Care Home: Lambert House

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What the care home does well Care plans are very well written and give good and detailed information about the individual and how their needs should be met. We saw evidence that the care plans were kept under constant review and updated whenever necessary. Staff support people living at the home to enjoy a lifestyle that reflects their preferences and personalities. A wide range of activities, including training and work experience, are available. Activities were also used to provide opportunities to encourage and support independence as far as the person was able. We spoke with the manager and three of the staff during the course of the inspection. All were experienced and well qualified. The staff spoken with demonstrated a good understanding of the needs of the people living at the home and a commitment to the work they do. It was clear that people using the service were at the centre of all that takes place in the home. The service has a very robust recruitment procedure in place and this is commended. It means that people using the service can be confident they are protected from abuse. There is also a very positive attitude towards staff training and this ensures that people are cared for by competent and well qualified staff. What has improved since the last inspection? Since the last inspection, areas for improvement have been identified and work implemented. At our last inspection, we made four requirements and all of these have been met. The manager has now obtained a National Vocational Qualification at level IV and has also completed the Registered Managers Award. The complaints procedure has now been rationalised and this is available to all residents and people who visit or use the service. People living at the home are given a copy of the complaints procedure in an easy to understand format and it has also been explained to them. There have been improvements to the environment, and the requirement regarding the locks on the paint cupboard has been met. Bedrooms and communal areas have improved as a result of the redecoration programme and the replacement of furniture. Staff are now receiving regular supervision that is recorded. Arrangements have been put in place for this process to be cascaded so that staff receive supervision sessions on a regular basis. A piece of land adjacent to the home has been purchased and this offers opportunities for more outside space for the people living at the home to enjoy. What the care home could do better: Although the way staff are supervised has improved and this process now takes place on a regular basis, improvements need to occur around the training of staff to undertake this task. Not all staff who are required to provide supervision have received formal training to do so and this needs to be rectified so they are confident and competent to carry out their role effectively. Consideration needs to be given to the bathing equipment currently installed in the home. Staff said that assistance needs to be given to some residents when bathing. It was noted that the baths are very low and could cause difficulties for staff if they need to assist people to wash or help people out of the bath. Key inspection report Care homes for adults (18-65 years) Name: Address: Lambert House 36 Notridge Road Bowthorpe Norwich Norfolk NR5 9BE     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: Geraldine Allen     Date: 0 6 0 4 2 0 1 0 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 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Lambert House 36 Notridge Road Bowthorpe Norwich Norfolk NR5 9BE 01603749845 01603749460 dianne@nacha.org.uk www.autism-anglia.org.uk Norfolk Autistic Community Housing Association Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dianne Dack Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Lambert House is are care home for up to eleven adults with a learning disability with autistic spectrum disorder. The home is owned by Autism Anglia. The home situated in the middle of a residential area in the suburbs of the City of Norwich. It is a large, detached, two storey building with parking to the front. There is a secure garden to the front of the Home and a secure paved area to the rear. The home has recently acquired land adjacent to the property that will be used as additional outside space. All service users have a single bedroom, either on the ground or first floors. The Home does not have a passenger lift. There are several communal rooms including activity rooms and a swimming pool. Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 11 Brief description of the care home The fee range at the time of inspection was between £1,400 and £2,800 per week, dependent upon the needs of the person. Please contact the service for the current fee range. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced and took place during the day of Tuesday, 6 April 2010. Before we undertook our inspection, we received a completed Annual Quality Assurance Assessment (AQAA), that had been completed by the manager, Ms Dianne Dack, and returned to us by the date we required it. We also received completed questionnaires from five staff working at the home. On the day of inspection we looked at various records, toured the premises, and spoke with the manager, staff and one person who lives at the home. We also observed practice where possible. As a result of this inspection, we have made two recommendations. The overall quality rating is that this is a two star service, this means it provides good quality outcomes Care Homes for Adults (18-65 years) Page 6 of 29 for people using the service. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: Although the way staff are supervised has improved and this process now takes place on a regular basis, improvements need to occur around the training of staff to undertake this task. Not all staff who are required to provide supervision have received Care Homes for Adults (18-65 years) Page 8 of 29 formal training to do so and this needs to be rectified so they are confident and competent to carry out their role effectively. Consideration needs to be given to the bathing equipment currently installed in the home. Staff said that assistance needs to be given to some residents when bathing. It was noted that the baths are very low and could cause difficulties for staff if they need to assist people to wash or help people out of the bath. 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 9 of 29 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 10 of 29 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 are admitted to the service only after a full needs assessment has been carried out. This assessment includes all relevant agencies involved in the persons care. People have the opportunity to visit the home so that they can meet staff and other people using the service before they moved in. Each person has a written contract that sets out the conditions in a way that helps them to understand. Evidence: There have been no new admissions since our last inspection, and so we obtained our information by looking in detail at care plans and by talking with the manager and her deputy. The manager told us that only planned admissions take place and there is a very robust admissions process. We looked at the kind of information obtained, and also the people who are involved when someone is about to move into the home. The Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: process includes formal assessments within the potential residents own home setting, and further assessment in other locations, for example day centres, where the potential resident spends