Care Home: Park View

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What the care home does well The service provides a home for people with a learning disability and other complex needs in two bungalows in the community. Each person has an up to date assessment to give a clear picture of what people`s needs are so that appropriate care and support can be provided. Each person has an individual care file that has a lot of information which helps to make sure that people get the care and support they need. Where people present behaviour that may be a risk to them or others, plans are in place and updated regularly so that risks can be reduced and people are protected from harm. Each person has a health action plan which helps to make sure that their health needs are met and their medication is well managed. The people who live in this home participate in the community and are helped to lead a full and active lifestyle taking into account their age and individual needs. Both bungalows were warm and welcoming on the day of the visit and had a relaxed atmosphere. The staff team are trained and supervised and we saw that they were attentive and treated the people who live in the home with dignity and respect. All of the people have a single room that is nicely personalised to their own taste. Relatives are very involved in the home and are made to feel welcome, making sure that family can keep in contact and people are supported to make choices about how they live their lives by family members and advocates where appropriate. The AQAA that the manager of the home has to complete prior to the inspection told us that: The home has achieved the Healthy Lifestyles Award and an A Scores on the Doors. All service Users have individual service user plans which include Health Action Plans. We work closely with health professionals to make sure peoples health needs are met. Specialist equipment is provided following an individual assessment. Independence is promoted with individual activity plans that provide a wide range of social stimulation both within the home and in the community. We have a good system in place to ensure that medication is stored and administered appropriately. Relatives are involved in the home. What has improved since the last inspection? Since the last inspection the environment has greatly improved, this now means that the staff are better able to meet the needs of the people who live at the home in a safe and proper manner.Lifting equipment has been installed which means that people can be cared for safely and bathing facilities have been greatly improved which means that people;s needs can be better met and people are afforded more choice and dignity. The AQAA that the manager of the home has to complete prior to the inspection told us that: We have begun to introduce person centred tools to enhance the quality of the care and support that we give to our service users. The home has undergone a major refurbishment which has included the provision of specialist bathing facilities and ceiling ceiling track hoisting hoists. We have supported service users on individual holidays. We have increased the level of partnership working with the Community nurses to ensure that health needs are met. What the care home could do better: People go out on a regular basis with programme workers who are specifically employed to do this. During the site visit one person, who is male, was being taken to the swimming baths by two female programme workers. This was because one programme worker had just started work and she was on induction, usually there is only one programme worker. The programme worker told us that usually when she is on her own, due the differences in their sex and the problems this causes when getting changing, the person is left for a period of time on their own. This needs to be addressed as people should not be put at risk while out of the building and the appropriate staff should be provided to support the person. The AQAA that the manager of the home has to complete prior to the inspection told us that: We intend to make sure that the views of service users, relatives and other professionals are sought by introducing a robust quality system. We intend to introduce more of the person centred tools and paperwork to evidence that we are working in a person centred way at all times. Key inspection report Care homes for adults (18-65 years) Name: Address: Park View 100-104 County Road North Hull East Yorkshire HU5 4HL     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: George Skinn     Date: 0 4 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Park View 100-104 County Road North Hull East Yorkshire HU5 4HL 01482448911 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kingston upon Hull CC care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Parkview is a purpose built establishment; it consists of three bungalows each of which have five single ground floor bedrooms, a lounge/dining room, one bathroom and two separate toilets. The three bungalows share a large garden but each has its own patio area. The home is registered to provide care and accommodation for up to 15 people who have a learning disability, and who may also have other physical needs, however since 12th May 2006 one of the bungalows has closed and some of the people have been re located leaving a total of eight people, four in each bungalow. The empty bungalow is now used for activity sessions, meetings, supervisions and a staff space. The home is close to local shops and next to a small park, and approximately 5 miles from the city centre of Hull. Public transport to various parts of the city is accessible and in addition people have Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 15 1 6 0 3 2 0 0 9 Brief description of the care home access to a mini bus. Additional charges are made for the following: newspapers/magazines and sweets and hairdressing. Information on the service is made available via the statement of purpose, service user guide and inspection report. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use the service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include reviewing information that has been received about the home since the last inspection and a site visit which lasted four (4) hours. We looked at records relating to the people who live at the home, staff and the management activities. During the visit care practices were observed where appropriate, and time was also spent watching the general activity within the home. We sent out surveys for the people who live at the home and staff to complete. Those returned from the staff told us they felt well supported and the homes environment had improved greatly since the last inspection, which helped them to better care for Care Homes for Adults (18-65 years) Page 6 of 27 the people who live at the home. People who live at the home were helped to complete surveys and these told us that they felt well cared for, were able to participate in plenty of activities and were happy living at the home. The survey also told us that people who live at the home were pleased with the improvements made in the environment and this now meant that they had more choice especially around bathing. The manager sent back the Annual Quality Assurance Assessment (AQQA) when we asked for it and this identified areas which have improved and areas which the manager felt needed to be improved. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 16th March 2009. The manager was available to assist throughout the visit. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? Since the last inspection the environment has greatly improved, this now means that the staff are better able to meet the needs of the people who live at the home in a safe and proper manner. Care Homes for Adults (18-65 years) Page 8 of 27 Lifting equipment has been installed which means that people can be cared for safely and bathing facilities have been greatly improved which means that people;s needs can be better met and people are afforded more choice and dignity. The AQAA that the manager of the home has to complete prior to the inspection told us that: We have begun to introduce person centred tools to enhance the quality of the care and support that we give to our service users. The home has undergone a major refurbishment which has included the provision of specialist bathing facilities and ceiling ceiling track hoisting hoists. We have supported service users on individual holidays. We have increased the level of partnership working with the Community nurses to ensure that health needs are met. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed prior to moving into the home. Evidence: There have been no new admissions to the home since the previous inspection; the people that live in the home have done so for many years. Therefore the standard in this area was not assessed and remains good. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed needs are documented in care plans with good risk assessments to enable a measured approach to risk taking. Staff ensure people who live at the home maintain a good quality of life by promoting independence and choice, providing opportunities for activities, occupational stimulation, access to local community facilities, and by ensuring that links to family and friends were maintained. Evidence: We looked at four (4) care files which belonged to the people who live at the home. We saw that these files contained an assessment and care plan completed by the placing Local Authority, a focus page for initial important information and an individual plan covering the majority of peoples needs. We saw that the care plans included very detailed communication passports ensuring that all staff knew how people communicated. In addition to the care plans there were management plans for epilepsy and dealing with behaviours that may pose a risk, morning and evening routines, likes and dislikes and daily activities. We saw that the Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: care plans made regular reference to the development and maintenance of peoples independence. There is good case file monitoring in place and the documents seen had been updated regularly and amended when peoples needs change. We saw that peoples needs had been reviewed regularly using both the Social Services Fair Access to Care review system and Person Centred Planning. We saw that good daily records were maintained by staff to indicate how peoples needs were being met. We saw a wide range of risk assessments in place to ensure that people were being protected from the risk of harm. At the last inspection it was noted that care plans would benefit further from including identification of needs in finance, culture and faith needs and contact with family and friends. We saw that this information is now recorded. At the last inspection it was noted that risk assessment were not in place for the use of bed rails in accordance with Department of Health Guidelines. We saw that the bed rails used are an integral part of the bed and as such are positioned to avoid any risk to the person using them. Risk assessments are now in place and we saw that a good record is kept of the safety of the bed rails. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities are provided within the home and community. This means that people have the opportunity to participate in activities that meet their individual needs, wants and aspirations. However they are not always supported by the appropriate staff to keep them safe from harm. Evidence: We saw that people are supported by staff to pursue their own interests and hobbies and therapeutic activities are provided a on a day to day basis. We saw good records of what people prefer to do and how they need to be supported to achieve this. For example one person is very interested in cars and other vehicles so their holidays and outings are arranged around any events which are taking place like motor racing so they can attend. Another person is a keen fan Hull City and the staff take them to all the home matches. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: We saw that peoples care plans contained a detailed record of their likes, dislikes and preferences. During the site visit we saw staff sitting and talking with the people who live at the home. We saw one person receiving a head massage which they thoroughly enjoyed. Program workers are employed to take people out to attend any specific activities like swimming, bowling and visiting the theatre. During the site visit one person, who is a male, was being taken to the swimming baths by two female programme workers. They described to us the way they cope with this due to differing sexes and the problems this causes when getting changed. Their description indicated that there could be some potential risk involved as the person is left for a period of time on their own. This needs addressing and safeguards put in place to eliminate all risk to the person. Visitors are made welcome at the home and they told us that they were highly delighted with the standard of care provided for their relatives. Menus continue to be in place but are subject to change if people preferred alternatives. Menus reflected that staff promote a healthy eating and tried to balance this with peoples likes and dislikes and special treats on occasions. The staff members generally prepare the meals with people helping if they were able to or wanted to. The assessment of the kitchens by Hull City Council under the Food Safety Act graded them as an A which is excellent. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are planned for and met in the home. Medication is managed in a safe and responsible way. Evidence: We saw that people who live at the home have access to a range of health care professionals this includes GPs, dentists, opticians, chiropodists, community nurses, specialist nurses, dieticians, speech and language therapists and consultants via outpatient clinics. We saw that health action plans had been developed for each person and a good record of health interventions and access to services were kept. Accidents were recorded and body charts completed when any bump or knock resulted in a mark to the skin. We saw that peoples weight was recorded and healthy eating promoted where required. We saw that staff speak to people in a kind and caring way and there was clearly a good rapport between them. Each person who lives at the home has a designated link worker and relationships had been built up between them and the persons close family. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: We saw that the care plans provided detailed information about how people wanted to be supported and the preferences they had for rising, retiring, activities, bathing, meals, appearance and clothes. We saw that best of interest meetings had been held for when it was decided that people who live at the home were unable to make an informed choice about health care and treatment. These meetings involved advocates, families, health care professionals and the staff and management of the home. None of the people who live at the home self medicate, all medication is handled on their behalf by the staff. We saw that all staff have received accredited training. We saw that medication is handled safely and people are protected by the procedures in place for the staff to follow. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes complaints procedure and kept safe from harm by the homes procedures and policies regarding safeguarding of adults. Evidence: We saw that there continues to be a complaint policy and procedure in place and this displayed around the home. The policy and procedure is also available in the Statement of Purpose and the Service User Guide. The homes AQAA told us that they had received one (1) complaint since the last inspection and the complaint records showed that this had been concluded satisfactorily. The AQAA also told us that the home had made two (2) safeguarding referrals the Local Authority Safe Guarding Team, one (1) of which was subject to investigation. This has now concluded. The CQC have received no concerns about the service since the last inspection. We saw that all staff have received training about how to recognise abuse and how to report this. When we spoke with the staff they were able to describe what they would do if they suspected any abuse was occurring in the home. They also felt confident that any concerns they raised with the manager would be dealt with properly Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 well maintained and clean. People are provided with equipment which meets their needs and affords them choice and dignity. Evidence: The home has undergone a complete refurbishment since the last inspection. All areas have been redecorated and equipment has been provided to meet the needs of the people who live at the home. Each house has a ceiling track hoist system in place in all lounges, bedrooms and bathrooms which helps the staff lift and move people safely. All the bathrooms have been refurbished and provide both bathing and showering facilities so people now have a choice and can bathe according to their preference. New baths have been fitted which better help people to bathe and help staff to get people in and out of the bath safely. Walk-in showers have been installed so people can use them easily and staff can assist safely. All bedroom and communal areas have been redecorated and these look comfortable and welcoming. New furniture has been purchased for both communal rooms and bedrooms and chairs and mobility aids have been provided in line with advice sought Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: from Occupational Physiotherapists which meet the needs of the people. Relatives who were visiting told us that The home is now 100 better and the council have spent a lot of money, we have booked to come and live here. Staff told us that they thought the new baths and ceiling track hoist systems were Brilliant and the new ceiling track hoist system helped the residents and them no end. Staff told us that the bathing facilities were much easier to use and the resident loved them one staff told us Its nice now because everyone can have either a bath or a shower its totally up to them. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared by staff in sufficient numbers who are trained and competent to do so. People are protected by the recruitment and selection practices. Evidence: We saw that there are enough staff on duty to meet the needs of the people who live at the home both during the day and at night. We saw that all staff were up to date with their mandatory training and have completed values and attitudes and equality and diversity training. Staff have completed training on how to manage people that present behaviour that may pose a danger to themselves or others. The home continues to have more than 50 of staff qualified to NVQ level 2 or above. Service specific training provided has included epilepsy, communication, eating and drinking, makaton and bowel massage. The speech and language therapist has provided some training in intensive interaction. When we spoke with staff they told us that they received a lot of training and they felt this equipped them to care for the people who live at the home. More specialised training can be provided and this is identified during staff supervision and Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: development interviews. We saw that staff have recently undertaken training about Deprivation of Liberty and the Mental Capacity Act and how this can impact on the people they care for. This means that people are cared for by well trained staff who have the skills to meet their needs. Staff recruitment files are located at the Hull City Councils headquarters and were not assessed at this inspection. However, previous inspections had detailed that there are robust policies and procedures in place regarding the recruitment of new staff members and this ensured that all the required checks were in place prior to the start of employment. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is run in their best interest. They are involved with the running of the home as much as possible. Their views and the views of others are used to inform the day to day functioning of the home. Peoples health and safety is promoted and protected as far as reasonably possible by the policies and procedures at the home and the training of staff. Evidence: The home has a registered manager in post. She is well qualified and experienced to undertake the role of manager and staff told us that they found her to be very approachable and supportive. The home continues to improve under the current management arrangements and provides detailed individual plans of care, meets peoples health needs and provides adequate numbers of staff who are trained, competent and caring. We saw that staff had completed training about health and safety, first aid, basic food hygiene, fire and infection control. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: We saw that all of the equipment used at the home had been serviced in accordance with the manufactures recommendations. We saw certificates which indicated that the electrical wiring and gas installations had been checked at the approved intervals. The Local Authority continues to have a well developed Regulation 26 visiting and reporting system in place that monitors the improvements being made and makes recommendations. The registered manager continues to notify the CQC of any events in the home using the Regulation 37 reporting system. Since the last inspection the environment has greatly improved; this means that the staff are better able to meet the needs of the people who live at the home in a safe manner. Equipment has been installed which means that people can be cared for safely and bathing facilities have been greatly improved which means that peoples needs can be better met and people are afforded more choice and dignity. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 12 People should be supported by staff who are compatible with the person both in ability, and in particular sex when needed, to eliminate all potential risk. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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