Care Home: Radfords

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What the care home does well People are well supported to make choices about how they want to live their lives.Most care plans provide a good picture of what people need. The new care planning system makes sure makes sure that people have a say in how they are supported and that this is followed up by staff.There are plenty of opportunites for people to join in activities in the wider community or provided by the Robert Owen Communities. These include learning, work and liesure. People are supported to make choices with the help of excellent communication support including pictures, symbols and multimedia presentations. This support is built around individual needs and preferences. Radfords helps people to get specialist health and personal help if they need itStaff listen to people`s concerns and act on them. They know how to protect people from abuse.Radfords provides a clean, homely and comfortable place for people to live.Staff are well trained to provide the support people need. What the care home could do better: Some assessments and care plans have not been properly completed so that everyone knows what people needThe medicines in the home need to be made more secure so that they cannot be misused or stolen.Health and safety checks and some risk assessments need to be updated to make sure people are kept safe. Key inspection report Care homes for adults (18-65 years) Name: Address: Radfords Main Street Broadhempston Totnes Devon TQ9 6BD 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: Graham Thomas Date: 0 9 0 4 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 36 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Radfords Main Street Broadhempston Totnes Devon TQ9 6BD 01803813622 01803813622 radfords@roc-uk.org;catkinson@roc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robert Owen Communities Name of registered manager (if applicable) Mrs Clare Atkinson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 12 0 care home 12 learning disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home Radfords is a detached property situated in the centre of the village of Broadhempston, near Totnes in Devon. Accommodation is provided in three houses called The Cottage, Hayloft and the Farmhouse. There is a main office and communal rooms, converted from previous farm and barn accommodation around a courtyard. Radfords is part of the Robert Owen Communities, a charity to help people with learning disabilities achieve their aspirations. Care Homes for Adults (18-65 years) Page 5 of 36 The organisation has other residential facilities locally. Care Homes for Adults (18-65 years) Page 6 of 36 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 Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home Before we visited Radfords we looked at our records about the home. This included information about any accidents or other events. These are called notifications. We also looked at the Annual Quality Assurance Questionnaire (AQAA) returned to us before our visit. Our visit to Radfords took place over six hours. We looked around the shared areas of the home and in some peoples rooms. Page 8 of 36 Care Homes for Adults (18-65 years) While we were there we spoke with two people who live in the home about the support and care they receive. We also spoke with the Deputy Manager and other staff We looked at care plans, staff records and other records about how the home is run Care Homes for Adults (18-65 years) Page 9 of 36 What the care home does well People are well supported to make choices about how they want to live their lives. Most care plans provide a good picture of what people need. The new care planning system makes sure makes sure that people have a say in how they are supported and that this is followed up by staff. Care Homes for Adults (18-65 years) Page 10 of 36 There are plenty of opportunites for people to join in activities in the wider community or provided by the Robert Owen Communities. These include learning, work and liesure. People are supported to make choices with the help of excellent communication support including pictures, symbols and multimedia presentations. This support is built around individual needs and preferences. Radfords helps people to get specialist health and personal help if they need it Care Homes for Adults (18-65 years) Page 11 of 36 Staff listen to peoples concerns and act on them. They know how to protect people from abuse. Radfords provides a clean, homely and comfortable place for people to live. Staff are well trained to provide the support people need. Care Homes for Adults (18-65 years) Page 12 of 36 What has got better from the last inspection What the care home could do better Some assessments and care plans have not been properly completed so that everyone knows what people need Care Homes for Adults (18-65 years) Page 13 of 36 The medicines in the home need to be made more secure so that they cannot be misused or stolen. Health and safety checks and some risk assessments need to be updated to make sure people are kept safe. