Care Home: Oakleigh

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What the care home does well The residents spoken to and those who had completed questionnaires expressed a high level of satisfaction with the home, the staff and the providers. People said they liked living in the home, they enjoy the activities and have choice in how they spend their time.People said that the staff listen to and act on what they say and that they can call a resident’s meeting at any time. Staff were observed working alongside residents encouraging them to make decisions for themselves. People commented on the cleanliness of the home and that they help to keep it that way. They are involved in the running of the home and are consulted about any proposed changes. The home is spacious and has extensive grounds which are well used. The detailed, individualised care plans are developed over a period of time to ensure that all the residents` needs are clearly identified and risk assessments completed. These are regularly reviewed and are signed by the resident concerned. The residents` behaviour is understood by the staff and well managed.The residents are encouraged to lead a healthy life style. They grow their own fruit and vegetables and keep animals such as chickens. The produce is then used by the residents for their meals. The residents are also involved in a wide range of physical activities such as running, swimming, cycling and walking as well as using the home`s wellequipped gym. This approach has enabled at least two people to lose weight.There is a good staff recruitment procedure and the staff are well trained.# What has improved since the last inspection? The quality assurance system has been extended to surveying relatives and professionals. An annual development plan for the home has been produced. A revised Service Users` Guide has been drafted and includes contributions from the residents. What the care home could do better: The home has not been asked to make any improvements. Key inspection report Care homes for adults (18-65 years) Name: Address: Oakleigh Shutterton Lane Dawlish Warren Dawlish Devon EX7 0PD 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: Jane Gurnell Date: 1 2 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 32 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 32 Information about the care home Name of care home: Address: Oakleigh Shutterton Lane Dawlish Warren Dawlish Devon EX7 0PD 01626866740 01626864771 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Tony England, Mrs Pamela England Name of registered manager (if applicable) Mrs Pamela England Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: Date of last inspection 3 0 0 8 2 0 0 7 A bit about the care home Oakleigh is a large, extended property situated on the outskirts of the seaside resort town of Dawlish. Care Homes for Adults (18-65 years) Page 4 of 32 The home has two floors with stairs to the upstairs rooms. Six people live at the home which provides specialised residential care to people with a learning disability whose behaviour may challenge services. The Registered Providers state that they work with people using the service is based on gentle teaching principles within the framework of a social learning programme. Each person has their own bedroom. No-one has to share a bedroom. Bathrooms are close to the bedrooms. The home has a large kitchen. Care Homes for Adults (18-65 years) Page 5 of 32 There is a lounge room, games room, gymnasium and an additional kitchen/multi purpose area. There is lots of land around the home (over three acres). This is used for gardening and tending to the homes chickens, geese and ducks. There are also ferrets and a cat. Activities arranged by the home include keep fit, gymnasium, karaoke, gardening, cooking, sport and arts and crafts. Information about the home, copies of inspection reports and fee levels can be obtained from the Registered Manager, Mrs Pamela England. Care Homes for Adults (18-65 years) Page 6 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 32 How we did our inspection: This is what the inspector did when they were at the care home This was a short notice inspection which enabled the owners to prepare one of the people living in the home for the inspection. All those living in the home were spoken with, three more so than the others. Prior to the inspection, all six people had returned a survey to us giving their views of life in the home: all were very satisfied with the care and support they received as well as their leisure and social opportunities. Both owners were present throughout the inspection and the staff on duty were spoken with and observed interacting with people as they went about their daily duties. Care Homes for Adults (18-65 years) Page 8 of 32 We looked at the care records of the people living in the home. We looked at other records that told us about how the home is run, including staff records. The Annual Quality Assurance Assessment completed by the owners had been received prior to the inspection and this gave us detailed information about the home. What the care home does well The residents spoken to and those who had completed questionnaires expressed a high level of satisfaction with the home, the staff and the providers. People said they liked living in the home, they enjoy the activities and have choice in how they spend their time. Care Homes for Adults (18-65 years) Page 9 of 32 People said that the staff listen to and act on what they say and that they can call a resident’s meeting at any time. Staff were observed working alongside residents encouraging them to make decisions for themselves. People commented on the cleanliness of the