Care Home: Lychgate House

What the care home does well Helps people to maintain their skills.Looks after people`s healthcare needs.Listens to what people want and responds to their views.Supports people to access a range of daytime activities.Provides support in a comfortable and homely environment. What has improved since the last inspection? Food stored in the refrigerator is labelled correctly to ensure that it is fresh and suitable for use.Paperwork related to recruitment has been improved to ensure that it adequately protects residents. Paperwork related to the administration of medication has been improved. What the care home could do better: Needs to review its policy around keeping people safe, to ensure that is current and up to date. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lychgate House 145 Shrub End Road Colchester Essex CO3 4RE The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Neal Cranmer Date: 3 0 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 32 Information about the care home Name of care home: Address: Lychgate House 145 Shrub End Road Colchester Essex CO3 4RE 01206500074 01206510916 mar.doobay@ntlworld.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Doobay Care (Lychgate) Limited care home 12 Number of places (if applicable): Under 65 Over 65 12 0 mental disorder, excluding learning disability or dementia Additional conditions: 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 The maximum number of service users who can be accommodated is: 12 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home Lychgate House is a detached property, situated in a residential area, close to a range of community facilities and Colchester town centre. This home provides care in a homely and comfortable environment for twelve adults, of varying ages, with mental health problems. Accommodation is provided on two floors. The first floor can be accessed by stairs or a passenger lift. There are eight single rooms and two shared rooms, all the rooms have a vanity unit and one has an en suite shower. There are two lounges and a dining room on the ground floor and a conservatory that can be used as a further lounge or small dining area. There is a pleasant, private garden to the rear of the property with a patio and mature trees. There is off road car parking to the front of the building. Care Homes for Adults (18-65 years) Page 5 of 32 The weekly charge for a room ranges from £650.00 to £700.00 per week. Items not covered by the fees include newspapers, hairdressing, chiropody, holidays, toiletries and clothing. Care Homes for Adults (18-65 years) Page 6 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 32 How we did our inspection: This is what the inspector did when they were at the care home This inspection was carried out on the 30th of September 2009, and included a tour of the premises, discussions with people living in the home and members of the staff team. Observations of how members of staff interact and communicate with people living in the home have also been taken into account. During the course of the inspection a range of documentary evidence was looked at such as care plans, rotas, menus and personal files. Care Homes for Adults (18-65 years) Page 8 of 32 To assist us the manager completed an Annual Quality Assurance Assessment, which is required by law to be completed by the service, with information about the home. Throughout the report this document will be referred to as the AQAA. Completed surveys were received from people living in the home and staff working there. What the care home does well Helps people to maintain their skills. Care Homes for Adults (18-65 years) Page 9 of 32 Looks after peoples healthcare needs. Listens to what people want and responds to their views. Supports people to access a range of daytime activities. Provides support in a comfortable and homely environment. Care Homes for Adults (18-65 years) Page 10 of 32 What has got better from the last inspection Food stored in the refrigerator is labelled correctly to ensure that it is fresh and suitable for use. Paperwork related to recruitment has been improved to ensure that it adequately protects residents. Paperwork related to the administration of medication has been improved. What the care home could do better Needs to review its policy around keeping people safe, to ensure that is current and up to date. Care Homes for Adults (18-65 years) Page 11 of 32 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Neal Cranmer Care Quality Commission The Belgrave Centre Stanley Place Talbot Street Nottingham NG1 SGG If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 32 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 13 of 32 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 . Service users can be confident that their needs will be appropriately assessed prior to them moving into the home. Evidence: The manager told us in the AQAA, To facilitate choice and to ensure that our service users know precisely what services we offer, we will provide detailed information on the home by publishing a Statement of Purpose and Service Users Guide. The home has a comprehensive Statement of Purpose and Service users Guide, copies of both of these documents were seen to be held in the three care plan files that we examined. Questionnaires that were completed and returned by residents of the service about the admission process confirmed that they felt that they were provided with sufficient information about the service. The admission policy provides for introductory visits so that prospective residents have an opportunity to meet the other residents and the staff. There is a three-month settling-in period and a review of the placement then takes place. The manager told us in the AQAA, A full holistic assessment is carried out before Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: prospective service users are admitted to the home. There have been no recent