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 14 of 36 If you want to speak to the inspector please contact Graham Thomas CQC South West Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel: 03000 616161 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 of 36 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 16 of 36 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2 Radfords carries out good assessments of what people need before they move in. However, these are not consistently carried out. This means that people cannot be confident that their needs will be met when they move in. Evidence: In the Annual Quality Assurance Assessment returned to us before we visited, the home told us: Detailed assessments are undertaken to identify prospective residents needs, wishes, interests and aspirations prior to their admission. We use trial visits to enable us to complete this process. This is backed up by receiving local authority care plans, risk assessments and an agreed pre-placement plan of trial visits. This also supports the process of being able to produce a person centered plan. We looked at the files of people who had moved into the home since we last visited. In one file we saw that the person had moved in to the home eighteen months before our Care Homes for Adults (18-65 years) Page 17 of 36 Evidence: visit. Although there were risk assessments, key workers reviews and monthly summaries, we could not find any information to suggest the persons needs had been assessed before they moved in. We could also find no clear plan based on the persons needs. The staff member we spoke with confirmed that there was no information about this. We saw in other files that information such as joint agency plans had been obtained and assessments had been made to check whether the service could meet peoples needs. These included detailed assessments of the peoples physical, social and psychological needs. Care Homes for Adults (18-65 years) Page 18 of 36 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. Standards 6, 7 and 9 Despite some shortfalls in care planning and recording, peoples needs are well met and they are generally well supported to pursue their own goals. Evidence: We looked at three peoples plans of care. A senior carer with whom we spoke told us about a new system that was being introduced and we saw examples of the work that was being undertaken to introduce the new system. The new system involves a person meeting regularly meeting with their key worker to agree their needs and goals. A further meeting involving the deputy manager is then held to decide how these agreed goals will be met. The plan is then produced which identifies the particular goal, how it is to be achieved, by what date and with whose support. This is produced in a format which is suited to the communication needs of the individual. We saw an example of such a plan which was written from the persons point of view. The home is also training its staff to produce plans in a new multimedia format using Powerpoint. A staff member who was involved in this work showed us a plan that had been produced in this format. Other files held in the office contained records such as individual risk assessments, medical Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: appointments and incident / accident reports. At the time of our visit, one person attended a medical appointment in accordance with their plan. We also spoke with people about the activities in which they were involved and which were clearly described in their plans. The planning was, however, inconsistent and we found that one person did not have a clear plan though there were records of key worker reviews and monthly summaries. We looked at how people were supported to make decisions about their lives. Two people with whom we spoke confirmed that they were able to make choices about how they wanted to live. Throughout the home we saw examples of the effective and imaginative use of aids to communication. For example, one person liked to know what they would be doing during the week. A timetable had been produced for the person using symbols. The person explained this to us and clearly understood the timetable and used it regularly. This was just one of numerous examples of the use of Total Communication we saw throughout the home that supported people to understand and make decisions about their daily lives. People told us that they chose the decor for their rooms and we saw how people were consulted and involved in meal planning and shopping. We also saw records and spoke with staff about how one person had been supported to make decisions about a relationship. The person had difficulty in discussing the issues face-to face but had been helped with the use of a talking mat. Individual advice for the person about sexuality had also been sought from an external professional. We saw that risk assessments had been produced for individuals and specific activities such as trips to the pub. Some of these needed to be reviewed. Care Homes for Adults (18-65 years) Page 20 of 36 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. Standards 12, 13, 15, 16 and 17 People living at Radfords receive excellent support to follow a lifestyle which meets their goals and preferences. Evidence: We spoke with people, looked at their plans and talked with staff about how people were supported to pursue the lifestyle of their choice. We saw that the care planning system, though inconsistently applied, was based on each individuals needs and goals. We also saw how Total Communication was used effectively throughout the home to support people to make decisions. People told us that they were involved in various activities during the week and spent one day per week completing domestic chores such as washing and cleaning. To assist people in these chores, we saw that cleaning materials had been labelled with symbols. One person showed us their own weekly timetable. This involved dance classes, working on Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: the services farm, attending a regular disco. The person also told us that they were involved in cooking and had a particular responsibility for ordering milk for their house. We also saw a general activities timetable that had been produced using widget symbols and spoke with staff about the activities supported by the home. This confirmed that one person was having driving lessons and other people were taking piano lessons. Around the home there were many photographs of people on holidays and doing various activities. People we spoke with confirmed recent holidays at Centre Parks and Butlins. The home has its own activities area where there is equipment such as exercise machines. Staff told us about an educational project in which people were involved. This is an accredited programme based on specific skills from which people can