Care Home: Middlefield House Nursing Home

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What the care home does well People live in a house, which is clean and comfortable.They are able to make their bedrooms homely with their own personal belongings. We saw they could arrange their room as they wished.People can take part in a range of social and leisure activities if they wish. For example some people went out to the gym and then for a picnic during the day. One person does some voluntary work.Staff respect people`s privacy and dignity and people told us they liked living there.People told us they liked the meals and we saw they have a choice.There have been few changes to the staff team. This means that people who live in the home get to know staff well. What has improved since the last inspection? They have made sure that matters we raised on our last visit have been addressed. These related to redecorating and improving some areas in the home such as the kitchen and a bathroom.We saw that some new lounge furniture has been provided, some areas have had new flooring laid and parts of the home have been redecorated.They are improving peoples care plans so that they are more individual and person centred.People who live in the home have had a short holiday of their choice. What the care home could do better: Arrange more specialised training about caring for people with dementia, so that all staff have the opportunity to participate in it and increase their knowledge and skills. It is acknowledged that the manager confirmed more training was to be planned. Key inspection report Care homes for adults (18-65 years) Name: Address: Middlefield House Nursing Home Middlefield Lane Gainsborough Lincs. DN21 1TY The quality rating for this care home is: Three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sue Hayward Date: 2 8 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 38 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 38 Information about the care home Name of care home: Address: Middlefield House Nursing Home Middlefield Lane Gainsborough Lincs. DN21 1TY 01427615577 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): middlefield@prime-life.co.uk info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd Name of registered manager (if applicable) Eleanor Kutse Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 17 0 Care home 17 learning disability Additional conditions: The maximum number of service users to be cared for in the home is seventeen. The service is registered to care for younger adults between the ages of 18 and 65 years whose primary need is that of a learning disability. Date of last inspection 0 2 0 5 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Middlefield House is one of a number of homes run by Prime Life a privately owned company. It is in a residential area close to the to the centre of Gainsborough. Sixteen men and women live at the home. They have one vacancy. Care Homes for Adults (18-65 years) Page 5 of 38 They have a mini bus, which they share with another home. This means that the people who live at the home can get around easily. Everybody who lives at the home has his or her own bedroom. Nobody has to share. Everyone is given information telling him or her what they can expect if they live there. Some information is on display. Care Homes for Adults (18-65 years) Page 6 of 38 The manager told us that the current cost per week for someone to live there is £425 - £725.96 per week. Hairdressing, chiropody and transport costs are extra. Care Homes for Adults (18-65 years) Page 7 of 38 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Three star excellent service Our judgement for each outcome: 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 8 of 38 How we did our inspection: This is what the inspector did when they were at the care home Throughout this report the terms we and us refer to the Care Quality Commission (CQC). Before the visit, the manager had completed a questionnaire. This gave us some important information about their own assessment of how well they are meeting standards and how they plan to improve the service. We sent out some surveys for people who live in the home to complete, however none have been returned so far. We will take into consideration the views of any we may receive and will use them to help plan any future inspections. Care Homes for Adults (18-65 years) Page 9 of 38 We followed the care of two people, checked their records and briefly looked at one other persons records. We spoke to two people who live at the home. One other person did not wish to speak to us. We observed how staff supported people during our visit, for example at lunchtime. Care Homes for Adults (18-65 years) Page 10 of 38 We saw three people’s bedrooms. We talked to four staff members who were on duty. The inspector looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. Care Homes for Adults (18-65 years) Page 11 of 38 We talked to the manager and gave some general feedback about the outcomes at the end of the inspection. Care Homes for Adults (18-65 years) Page 12 of 38 What the care home does well People live in a house, which is clean and comfortable. They are able to make their bedrooms homely with their own personal belongings. We saw they could arrange their room as they wished. Care Homes for Adults (18-65 years) Page 13 of 38 People can take part in a range of social and leisure activities if they wish. For example some people went out to the gym and then for a picnic during the day. One person does some voluntary work. Staff respect peoples privacy and dignity and people told us they liked living there. People told us they liked the meals and we saw they have a choice. Care Homes for Adults (18-65 years) Page 14 of 38 There have been few changes to the staff team. This means that people who live in the home get to know staff well. What has got better from the last inspection They have made sure that matters we raised on our last visit have been addressed. These related to redecorating and improving some areas in the home such as the kitchen and a bathroom. Care Homes for Adults (18-65 years) Page 15 of 38 We saw that some new lounge furniture has been provided, some areas have had new flooring laid and parts of the home have