Care Home: Kean Street, 17

What the care home does well The project continues to provide a caring, safe and enabling environment for people who use the service provided by a dedicated and skilled staff team. Time is taken to listen to people, their wishes, needs and meet them. What has improved since the last inspection? There is a new care planning system called pathway that has been introduced that encourages and enables people who use the service to take more control over their lives by making decisions and taking responsibility for their actions. This has led to more person focused activities provided that are really aimed at what people actually enjoy and want to do. These include individual activities and those that involve the whole project making good use of resources and facilities available in the project and community. The medication recording and checking system has been re-designed by two of the staff team is far more efficient and cross references if people have taken their medication, when and if the tablet count corresponds to the records kept. What the care home could do better: The lifts in the building have broken done intermittently since April 2009 and this is an on-going problem. Key inspection report Care homes for adults (18-65 years) Name: Address: Kean Street, 17 17 Kean Street Covent Garden London WC2B 4AZ     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: Wynne Price-Rees     Date: 2 6 1 0 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: Kean Street, 17 17 Kean Street Covent Garden London WC2B 4AZ 02072408338 02072408558 oliverkemp@lookahead.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Look Ahead Housing & Care care home 31 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: 31 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 Keane Street is a care home for 31 people with severe and enduring mental health needs encouraging people to live as independently as possible. Peabody Trust owns the property with the care provided by Look Ahead Housing and Care. There are 31 self-contained flats on four floors with lift access to all floors. Each flat has a lounge/bedroom, kitchen and an en suite bathroom and toilet. On each floor there is a communal lounge, kitchen and bathroom. People who use the service have the facilities to prepare meals in their flats and a choice of meals is also provided in the lower ground floor dining area. In the basement there is a large dinning area which holds a pool table and table football. There are two communal lounges and also a small Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 31 2 5 1 1 2 0 0 8 Brief description of the care home well equipped gym. Externally, there is an attractive patio and garden area to the rear of the home and a balcony with potted plants on the same level as the reception area. 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: The quality rating for this service is 3 stars. This means people who use the service experience excellent quality outcomes. The inspection was unannounced and took eight hours spread over two days on the 6th and 10th of November 2009. During the inspection, the Care Manager, people who use the service and staff were spoken with to find out their views about the service. Seven questionnaires have also been returned by people who use the service. Care practices were observed, records and procedures checked and a premises tour undertaken. All key standards were inspected and this information compared to the AQQA annual selfassessment document returned to us by the project and triangulated with all the information we have received since the last key inspection. This gives us the new quality rating. An AQQA is a self-assessment document completed the project that tells us how well they think the service is performing. We sampled the pathway plans of three people who use the service. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs fully assessed before moving in and they choose if they want to move in. Evidence: I visited before moving in. The project has a thorough assessment policy and procedure that a sample of three files of people who use the service demonstrate is followed. All referrals are made by Westminster Community Mental Health Team who are part of Westminster City Council. Currently there is one vacancy and the project will be taking referrals on the Monday following the inspection. All referrals are accompanied by a risk assessment that enables the home to decide if needs of people who use the service can be met. The assessment is carried out jointly with people who may wish to use the service and if everyone agrees needs can be met and the placement is what people want an initial six week license is granted. At the end of this period the placement is reviewed to make sure the person using the service is still happy living at the project and the staff team feel the placement is appropriate. Assessment information provided includes departure notes, discharge summary and adult mental health assessments. No new Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: people who use the service have moved in since the last key inspection. Some of those spoken with and questionnaires returned confirmed they were able to visit the project and carried out a joint assessment before deciding if they wished to move in, this was the type of support they needed and wanted. They also confirmed they had received enough prior information about the project to decide if they wished to move in or not. 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. There are comprehensive care plans that show how people who use the service are supported to develop their independent living skills. People who use the service are encouraged to make their own decisions within a risk assessed environment. Evidence: I regularly look at my plan with my key worker. People who use the service and questionnaires returned confirmed that everyone has a pathway plan that they input into as much or as little as they wish. A sample of three plans demonstrated that all the areas required by standard six were included. Initially the plans are put together with the person using the service using information that they had agreed was correct and any other information provided as part of the referral. The pathway plan is a new system that has been introduced since the last inspection contains twelve main support areas and aims to enable people who use the service to take more responsibility, control and give them more choices. All pathway headings are entitled myself. One person who uses the service is putting forward an argument Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: for moving from the fourth floor to the ground floor using the pathway system and has submitted an application accordingly based on this. The system identifies high, medium and low levels of need based on the level of support required. All aspects of the plan have to be agreed between the person who uses the service and their key worker. If the person who uses the service feels they do not need support in certain areas of the plan and the key worker thinks they might need some support, that area is broken down into four pillars and discussed. Together they look at the support area in greater detail and highlight parts of it that the person who uses the service may feel would be useful to have supported. If they feel they still dont need any support a risk assessment is carried out specific to this particular area and if the risk is high appropriate monitoring is put into place. All pathway plans are discussed during key worker sessions, weekly team meetings and any risks are notified to the placement monitoring team. Each key worker session reviews one of the twelve key areas identifying which area has the highest priority. The sessions take place monthly or as and when required depending on type and level of support need. The plans are underpinned by risk assessments that are reviewed six monthly or when needs and circumstances change. All staff are made aware of any changes daily and these are recorded on the daily contact sheet. The team has access to a toolkit that helps them to operate the system and includes information on questions you can and cannot ask, how to avoid asking leading questions and appropriate language to use in order to facilitate as much choice as possible. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service take part in appropriate activities at home and within the community, maintain good contact with family and friends and their rights and responsibilities are recognized. They receive a healthy, balanced and nutritious diet. Evidence: There are a lot of activities to choose from. I tend to do what I want rather than group activities. I enjoy the gardening group. The James Bond themed party was great. Activities are incorporated within individual pathway plans and a sample of three of the plans demonstrated they are used to help people who use the service and staff to identify what people would like to do and then source available resources within the home and externally to provide appropriate activities. This means that activities provided are tailored to the needs and wishes of the individual rather than the other way around.They are also risk assessed. With the introduction of the pathways system Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: activities have become more individualized although there are a number of well established groups such as the art group and new ones like the gardening group. Pieces of art produced by people who use the service are displayed around the home and the gardening group have established a cabbage patch to produce produce for the home and there are plans for flowers with the predominant choice of roses being planting . Other flowers will also be planted to decorate the project. The gardening group takes place weekly with a community gardener visiting every other week. Activities have been identified to take place on each shift and staff have been given information about the best way to deliver them. The current affairs guidance says tea or coffee should be made before starting and a selection of newspapers and articles provided from which debate can be encouraged. During the inspection a current affairs session took place and the guidance was followed. Information about the activity is included in staff handover sheets to inform those coming on duty. It is the choice of people who use the service if they wish to participate or not. Other available activities provided include film mornings using the projects own projector, social club and walking. Good use is also made of local amenities such as shops, cafes and a sports centre that provides access to swimming. They also play tennis at Lincolns Inn. The communal eating area has been re-styled into a cafe with opening times of 8 am to 6 pm with the opportunity to eat outside in the garden area if people wish. This provides more variety of choices and extended times when meals and snacks are available giving greater choice to people who use the service. A questionnaire has also been filled in during key work sessions to identify meal likes and dislikes to further improve the quality and variety of meals. These have been incorporated within menu planning and from 1st October if people who use the service let the catering staff know if the choices available are not what they want, by 11 am and 4 pm for respective main meals they are given further options. People who use the service monitor their diets with staff as part of the pathway planning to help maintain a healthy diet. After extensive consultation people who use the service chose a James Bond themed party as their main star activity of the year, making posters starring people who use the service. Some people who use the service dressed up, there was a fruit cocktail bar, Bond quiz and itinerary created in the style of a spy memo. The latest Bond movie release was also shown with surround sound. Ninety people were invited with fifty attending including friends from other projects and volunteers made a casino in the basement. A Halloween party has also been planned with a pumpkin designing workshop. People who use the service have sourced a number of courses to enhance their skills including painting and decorating, history of art through language and computer literacy. Someone regularly attends church and some people go to the Rainbow Club that is a mental health well-being group. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: Appropriate family links are maintained and one person who uses the service is going on holiday with their family the week after the inspection. Someone else is frequently visited by their sister. Care Homes for Adults (18-65 years) Page 15 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. People who use the service have their physical and emotional health needs met. Medication is suitably administered, recorded and there were no errors . Evidence: I self-medicate. The project does not generally provide personal care although staff will provide support if required. Part of the pathway system objective is for people to take more control and responsibility and therefore people are enabled, prompted and encouraged to develop a healthy lifestyle and look after their personal hygiene as part of life-skill development. Health needs and awareness are incorporated within the support plans and diet regularly monitored. The people who use the service are registered with GPs and have access to community based health care services including district nurses and the community mental health team. They are encouraged and enabled to make and keep their own medical appointments. They are also offered annual health checks. Currently there are three people who use the service who are self-medicating. This is incorporated within their pathway plans and uses a stepped supported system that leads to people eventually being completely self-medicating. Medication is monitored Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: as part of risk assessment. The medication recording system is greatly improved with cross referencing of Medication administration sheets and a handover folder that is checked by each shift going off or coming on. There is a stock check book. The new system was developed by two staff team members. The MARR sheets and stock book were checked and found to be up to date and accurately recorded. MARR sheets are medication administration records. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can feel confident they are listened to and their complaints and concerns investigated with outcomes. They are safe and well protected by the adult protection procedures in place. Evidence: I know how to complain when I have to. There is a written complaint policy and procedure that people who use the service said they were aware of. A record of complaints is kept although there are none currently. The procedure and records meet the requirements of the standard and show people who make complaints have them taken seriously and they are fully investigated with outcomes recorded. Each complaint is numbered and reviewed in batches to identify if there are any emerging patterns. Incidents records are also kept and forwarded to us. These forms are called regulation 37 notifications. Currently there is one POVA issue that is being investigated by the police. POVA is the protection of vulnerable adults. POVA training is included as part of staff induction and there are annual refresher courses available. Staff have access to adult protection training that is provided by Westminster City Council. The recruitment interview also includes questions around adult protection and what someone would do in certain scenarios. Staff are also CRB cleared before starting work unsupervised. CRB is the Criminal Records Bureau. There is also a policy and procedure regarding aggression by people who use the service and a direct line to the organization should someone think abuse might be Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: taking place. Personal finances are included as part of the support plan to encourage life skill development and gain confidence. Any monies held on behalf of people who use the service is fully documented with transaction, balance and receipt. 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. People who use the service live in a safe, comfortable and homely environment. Everyone has their own bedroom and there are suitable communal areas provided. There are concerns surrounding the reliability of the lifts Evidence: Im satisfied with my flat. It gets a bit cold when the garden doors are left open. I find it very relaxing. A tour of the premises showed that it is suitable for the stated purpose. People who use the service have their own flats and the communal areas have been brightened up by hanging works of art that they have created. The cafe area has also been redecorated by volunteers. There are communal areas on each floor and a main communal lounge in the basement with a pool table and small cinema that leads to the garden. The garden has been well-developed by the project gardening team that is made up of people who use the service. Cabbages have been planted and they have also have plans for further development. The project was clean, tidy and well maintained although one area of concern is the lifts that periodically breakdown. A new company has been awarded the lift maintenance contract and was in attendance during the inspection. 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. There are suitably trained, competent and diverse staff employed to meet the needs and wishes of people who use the service that have been properly vetted. People who use the service can be confident that they are protected by the homes robust recruitment policies and procedures. Evidence: The staff are pretty good. I check my plan with staff. They always treat me well. They usually listen. Care practices observed showed that staff are very supportive and patient with people who use the service and listen to what is being said rather than putting words in peoples mouths. They support and encourage people to get their point of view across. They also encourage people who use the service to develop their life skills by using facilities within the community. The staff rota demonstrated there are staff in enough numbers during the day and night to meet the needs of people who use the service. Currently there is one staff vacancy for a support worker and the project is looking to fill the post within the organization. Staff receive induction training at Kean Street that compliments the training provided by the organization. They are given the opportunity to go through policies and procedures and receive mandatory training in health and safety, fire and medication administration. The induction consists of a series of modules all of which must be Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: completed and signed off. This takes approximately twelve weeks. There is also POVA first training that takes place at head office. Staff have access to a twelve monthly rolling training programme that is reviewed in consultation with front line staff to make sure their needs are met. Staff also have access to training provided by Westminster City Council. Over 80 of staff have attained NVQ level 2 or above. There is a thorough recruitment policy and procedure that a sample of staff records showed is followed. It meets the requirement of the standard. Wherever possible people who use the service are involved in the recruitment procedure sitting in on interviews and conducting premises tours. Staff receive a handbook with their contracts outlining duties and expectations. 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 home is well managed in the best interests of people who use the service and the quality assurance system is effective. Health and safety is well managed meaning people who use the service live in a safe environment. Evidence: A new Contracts Manager was appointed in April 2009 who has applied for registration and is currently undertaking an NVQ level 4 management qualification. They have a business degree and had been a Team Leader at Kean Street for the previous two years. The project has a quality assurance system that contains identifiable performance indicators. These identify action to be taken and action plans. The system includes monthly person in control visits during which a minimum of two people who use the service and staff must be interviewed. There is an annual two day quality assurance audit and surveys are sent out to people who use the service. Monthly house meetings also take place and there are three monthly contract monitoring meetings. There is a comprehensive strategic work plan developed after consultation with staff and people who use the service that includes key areas such as service delivery, staff, Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: quality assurance, regulatory compliance and customer involvement with timescales. There was an annual up to date building risk assessment in place, fire evacuations take place six monthly with the last on 3rd July 2009, fire point are tested weekly and the fire fighting equipment was checked and serviced in August 2009. Fire door seals have also been replaced in the last six months. There is also a project map in the event of fire that indicates risks to person, action to take for evacuation depending on the individual. The PAT tests of portable electrical goods took place in September 2009 and are updated whenever someone brings an appliance to the project. Fridge and freezer temperatures are checked and recorded twice daily. COSHH procedures have recently been updated as part of quality assurance. COSHH is control of exposure to hazardous waste. Security checks take place each shift. 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 29 23 The lifts must be maintained 25/02/2010 and serviced so that they work. The lifts have regularly been braking down since April 2009. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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