Care Home: Portland Street (12-14)

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What the care home does well The Home provides an excellent service to the people who live there. The Home is very well managed by a Manager who is suitably qualified and experienced to manage the Home. The Manager provides clear leadership and motivation to the staff team to provide a good quality service to the residents. The staff receive appropriate training and supervision to enable them to carry out their roles effectively. The residents told us that they like the staff and that they feel safe at the Home. The aim of the Home is to enable the residents to maintain and develop their independence. Support is provided when residents need it but they are encouraged to take part in as much of the running of the house as possible. Residents told us that: `this is the best place Ive ever lived`, `I love it here`, `Im happy with the staff support`. Health and social care professionals responded positively in the surveys and state that the Home is well managed, that staff seek advice appropriately and always ensure advice is incorporated into care plans. The location of the Home means that there is easy access to a wide range of leisure, work and employment opportunities. Staff provide support to residents as appropriate to enable them make the most of these opportunities. What has improved since the last inspection? Many areas of the Home have been redecorated and had new furniture or carpets. A new smoking shelter has been built in the garden so that the Home is now a nonsmoking building. Training continues to be provided to enable the staff to carry out their roles effectively. What the care home could do better: There are still areas of the Home which would benefit from redecoration and refurbishment. The office is going to be moved downstairs which will be a better location for it as well as providing better storage for medication. The staff need to ensure that all of the care plans contain the level of detail that the majority already do so that there is clear guidance for staff about how to meet the needs of the residents. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Portland Street (12-14) 12-14 Portland Street Kings Lynn Norfolk PE30 1PB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lella Hudson     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Portland Street (12-14) Kings Lynn 12-14 Portland Street Norfolk PE30 1PB 01553769091 01553749091 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Jane Mace Type of registration: Number of places registered: The Regard Partnership Ltd care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 13 The registered person may provide the following categories 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: Mental Disorder Code MD Date of last inspection Brief description of the care home 12 - 14 Portland St is a Care Home providing care for up to 13 adults with mental health problems. The Home was bought by the Regard Partnership in 2007 and completed the registration process in 2008. The Home consists of two houses and a flat which are joined together. It is situated in the centre of Kings Lynn and is close to the bus and rail stations as well as all of the facilities of the town. The fees currently range from £270.00 to £500.00 per week and are negotiated on an individual basis dependent on need. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 13 Care Homes for Adults (18-65 years) Page 5 of 28 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: This report contains information gathered about the Home since the last Inspection (July 2007). It contains information that was within the completed Annual Quality Assurance Assessment which the Manager completed and returned. We received completed surveys from staff, residents and health/social care professionals. We also carried out an unannounced visit to the Home on the 23rd January 2009. The Home was sold to the Regard Partnership in 2007 through a share buy out. Therefore there was only a need for a new application for registration in 2008 when the organisation applied to change the name of the organisation. The Manager of the Home has worked there for several years. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home has an effective admissions procedure Evidence: We spoke to the Manager about the admissions procedure and this includes inviting the prospective resident to spend time at the Home as part of the decision making process. There are currently no vacancies at the Home and there is a waiting list. The completed residents surveys all stated that they had enough information about the Home prior to moving in. Care Homes for Adults (18-65 years) Page 11 of 28 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. The care plans and risk assessments contain clear guidance for staff about how to meet the residents needs. The residents are consulted about issues that affect the running of the Home. Residents are encouraged to make their own decisions about issues affecting them. Evidence: The organisation has introduced new formats for the care plans and staff have received training about this new system. We looked at two of the care plans and risk assessments. Following initial assessments the care plans contain information about how the residents needs should be met. In general, these are detailed and contain clear information about how to meet individuals needs. For example, there is clear information for staff about the possible triggers that may cause a resident to have some challenging behaviours. There is then information about how these should be managed. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Although there is a stable, consistent staff team who clearly know the residents well it is important that all of the care plans are detailed. For example, one of the care plans that we saw does not explain how staff should support a resident to maintain their bedroom. The care plans are written in a very individual style with the emphasis being on involving the resident in the development of the plan and of the need for staff to encourage residents to make their own decisions. For example, one of the residents care plans includes a contract about a particular issue that has been signed by the resident and the Manager. Staff discuss the contract with the resident on a weekly basis to ensure that they remember its content and are still happy to abide by it. There is evidence of regular reviews of the care plans. There is also evidence that risks are recognised and assessed with guidance available to staff about how to manage these. Discussions with the Manager and staff show that the need to balance the importance of encouraging residents to make their own choices and the risks associated with this is regularly discussed. The staff surveys that we received all stated that the staff feel that they get enough information about the needs of the residents. Staff also told us that they feel that they have good information about residents needs and clear guidance about how to meet their needs. The completed surveys from health/social care professionals all state that the staff team always seek advice appropriately and incorporate this into the care plans. Residents told us that they are involved in decision making about their own care and also about issues that affect the running of the Home. Weekly house meetings take place in which residents are encouraged to raise any moans and groans as well as to talk about positive things that are happening. Issues relating to the household are discussed, such as plans for maintenance work, changes to the way in which the household tasks are carried out. The Manager and staff are aware of the importance of encouraging all residents to have their say and of ways to ensure that those residents who are not so confident are able to make their voices heard. The Manager said that some of the residents are involved in mental health advocacy groups. The Manager and Senior have attended Mental Capacity Act training and are aware of how to contact an Independent Mental Capacity Advocate if necessary. Care Homes for Adults (18-65 years) Page 13 of 28 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. The residents take part in a wide range of activities both within the local and the wider community. Residents enjoy their meals and are encouraged to assist with shopping and cooking. Evidence: We spoke to residents about how they spend their time. They told us about a range of activities, employment and educational courses that they take part in. These include taking part in music groups, doing voluntary work, literary courses, advocacy groups, snooker, shopping, craft groups. The Home is situated in the middle of Kings Lynn and so there is easy walking access to the shops and other facilities within the town. The Home is within easy walking access of the bus station and the rail station. The Home also has a vehicle. The Manager said that the residents all have bus passes and, where possible, they use these to travel on public transport as it encourages their Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: independence. The care plans include information about how the residents like to spend their time and of the support that they need to do so. Residents said that they are able to make their own decisions about how they spend their time and where they go. During our visit to the Home residents were coming and going the whole time. Some residents chose to stay at home that day and were either involved in household tasks or spending time in their rooms as well as using the communal lounges. The residents are mostly independent with regard to taking part in activities and so the staffing levels that are provided are adequate to support those that do need support. The residents agree a rota for assisting with household tasks. The kitchen is not very big and residents all have access to the kitchen to make drinks/snacks throughout the day. Some of the residents assist staff with preparing meals but this can only be done in small groups due to the size of the kitchen. There are fruit and snacks available on the side in the lounge. Two of the residents live in a flat attached to the main house and they have their own kitchen and are able do their own catering. Residents told us that the majority of them like to have their meals together at the large table in the dining room. We observed the lunchtime meal as being a relaxed and friendly occasion with lots of laughter. Staff join the residents for meals. We spoke to one of the relatives and they said that they visit on a very regular basis and are always made to feel welcome. They said that the staff keep them informed of any issues affecting their relative. They also said that they feel that their relative is lucky to be living in this Home. Care Homes for Adults (18-65 years) Page 15 of 28 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. The residents health and personal care needs are met in a way which encourages their independence and respects them as individuals. Medication is managed in a safe way. Evidence: We spoke to residents about the support that they receive from the staff team and they said that the staff are kind and helpful, that the staff know individual residents well and that they are good at knowing when residents need extra support. This confirms the information within the residents surveys that we received. The responses within the surveys from health and social care professionals are all very positive. They all state that the health needs of the residents are met and that the staff seek advice appropriately. They state that any advice is incorporated into the care plans. Additional comments were made such as: the staff take a personal interest in each resident, there is excellent communication, they ask for help at