admissions made to the home. The last admission took place over two years ago. As part of our inspection we examined three care plans, including those of the people last admitted to the home. All of the plans examined had assessments on file which had been undertaken by either the registered manager or the homes proprietor. The assessments covered the following areas of need: communication, mental health (past and present), physical healthcare needs, medication, personal care, mobility and domestic skills. To enable the home to assess the effectiveness of their assessment process they use feedback questionnaires. One was examined and the responses indicated that the person felt that they had been provided with a good level of information about the home, and that they were able to understand it. The responses went on to say that the person felt that their needs were understood when they moved in. The person also indicated that they were made to feel welcome and were treated well and were listened to. The person completing the questionnaire also indicated that they were provided with a residents handbook and information pack about the home upon their arrival in the home. Care Homes for Adults (18-65 years) Page 15 of 32 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 . People living in Lychgate House receive good quality care based on their assessed and identified needs. Evidence: The manager told us in the AQAA, We work with the resident, their relative or representative if appropriate, to draw up a written plan of care. A sample of three care plans was examined. Each care plan clearly identified the need and aim or the desired outcome. Guidance to staff was clear in respect of interventions in place. Staff surveys returned indicated that staff felt that they were provided with up to date information about peoples needs to enable them to support them effectively. The home operates a key worker system, to help ensure continuity of support. Residents spoken with confirmed that they were aware of who their key worker/s were, they also indicated that they had a good rapport with their key workers. Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: One residents care plan examined specifically related to their inability to manage their own financial affairs. The action to support this need was that a Mental Capacity Assessment was undertaken by the person’s social worker and the homes manager. An advocate was also involved to provide support to the resident. A copy of the completed assessment was held in the persons care plan file. The manager told us in the AQAA, Risk assessments are carried out, which respect the individuals rights but also ensuring theirs and others safety. Risk assessments were relevant to each person with some relating to personal care needs and daily living tasks, whilst others were related to the use of public transport and accessing the local community. Each care plan file contained an evaluation sheet to look at the continued relevance of the care plan interventions and risk assessments. From our observations it was evident that people make choices about what they do during the day. An example of this was observed when a resident said that they did not want to attend their scheduled day service provision, but instead wished to go to town. The manager was observed to respect and support the persons decision, however the resident was supported and encouraged by the manager to take responsibility for making the telephone call to cancel their attendance. Care Homes for Adults (18-65 years) Page 17 of 32 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 living in Lychgate House can expect to enjoy a lifestyle that meets their wishes and needs. Evidence: The manager told us in the AQAA, We provide a lifestyle for service users which satisfies their social, cultural and recreational need. There was an activity planner on the notice board that documented activities available including art, beauty sessions, current affairs, and trips to town or the local public house. A number of residents residing in the home attend an external activity facility known as the Coffee Shop here they take part in a variety of activities including woodwork, quizs, social groups, gardening and music sessions. On the day of our visit residents were seen making their way to this activity either independently by public transport or by pre-arranged taxis. Care plans examined included records of peoples preferences regarding how they liked to spend their leisure time, and responses in Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: surveys indicated that people were free to choose what they wanted to do throughout the day and at weekends. Examination of the homes visitors book showed that residents were actively accessing local facilities. There were many entries showing people going out to the local shops and town. Relatives spoken with said that they were free to visit the home at any reasonable time of day and were always made welcome by the staff. The home operates four weekly rotational menus, which were seen to provide information about breakfast, dinner, tea and supper. The menus showed that residents were provided with two options at main meals. Residents spoken with during the course of our inspection said that the meals provided by the home were good, comments about the meals in questionnaires returned included good food, food good, good cook good food, I like the food. . The home employs a cook for five days a week. On their days off a member of the care team is designated to have responsibility for meal preparation. The lunchtime meal was discreetly observed. All of the residents were able to manage their meal independently, but staff were on hand to provide assistance if required. Residents said that they were free to choose where to receive their meal. The lunchtime meal was nicely presented and consisted of pie and mash with a selection of vegetables. The residents said that