time. This helps the service to gain further insight into the persons specific needs and how they should be met. Each person receives a contract that is written using pictures to help the person understand what the contract contains. Care Homes for Adults (18-65 years) Page 12 of 29 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. Each person has a plan that sets out their assessed needs and goals, and how they should be met. The plan is kept under review and regularly updated. People are supported to make decisions about their daily living and these choices are respected by staff. People are supported to take assessed risks as part of their independence. Risk assessments help to identify and reduce the level of risk. Information that is held about people using the service is handled and stored appropriately so that confidentiality is maintained. Evidence: We looked at two care plans in detail and found it very easy to understand the needs of the people and how they should be met. The care plans were well laid out and provided information not just about the persons care, but also about the other people Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: involved in supporting them outside of the home. There was particularly good information about communication There was evidence within the care plans, that people are supported to be as independent as possible within a risk assessment framework. This means that potential risks are identified and actions are taken to reduce them as much as possible, whilst continuing to enable the person to do the things they want to do. We spoke to one person living at the home and he told us he was able to make choices around his daily living. He spoke about choosing his bedroom decoration and how the room was laid out. He also spoke about going out shopping on his own and making drinks and preparing food in the kitchen. The resident also told us about his involvement in Project Search, and how this meant he was able to gain experience in a workplace setting. The standard of recording was high and we noted that all records were written using appropriate and respectful language. Peoples confidentiality was ensured because all records containing personal information was stored in a locked cabinets. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in activities that reflect their preferences and abilities. People are able to take part in activities in the local and wider community as they wish. Staff support people to maintain family links and friendships and these are fully recorded. People are involved in the daily routines of the home and are supported to be independent and to make individual choices that reflect their preferences. People are supported to make choices about the food they eat. They are offered a nutritious and varied diet and are able to access food and drink when they wish Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: On the day of inspection, there were 10 people living at the home. Of these, one was away on holiday, and most others were involved in activities outside of the home. We spoke with the staff and also one resident so that we could get a better understanding of daily living at the home. The care plans described the daily activities and programs for each person. Each program was highly individualised to reflect the needs and abilities of each person. The manager told us about the study centres run by the organisation so that people are able to learn skills that will help them to access work experience. We spoke with one resident who is currently doing work experience through Project Search. The manager spoke about some of the many activities that people can take part in within the local and wider community. These were recorded within the persons care plan as appropriate. Many of these activities include leisure such as swimming, badminton, snooker and music. We saw good evidence that people are supported to maintain their contacts with family and friends. Each care plan we looked at contained good information about all the important people in that persons life. There was also a list that detailed events and anniversaries so that the person could be supported in remembering them. People living at the home are encouraged to be involved in daily routines including, menu planning, food shopping and preparing meals. One person living at the home has their own key so that they are able to come and go as they please. Because everybody was out and about on the day of inspection, we were not able to assess the quality of food provided. On the day of inspection, the cook was unwell although alternative arrangements had been made. Each of the care plans included information about the persons preferences around food and drink and it was possible through discussion to confirm that personal preferences were considered at mealtimes. People living at the home are able to make drinks and snacks for themselves with support if necessary. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care and support that is sensitive and flexible and ensures the persons privacy and dignity is maintained. People have access to all health care services and this ensures their physical and emotional health needs are met in a timely way. Staff receive training that ensures medicines are stored, administered and recorded safely. Evidence: We saw very good evidence that showed the staff gave support to people at the home as needed, whilst encouraging and maintaining independence wherever possible. The care plans gave very good information about how the person wanted to be supported and records demonstrated that staff respected peoples wishes. The care plans contained very good evidence that demonstrated peoples physical and emotional health needs were being met. All health interventions were fully recorded and followed-through as appropriate. Records included details about all the health Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: professionals involved in each individuals care, including community nurses, GPs, consultants, speech-language therapists, dentists and epilepsy nurses. Clinical review notes were also kept on file. We looked at the arrangements for the storage and administration of medicines. The home uses a monitored dosage system and all staff have received training about how to handle and administer medicines safely. The records were looked at and these were clearly written and up-to-date. On the day of inspection, there were no controls medicines at the home. All medicines were kept securely locked. Care Homes for Adults (18-65 years) Page 18 of 29 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 clear complaints procedure which is made known to people living at the home and also visitors to the service. People are protected from abuse by staff who are well-trained and by robust recruitment procedures. Evidence: We looked at the homes complaints and compliments records. Each person receives a copy of the complaints procedure that has been written using pictures to help people understand. The complaints procedure is also displayed within the home. The manager told us that five complaints have been received during the last 12 months and all of these have been investigated and resolved within 28 days. Actions have been taken to improve the service where appropriate. We have not received any complaints about the service. We looked at the records held about complaints received and these were clear and provided information about the actions that have been taken as a result. The manager told us that she treats all expressions of dissatisfaction as a complaint and uses the process to review practice. It was very clear from our discussions with the manager, that she has a very positive attitude towards expressions of complaint or concern and this is to be commended. At our last inspection, we made a requirement about the complaints process and this requirement has been met in full. The manager told us she has made two referrals to the safeguarding adults team. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Staff told us they had received training about the protection of vulnerable people and they demonstrated a good understanding of this. We also looked at the staff recruitment process and were able to see that it is very robust and helps to ensure that people are safeguarded from abuse. Care Homes for Adults (18-65 years) Page 20 of 29 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 premises are suitable for the stated purpose and are well maintained. A good standard of decoration was seen. Sufficient numbers of bathing facilities are provided however these need to be assessed to ensure people are not at risk due to the height of baths. All communal areas are safe and easily accessible to people. The home is clean and hygienic and there are no offensive odours. Infection-control processes are in place. Evidence: A tour of the premises was completed and all areas of the home were seen. We were able to see an improvement in the environment of the home since the last inspection. Communal areas have been redecorated, with residents being involved in choosing colour schemes and furnishings. Bedrooms have also been redecorated and refurnished and people have been involved in choosing their own colour schemes and soft furnishings. Some of the bedrooms were highly individualised and reflected the persons preferences and personality. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: The dining room was laid out in such a way that it encourages opportunity for communication at mealtimes. The kitchen was clean and tidy, with some residents having access to make drinks and snacks with staff assistance as appropriate. Although the bathrooms were clean and tidy, there was some discussion with the deputy manager about the height of baths. He said that staff need to assist some residents with bathing and concern was expressed by us that they may be at risk when helping people out of the bath. Risk assessments need to be made and remedial action taken as appropriate. At the last inspection we raised concerns about the way paints was stored in the activities room. At this inspection we noted that the door was locked and the paint stored securely. The manager stated that the organisation has recently purchased land adjacent to the home and this plot has now been cleared of all overgrowth. It is intended that this land will be used as an extension to the gardens and for growing vegetables and other plants. On the day of inspection the washing machine had broken down and an engineer was awaited to effect repairs. As a consequence, dirty laundry had been placed in laundry bags and these were taken to the local launderette during the course of the day. It was noted that the washing machine has a sluicing and foul laundry wash that disinfects soiled linen. On the day of inspection all areas of the home were clean and tidy and there were no unpleasant odours. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and have the competencies and qualities to meet the assessed needs of the people using the service. Very robust procedures are in place for staff recruitment and this helps to protect people using the service from abuse. Staff receive training and development opportunities that reflect the needs of the people using the service. Staff receive regular supervision however not all staff who provide supervision have been trained to do so. Evidence: We looked at three staff files to see what processes were followed when new staff were appointed. Each of the staff files were very well laid out and it was easy to find the information we were looking for. We were able to see that the service follows very robust recruitment procedures and this is commended as it helps to protect people from abuse. We saw elements are very good practice for example, three written references are obtained before the person starts working at the home. We were also able to see that all staff have Criminal Records Bureau checks before they start work. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: All new staff receive thorough induction training that is fully recorded and covers all of the elements of the work they are required to do. The service has a very positive approach to training and the manager told us that National Vocational Qualifications have been completed by 12 staff over the last year, with the remaining six staff waiting to start. We also looked at the staff training records and could see that staff have access to all statutory training, and that is updated on a regular basis. They also have access to training that is relevant to their role and the needs of the people using the service. At our last inspection, we made a requirement about staff supervision because this was not taking place on a regular basis. The manager told us that the situation has now improved and staff receive supervision on a regular basis. She told us this responsibility had been delegated to senior support workers however, not everyone who is undertaking supervision of staff has received formal training. This needs to be completed without delay so that staff providing supervision feel competent and confident to carry out this role. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a registered manager who is experienced, qualified and competent to undertake the role. The service seeks the views of people living at the home and other interested parties as part of a quality monitoring system. People are protected by good health and safety working practices. Evidence: The manager is qualified and experienced to run the home. We made a requirement at the last inspection about the managers qualifications and this has now been met in full. Ms Dack has now complete a National Vocational Qualification at level IV and also the Registered Managers Award. She told us she has also attended other training that includes dealing with disciplinary matters and investigations. She says she tries to keep her own training needs in mind and up-to-date and has recently completed training about Data protection, The Mental Capacity Act and Deprivation of Liberty. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The manager told us the service seeks the views of people using the service, parents and carers to ensure they are providing a good service. she said the organisation is looking to develop quality assurance standards to use throughout all of its services. A variety of health and safety records were looked at during the course of this inspection. These included electrical systems and appliances, gas appliances, water temperatures and hygiene control, and fire safety. All records were up-to-date and there was evidence that the servicing of appliances and systems takes place as part of a service contract. Accident records were seen and these were well completed, with copies kept in the persons file as appropriate. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 1 27 It is recommended that risk assessments are carried out and remedial action taken as appropriate, to ensure people using the service and staff are not put at risk due to the height of the baths. All staff who provide supervision should receive formal supervision training so that they are confident and competent to undertake this task. 2 36 Care Homes for Adults (18-65 years) Page 28 of 29 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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