Care Home: Matlock Close 4

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What the care home does well There is good information about the service in easy to understand language and people are assessed before coming to the home, to make sure that their needs can be met. Although the majority of the residents are non verbal, the staff have a good understanding of their needs and they communicate well with each other. Individual care plans are written in a way that clearly guide staff about how best to care for the resident. Each resident has a key worker who takes particular responsibility for their care and support. The home provides good opportunities for people who live in the home to enjoy a stimulating and fulfilling lifestyle by making use of everyday opportunities in the community. The staff have all undergone training in how to prepare meals for people who have difficulty swallowing food and drink, and how to support them to eat safely. They have also been trained in mandatory health and safety subjects. The staff are knowledgeable about how to protect people from being abused. There is a good system for managing residents personal finances. A senior manager carries out monthly visits to the home to monitor how the home is being run. Copies of these reports are available for inspection in the home. What has improved since the last inspection? Since March this year, signifcant improvements have taken place when the new manager was appointed. This has led to a better team spirit and improved morale among the staff team. At the last inspection, we were concerned about the number of staff vacancies which could have an impact on the continuity of care for the residents. Since then, severall full time staff have been recruited and the remaining vacancy is about to be filled. The system for recording complaints has been improved to provide evidence that complaints have been responded to and whether complainants are satisfied. The washing machine has been repaired and residents now have full laundry facilities. An accurate record of all medication stock that comes into the home is recorded on the MAR sheets. Regular meetings have been reinstated with residents to ensure they have a say about how the home is being run. What the care home could do better: Staff must ensure that they sign for all medication that they administer. This is to prevent mistakes which could adversely affect residents` health and wellbeing. The lighting in residents` bedrooms must be reviewed to ensure that staff are able to provide appropriate and safe personal care at night. There is a damaged radiator cover in a corridor which could cause an accident to residents and staff. This must be repaired or replaced. Key inspection report Care homes for adults (18-65 years) Name: Address: Matlock Close 4 Matlock Close 4 Barnet Hertfordshire EN5 2RS     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: Thomas McKervey     Date: 2 0 1 1 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 28 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 28 Information about the care home Name of care home: Address: Matlock Close 4 Matlock Close 4 Barnet Hertfordshire EN5 2RS 02084499055 02084499055 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.dimensions-uk.org Dimensions (ADP) Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Limited to 8 adults who have a learning disability (LD), and who may also have a physical disability (PD). Date of last inspection Brief description of the care home 4 Matlock Close is a large purpose built detached bungalow for eight adults with learning and physical disabilities and has been designed for people who use wheelchairs. The home has a substantial plot with gardens to the sides and rear. All bathrooms and toilets are adapted to meet the needs of people with mobility problems, and wheelchair access is very good to all areas of the home. There is a large kitchen and dining room, a comfortable spacious lounge, and a another lounge at the rear of the home where the residents can relax. There is off street parking to the front of the home for several vehicles. The home provides a vehicle with a tail lift for taking residents out in the community. The property is owned and maintained by Notting Hill Housing Association. The service is managed by an organisation called Penatahact, which trades as Adepta. The home is situated in a quiet cul-de-sac in a housing estate in High Barnet, which Care Homes for Adults (18-65 years) Page 4 of 28 1 6 0 3 2 0 0 9 8 8 Over 65 0 0 Brief description of the care home has some local shops and is a short bus journey to Barnet Town Centre, Barnet General Hospital, Whalebone Park and primary schools are also located a short distance from the home. The range of fees for people living in the home is from £1,110 to £1,145 per week, depending on the level of their disability. The provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 28 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 unannounced inspection was completed in four hours. The current person in charge, (referred to as the acting manager until she is registered with the Commission), was present during the inspection and fully cooperated in the process. We spent time with the acting manager discussing how the service was progressing and any new developments. Most of the people who live in the home are non verbal but they can make their needs known in other ways that we were able to observe. We examined three residents records and visited all areas of the home. We spoke to all the staff who were on duty and also looked at their records. We examined the medication standards and various records relating to the running of the home. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 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. Potential users of the service can feel confident that the home will carry out an assessment of their needs to make sure the home is suitable for them. People with physical disabilities are able to move about freely in all areas of the home. Evidence: At the last key inspection, the service was rated as adequate. This was an improvement from the previous inspection, but Barnet local authority had stopped referring any new people to the home until they were satisfied that the home met certain conditions. The local authority are now satisfied that it is appropriate to refer to the home. Two new people, who use wheelchairs, have been admitted since the last inspection, which means that the home is now fully occupied. We examined the new residents case files and found that needs assessments had been carried out by the referring primary care trusts, local authorities and by the homes manager. The majority of people who live in the home use wheelchairs. The home is purpose built for people who have mobility problems and all doors and corridors are wide enough to allow wheelchair access to all areas of the home. There are assisted baths Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: and other adaptations provided throughout the building. The new residents had visited the home with their relatives before moving in. During the inspection, we observed relatives of one of the new residents, signing a tenancy agreement on behalf of the service user. Care Homes for Adults (18-65 years) Page 10 of 28 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. The people who live in the home can feel confident that the staff have a good knowledge and understanding of their needs and how best to support them. Individual care plans are drawn up to reflect the persons support needs. Evidence: All of the people who live at this home have highly complex needs and the majority are unable to communicate verbally. However, each person has a care plan that provides guidance for staff about how to communicate with them to help them understand their needs and wishes, for example by facial expression, gestures and using objects of reference. We noted the following in one persons care plan; He likes to feel the material to get some idea of what he will be wearing today. In another care plan it was stated; Interacts using gestures; will maintain eye contact when people talk to him. We looked in detail at three care plans, including the two new residents. One person had only been in the home for a few weeks and had an interim care plan in place until Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: their needs were more thoroughly understood. The care plans we looked at addressed a wide range of needs, for example; mobility, nutrition and eating skills and social contacts. Residents day and night routines and important rituals were also documented in the care plan. Most of the people who live in the home have difficulty in making their wishes known verbally. However, the staff described how they support people to make choices; for instance, the colour schemes in their bedrooms and choosing meals, some of which are shown in pictures. In some cases, the wishes of parents are consulted on residents behalf. There are records showing that the people who live in the home are supported by staff to do the shopping and other household tasks in the general running of the home. There were a substantial number of risks identified in the care plans. These addressed a wide range of activities that the residents participated in at home and in the community. There were guidelines for minimising each risk so that the person was not restricted from enjoying these activities. Care Homes for Adults (18-65 years) Page 12 of 28 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. The people who live in the home can feel confident that they will be supported to enjoy a wide range of opportunities to develop their personal and social skills and to choose how they wish to lead their lives. Residents have choice about their meals and staff make sure that people who need particular help with eating, are supported safely. Evidence: At the time of this inspection, one resident was spending the weekend with their family, which is a regular occurrence. Another person was at an event held by Barnet local authority which was held as part of their service planning strategy. This involves consulting with people who have disabilities. We were shown photographs of a recent Halloween party in the home. All the staff and residents were in fancy dress and appeared to be having a great time. During the afternoon, we saw an outside entertainer playing a guitar and having a singing session Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: with two residents. There were records of visits by relatives in the visitors book. The residents can see their friends and relatives in the various communal areas or in their bedrooms if appropriate and safe to do so. All the residents have either already had a holiday this year or one was planned in the near future. The home has its own wheelchair friendly vehicle, but public transport is also used extensively by residents when they go out. Appropriate risk assessments are recorded to ensure that staff are aware of any potential hazards to health and safety when in the community or in the home. There are records in each persons diary of what activities they took part in. For people who are non verbal, pictures of meals are used to enable them to choose what to eat. The menus indicated that meals are varied and nutritious. Several residents have to be peg fed. There has been considerable focus on staff training about how to support people who have a swallowing difficulty. These guidelines are clearly displayed in the kitchen and in care