home and that they help to keep it that way. They are involved in the running of the home and are consulted about any proposed changes. The home is spacious and has extensive grounds which are well used. The detailed, individualised care plans are developed over a period of time to ensure that all the residents needs are clearly identified and risk assessments completed. These are regularly reviewed and are signed by the resident concerned. The residents behaviour is understood by the staff and well managed. Care Homes for Adults (18-65 years) Page 10 of 32 The residents are encouraged to lead a healthy life style. They grow their own fruit and vegetables and keep animals such as chickens. The produce is then used by the residents for their meals. The residents are also involved in a wide range of physical activities such as running, swimming, cycling and walking as well as using the homes wellequipped gym. This approach has enabled at least two people to lose weight. There is a good staff recruitment procedure and the staff are well trained. # What has got better from the last inspection Care Homes for Adults (18-65 years) Page 11 of 32 The quality assurance system has been extended to surveying relatives and professionals. An annual development plan for the home has been produced. A revised Service Users Guide has been drafted and includes contributions from the residents. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home. Care Homes for Adults (18-65 years) Page 12 of 32 If you want to speak to the inspector please contact Jane Gurnell Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 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 13 of 32 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The comprehensive assessment undertaken for people considering moving to Oakleigh and the detailed statement of purpose, provide sufficient information to enable all those concerned to make the decision as to whether Oakleigh is an appropriate home for them. Evidence: There have been no new admissions since the last inspection. However, Mrs England described that the procedure remained unchanged with each person having a thorough assessment of their needs and a number of visits to the home to ensure it was suitable and provided them with a lifestyle of their choosing. The most recent person to be admitted said he had been given information about the home and had visited several times, staying for a meal and overnight before moving in. He said he had been able to meet the other people living in the home and he felt he had settled in well and had a good life at Oakleigh: he said he was very lucky to be here. The comprehensive pre-admission assessment gathered information about the level of assistance required with personal care, dietary needs, social interaction and behaviour, sleep patterns, interests, likes and dislikes and religious beliefs. Mrs England also Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: confirmed that reports from the previous placement and information from other health care professionals such as Social Workers or Nurses was obtained to gain a clear and detailed picture of the persons needs. Each person living in the home returned a survey to us and all said they had been given enough information about the home and had been asked if they wanted to move in. Care Homes for Adults (18-65 years) Page 16 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their care plans clearly identify their needs and personal goals and how these will be met. Evidence: All the people living in the home were spoken with, some in more depth than others. All said they were happy at Oakleigh and they enjoyed the lifestyle and support they received from staff. Three people said they felt very lucky to live here and enjoy such a varied lifestyle. The care and support files for two people were examined in detail. Both were found to be comprehensive focusing on what each person is able to do for themselves, their long- and short-term goals and what assistance is required from staff with regard to person care, skills development, promoting independence and managing anxiety. It was evident that specialist advice regarding managing potentially difficult behaviour was provided by Nurses and Psychiatrists and this information was included in the plans. Both care plans looked at had been reviewed in March and all those involved, including the person for whom the plan had been written, had signed to say they agreed with the content. Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: Risk assessments were clearly written and explained about how to keep people safe and included leisure and social activities in and out of the home as well as situations where the person may become anxious or aggressive. These had also been signed by each person ensuring that they were fully aware of what action the staff needed to take in various situations. On examining previous records it was obvious that there had been a high degree of success in managing very challenging behaviour while enabling people to remain living in a homely environment in the community. Care Homes for Adults (18-65 years) Page 18 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and well-being is promoted by the provision of a healthy diet and active lifestyle. Evidence: People said they are involved in the day-to-day running of the home. They said they are expected to keep their rooms clean and tidy, help with housework, take turns to choose, prepare and cook the evening meal for everyone and to help in the vegetable garden and with looking after the homes many animals. They also said that the staff listen to them and take notice of what they say. Meetings are held every