Care Home: Peterborough Avenue

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What the care home does well It was very evident that the home is operated for the benefit of the people that live there and that every effort is made to retain their independence and to enable them to continue to exercise choice control over their lives. The routines of daily living activities are flexible and varying to suit individual needs and preferences. People spoken to said that they were very happy in their home. it was apparent that they are very comfortable and at ease with the manager. There is a very small, stable staff and well-trained staff team. Therefore people receive consistent support from staff that know them well and who have the skills and experience to meet their needs. Feedback and comments from relatives and other professionals was very positive: A representative of the learning disability team said, "we were very impressed with the way Rita runs the home and involves residents in everyday appropriate activities. We felt that she excelled at meeting the criteria of valuing people." A representative of the local day centre said, "it is a very personal and family orientated care home. Service users always talk favourably about their home." Relatives said: "we are happy with the care that he receives. The service is 100% firstclass." "His self confidence has improved and his health and well-being are closely monitored. He is relaxed and happy." What has improved since the last inspection? There were not any requirements and recommendations at the last inspection. Due to people no longer receiving day services from the local authority the home has supported people to find new things to do. This includes an art and design class and also a music and movement class. Some ongoing improvements have been made to the environment and this includes refurbishing the central heating, decorating the dining room, hall, stairs. landing and kitchen and improving the security to windows and patio doors. What the care home could do better: The service continues to grow and develop and people are supported to be as independent as possible. There are not any requirements and recommendations from this visit. Key inspection report Care homes for adults (18-65 years) Name: Address: Peterborough Avenue 71 Peterborough Avenue Cranham Upminster Essex RM14 3LL     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: Jackie Date     Date: 0 7 1 2 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: Peterborough Avenue 71 Peterborough Avenue Cranham Upminster Essex RM14 3LL 01708225196 01708223189 rita155lewis@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Rita Antoinette Lewis care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Cara Linn Care Home at 71 Peterborough Avenue is a care home registered to provide long term care, support and accommodation to 3 adults with learning disabilities. The home operates as a small family home and is situated in a residential area of Cranham, and is close to local shops, major road links and public transport. The house is semi-detached with car parking facilities to the front of the home, and the rear garden is well maintained with flowerbeds, lawn and patio. Peoples independence, choice, dignity and respect is promoted at all times, and they are encouraged to participate fully in the life of the community. A copy of the statement of purpose and service users guide, together with a copy of the last inspection report, was available in Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 3 Brief description of the care home the hallway of the home and a copy of the statement of purpose will be sent on request to the manager. Currently all of the three places are commissioned by the London Borough of Havering who have agreed fee levels with the proprietor. 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: 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 peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was on 15th January 2007. This inspection was unannounced and took place over four hours. This was a key inspection and all of the key standards were tested. People using the service were asked to give their view on the service and their experience of living in the home. Only the manager/proprietor was on duty and therefore there was not an opportunity to talk to staff. All of the shared areas were seen and some of the individual bedrooms. Staff, care and other records were checked. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in November 2009. Information provided in this document also formed part of the overall assessment. Feedback from relatives and other professionals was seen at the home and this information was also used as part of the overall assessment. We would like to thank the people living at Peterborough Avenue and the manager for Care Homes for Adults (18-65 years) Page 6 of 29 their input during the inspection. 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: 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. Care Homes for Adults (18-65 years) Page 8 of 29 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 Statement of Purpose and Service Users guide provide people with the information that they would need to make an informed choice about whether they wish to live in the home. If a vacancy arose the required information would be gathered on a prospective resident and they and their relatives could spend time in the home to find out what it would be like to live there and to enable the person to make a choice about living in the home. Evidence: Standards 1, 2, 3 & 4 were tested. The statement of purpose and service users guide include detailed information about the service provided and this is available in a pictorial format to make it easier for people to understand. Three men live at this home and they have all lived together for several years. The newest person having moved to the home in 2003. The previous Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: inspection found that people had the opportunity to visit and spend time at the home. They met staff and other people living there. In addition the manager and her staff undertook a very comprehensive assessment of the persons needs. Following the visit the manager, other people living at the home and the staff team considered the application and had a full discussion before the admission was agreed. Care staff at the home have undertaken training in caring for people who have a learning disability, and are able to understand and meet the needs of the people living there. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed and changing needs and goals are reflected in their individual plans and they are enabled to make decisions about their lives with the necessary assistance. People are consulted on, and can participate in, all aspects of life in the home and are supported to take risks as part of their independent lifestyle. Peoples personal information is handled appropriately and they can be assured that their confidences are maintained. Evidence: Standards 6, 7, 8, 9 & 10 were tested, Each person has a personal profile and care plan. These had been reviewed monthly and updated when needed. People had signed these and were able to confirm that they had been involved in drawing up their care plans. From looking at the files, talking to people and observations on the day it was evident that the service is run as a small family type home and people are involved in everything that happens there. For example one person had written in his book, I helped Rita to plant busy Lizzies in Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: the garden. He had also written, we talked about our menu. People always go with the manager or a member of staff to collect shopping, to pick up their prescriptions and medication or to go to the building society to collect their money. They were very much at home and talked about what they did in the home and how much they liked living there. Their opinions are sought and valued. Feedback seen from the learning disability team said that they felt that the manager excelled at meeting the criteria of valuing people. Daily notes are kept for each person and contained details about what they have done, how they have been and what they have eaten. Therefore there is a clear record that can be used as part of the review process and to monitor and assess peoples changing needs. Risk assessments are in place. These identify risks for each person and indicate ways in which the risks can be reduced to enable their needs to be met as safely as possible whilst supporting them to be as independent as possible. Risk assessments covered the necessary areas and were relevant to individual needs. Peoples information and records are stored in a lockable filing cabinet and it was evident that peoples information is handled appropriately and that their confidences are maintained when necessary. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to be as independent as possible, to take part in meaningful and enjoyable activities and to be part of the local community. They are encouraged and supported to maintain contact with family and friends which is to the benefit of all parties. A healthy balanced diet is offered and people have meals that they have chosen, like, and that meet their needs and preferences. Evidence: Standards 11, 12, 13, 14, 15, 16 & 17 were tested People are encouraged and supported to lead an active life within the local and the wider community. They are well known in the local community as they use local Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: shops, the library, the local chemist and building society regularly. One person attends a gardening project for three days a week and he travels to and from this independently. People used to have access to the local authority day service but this finished in March 2009. As a result of this the manager and the staff team have helped people to find other things to do. For example they go to the local YMCA, to a local church for music and movement, to an art and design group and a social club. There are frequent trips to theatres, concerts, museums and sites of interest. People are encouraged to keep an activities book with photographs and programmes of what they have done and where they have been. In individual bedrooms and around the home there were photographs of people on holidays, day trips and doing activities. Home activities are also encouraged and this includes jigsaws, music, making a scrapbook and developing their literacy. Residents meetings are held and discussions include day programmes and birthday celebrations. People are also supported to exercise their right to vote in local and general elections. Family and visitors are always welcome at the home and there is a quiet room and conservatory if people wish to entertain visitors privately. All of the people living at the home have contact with their families. It is a mixture of visits and telephone conversations as not everybody lives locally. Feedback seen from one relative said that good contact was maintained by phone and letter and that he was thrilled that his relative had been enabled to attend a family wedding. As previously stated this small home operates as a family type environment and the manager and her family live on the premises. Therefore people eat together with the manager/proprietor, her family and staff. People discuss and choose the menu and help with the preparation of food and laying the table. They also make cakes and desserts. The menu is balanced and healthy and takes into account that one person has diabetes. On the day of inspection both men chose different things for their lunch. One person can and does make his own drinks and sandwiches regularly. Peoples religious needs are met with the encouragement and support of the manager and staff team. One person is a member of the Salvation Army and goes to their services each week. Another person goes to church with the manager. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receive personal care that meets their individual needs and preferences. People are supported to receive their prescribed medication safely. People who use this service are actively supported to receive the medical and health care that they need and to remain as healthy as possible. Evidence: Standards 18, 19 & 20 were tested. Peoples personal care needs and the support that they need are identified in their personal plans. This support is flexible and provided in privacy. People are given as much independence as possible in this area. Times for getting up and going to bed are flexible and in accordance with the wishes of each person. The two men spoken to were able to confirm that they choose what to wear each day and also that with support from staff they choose and buy their own clothing. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Each person is registered with a local GP practice and receives specialist input as and when required. This includes input from the psychiatrist. Two people had significant health issues when they moved into the home which resulted in surgery and inpatient stays. They were supported through follow-up visits and in both cases their health has stabilised. People have full bloods screening each year and thyroid, sugar and cholesterol levels are monitored. Weekly weight and blood pressure checks are carried out. If anybody needs to attend a medical appointment the manager always ensures that these are kept and that people are accompanied. Each persons file contains a record of medical appointments and these show that they have checks from the optician, dentist and when needed the chiropodist. The outcomes of all visits are clearly documented and actioned and show that peoples health care needs are closely monitored and that they have regular access to health care professionals. Feedback from a relative was, his health and well being are closely monitored. Medication is administered via a monitored dosage system and people go to the local chemists to collect these. All of the staff have received medication administration training and the district nurse administers insulin daily for one person. The medication folder contains MAR (Medication Administration Records) with photographs of each individual and details of allergies highlighted in red. There is also information on how to administer eye drops and opening dates are recorded on eye drops. These are all good practice. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples views are listened to and acted upon and they are safeguarded by the working practices at the home and by the support of the staff team. Evidence: Standards 22 & 23 were tested. The complaints procedure is displayed in the home and this gives people details about how to complain and the different options of whom they could complain to. It also has the relevant addresses and contact numbers. The people living at Peterborough Avenue have a pictorial complaints procedure to make it easier for them to understand. There is a complaints record but there were not any recorded complaints. Minutes of residents meetings confirmed that during the course of these people are asked if there is anything they wish to discuss, are there any problems or is there anything theyre not happy about. The proprietor/manager has daily contact with the people living there. They eat together and she helps to provide their care and support. People were very relaxed in her company and obviously talk to her about all aspects of their life. From viewing training records it was evident that staff have received training in protecting vulnerable adults. Safeguarding issues are also discussed at staff and residents meetings. At the time of the inspection there had not been any safeguarding issues or concerns. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: All of the people using this service require support with their financial matters. Each person has a building society account and they always go to the building society with the manager and sign to withdraw their cash. The manager then supports them to pay their bills etc. Records are kept of expenditure and cash and also of their accounts. The homes policies and practices regarding peoples money and financial affairs ensures that they can access their personal financial records and that money and valuables are safely stored The section on staffing later in this report gives information that confirms that there is a robust recruitment procedure and this also helps to safeguard people living in the home. 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. People live in a homely, comfortable and safe environment which is well maintained, clean and hygienic and suitable for their needs. Evidence: Standards 24, 25, 26, 27, 28, 29 & 30 were tested. The service operates as a small family home and is situated in a residential area of Cranham, and is close to local shops, major road links and public transport. The house is semi-detached with car parking facilities to the front of the home, and the rear garden is well maintained with flowerbeds, lawn and patio. The manager/proprietor lives on the premises and has her own accommodation on the second floor. There is a lounge/dining room to the front of the home, and a lounge and a conservatory to the rear. The rear lounge is used as a quiet lounge if necessary. The kitchen was clean and food kept appropriately in the fridge/freezer. There is a utility room where people are able to do the laundry with support from staff. Bedrooms are decorated and furnished to a good standard and it was evident that people are encouraged to personalise their bedrooms in accordance with their own needs and choices. They had stereos, televisions, DVDs, books, certificates of Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: achievement, jigsaw puzzles and photographs were displayed. Stair rails, bath grabs and a hand rail for the toilet have been fitted to assist people. Bathing and toilet facilities were adequate and suitable for those living there. Overall the home was clean, comfortable and well maintained. The people living there are comfortable in their home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected by the recruitment practices of the service. Staffing levels are sufficient and staff receive the necessary training and support to meet peoples needs. People are supported by a staff team who know them well and are committed to provide a very good quality service that meets individual needs. Evidence: Standards 32, 33, 34, 35 & 36. There is a very small and stable staff group that have looked after the same people for over four years and the home has never had to use agency workers. There is usually only one person on duty and this is sufficient to meet peoples needs. On the day of the inspection only the manager was on duty and therefore there was not an opportunity to talk to any of the staff. Records are kept of staff training and show that staff receive the training needed to meet the needs of the people using the service. All staff have now gained qualifications of different sorts. One person has a level one qualification in learning disability; another has NVQ level III a third NVQ level II. Other training that staff have had includes protection of vulnerable adults, mental capacity Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: act deprivation of liberty safeguards, record keeping, moving and handling, medication, food hygiene, infection control risk assessments and fire safety. Staff meetings take place every three months and staff receive supervision and annual appraisals. The service operates a robust recruitment selection procedure that includes application forms and interviews. Two references are obtained and POVA (Protection of Vulnerable (Adults) and CRB (Criminal Records Bureau) checks are carried out. Staff files seen contained all of the necessary information including proof of identification. Therefore people are protected by the services recruitment procedure. Feedback seen from a relative was, I have never had any doubt that he is very happy and well cared for. Ive every confidence in all of the staff. Another wrote, we are very happy with the care that he receives. The service is a hundred percent firstclass. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Peterborough Avenue benefit from a service that is very well managed and where their opinions are sought, valued and acted upon. They live in a safe home Evidence: Standards 37, 38, 39 & 42 were tested. The registered manager has the necessary management qualifications and nursing qualifications. She is highly competent to run the home and meets its stated aims and objectives. She was able to demonstrate an up to date knowledge of legislation. The manager ensures that the policies and procedures are reviewed and updated on a regular basis and that staff follow these policies and procedures. From talking to people it was evident that the ethos of the home is open and transparent and that peoples views are listened to and valued. It was also evident that people are always very involved in the day to day running of the home, and that their views are paramount. Clearly the home is operated for the benefit of the people living there and they see this as their home. Feedback is actively sought from them about the services Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: provided, and relatives and other visitors to the home are requested to make their views known to the manager and staff. Feedback from the learning disability team said, we are very impressed with the way that Rita runs the home and involves the residents in every day appropriate activities. She excels at meeting the criteria of valuing people. Insurance cover is in place which ensures that the home is well able to fully meet any loss or legal liabilities. All of the necessary health and safety checks are carried out and records are kept of these checks. A safe environment is maintained. 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 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 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. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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