Care Home: Northmead House

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What the care home does well Northmead House provides people with a respite service and it ensures that people can continue with their usual placements during their stay. The home is located in a quiet area overlooking fields whilst being only a few minutes drive from the motorway. Each person has their own bedroom which they can personalise during their stay. The home is comfortably furnished and promotes a `homely` feel. The home has good pre-admission assessment procedures in place which ensure that peoples` needs and aspirations can be met by the home before a placement is offered. People are also able to `test drive` the home before making a decision to use the service. The home liaises with relatives and health care professionals to ensure a smooth transition for people. Each person has a plan of care which is developed from a range of assessments. People using the service and their representatives are encouraged to be involved in the care planning process. People are supported to continue with their day centre placements, educational and work placements. The home also ensures that people have access to a range of social and leisure activities. People using the service benefit from a well motivated staff team who have been appropriately trained. Staff described the home as a `happy place to work`. Staffing levels are good and these are flexible to meet the needs, including social needs, of people using the service. Effective management procedures are in place. Staff told us that they felt very well supported. Systems are in place to seek the views of people on the quality of the service provided. Effective complaints procedures are in place which ensure people feel confident in raising concerns. The home have a range of policies and procedures in place which reduce the risk of harm or abuse to the people using the service. Health and safety procedures within the home were found to be up to date. What has improved since the last inspection? The home have taken steps to address the four requirements raised at the last inspection. Care records were found to contain a photograph of the individual using the service. We found that the home was following more robust procedures for the recruitment of staff. There was evidence that two satisfactory references had been obtained before employment commenced. Electrical hardwiring certificates were up to date and action has been taken to appoint and make an application to the Commission for a registered manager. What the care home could do better: This was a positive inspection. One requirement has been raised. In line with the Care Homes Regulations 2001, the registered provider must ensure that written copy of their monthly unannounced visits must be maintained at the home and be available for the manager and the Commission. Key inspection report Care homes for adults (18-65 years) Name: Address: Northmead House 3 Northmead Puriton Bridgwater Somerset TA7 8DD     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: kathy McCluskey     Date: 2 2 0 7 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 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 29 Information about the care home Name of care home: Address: Northmead House 3 Northmead Puriton Bridgwater Somerset TA7 8DD 01278683478 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jeafoster@somerset.gov.uk Somerset County Council (LD Services) Name of registered manager (if applicable) Miss Julie Foster Ms Clare Lois Marks Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Registered for respite care placements only. Registered for up to 10 persons in category LD who may have a concurrent physical disability. Registered to continue providing care to one named service user who is now over the age of 65 years. Date of last inspection Brief description of the care home Northmead House is a large detached house situated in the village of Puriton. The home is registered with the Care Quality Commission to provide short stay respite care Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 10 10 Brief description of the care home for up to 10 adults between the age of 18 & 65 years who have a learning disability and who may also have a concurrent physical disability. Appropriate adaptations have been provided within the home to assist with peoples mobility needs. There is an enclosed garden at the rear of the property. The home is not registered to provide nursing care. Northmead House is run by Somerset County Council. The responsible individual is Mr David Dick. The Commission are currently processing an application for a registered manager. We were informed that weekly fees were currently between £56.55 and £108.10 and were determined by age and needs. The home also have a scale of charges for shorter respite stays. People using the service meet the cost of their own personal items, newspapers and toiletries. The home provides transport and people who use the transport are charged/invoiced. a small amount per mile. Information regarding fees and charges should be obtained from the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over one day by regulation inspector Kathy McCluskey. At the time of this inspection 7 people were using the respite service. The acting manager was present throughout this inspection. We were given unrestricted access to all parts of the home and all records required for this inspection were made available to us. The home completed its Annual Quality Assurance Assessment (AQAA) and returned this to the Commission within agreed timescales. The AQAA is a self assessment which focuses on how well outcomes are being met for people. The AQAA also provides us with some numerical information. We sent comment cards to people using the service, staff and health care professionals to seek their views on the quality of the service delivered. We received completed comment cards from two people using the service. Care Homes for Adults (18-65 years) Page 6 of 29 The term we used throughout this report refers to we the commission. We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of our inspection findings and should be read in conjunction with the whole of the report. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: This was a positive inspection. One requirement has been raised. In line with the Care Care Homes for Adults (18-65 years) Page 8 of 29 Homes Regulations 2001, the registered provider must ensure that written copy of their monthly unannounced visits must be maintained at the home and be available for the manager and the Commission. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place to ensure that people have enough information to make an informed decision about using the service. Appropriate pre-admission procedures are in place to ensure that the home can meet the needs and aspirations of an individual before a placement is offered. People can be clear about the fees to be charged and of their rights and terms and conditions of occupancy Evidence: The home have produced a Statement of Purpose and Service User Guide (Welcome Pack), which provide information about the home and services offered. In addition to this the Somerset County Council have also produced a document called Our promise to you, which outlines the standards of care that people can expect. Documents are available in appropriate formats for people using the service. We were able to see evidence that people are appropriately assessed before a respite Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: placement is offered. The home also liaises with other health care professionals as appropriate and assessments are obtained. People who are thinking about using the service and/or their representatives are encouraged to look around the home and meet staff and other people using the service. People are then offered day visits, where they can stay for a meal, and an overnight stay. Two people using the service completed comment cards for the Commission and both confirmed that they had been able to make an informed decision about staying at the home. The home have a good supply of equipment to assist people with mobility difficulties. Some bedrooms are fitted with overhead tracking and all bedrooms have the provision of an adjustable bed. Staff have received appropriate training. People are provided with a written contract which details the term and conditions of the stay and the fees to be charged. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs, abilities and preferences are clearly set out in their plan of care. People are supported to take risks as part of an independent lifestyle. People using the service can feel confident that information about them is handled appropriately. Evidence: We examined two care plans at this inspection and found both to contain clear information on the individuals assessed needs, abilities and preferences. We were able to see that people using the service and/or their representative had been involved in the care planning process. Currently the home are recording this without obtaining signatures. We have recommended that the home requests that the individual or their representative signs the care plan to confirm their agreement. We have also recommended that this is followed for the review process as we were unable to see how care plans were reviewed each time an individual used the respite service. This Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: would ensure that any care plan remains appropriate to meet their needs, abilities and wishes. During this inspection we found no evidence of any restrictive practice. Risk assessments were available in care plans and these evidenced that peoples health, safety and well being had been considered for aspects of life both within the home and when taking trips outside of the home.Within the risk assessment process, people are supported to make decisions about their lives. The majority of people using the service continue to attend day centre and educational/work placements, though the home consults with them on their preferences for leisure time. Staff have received Inclusive Interaction Environment training (ICE) which aims to increase opportunities for choice and to promote Independence. People who completed comment cards for the Commission confirmed that they were supported to make choices about their lives. Staff spoken with at this inspection were very clear on the rights of people using the service. Policies and procedures are in place for staff relating to confidentiality. During this inspection we found all records pertaining to people using the service to be appropriately stored. We were invited to sit in on a handover which was conducted in an appropriate location and in a professional manner. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to continue accessing day centre, educational and work placements during their respite stay at the home. People have the opportunity to join in with a range of social activities. Staffing levels are flexible to meet peoples social needs. People are involved in menu planning with the support of staff to ensure that they receive a nutritious and well balanced diet. Evidence: Through discussion with staff and on examination of records we were able to see evidence that people are supported to access a range of social, leisure, vocational and work placements. The home ensure that people can continue with their usual Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: placements during their respite stay and staffing levels are flexible to ensure that peoples needs are met. Staff spoken with were very positive about staffing levels and of the opportunities available to people. The majority of people currently using the service attend local day centres. Some are supported to access local colleges and work placements. Each person has a day planner so that they know what they are doing each day. The home also displays information, including photographs so that people always know which staff will be on duty to support them. Generous staffing levels also ensure that people are able to access a range of leisure/social activities. We were informed that people make decisions about what they would like to do in the evenings and at the weekend. Favorites include trips to the local pub, bowling, walks and picnics. People are also supported to go shopping. The home has a wheelchair accessible vehicle. Routines within the home and staffing levels are flexible to meet the needs of people using the service. People are provided with a key to their bedroom on request. We were informed that people are now, with staff support, involved in menu planning on a Saturday morning. Staff ensure that choices offer a nutritious and well balanced diet. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that people receive appropriate support to meet their personal hygiene needs. The home ensure that peoples health care needs are met. Safe procedures are followed for the management and administration of peoples medication. Evidence: Staff support people to meet their personal care needs in line with their plan of care. Care plans examined contained clear information as to the individuals abilities and assessed needs. Each bedroom contains a wash hand basin as a minimum and the home has a range of specialised bathing equipment to assist people. Care plans contained the contact details of peoples health care professionals and we were able to see evidence that people are supported to attend appointments as required. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: We examined the homes procedures for the management and administration of peoples medication. We were informed that there was currently nobody using the service who was able to self medicate. We found medication administration records (MAR) to be well maintained. Staff make clear records of all medicines received in to the home and those returned home with the individual at the end of their stay. Two staff signatures confirm all entries made on the MAR charts. This is good practice as it reduces the risk of any errors. Clear protocols were in place for the use of peoples as required medication. Detailed information and protocols were seen to be in place for the use medazolam, a drug prescribed for some people with epilepsy. Staff confirmed that they had received training in the administration of this prescribed medication. All medicines were found to be securely stored with no excess stocks apparent. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that people feel confident in raising any concerns they might have. Procedures are in place to ensure that people are protected from the risk of harm or abuse. Evidence: The home has procedures in place which allow people to raise any concerns they might have. The manager informed us that she is in the process of making the complaints procedure available in every bedroom which will be produced in an appropriate format. The service also has a copy of the DVD produced by people using the Somerset County Council services, titled I want to make a complaint. The home maintains appropriate records for any complaints received and we were able to see evidence that past complaints had been appropriately investigated and responded to. The home have not received any complaints in the last twelve months and no concerns have been raised directly with the Commission. Two people using the service completed comment cards for the Commission and both confirmed that they knew how to raise concerns. The home has a range of policies and procedures in place for staff which reduce the risk of harm or abuse to people using the service. Staff spoken with were very clear on procedures for reporting concerns both within the Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: home and to outside agencies. All confirmed that they would feel confident in raising concerns and that there concerns would be acted upon. No concerns were raised with us during this inspection. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and homely environment. People have their own bedrooms which they can personalise during their stay. The home has a range of equipment to assist people with mobility difficulties. The standard of cleanliness is good and the home has procedures in place to reduce the risk of the spread of infection. Evidence: Accommodation is arranged over two floors with a shaft lift and stairs giving access to the first floor. All bedrooms are for single occupancy and vary in size. Two bedrooms on the ground floor and one bedroom on the first floor are fitted with overhead tracking for a hoist. All bedrooms have the provision of a profiling bed. All bedrooms have the provision of a wash hand basin as a minimum. There is a very spacious kitchen, a dining room and a comfortable sitting room. Fixtures and furnishings help to promote a homely feel. Corridors are wide and grab rails and ramps are appropriately sited. Assisted bathing facilities are available on each floor. Both have the provision of hi low baths. One has the provision of a Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: shower bed. A wet room is also available on the first floor. Apart from one room, the home is not fitted with a call bell system. We were informed that listening monitors are used following appropriate assessments. The standard of cleanliness was found to be of a good standard. Liquid soap and paper hand towels were seen to be appropriately sited and we found that staff have access to a good supply of protective clothing. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are flexible to meet the needs of the people using the service. Staff morale is very good and people also benefit from a well trained workforce. Staff recruitment procedures have improved and now offer better protection for people using the service. Evidence: Staff spoken with during this inspection were very positive and described the home as a very happy place to work. Staff told us that they felt very well supported and that training opportunities were good. Staff told us that they had received appropriately training to enable them to meet the needs of people using the service. Staff were very positive about staffing levels at the home. They told us that staffing levels ensured that peoples assessed needs and social needs were met. We were informed that the minimum numbers of staff on duty would be three. On the day of this inspection, five staff were on duty. The acting manager told us that there were no problems in accessing additional staff as required. Nights are covered by one waking and one sleep in staff. No concerns were raised with us about staffing levels. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: We were informed that of the 18 permanent care staff employed, 11 have achieved an NVQ level 2 in care as a minimum. This equates to 62 which exceeds the recommended 50 of the National Minimum Standards. We examined two staff recruitment files at this inspection and both contained all required information. We were able to see evidence that staff did not commence employment until receipt of two satisfactory references and an enhanced Criminal records check (CRB) and check against the protection of vulnerable adults register (POVA). As the recruitment process is completed by the Somerset County Council, we discussed the need for the manager to ensure that any gaps in employment noted on the application form, are fully explored and reasons documented. We were informed that newly appointed staff follow a comprehensive induction programme which also covers all mandatory training. A staff training matrix told us that staff have also completed more specialised training in autism, total communication, epilepsy and the administration of related rescue medication, intensive interaction, inclusive communication environment, mental capacity act, abuse and the protection of vulnerable adults and peg feeding. We were able to see evidence that staff received regular formal supervision sessions. Records were available in staff recruitment files examined. Staff confirmed that they felt very well supported. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Commission is currently processing an application for the acting manager to be registered manager. The home has been effectively managed and staff spoken with were very positive about the open and inclusive style of management promoted by the acting manager. Quality assurance procedures are in place to seek views on the quality of the service provided. The registered provider needs to ensure that copies of their visits are maintained at the home. The home takes appropriate steps to ensure the health and safety of persons at the home. Evidence: The home does not currently have a registered manager though the Commission are currently processing an application from the acting manager. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Staff spoken with were very positive about the acting manager and of the support they received. They described the acting manager as very approachable and proactive. We saw documented evidence that staff have the opportunity to attend regular meetings. Minutes are maintained. We were informed that formal meetings for people using the service do not currently take place though this is in the process of being reviewed. Quality assurance procedures are in place. The home seeks feedback from relatives following respite stays. We were also informed that quality questionnaires are sent out at least twice yearly to seek feedback on the quality of the service provided. In line with the Care Homes Regulations 2001, a provider representative is required to conduct monthly unannounced visits to the home to assess the quality of the service provided. Although we were informed that the visits take place, there was no documented evidence to support this. Copies of reports made, must be made available to the manager at the home. Copies must also be available for the Commission. We found that the home was taking appropriate steps to ensure the health and safety or persons at the home. Servicing and safety checks were found to be up to date. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 39 26 (4)(c) & 5 - The registered person must ensure that reports are completed and maintained at the home relating to the visits made under this regulation. This is to ensure that the manager can review the quality of the service provided and so that they are aware of any issues identified 31/08/2009 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 The home should ensure that care plans are reviewed with the individual and/or their representative each time they use the service. This would ensure that the plan of care continues to meet the individuals needs, abilities and preferences. This should be signed by all involved in the review process. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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