plans. Staff are not permitted to assist residents to eat until they have been trained in this procedure. Care Homes for Adults (18-65 years) Page 14 of 28 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 who live in this home can be confident that generally, their healthcare needs are being met. However, more care must be taken in the recording of administration of medication to prevent mistakes which could compromise residents wellbeing. Evidence: The majority of residents use wheelchairs and several residents have difficulty with swallowing food and for these people, there are detailed guidelines in place about ensuring that food is cut up finely or puried. Some residents are on peg feeds and advice from dieticians is documented regarding the amount of feed each person needs. We saw records to show that all residents are weighed regularly, and in the case of one individual, special monitoring was in place regarding their weight. One resident has spent considerable time in hospital this year and had just returned to the home at the time of the inspection; otherwise, we were informed that all the residents were in good general health. In the case files we examined, there were records of appointments with the G.P, consultant psychiatrist and speech and language therapist. Staff wear alarm devices which activate when they need to summon help urgently from anywhere in the home, for example if a person suffers an epileptic seizure. The Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: speech and language therapist had inducted staff in the use of this equipment. The residents have Health Action Plans, which record their medical history, any allergies and immunisation status. None of the people who live in the home are able to take medication by themselves. We found that the medication was properly stored and temperatures of the cabinet were recorded as being satisfactory and there was a record of all medicines returned to the pharmacy. We examined the records of administration of medicines, (MAR), and found that generally, staff signed when they administered medication. However, we found two occasions when medicines were not signed for in relation to one resident and there was no record of whether or not they had been given. We expressed our concern to the acting manager about this and we have made a requirement about medication issues. We acknowledge, that within two days of this inspection, the acting manager had carried out an investigation and implemented an action plan for staff to address this issue. The acting manager informed us that she was satisfied that in the instance we identified, the resident had been given their medication. Care Homes for Adults (18-65 years) Page 16 of 28 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. Residents and other stakeholders can be confident that their concens or complaints will be taken seriously and investigated. Staff are aware of the whistleblowing procedure and how to report incidents of abuse. Evidence: The complaints procedure is in picture format and is pinned to the residents notice board. We read complimentary comments that the home had recently received. One was from a day centre which several residents use. The staff at the day centre stated that the service had greatly improved, especially the communication between the two services. In June, a relative wrote to the area manager to say that they could see a vast improvment in the management of the home. We examined the complaints records. Only one complaint had been made since the last inspection which was about a residents whhelchair. This was responded to appropriately and promptly. Recently, a safeguarding meeting was held by the local authority to investigate bruises which had been sustained by a resident and were unaccounted for. The outcome was that there was an acceptable explanation and no abuse had taken place. We observed that the residents appeared well cared for and looked happy. There was a friendly and relaxed atmosphere and staff continually included the residents in conversation in a caring manner. The staff records showed that they had attended training in adult protection, or if new staff, this was booked for them to attend. In our discussions with the staff, we were Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: satisfied that they were fully aware of safeguarding issues and how to report any concerns or suspicions of abuse. Care Homes for Adults (18-65 years) Page 18 of 28 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. Residents can be confident that they live in a home that is comfortable, well maintained and in a good state of decoration. Evidence: We visited all areas of the home, including residents bedrooms. We found a good standard of decoration throughout the home. The gardens were also well maintained and the paved areas around the building provided a level surface, which enables safe access for wheelchair users. The bedrooms were decorated in the preferred taste of each resident. The bedrooms either have carpets or laminate flooring, depending on the needs of each resident. Each person had pictures and other personal mementoes on display. One resident has a particular interest in football and there were posters of his favourite team on the walls. A new residents room was about to be redecorated while they were away on holiday. Bedrooms were well furnished and had wall mounted lights. However, we were informed that this lighting arrangement was not very suitable for staff when providing personal care at night. We have made a requirement for all bedroom lighting to be reviewed. We noted that a radiator cover in a corridor was damaged and presented a safety hazard. We have made a requirement for this to be repaired. The home is well equipped with hoists, assisted baths