the meal was nice. At the end of the meal residents were observed assisting to clear the table of cutlery and crockery. Care Homes for Adults (18-65 years) Page 19 of 32 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 using the service can expect their personal and healthcare needs to be identified and met as they would wish. Evidence: The manager told us in the AQAA, The home takes a person centered approach to all aspects of the care process. This enables and empowers residents to take as much control as possible. Overall people living in Lychgate House are able to take responsibility for their own personal care needs. As a result of their mental health problems a few people need support to maintain good personal hygiene. Mostly this takes the form of prompting and encouragement and where this is necessary there is a care plan in place. Staff spoken with were able to explain how they encourage people to maintain good standards of personal care. The manager told us in the AQAA, Residents choose their own GP and manage their own health care and can always talk to or see their GP. Records examined showed evidence of involvement from a range of health care Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: professionals including general practitioners, consultant psychiatrists, community psychiatric nurses,, chiropodists and dentists. Other records seen included weight monitoring records, these were seen to be fully completed and up to date. There was evidence seen in the files sampled of people being supported to attend hospital outpatient appointments. Relatives spoken with during the course of our visit said that they were always notified by the home if their relative was ill or unwell. The homes arrangements for the management of medication was examined. The home uses a Monitored Dosage System (MDS) for the administration of medication. Arrangements for administration and storage were sampled and were found to be in order, with no evidence of any gaps or omissions in the records examined. Medication was stored in a locked cupboard. Staff spoken with were able to demonstrate an understanding of their responsibilities around appropriate storage, administration and recording of medication. The lunchtime medication round was observed. Medication was seen to be administered at the correct time, and the staff member involved in the administration round was seen to carry it out in a supportive and professional manner. Care Homes for Adults (18-65 years) Page 21 of 32 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 using the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the services complaints and safeguarding policies and procedures. Evidence: The manager told us in the AQAA, We provide and operate a simple and clear complaints procedure, which is readily available to all service users. Reference to the homes complaints procedure was included within the homes Statement of Purpose and Service Users Guide, and all of the care plans that we examined contained copies of the Service Users Guide. The complaints procedure was posted prominently around the home. All of the surveys returned indicted that people were aware of who they should speak to if they were unhappy with any aspect of the care provision. On the day of our visit people spoken with said that they would speak to the people who owned the home if they were unhappy. Relatives spoken with said that they were also aware of who they should direct any complaint or concern to. The home does maintain a complaints log for reccording any complaints received. The log was sampled and indicated that no complaints had been received. The manager told us in the AQAA, We make all possible efforts to protect service users from every sort of abuse and form possible abusers. The home has in place a policy regarding abuse. This was last reviewed in 2008 and Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: was found to be in need of further review to ensure that it is reflective of current good practice in relation to safeguarding. Records examined and discussion with staff indicated that training had been provided around safeguarding (previously referred to as Protection of Vulnerable Adults or POVA now called Safeguarding of Vulnerable Adults or SOVA). Staff spoken with were aware of their responsibilities around keeping people safe. There had been no safeguarding referrals made to the local authority under their safeguarding procedures. Care Homes for Adults (18-65 years) Page 23 of 32 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 can expect to enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: The manager told us in the AQAA, The physical environment of the home is designed for service users convenience and comfort. We maintain the buildings and the ground in a safe condition and we make arrangements for the communal areas of the home to be comfortable and safe. A tour of the premises was undertaken including residents personal living areas, bathing and toilet facilities, communal living areas and gardens. All of the residents rooms visited were seen to be individually decorated and their was evidence of people having personal possessions around them including photographs, ornaments and sof toys. Residents spoken with said that they were happy with their rooms. Communal areas visited were found to be comfortable and homely and residents were seen to be very relaxed in these areas particularly following lunch. The furnishings and fittings in the home were domestic in nature and were of a good quality. The home benefits from two lounge areas and a small conservatory and during the course of the inspection residents were seen accessing all of these areas. The home also has a small pleasant garden area at the rear of the property and on the day of our visit residents were seen accessing this area. Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: The laundry is small and compact, but contained all of the necessary equipment to manage the laundry requirements of the home. Records showed that staff had received training in infection control. Responses received from surveys returned indicated that the home was always fresh and clean. On the day of out visit we found no evidence of any unpleasant odours or smells. Care Homes for Adults (18-65 years) Page 25 of 32 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 living in the home can be confident that they will be cared for by a team of staff who are competent to meet their needs and who have been employed following a thorough recruitment process. Evidence: The manager told us in the AQAA, We provide at all times an appropriate number of staff with qualifications in NVQ level 2 in Health and Social Care. Records examined showed that the home employed seven care staff, of whom five held an NVQ qualification at level 2 or better. The rotas were examined and confirmed that there were sufficient staff on duty to meet peoples needs. During the day there are four staff on duty in the morning and three in the afternoon, with night support being provided by one waking night staff and one sleep-in member of staff. In addition the home employs a cook and domestic staff. maintenance staff are accessed as and when required. We observed that people were interacting positively with staff and it was evident that there was a good rapport between staff and the people living in the home. Comments from residents in surveys included the staff are polite and kind, and look after me well. A member of staff who completed a survey told us, All staff work together as a team. The manager told us in the AQAA, All potential staff have Protection of Vulnerable Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: Adults (POVA) checks and Criminal Records Bureau Checks (CRBs) carried out prior to being offered employment. Five personal files were examined and found to be well organised. All documentation required by regulation was in place including an application form, two written references and proof of identity. There was also evidence on file to show that people had been appropriately checked through the Criminal Records Bureau system. All of the staff surveys returned answered positively when asked Did your employer carry out checks, such as your CRB and references before you started work. The staff files of the person most recently employed in the home was examined. This showed that they had received an induction which was in line with Skills For Care Common Induction Standards. Training records in personal files contained evidence that staff had completed a range of training including administration of medicines, food hygiene, safeguarding, infection control and manual handling. Staff spoken with said that access to staff training was good and all of the surveys returned indicated that staff were being provided with training that was relevant to their role, helped them to understand and meet the needs of the people in the home, and helped them to keep up to date with new ways of working. The survey responses also indicated that staff felt that they had enough knowledge through training about health and medication. Staff records and discussion with staff indicated that they were being provided with regular supervision. Staff said that supervision was being provided monthly by the registered manager and the assistant manager. The assistant manager spoke of having received training around supervision and appraisal. Care Homes for Adults (18-65 years) Page 27 of 32 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 appropriately managed in the best interests of the people living there. Evidence: At the time of our visit the registered manager was away on extended leave. In their absence the home was being managed on a day to day basis by the assistant manager supported on a daily basis by the proprietor. Interactions observed during the day between the manager and the residents, and the manager and staff were all supportive, friendly and appropriate. Staff spoken with and responses received in surveys indicated that both the manager and the proprietors are very supportive and provide a clear sense of leadership and direction. The home has developed a quality assurance system to enable the residents to express their views of the service and suggest changes they wish to have made. One questionnaire is completed soon after admission to find out if the admission process met the expectations of the resident and covered such areas as the level of information about the service and whether the terms and conditions of the residency were explained and whether or not people were welcoming. A further questionnaire is then offered to residents on an annual basis and asks for their views about a number Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: of issues including personal care, the premises, daily routines, staffing and peoples view of the meals provided. The results of these questionnaires are evaluated and changes made accordingly. Residents meetings are held monthly (last one was in September 2009) and minutes are taken and posted on the notice board. Topic covered include issues such as smoking, meals, and activities. The meeting minutes clearly identified comments that had been made by individual residents. Relatives spoken with were particularly complementary about the service, these included excellent, always friendly and polite. A sample of health and safety records were examined and found to be current and up to date, these included the gas installation certificate and records relating to fire safety. other records examined showed that staff had received training in infection control. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 The home policy/procedure around safeguarding requires updating to ensure that it is reflective of current good practice. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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