held every two weeks. The manager told us these were used to review the services provided in the home and develop action plans to improve service delivery. Information from the AQAA was evidence that the provider had developed all of the required policies and procedures and these were reviewed regularly. During this visit we reviewed a selection of care records kept in the home. These included residents care plans, risk assessments, medication and finance records. We saw that all of the records were well maintained and up to date. While we were in the home we saw no health and safety issues, but staff must make sure that fire doors in the home are not wedged open. The manager told us that the providers General Manager carried out monthly monitoring visits to the home. The visits were unannounced and a written report was sent to the home following each visit. 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 42 23 Staff must make sure that fire doors in the home are not wedged open at any time. This will help to make sure that residents, staff and other people are safe in the event of a fire. 30/09/2009 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!