choose to complete a number of units. We saw how people were routinely involved in shopping and cooking. We saw recipes that had been produced using pictures and symbols to aid peoples understanding. Staff told us that these were used as a basis for deciding on weekly menus at meetings of people living in the home. The menus we saw showed how one persons choice of a vegetarian diet was being supported. We looked at how the home supports people to maintain their relationships with people important to them. One person had been supported to make decisions about a relationship. The person had difficulty in discussing the issues face-to face but had been helped with the use of a talking mat. Individual advice for the person about sexuality had also been sought from an external professional. We also spoke with one person who told us about how they were supported to travel independently to their family home in Wales. Care Homes for Adults (18-65 years) Page 22 of 36 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. Standards18, 19 and 20 People living at Radfords receive a generally good level of personal and health care support. However, the systems concerning the use of medicines are not sufficiently robust. Evidence: We looked at the personal support people received at Radfords. Each person has a key worker who takes a particular role in providing support to the person and making sure issues are followed up. During our visit, we saw that staff were very respectful towards people living at the home. At all times people were offered choices about what they wanted to do and how they wanted to do it. For example, we met two people. One chose to meet us with the support of staff and the other chose to meet us alone. During our tour staff were attentive to the privacy and dignity of people living in the home. We saw that they knocked on doors before entering rooms and made sure that doors were closed where people were using the bathroom. Access to health care and other specialist supports is supported by the home. In the care plans we looked at, we saw evidence of both routine and specialist health care appointments including, for example, thyroid and ear tests. One person attended a medical appointment during our visit. We saw how work with the local Speech and Care Homes for Adults (18-65 years) Page 23 of 36 Evidence: Language Therapy team had supported people individually and generally around the home. As previously mentioned in this report, one person had received external advice and support concerning a significant relationship. We checked the homes system for supporting people with their medication. We looked at the records for one person who managed their own medication. There was no risk assessment for this. This is important to ensure the safety of the person and make sure they are getting the medicines they need. Other medication was stored in the office. The storage was insufficient to accommodate all the medicines so some were kept outside the secure cabinet. Although these were low risk medicines, it is important that they should be stored securely to avoid abuse or theft. Medicines requiring cool storage were stored in a lockable box in a fridge in the office The office in which medicines were stored was seen to be open and unattended during our visit. We examined the records concerning the administration of medicines. Each record contained a photograph of the person to help minimise the possibility of error. On one record we saw notes and instructions for staff about the persons allergies and their asthma. The records of the medicines administered were not all complete. Some gaps were seen in the records so that it was no possible to account clearly for all the medicines used. Care Homes for Adults (18-65 years) Page 24 of 36 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. Standards 22 and 23 People moving to Radfords can feel confident that their concerns will be listened to and acted upon. They are generally well protected from abuse. Evidence: Since we last visited the home, we have not received any complaints. People with whom we spoke in the home said that staff listened to what they said and acted upon it. We saw that the home had produced a complaints procedure that was in a format suitable for people living there. We asked to see the homes own complaints log but this could not be found. However, we saw records and spoke with staff about one person with autism who tended to become anxious. There was specific guidance for staff in a worry book as to what the persons current anxieties were, how they should support the person and respond to their concerns. The support provided for one person concerning a personal relationship referred to above, helped the person to make decisions and express the limits within which they felt comfortable. Staff have ensured that these decisions have been respected. The homes records about staff training showed that there was a programme for training staff in the safeguarding of vulnerable adults from abuse. This training was confirmed by the staff with whom we spoke. These staff were all clear about the homes policies and Care Homes for Adults (18-65 years) Page 25 of 36 Evidence: procedures for responding to any abuse either suspected or witnessed. Care Homes for Adults (18-65 years) Page 26 of 36 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. Standards 24 and 30 Radfords provides a homely, clean and comfortable environment. Risk assessments and health and safety monitoring need to be updated to ensure the home remains safe. Evidence: Radfords is located in the village of Broadhempston. The home is reasonably accessible with limited parking immediately outside the home and some on road parking in the village. The home is based around a restored rustic courtyard with three self contained houses. These are called The Cottage, Hayloft and The Farmhouse. There are also a general office, managers office and large upstairs activities cum meeting room. The home is suitably fitted