and other adaptations to assist Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: staff in supporting disabled residents in a safe manner. There were records to show that the equipment is serviced regularly. We noted that the room at the rear of the home contained old furniture and equipment which the acting manager said was awaiting disposal. This room is intended to be used as a sensory area for residents. The kitchen furniture and cupboards were in good repair. The kitchen is large enough to allow access for the residents to sit in and eat if they wish. There is a large, very attractive lounge at the front of the home, which is comfortably furnished. A cleaner is employed in the home and at the time of the inspection, the home was clean and tidy and smelled fresh. Care Homes for Adults (18-65 years) Page 20 of 28 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 who live in the home can feel confident that the staff are able to meet their needs by being trained in how to support them safely. The staff receive regular supervision to monitor their performance in meeting residents needs. Evidence: At the time of the inspection there were eight people living in the home and we were informed that, since the last inspection, several staff had been recruited and there was only one vacancy which was in the process of being filled. It was particualrly pleasing to hear that there were now several staff who are able to drive, which enables the minibus to be used more to take residents out. We looked at the staff rota, which matched the identity of those who were on duty. There are normally four staff on the early shift, four on the evening, one waking and one sleep in staff at night. We were informed that the rotas are flexible to ensure that sufficient staff are available when the demand is highest. The staff to whom we spoke, said they were satisfied that there were enough staff to meet residents needs. It was not possible to check new staffs recruitment records as these are held at the head office with the agreement of the Commission. These will be examined in due course by the Commissions Performance Relations officer. We are satsfied that proper procedures are followed, including obtaining references and Criminal Records Bureau Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: checks before staff start working in the home. We were shown a spreadsheet that shows all the training that staff have undergone, including mandatory health and safety courses and any training that is still outstanding for new staff. We were satisfied that staff had been trained in protecting people from abuse, as well as specialist courses like epilepsy and dysphasia as mentioned above. There were records of regular staff supervision, and all staff had an annual appraisal in the past year. All of the above was confirmed by the staff who were spoken to. Care Homes for Adults (18-65 years) Page 22 of 28 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 residents can feel confident that they are living in a home that is now being well managed. Care is taken to ensure that their personal finances are properly managed and there are good systems in place to safeguard residents health and safety. Evidence: As reported at previous inspections of this home, there have been frequent changes of managers over the past five years. The person in charge now, was transferred from another of the companys homes in April 2009, where she was the manager. At the time of this inspection, she was about to apply to the Commission for her registration. We found that the new manager is very experienced and has brought about significant improvements in the service. This was borne out by complimentary letters we saw and have referred to elsewhere in this report. We also noted an improvement in the staff team morale which was confirmed in the discussions we had with them. The acting manager was very open about the problems she was still dealing with and we were satisfied with the progress she was making. This included regular meetings with staff and formal supervision. We examined the personal finance records of two residents at random. Receipts were Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: kept for purchases and two staff sign when they withdraw cash from residents money pouches, which are then sealed until the next transaction. The cash in the pouches balanced with the records. We saw minutes of staff and residents meetings which are held regularly. We were shown copies of reports of monthly monitoring visits by senior managers and we were informed that the annual survey of residents and stakeholder views had just taken place and was currently being summarised. We found that the manager has updated most of the records in the home to ensure they are accurate. These include fire alarm tests and drills. The temperatures of fridges, freezers and cooked food were being recorded. The major service installations, eg gas, fire alarm system and extinguishers, were serviced in the past year and there was a current insurance certificate on display. Care Homes for Adults (18-65 years) Page 24 of 28 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 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 Staff must ensure that they sign for all medication that they administer. To prevent mistakes that could compromise residents wellbeing. 09/12/2009 2 24 23 The damaged radiator cover in a corridor must be repaired or replaced. To prevent injury to residents and staff. 09/12/2009 3 26 23 The lighting in residents bedrooms must be reviewed. To ensure that staff are able to provide appropriate personal care at night. 09/12/2009 Care Homes for Adults (18-65 years) Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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