an early stage. As previously stated in this report the care plans mostly contain detailed information Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: about how the residents personal and healthcare needs should be met. This includes information about their physical health and mental health needs. Usually residents do not need support, other than prompts, with regard to personal care but where this is needed then care plans are in place to provide guidance to staff. The care plans also contain evidence of residents attending regular health appointments with GP, dentist, optician and any other healthcare proffesionals as needed. Staff said that some residents attend appointments on their own and others want, or need, staff support to do so. Staff gave us good examples of how individual residents needs have been met and the support that they received with regard to this. Staff have a good understanding of the needs of the residents and of the signs of any ill health. For example, one of the residents has a new bed which enables them to sleep in a bed rather than in a chair. The Manager has achieved the Certificate in Community Mental Health and the Senior is currently undertaking this. Other staff have got relevant training such as psychology degrees. The Manager said that there are plans for the two staff who do not have a formal qualification with regard to mental health to be able to achieve this. She also said that it can be difficult to source training with regard to mental health locally but that she applies for places when this arises. The medication cupboard is due to be moved into the office when this moves downstairs. This will be more appropriate as currently this is stored in a locked cupboard in the lounge which means that there is little space to work in and that it is often a noisy environment. It also means that there is little room to store large boxes of tablets. Medication records are kept appropriately and only staff who have received training are able to administer medication. There are photos of the residents in the medication folder as well as signed confirmation that they are happy for staff to administer their medication. There are risk assessments in place for anyone who self medicates and for those taking Clozapine. There is PRN (as required) guidance in place, except for one resident. We were told that their PRN has not been used for many months and that the Senior will ensure a review takes place and that PRN guidance will be available if it continues to be prescribed. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents feel safe living at the Home and have confidence that any complaints will be taken seriously and addressed. Staff training and policies are in place to provide protection to the residents from abuse. Evidence: The Commission have not received any complaints about the service and the Manager confirmed that they have not received any complaints since the last Inspection. The Home has a complaints procedure and residents who spoke to us said that they are confident that any complaints would be dealt with appropriately. The responses in the residents surveys indicate that they know who to speak to if they are unhappy about something. The staff surveys all state that they know what to do if someone wishes to make a complaint. Staff who spoke to us are all aware of the complaints procedure and also the procedure in place to raise any concerns about possible abuse of any kind. According to the training matrix the majority of the staff, except for new staff, have attended Safeguarding training. The Manager has plans in place for the newer staff to attend. Safeguarding is covered within the induction so new staff receive information about this prior to attending formal training. Residents are given opportunities to raise any concerns that they have in a variety of Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: ways. Some residents attend formal advocacy groups outside of the Home. Regular meetings take place between residents and keyworkers and there are weekly house meetings at which residents are encouraged to raise any issues. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home provides adequate accommodation for the residents. Evidence: We looked around the communal areas of the Home and three of the residents gave us permission to see their bedrooms. Five of the bedrooms are ensuite. Residents are given support by staff, as needed, to keep their bedrooms clean and tidy. Residents take part in a rota for carrying out other household tasks such as washing up and keeping the lounges clean and tidy. Within the AQAA that the Manager sent to us she listed the improvements that have taken place since the last Inspection and these include the decoration of two bedrooms and the building of a smoking shelter in the garden as the Home is now a non smoking house. The Manager gave us the maintenance plan for the Home and this shows that an audit of the building has taken place with work identified and given a priority rating. There are still areas of the Home which would benefit from redecoration and refurbishment. There was a maintenance member of staff at the Home on the day of our visit carrying out electrical work. The Manager said that the organisation has recently agreed the Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: redecoration of one half of the house. Two of the residents live in a flat which is next to the main house. This provides them with a shared kitchen in addition to their own rooms and a bathroom. In the main house there are bedrooms on the ground and first floor. There is a large lounge/dining room as well as a second quiet lounge. The room which used to be the smoking room is going to be the office which will provide a larger office in a more convenient location. The Manager said that only personal laundry is done at the Home, other laundry is sent out to a commercial laundry. The Manager said that