been redecorated. They are improving peoples care plans so that they are more individual and person centred. People who live in the home have had a short holiday of their choice. Care Homes for Adults (18-65 years) Page 16 of 38 What the care home could do better Arrange more specialised training about caring for people with dementia, so that all staff have the opportunity to participate in it and increase their knowledge and skills. It is acknowledged that the manager confirmed more training was to be planned. Care Homes for Adults (18-65 years) Page 17 of 38 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 Sue Hayward Operations Directorate Care Quality Commission East Midlands Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel. 013000 616161 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 18 of 38 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 19 of 38 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. There are good procedures in place to assess peoples needs and introduce them to the service before they are admitted to the home. Evidence: The care records of two people the service supports were checked, one who had been admitted since the last key inspection took place. Care records showed that there had been an assessment of need and care plans drawn up for both people whose care we followed on this occasion. Staff had a good knowledge of the needs of the people they were asked about and records showed that assessments had included obtaining information from other significant people such as social services and relatives. Records showed that where needed, risk assessments were also carried out and any actions needed to reduce risks were well documented. Information telling people about the service is made available to people who use the service and we saw that it is also in simple pictorial form for people who may be better able to understand it in this format. We saw copies of previous inspection reports were available to be viewed in one of the lounges and other important information such as Care Homes for Adults (18-65 years) Page 20 of 38 Evidence: their certificate of registration, the fire and visiting procedure were on display. One person we were able to speak with told us they liked living at Middlefield. Care Homes for Adults (18-65 years) Page 21 of 38 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. Peoples individual needs are well met and their independence is promoted. Evidence: The personal files we checked on this occasion were well organised and contained detailed information about people the service supports such as care plans, personal historys, risk assessments and references where needed to peoples ability to make significant decisions under the Mental Capacity Act. We saw that each persons care plan is reviewed regularly. Care plans covered areas such as personal hygiene, physical health, behaviour, mental health and well being, financial management, communication sleeping, mobility, elimination and social inclusion. They included significant information such as details of next of kin, health professionals and also peoples wishes after death. We were shown that they are in the process of transferring information so that care plans are more person centred and include information pages about people such as The things I like and The things I dont like. We saw risk assessments had been completed for each individual highlighting significant areas of risk and any actions needed to minimise them. Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: Due to the needs of the people we case tracked we were unable to discuss in depth with them their views about the care given. We saw people looked well cared for and staff were attentive to peoples needs e.g. when assisting a person to the lounge who had a visual impairment, a learning disability and dementia care needs, the staff member constantly gave reassurance and reminded them of potential hazards when walking from room to room. Staff we spoke to had a good knowledge of the needs of people we asked about. A person told us I like it here. We also noted a comment made by a relative in a survey about the quality of the service I have always found the quality of care and well being of my relative to be excellent. Care Homes for Adults (18-65 years) Page 23 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the flexible mealtime arrangements and enjoy the range of social, recreational and vocational activities. Evidence: We saw records are kept to show there is a range of activities and leisure pursuits that people participate in. On the day of the visit we were told that a group of people would be attending a gym and then going for a picnic. One person who receives individual support from a staff member was also attending a British Heart Foundation charity shop to help out. We saw that people in the home were doing jigsaws and watching television. There is also a lounge which is equipped with sensory equipment for people to use. The service has shared use of a minibus with another home within the group and we were told trips out occur twice a week. We saw photographs of people involved in activities and outings. We were told various holidays were arranged last year for people who live in the home to places such as Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: Butlins and Mablethorpe according to peoples individual preferences. We saw that there is a programme of activities on display in the home which includes crafts, listening to music and film nights. People who live in the home are also able to help out with household tasks if they wish. We saw comments from surveys that the service has received from relatives included The staff have always gone out of their way to look after me on visiting, indicating that people are made to feel welcome. We observed part of a meal time. We were told meal times are flexible and we saw people having them at different times. We saw people were provided with equipment such as high sided plates to assist them to eat their meals independently and that staff were available to offer support to people at lunchtime. When doing so they respected peoples dignity by sitting down whilst assisting them to eat their meals and politely reminding them to have a drink if a prompt was