Care Home: Malvern

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What the care home does well The service provides a relaxed, homely and inclusive atmosphere. Staff were observed to be attentive and interacting with people throughout this visit. People living in the service were observed to be happy and three people told us the staff are nice. Staff have a good knowledge of people`s needs and know them well. The home had provided a person with a video about the home prior to them moving in to support them with their transition and staff spent time with them and their family so the person could get to know them. People are supported to participate in a range of varied and appropriate activities, which meet their needs and preferences and they are encouraged to be independent. During this visit some people had been to cookery classes and music. One person who likes football, who was supported by a member of staff to go to the local park. Another person said, "I have been horse riding". Staff were observed to offer choices to people and people asked their preferred choice of lunch and one person was observed laying the table for tea. Staff are well trained and have received training, which meets the needs of people living in the service which was confirmed by staff. What has improved since the last inspection? The windows that were identified without restricters at the last inspection have been replaced . Records seen during this visit demonstrate that staff now receive regular, formal supervision. What the care home could do better: No requirements were made as a result of this inspection. Two good practice recommendations were made Key inspection report Care homes for adults (18-65 years) Name: Address: Malvern 10 Ringley Avenue Horley Surrey RH6 7HA     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: Lisa Johnson     Date: 1 1 0 6 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: Malvern 10 Ringley Avenue Horley Surrey RH6 7HA 01293430686 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashcroft Care Services Ltd Name of registered manager (if applicable) Mr Ralph Trevor Muller Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Malvern is a six bedded home for people with a learning disability. The service is located in Horley, within walking distance to the town centre. The home is a large detached house. On the ground floor is an office, a communal lounge, a dining room, a kitchen and bathroom with a shower, laundry facilities and two bedrooms. On the first floor there are four bedrooms, a sleeping in room for staff and a bathroom with a shower. The home has a front and rear garden, which is well maintained, and private parking is available to the rear of the building. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 Brief description of the care home The weekly fees for the service range from £1,000 to £3,000. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and 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 visit was part of a key inspection, which took place over five hours commencing at 1120 am and finishing at.4.55pm This inspection was carried out by Mrs. L Johnson Regulation Inspector . The last key inspection was carried out 26th June 2007 and we conducted an Annual Service review 23rd June 2008. Information was provided to us before this visit in the annual quality assurrance assessment. (AQAA). This is an assessment that focuses on how well outcomes are being met for people living in the service. reference is made to the AQAA throughout this report. During this visit we had the opportunity to speak with five people who live in the service and we received two feedback surveys. Surveys were also recieved from three Care Homes for Adults (18-65 years) Page 6 of 27 members of staff and a health and social care professional. During this visit we looked around the home and some people invited us to see their bedrooms. We looked at some peoples care plans, risk assessments, medication administration practices,staff recruitment and training records, health and safety and policies and procedures. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information,which they need to know to make an informed choice about the suitability of the home as a place to live. Peoples needs are assessed prior to admission to the home. Evidence: The home has a statement of purpose and service user guide, which provides information to people and their representatives about the home, which is provided in advance of admission and can be provided in alternative formats. Since our previous visit there have been two new people admitted to the home. Preadmission assessments are conducted , which were seen in peoples files that were sampled during this visit. Information seen also demonstrated that assessments and information is obtained from care managers, previous placement, families and specialist services. The organisation (Ashcroft Care Services ) has a central clinical team who support the manager in making a decisions about the suitability of the placement. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: People and their representatives are invited to visit the home, although one of the most recent people admitted was unable to visit and this persons transition had to be undertaken gradually. The manager and staff visited and worked with the person and their family and introduced a personalised video, which included images of the environment that they were moving to, which achieved a positive outcome for the person who has now settled in to their new home. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a plan of care in place. People are able to make decisions about their life with support if they need it and they are supported to take risks as part of an independent lifestyle. Evidence: Care plans are generated from assessment. During this visit we looked at three peoples files. Information included peoples health, medical, personal, emotional and social needs. Peoples care plans are reviewed monthly and a six monthly formal review is conducted where people and their families are invited to attend if this is the persons wish plus relevant health and social care professionals. Records are maintained of reviews, which were detailed and comprehensive. Information supplied in the AQAA says that staff consult with families, care manager and other professionals to support decision making around peoples needs. Since our previous visit staff have received person centered planning training and essential lifestyle plans have been introduced , which are at different stages of Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: implementation. During this visit we viewed one of the completed essential life style plans, which provides accessible information, although it was recommended that goal plans be included as the current Ashcroft Care Services paperwork is not easily accessible for people. Consideration should also be given to implementing systems to ensure that people or their representatives sign their care plan to confirm their agreement. Three members of staff surveyed said they are given up to date information about the needs of people they support and the ways that information is shared with other staff works well. Decision making and choices are limited for some people due their complex needs. However the service has developed methods of offering choices such as choosing their meals, which we observed at lunchtime when staff asked each person what they would like for their lunch. People are offered