and equipped for the able bodied people whom it accommodates. Since we last visited, modifications have been made to the Hayloft area, which is now provided with its own utility area and a better lounge. During our tour of the home we saw that it was furnished in a comfortable and homely way with a reasonable standard of decoration. People told us that they chose the decor of their rooms and were involved in decisions about other areas. We saw that individual accommodation as well as communal areas were personalised with peoples own Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: possessions, ornaments and pictures. We found the home to be clean and free from any offensive odours. All people living at Radfords clean their own rooms and communal areas as part of daily living in a community. There are no domestic staff. People are supported to do their own laundry. All but one house has a separate laundry facility and these were seen to be clean and suitable for the domestic scale use to which they were put. We looked at risk assessments and maintenance records. Some risk assessments such as one for the radiator in a persons room needed to be updated. The programme of routine health and safety quality monitoring had not been updated since 2008. Care Homes for Adults (18-65 years) Page 28 of 36 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. Standards 32, 34 and 35 People living at Radfords are supported by sufficient numbers of well-motivated staff who receive the training they need to do their jobs. Evidence: We spoke with four staff and the Deputy manager and looked at the records of newly recruited staff. Our observations of staff at work showed the staff to be well motivated, respectful and with a clear understanding of the individual needs of people living in the home. A robust recruitment procedure is operated by the home which includes formal interview, identity and criminal records checks. Evidence of this was seen in the files of staff recruited since we last visited and confirmed by staff with whom we spoke. Staff confirmed that their training needs were well met and this was reflected in the homes training records. The AQAA returned to us by the home described a 12 week induction programme which was based on a nationally recognised framework. One staff member spoke with us about their induction and confirmed the evidence which was also seen in staff files. Other training was described in staff files and confirmed by staff members. This included health and safety topics as well as subjects relevant to the needs of people living in the home. Such topics included for example, infection control and fire Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: training, autism, dementia associated with Downs Syndrome sexuality and Total Communication. One staff member also told us about the specialist training supported by the home to implement multimedia person-centred care plans. We also saw evidence of support for staff to undertake National Vocational Qualifications. The staff rotas showed that during the day 2 or more staff are on duty while in the evenings 3 are on duty to ensure one person could support cooking a meal in each house and evening activities. On Saturdays four staff are on duty. This is in keeping with one person who is funded part-time for one to one care. Care Homes for Adults (18-65 years) Page 30 of 36 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. Standards 37, 39 and 42 People living at Radfords can feel confident that the home will be generally well run in their best interests. Evidence: Since we last visited the home, a new manager has been registered with the Commission. She has a National Vocational Qualification in care at level 4 and is currently working towards a management qualification. She has previously worked in another of the services homes as a deputy manager. At the time of our visit, she was on annual leave. Our inspection findings have revealed that the home is generally well run with excellent performance in some areas. People living in the service are well supported to exercise choices and staff are well supported with a good training programme. Some shortfalls have been identified in care planning, medication and updating of risk assessments which form part of the homes quality monitoring system. This represents a slight decline in the excellent standards we found at our last visit and suggests that a more robust approach to quality monitoring is needed. Care Homes for Adults (18-65 years) Page 31 of 36 Evidence: We looked at safety issues in the home. As previously mentioned in this report, staff receive training in health and safety topics such as fire safety and infection control. Some records were seen of routine maintenance such as boiler maintenance and legionalla testing. However, as previously mentioned. the homes own health and safety checking system had not been kept up to date since 2008. Despite this shortfall in recording there was no evidence in accident records or from our observations that people were placed at any undue risk. Care Homes for Adults (18-65 years) Page 32 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 The registered person must 31/05/2010 ensure that all medicines are securely stored. This is to ensure that all medicines can be accounted for and are not vulnerable to misuse or theft. 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 2 3 6 20 20 Care plans should be produced consistently for all people living in the home. Risk assessments should be produced for all people administering their own medicines. Medicines should be routinely audited to ensure that records are clear and account for all the medicines used and held. Risk assessments and health and safety checks concerning 4 26 Care Homes for Adults (18-65 years) Page 34 of 36 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 the homes environment should be updated. Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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