the hot water temperature is not regulated but that daily water temperatures are checked and recorded. Care Homes for Adults (18-65 years) Page 21 of 28 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 staff receive appropriate training and supervision to enable them to carry out their roles effectively. Staffing is provided in adequate numbers to meet the needs of the residents. The Home follows effective recruitment procedures. Evidence: The residents told us that the staff are kind and that they provide good support. One of the residents said: the staff are lovely and this is the nicest place Ive ever been. We observed staff supporting residents in a kind and respectful way. There was lots of laughter and a relaxed atmosphere. The staff spent time with the residents throughout our time at the Home. We spoke to a relative whilst we were at the Home and they spoke positively about the staff and the support that they provide. We spoke to staff and they confirmed that they had received good induction and that they are able to access appropriate training. They said that they receive regular formal supervision. This information was confirmed through discussion with the Manager and through looking at a selection of personnel files and seeing the training matrix. The organisation is redoing some of the Criminal Records Bureau checks as they have discovered that some staff who had started work at the Home prior to the organisation Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: taking over had only had checks done at a Standard level when they should all be Enhanced. Training records show that all of the staff team, except for bank staff, have achieved at least NVQ Level 2 in care and that the new member of staff is due to start this later this year. Training is provided through local training providers and through the organisations training department. Some training is provided through e-learning using the computer in the Home. As mentioned earlier in this report, the Manager said that there is little available training with regard to mental health subjects in the local area but that the majority of the staff team have either completed the Certificate level or have a related degree. Residents and staff told us that there are usually two staff on duty during the day and one on duty after 6pm with a member of staff doing a sleep in. Staff and residents said that this is satisfactory to meet the needs of the residents. Discussions with staff show that they are enthusiastic about working with the residents and that they have a good understanding of the needs of the residents and how these should be met. They spoke in a respectful manner about the residents and gave good examples of how they proactively support residents to maintain and develop their independence. Regular staff meetings take place and staff told us that they feel that they work in a very supportive team and really enjoy working at the Home. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home is very well managed in a way which puts the needs of the residents first. The views of the residents are sought on a regular basis. The health and safety of the residents and staff is given a high priority and action taken to address any problems. Evidence: We spoke to the residents and staff about the management of the Home. They were all very positive about the Managers style of management and of her commitment to providing a high quality service to the residents. Staff said that they receive very good support and that the Manager provides clear leadership and motivation to the staff team. The Manager has appropriate skills and qualifications to manage the Home. There is now a Senior support worker who works closely with the Manager and undertakes management tasks. An on call system is in place for staff to obtain support when senior staff are not on duty. The Manager receives regular supervision from her line manager and receives more informal support from the other two Managers who manage other Homes in the county owned by the same organisation. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The Home was purchased by the Regard Partnership in 2007 but there was not a need for an application for registration with the Commission at that time as it was a share buyout. However, in 2008 the name of the organisation was changed to reflect the new ownership and an application submitted for a new registration with the Commission. The surveys that we received from health and social care proffesionals all indicate that the Home is well managed and that the Manager has good communication skills. Additional comments were made such as: the Manager communicates effectively, the Home is very well managed. The Manager had completed the AQAA in a detailed way. She has a good understanding of the positive aspects of the Home and of the improvements that still need to be made. The Manager gave the residents surveys in September 2008 with regard to the quality of the service that they receive. All of the responses were positive. Regular audits of other aspects of the service provided are carried out and there is evidence that action is taken to address any issues. The Manager said that the recommendations made in the Food Hygiene Inspection that was carried out in July 2008 have been carried out. We looked at a sample of Health and Safety records and these show that regular maintenance and servicing of equipment takes place. Regular Health and Safety checks are carried out with regard to the accommodation and a formal audit was carried out in March 2008 and October 2008. A fire risk assessment was carried out in September 2008. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 24 It is recommended that a risk assessment is carried out with regard to water temperatures Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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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