choices about their clothing, personalising their bedrooms and preferred decor. Staff conduct monthly meetings with people and their views are sought about activities and holidays that they would like to attend. Staff also aim to explain changes to the running of the home. People have an individual bank accounts and some people are are able to handle their money with support at different levels such as payment for goods to promote their independence. Detailed and comprehensive risk assessments and behavioral management guidelines have been implemented, which are discussed during review meetings, agreed with people, their families and care managers. Some of the assessments sampled during this visit included, bathing, traveling in vehicles and behaviors which challenge. The manager was advised to record the date of the next review to ensure that these are up to date. Care Homes for Adults (18-65 years) Page 13 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. Peoples preferences, social, cultural, diverse and recreational interests and needs are met. People maintain contact with their family , friends , representatives and the local community. People are supported to exercise choice over their lives and are provided with varied and well balanced meals. Evidence: People have an individually tailored and structured weekly activity timetables, which meets their needs and preferred choices. On arrival at the home everybody except one person was out attending activities. On return to the home people told us about some of the activities that they attend including, I have been horse riding;Cooking at college where I made beefburgers . Another person told us that they go swimming,attend music and bowling. Other activities include attending arts and crafts, gardening groups, pottery, drama group visiting the cinema and attending discos . One person requires support to join in and participate in new activities and Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: experiences, who told us that he likes to visit the supermarket to buy yoghurts and their time table reflected that they go the shop and visit the library. During this visit a member of staff supported a person to go to the local park for a game of football,which meets their preference. The home has a their own vehicle and also have access to other shared vehicles. Holidays take place and the duration is determined by each persons needs and preferences. Holidays are usually taken on an individual basis and days out including visits to the coast take place. People are supported to access local community facilities such as local shops, restaurants and pubs where some relationships have been built and some of these facilities know people living in the home by name. People are also supported to use local transport. People maintain good links with their families and friends and two people told us that they visit their families at weekends. Families are able to visit in private within the home and they are invited to care reviews where this meets with peoples wishes.During this visit a person was observed to be discussing their shopping trip with a member of staff to buy some flowers for their relatives birthday. Throughout this visit good interaction and relationships were observed between people and staff who spent time with each other undertaking activities and people were observed to be accessing all areas of the home. One person likes to spend time alone in their room watching their favorite films, which was observed to be respected by staff. People are supported to participate in household activities. A person told us that that they help clean their room and another person was observed laying the table for tea. People living in the service are encouraged to participate in meal preparation and one persons individual plan identified that help prepare their breakfast and packed lunch. People are involved in planning the weekly menu and participate in the weekly shop and selecting meals. The menus were varied and well balanced and healthy eating is encouraged . Three people told us that they enjoy salad and fruit, which was available for people to help themselves to in the kitchen. People told us that they enjoy their meals and choices were accommodated. At lunch time people had sandwiches for lunch and we observed that each person was able to request their preference. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are met and peoples preferences for support are respected. The home supports people with their medication in a safe way. Evidence: Peoples files sampled contained information in What people need to know about me and how i communicate. Peoples personal care guidelines, and preferred routines were also recorded. One persons care plan identified that is important to them to to wear certain types of clothing in their favourite colours. People are able to choose who provides their support and preferred gender. Information in the AQAA states that new staff are are inducted into personal care by shadowing an existing experienced member of staff to ensure that they are aware of peoples likes and dislikes. Accessible health action plan assessment booklets are being developed, which identify peoples individual health needs. People are supported to access a range of health and social care professionals including, a clinical behavioral specialist, district nurses, psychiatry, therapies, chiropody , dentist and other specialist referrals are made through the general. practitioner. We were informed that one person becomes anxious attending new activities and health appointments, which has to be introduced slowly Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: and staff have supported this persons preference to receive visits from health care professionals in the home . A social and health care professional surveyed stated that peoples social care and health needs are always properly monitored and met and and that peoples privacy and dignity is always respected. They also said, The service has a person centered approach when caring for the individual i support. Checklists and records are maintained of all consultations. Physical and emotional care is also monitored through weight records, sleep charts, epilepsy charts observations and behavioral records. Staff training schedules and records sampled demonstrated that they have received a specialist training, which meets the needs of people living in the service. The home has a medication procedure in place, which is regularly reviewed and updated. Staff receive accredited training and assessments and a list of all staff authorised to administer medication is maintained .People currently living in this service are unable to self medication Peoples medication is reviewed every six months. Medication was stored appropriately. Medication is dispensed by a local chemist using the monitored dose system (MDS). Medication administration records contained photographs of the person for identification and no gaps were identified in the administration of medicines. Systems were also in place for the disposal and receipt of medication. 