needed. We spoke to the cook and checked records of the meals provided. We saw there is a choice of main meal and menus were varied and healthy. Staff were aware of peoples individual preferences with regards to their diets. Care Homes for Adults (18-65 years) Page 25 of 38 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive a good standard of care, which meets their current needs and supports their independence. Evidence: We checked the records kept of medication of both people we case tracked. These were well maintained. We saw medication is stored safely and there are satisfactory facilities in place for the storage of specific medications such as those that need cooler temperatures. We saw the report of the most recent visit by a community pharmacist. This was carried out on 23/03/2010 and made some recommendations such as making sure the maximum and minimum temperatures for the refrigerator used to store some medicines was recorded. There were records in place to show this is now being done. The manager told us no-one is currently responsible for administering their own medication as all need the support of staff with this. They have a system in place whereby a pharmacist predispenses medication into individual packs which staff then check and administer. This is administered by the qualified nurse on duty; however discussion with staff and training records confirmed care staff have also had training as there are occasions when this is necessary for example, when they accompanied people on holiday. Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: Personal records detailed each individual’s health needs. People looked well cared for and we saw staff assisted them appropriately with their needs. Due to the dependency levels of the people whose care we were following we were not able to speak in depth with them about how satisfied they were with the care and attention they received. However, their records showed that they have regular appointments with health professionals such as doctors. The manager also told us that a psychiatrist visits the home six monthly, which people found beneficial. There were also records in place to show how staff monitor peoples health for example by checking their weight regularly and their food and drink intake and output as needed. Comments from surveys relatives and other professionals had completed for the service were positive. For example one said Lovely staff who seem highly dedicated and caring in their work. A credit and I have always found the quality of care and well being of my relative excellent. We saw appropriate equipment was in place to cater for peoples needs such as bath seats, hoists, wheelchairs, special crockery and heightened toilet seats. Care Homes for Adults (18-65 years) Page 27 of 38 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. Satisfactory processes are in place, which help to keep people safe. Evidence: There are satisfactory policies and procedures in place about raising complaints and about the protection of vulnerable adults. We saw these were on display around the home, although some need reviewing to make sure that they consistently contain the correct details of how we may be contacted. Information is also available for people about how to make a complaint in a simple pictorial form for people who find it easier to communicate in this way. Staff we spoke to recognised that some of the people they care for have very dependent needs and may be unable to raise concerns and complaints verbally. They said they use observations as a means of establishing people’s satisfaction with the service and that changes in peoples behaviour may be an indication of distress. They described what they would do to try and ascertain any problems in order to rectify them. People we saw looked well cared for and a person told us they liked it here. We observed staff treated people with kindness and patience when supporting them around the home and at mealtimes. Training records showed that the protection of vulnerable adults is a subject included in the staff training programme. Staff comments confirmed they knew the different forms abuse may take and of their role to report such matters. There have been no protection Care Homes for Adults (18-65 years) Page 28 of 38 Evidence: of vulnerable adult’s referrals in the past year. Neither have we received any complaints. Any complaints received by the service are recorded and we saw the last recorded complaint was over a year ago and detailed the actions taken to investigate and resolve it. We checked the records of recruitment of two staff which showed that the procedure includes obtaining reference checks, proof of identity and checks of the Independent Safeguarding Authority register prior to employment. Although there was evidence that Criminal Records Bureau checks had been applied for this information was not available in the service. The manager has since forwarded this information to us. Care Homes for Adults (18-65 years) Page 29 of 38 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 which is well maintained, generally clean and tidy and is suitable for their needs. Evidence: We saw the bedrooms of four people the service supports including the two whose care was being followed. They were clean and tidy and had been made more homely with peoples personal possessions. Bedrooms are lockable and we were told people who live in the home can have keys to them if they wish. All lounges were seen as was the dining room, kitchen, laundry and bathrooms. Generally, areas were clean and tidy. New settees and chairs were seen in the lounges and new flooring has been provided to areas of the home The home was warm and we saw that radiators were guarded, to prevent the risk of burns. They have addressed the areas of the environment which needed attention and was raised during the last key inspection. We saw the report of the most recent visit of a fire officer which occurred on 20/07/2009 and found the fire safety of the premises to be satisfactory. We also saw that records were in place, which showed that a risk assessment of the safety of the environment had been carried out. We saw records were in place to show when specific areas of the kitchen had been Care Homes for Adults (18-65 years) Page 30 of 