few months but people said they can call a meeting whenever they wanted to discuss something as a group or which involved everyone living in the home. During the inspection people were observed doing housework and laundry, doing tasks around the garden such as cutting the grass and building a wall, as well as preparing the evening meal. One person showed us around the extensive grounds, vegetable garden and greenhouses, talking enthusiastically of the crops grown and cooked: he said any Care Homes for Adults (18-65 years) Page 19 of 32 Evidence: excess in produce was shared with the neighbours. He also showed us the area where the chickens, ducks, pigs, sheep and other animals are kept. The ethos of the home is to maintain a healthy lifestyle. In addition to the healthy diet, people benefit from the homes well-equipped gym and from other activities such as cycling, swimming, running and going for long walks: one person was seen to arrange going for a jog with one of the owners that evening. Two people had lost a significant amount of weight and said they felt much fitter and better in themselves. The home also has a games room which has a pool table, darts board and karaoke machine as well as table games and arts and crafts materials. Time is also spent on improving literacy and numeracy skills. People make good use of community facilities and activities such as going to football matches, the cinema and discos. People are encouraged and supported to maintain contact with friends and relatives and this was confirmed by those spoken with. Care Homes for Adults (18-65 years) Page 20 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care and support in the way they prefer and which promotes privacy, dignity and independence. Health care needs are clearly identified and people receive prompt medical advice. Evidence: The home operates a key worker system which ensures that each persons individual needs are identified and met. People are encouraged to be as independent as possible with their personal care and this was clearly recorded in the two care plans looked at. This was confirmed by the people spoken with who said that they would seek help when required from the person with whom they felt most comfortable. One person required help with bathing and shaving and the manager ensures that staff of the same gender provides that assistance. All contact with health care professionals is recorded in the care plans. The manager stated that staff support is provided to attend appointments and that staff will go in with them for the consultation if requested or if a risk assessment indicates that this is required. The manager said that they have a good relationship with the local GP. The manager stated that they have worked hard with the relevant medical staff to reduce the amount of medication people are taking. They have had a high degree of success and Care Homes for Adults (18-65 years) Page 21 of 32 Evidence: only three people take any medication. This is dispensed by the pharmacist in bubble packs and two people are encouraged, with staff supervision, to remove the medication from the packs themselves. Medication was stored safely and records were seen to be correct and up to date. All staff have received training from the local pharmacist about the safe administration of medicines. Care Homes for Adults (18-65 years) Page 22 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by their knowledge of the complaints procedure, robust recruitment practices and staff training in recognising abuse. Evidence: All six people living in the home had completed a survey prior to the inspection. Through those they all stated that the staff listened to them and acted on what they said, that they knew who to speak to if they were not happy and that they knew how to make a complaint. Each of them has their own copy of the Service Users Guide which contains a copy of the complaints procedure. Oakleigh has received no formal complaints and no complaints about the service have been received by the Commission for Social Care Inspection. The recruitment files for two staff indicated that all the necessary pre-employment checks had been carried out ensuring as far as possible only suitable people were employed at the home. The manager stated that issues around recognising abuse are discussed periodically at residents meetings. All staff except the newest recruit have had training in the protection of vulnerable adults. Records of peoples money were found to be in order. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Oakleigh provides people with a homely, comfortable and safe environment in which to live. Evidence: All areas of the home seen during the inspection were found to be clean, tidy and free from offensive odours. People said that the home was clean and that they all helped to keep it that way. People said they chose the way in which their rooms were decorated and furnished which reflected their own taste and accommodated their particular needs. They also said that they are consulted about how the rest of the home is decorated. The home is light, airy and spacious throughout with plenty of room for people to spend time together or be on their own if they wish. The home has considerable communal space. There are two large kitchen areas with dining space, a comfortable and homely lounge, games room and gym. The grounds are extensive with areas for leisure activities as well as the large vegetable garden and the enclosures for the animals. An outside sink area has been installed since the previous inspection and is used for preparing fish caught by the people living in the home. Day-to-day repairs and maintenance of the grounds are undertaken by Mr England, one of the owners, with the assistance of the people living in the home: on the day of the visit to the home one person explained he was helping build the walls of a new garage and Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: another person was seen to be cutting the grass. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs sufficient staff who have the skills, training and understanding to meet peoples needs. People are protected by good staff recruitment procedures. Evidence: Many of the staff have worked at Oakleigh for a number of years and as such have built an excellent relationship with the people who live there, the majority of whom have behaviours which may be self-injurious or aggressive toward others. The staff are able to recognise early indications that someone is becoming upset or anxious and can redirect and offer support early to reduce the situation from becoming more distressing. All staff have received training in managing aggressive bahaviour and how to restrain someone safely should that be necessary. The files for two of the staff were examined and found to have all the necessary documentation. These included a completed application form, two references, proof of identity and police checks. The files also included the training records. Induction training for new staff is phased over a three month period with a checklist to be signed off as it is completed to ensure that all areas are covered. All new staff work a six month probationary period to ensure that are suitable to work at the home. Of the seven staff Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: employed, five have achieved a NVQ in Care at least level 2: one more experienced member of staff has achieved the Registered Managers Award. Other recent training has included fire safety, epilepsy, first aid, food hygiene and safe handling and restraint. During the inspection staff were observed to be working alongside people encouraging them to make decisions for themselves rather than telling them what to do: people said the staff treat them well. Some commented that they like doing activities with the staff. In discussion with the staff on duty during the inspection it was clear that there was a good understanding of each of the persons behaviour, which can be very challenging, and how this should be managed. The home owners meet with staff regulary individually and in groups to discuss the running of the home, the support of the people living in the home and their own personal training and development needs. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the home is well run and that their views will be taken into consideration in the plans for the home. Evidence: The registered manager is also one of the registered providers. She and her husband have provided the service for over 20 years and two of the people have been with them for that period of time. The manager has NVQ level 4 and the Registered Managers Award, as has one of the more experienced members of staff. People spoken with were very appreciative of the support they receive from both the owners. They said they were easy to talk to and took notice of what they said. During the inspection it was observed that the people living in the home and the staff approached the owners with confidence and were well received. The staff clearly knew what was expected of them and appeared happy working with people. People said that their views are listened to by the staff. Regular meetings are held at their request or if a matter needs to be raised with them. If a meeting hasnt been held for three months then the manager will call one. People are always asked at those meetings if they are happy with the care provided. They are also encouraged to complete Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: questionnaires about life in the home. The minutes of the last two meetings were looked at as well as the results of the questionnaires: all indicated people were very happy with the care and support they received and their involvement in leisure and social activities. Surveys had been recently sent to relatives and health care professionals such GPs, a psychiatrist, social workers and an advocate. There was a good response to these and the results indicated that those consulted felt the home provided an excellent service to people. Comments included, welcomes professional input, keeps me informed, consistent, committed, professional and dedicated staff and wonderful people. This was further supported by the survey we received from a health care professional prior to this inspection: their comments included, fantastic range of activities at the home and in the community, wonderful range of home reared meat and vegetables, conscious of maintaining fair and safe boundaries and family contact. The home encourages safe working practices by ensuring that staff have training in manual handling, infection control, fire safety, first aid and food hygiene: the people living in the home are invited to attend the training as well. They also have training in techniques for managing challenging behaviour. Risk assessments have been completed for the environment and for the different aspects of peoples behaviour. The required policies and procedures are in place and regular fire and other safety checks are made and recorded. Accidents and incidents were seen to have been recorded appropriately. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes No Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 31 of 32 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 32 of 32 - 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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