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. If people have concerns they know how to complain and they are safeguarded from abuse Evidence: The home has complaints procedure in place. This is also provided in the service user guide and has been made accessible in pictorial/symbol format. Since our previous visit two complaints have been received by the service, which were addressed and resolved. The procedure has been updated to include the contact details of the Care Quality Commission should anybody wish to contact us and a copy has been supplied to families. People spoken with during this visit told us that they knew who they could talk to if they were unhappy , which was also confirmed by two surveys received. Two people also said the staff are nice and i am happy here Safeguarding vulnerable adults from abuse procedures are in place, including the most recent local authority multi agency procedures. A local procedure for reporting any safeguarding matters was displayed in the office . Staff receive non violent crisis intervention and challenging behavior training to enable them to understand peoples aggression. Staff training schedules and certificates sampled confirmed that the manager and staff have attended safeguarding training, although it is recommended that the manager attends the local authority multi- agency training. Since our previous visit the service has demonstrated that safeguarding matters have been referred promptly following Surrey multi agency safeguarding vulnerable adults from Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: abuse procedures. 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 live in a home that is in the main safe, comfortable, homely and clean. Evidence: The home is situated in a residential street, which is in walking distance from Horley Town centre shops and amenities. The home provides a large kitchen/diner, separate dining room and sitting room. There is a well maintained garden to the rear of the property and a gardener has been employed to carry out general maintenance of the grounds. Due to major upgrade work with regard to fire safety, plans for further decoration had to be put on hold, which may now resume. A survey received commented, that home would benefit from some more pictures in communal areas to make it more homely. Two people invited us to see their bedrooms, which were comfortable, reflecting their gender and personalised meeting their preferences and interests. During this visit the home was cleaned to a good standard and was hygienic. Separate laundry facilities are provided and cleaning schedules and infection control procedures are in place. Staff receive infection control and food hygiene training and new procedures in relation to to food hygiene have been implemented. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by staff that are competent and trained to meet their needs and they are protected by the homes recruitment policies and practices. Evidence: Currently there are six people living in the service and staffing arrangements are flexible to meet their needs and they are supported by a team who are of mixed gender. We were told that are usually five members of staff on duty during the day and at night time people are supported by a waking and sleep in member of staff. The service currently employs thirteen care staff and eight hold National Vocational Qualifications (Level 2 or above. New staff receive induction following the Skills for Care core induction standards. Where staff who join without national vocational qualifications this is highlighted in their development plan and will be applied for after their probationary period. Three members of staff surveyed said that the induction covered everything they needed to know very well. Staff are provided with the General Social Care Code of conduct (GSCC) ensuring that they are aware of their roles and responsibilities working in a social care setting. Staff training and certificates are maintained of all training that they have received. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: This includes mandatory training and specialist training including autism, challenging behavior,non violent crisis intervention and epilepsy awareness, this was confirmed by records sampled. Staff surveyed said that that they have enough knowledge to meet the differing needs of people that they support. Three members of staff training records were sampled, which confirmed that had received both mandatory and specialist training. The manager has attended mental health capacity act and deprivation of liberty training and all staff have been enrolled on new equality and diversity training. The home is an equal opportunities employer and information supplied in the AQAA states that applicants visit the home, giving opportunity for them to meet and interact with people living in the service so they can assess suitability and personality. Staff surveyed confirmed that pre- employment checks were carried out, which was demonstrated by information seen during this visit. Three members of staff personal files were sampled, which contained the required information, including a completed application form, two written references and records confirming that enhanced criminal records bureau check (CRB) had been conducted. Staff records sampled demonstrated that staff receive regular formal supervision, which was also confirmed by members of staff surveyed. 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 run in the best interests of people living there and their health and safety is protected. Evidence: There is an experienced manager in post , who has been registered with the Commission in previous employment and has made an application to register with us for their current post. The manager has obtained the registered managers award and has demonstrated that they have undertaken refresher mandatory training and specialist areas. During this visit the manager was seen to have an open and inclusive approach and made themselves accessible to both people living in the home and staff. Three members of staff surveyed confirmed that they receive enough support from the manager and regular staff meetings areheld. Monthly quality monitoring visits are conducted by the organisations quality assurance manager for the provider (Ashcrocft Care Services) These reports were available and sampled during this visit. The orgaisation carries out annual feedback surveys to listen to and gain feedback from people using the service and their Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: representatives. The outcomes are analyzed and feedback is provided. This information was available to view at the time of this visit. The service has a range of policies and procedures which the organisation (Ashcroft Care services) are currently updating. Health and safety procedures are in place and risk assessments are carried out. Systems were in place for checking the water temperatures and fire assessments have been completed. Items hazardous to health were stored and locked away safely . Staff receive regular refresher training, which includes, health and safety, moving and handling and first aid ensuring the welfare and safety of people living in the service . Accident and incident records are maintained and the service has demonstrated that the Commission is informed of any incidences that we need to be made aware of. 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 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 6 It is recommended that peoples goal plans are included in their essential lifestyle plan and that people and/or their representatives sign their care plan to confirm their agreement. It is recommended that the manager attends the local authority multi- agency safeguarding vulnerable adults from abuse training. 2 23 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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