38 Evidence: cleaned although nothing had been recorded for the daily routines for the Monday and Tuesday prior to our visit. The manager agreed to address this matter with the staff member responsible for this. We saw there was equipment in place to assist people who have physical disabilities, such as heightened toilet seats, wheelchairs, a lift and crockery designed for people with specific needs. Staff told us they had been provided with equipment such as gloves and aprons to use to make sure good hygiene practises are followed. Hand sanitizer is available for use within the home. We saw that records kept of staff meetings showed the importance of using aprons and gloves and of implementing good infection controls was discussed at them. They have told us they have relevant policies and procedures in place and staff training records showed that this included health and safety matters such as moving and handling. The manager confirmed there had not been a recent visit from an Environmental Health Officer. Comments indicated people liked living at the home. Care Homes for Adults (18-65 years) Page 31 of 38 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 receive care from a consistent team of staff who are well trained. Evidence: The manager confirmed that she is part of the staff rota for 30 hours per week and also has 12 hours per week of administration time. We checked the staff rota for the week commencing 24/04/2010, which the manager confirmed was also the record of actual hours worked. We saw that there was always a qualified nurse and three care staff during the day and at night a qualified nurse and two care staff on duty. In addition there is specific staff time allotted to enable some people to have individual support and this was also shown on the staff rota. In addition there is housekeeping, catering and gardening staff employed. The manager said there were no staff vacancies currently and there have been few staff changes. We saw that staff were available to assist and support people when needed. For example, at lunchtime there were sufficient staff available to help those people who needed support to eat their meals. Staff told us that they thought that the number of staff on duty enabled them to meet the current needs of people. Both male and female staff are employed. Staff said they were well supported by the manager. We saw that there are records to Care Homes for Adults (18-65 years) Page 32 of 38 Evidence: show staff performance is monitored through individual supervision and annual appraisal. In addition staff meetings are held periodically, the most recent meeting taking place on 12/02/2010. The organisation has a staff training programme in place which includes regular updates of some matters and some specialised training. Each new employee follows a training programme to induct them into the work. They have also told us that seven of the nineteen care staff employed have achieved a nationally recognised vocational award in care at level two or above. Not all staff have had had training yet about caring for people with dementia care needs and a staff member commented that they would like to have training as there are people who have needs associated with this within the service. We observed that staff were kind, patient and attentive when supporting people. Care Homes for Adults (18-65 years) Page 33 of 38 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is being well managed and promotes the health, welfare and safety of the people who live in it. Evidence: There has been a change to the management arrangements since the last key inspection took place. The current manager successfully followed our processes and became the registered manager of the service in April 2009. She is a qualified nurse and has achieved a recognised management award. She is also studying for a degree in psychology. Comments from the manager, staff and from records we checked confirmed there are systems in place to monitor the quality of the service. For example, staff meetings are held. We also saw that surveys about the quality of the service had been returned from some relatives and other professionals this year. Their comments about the service were positive and included, May I say at our last visit at Christmas we noticed much improvement from previous visits, The staff always go out of their way to look after me on visiting. Lovely staff who seem highly dedicated and caring in their work. A credit and I have always found the quality of care and well being of my relative to be excellent. Care Homes for Adults (18-65 years) Page 34 of 38 Evidence: The manager confirmed that she had held meetings for people who live in the home and their relatives to obtain their views but these had not proved successful. However, she said she makes herself available to see people individually if they wish. In addition she confirmed a Representative from the organisation regularly visits the home to monitor the quality of the service. They told us they have a range of policies and procedures in place to promote peoples welfare and safety. We saw risk assessments of the safety of the environment had been carried out as well as a fire safety risk assessment. We saw that certificates were in place to show the training staff had participated in and this included health and safety matters such as basic food hygiene, moving and handling and first aid. They have told us equipment has been serviced as recommended. Records of fire fighting equipment we checked on the day confirmed it had been serviced this year. Records were also in place to show the fire alarm system was checked weekly. Records kept of any maintenance issues showed that these were followed up on and completed. People we saw looked well cared for. Care Homes for Adults (18-65 years) Page 35 of 38 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 36 of 38 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 Care Homes for Adults (18-65 years) Page 37 of 38 Helpline: Telephone: 03000 616161 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. © 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. Care Homes for Adults (18-65 years) Page 38 of 38 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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