Care Home: Rivers Street

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What the care home does well People are supported well in all aspects of their lives for instance, residents are encouraged to take part in their community, people are given support with their life skills such as grocery shopping and cooking their meals in the home. The home is an open and welcoming place where residents and their family and friends can visit anytime during the day. The environment is one of calm and is homely, where people are confident in expressing their views. The staff said, "The home creates a happy and safe environment for the people we support to learn new skills and grow independence and live the life they choose". People said "I like living here at this home I am very happy". Health professional said "Listens to how people wish to live their lives". The home recently celebrated its 25th Anniversary of providing care and support to the residents and their family and friends have sent in compliments, which were endless for example, "Thank you for 25 special years also a huge thank you for teaching me the value of life". What has improved since the last inspection? The service has met a number of its requirements from the previous inspection and includes: Review care plans on a regular basis in order to monitor peoples changing needs. Further development and expand risk assessments in order to protect individuals in the taking of calculated risks. What the care home could do better: Ensure the staff training in the protection of vulnerable adults is updated on a regular basis; this would ensure that people who use the service are safe from harm at all times. Key inspection report Care homes for adults (18-65 years) Name: Address: Rivers Street Rivers Street Bath Bath & N E Somerset BA1 2QA     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: Michael Miles     Date: 1 9 0 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 28 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) © 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 28 Information about the care home Name of care home: Address: Rivers Street Rivers Street Bath Bath & N E Somerset BA1 2QA 01225335066 01225335066 helen.spurrell@dimensions-uk.org www.dimensions-uk.org Dimensions (UK) Ltd care home 14 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: May accommodate up to 14 persons with learning disability aged 18 years and over Date of last inspection Brief description of the care home 44 - 45 Rivers Street is a 13 bedded care home which is able to provide accommodation for people with learning difficulties. The property has been converted from two adjoining terrace houses. The house can be described as a Grade II listed Georigan building which has had the adjoining wall removed to make the property into one large building. The accommodatin is over four floors. The home can be found in the cental part of Bath which has a number of facilities to offer; such as Baths shopping area, numerous green walkways and parks, clubs, pubs and churches, cafes and resturants. There are regular access to public transort such as buses, taxis and Bath train station is close by. The aims and objectives of the service is to provide a home which fulfils the needs of all involved in its daily life; to provide a high standard of care within a supportive environment, which enables each person to reach their full potential whilst boosting Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 1 13 Brief description of the care home their self esteem and dignity. The staff team provide 24 hour care on a daily basis. The fees charged are based on individual assessment and range from £433.68 488.15 per week. This information was obtained from the manager at the time of the inspection. The service is managed by Dimensions UK Ltd. There is a sitting tenant on the third floor. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: An unannounced visit was made on 19th February 2009. During the visit we: Looked at information about the people who use the service and how well their needs are met. Looked at other records such as the policies and procedures, the staff rotas, and the medication procedures and practices. Discussed the staff team to determine whether they had the skills and knowledge and training to meet the needs of the people who use the service. Looked around the building to make sure that the home is clean, safe and comfortable Care Homes for Adults (18-65 years) Page 6 of 28 to meet peoples needs. We looked at information we have received since the last inspection visit, which included; how the service dealt with any complaints & concerns since the last visit. Any changes to how the home is managed and the providers view of how well they care for the people living at the home. We shared findings of the inspection with the manager. 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 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 8 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 9 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.People who use the service are confident that their needs can be met as there is sufficient information is made available to help people make an informed choice about their place of residence. Evidence: The homes Annual Quality Assurance Assessment (AQAA) form was completed giving enough detail about what the service does for potential residents. There have been no new admissions into the home since the last inspection. The existing residents currently using this service are a long standing group of people who have lived together at the home for several years. The homes Statement of Purpose (SoP) contains sufficient information which helps people to decide about their place of residence. The SoP contains pictures; the aims and objectives, information about access to specialist services, social activities, and the use of communication methods such as Makaton, sign and symbols to empower people to communicate. A full assessment is undertaken to ensure that the home can meet peoples needs. Multi disciplinary team correspondence was seen in peoples care files, this shows that Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: a number of agencies were involved in helping people to find the appropriate place of residence. A number of the residents said yes to the question were you given enough information about this home before you moved in so you can decide if it was the right place for you? Resident said, its a lovely place. Another resident said, I am friends with all of the residents. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.The service involves people in planning of their care support plans which promotes a positive quality of life and independence; people are encouraged to make their own choices and the risk assessments support the decisions and options people make. Evidence: A selection of care plans were looked at to assess if residents individual needs and choices are being met. The care plans showed that care was given in a flexible and equitable manner. The care plans are person centred and focus on peoples needs. For example, people who wished to take part in a college course of choice could do so with support. Another example was if residents wish not to attend a church service this is recorded in their care plan. This shows that the home listens to and acts upon the requests people make whilst living in the home. People who use the service make their own informed decisions and this was observed during the inspection for example, residents informed the manager that they were going out and would be back in time to help make lunch. Residents responded always to the question, do you make decisions about what you do each day? Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The homes AQAA states that residents know that theyre assessed and changing needs are reflected in their support plan which they take an active part in the planning of. This was observed during the inspection which showed a number of the care support plans had residents involvement; many had textual and pictorial images which are personal to the residents; residents signatures were seen in their care plans also one resident at the time of the inspection was sat with the manager communicating via the use of a pictorial package which was on a computer. There was also evidence to show that the care plans were being updated every six months with the next due date of the care plan seen. Residents risk assessments were seen in their care plans and show that people are supported to take risks as part of their daily routine. For example, residents who are able to go out on their own are risk assessed and supported with a comprehensive plan which encourages people to live the life they choose within safe guidelines. 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.People who use the service enjoy a full and stimulating life style with a variety of options to choose from which promotes their personal development. The meals are balanced with a choice of healthy options Evidence: People are supported to take part in their own personal development and participate in appropriate activities of their choice. For instance, a resident was observed knitting whilst listening to the news in a quiet part of the house. Another resident was being collected by a taxi to attend their regular day care session. People are involved in a number of activities such as the Gateway club; attending football matches and going to the sports centres, a number of residents were going shopping at the time of the inspection. Other activities that residents take part in include, cake making, lunch clubs and helping out at the local church. The home has a DVD which shows a number of activities which residents were involved in at Rivers Street. This is an informative piece of film. The house was fairly busy and active with people going about their daily Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: lives. The service uses an advocacy agency, which enables people to obtain independent support. People are involved in maintaining appropriate relationships with friends and family. For instance, during the lunchtime meal which was taking place at the time of the inspection, several relatives and friends shared lunch with the people who use the service. It was a huge social event; there was lots of laughter, banter and people generally being very sociable at the table. It was one big happy family a real pleasure to observe. One resident said mum had lunch today I see mum often 2/3 times a week the home helps me with this. Visitors were made to feel very welcome and offered a place at the table. Other written comments from family and friends include and are centred on the homes 25th anniversary; I would like to thank all the residents and staff for their part in my life,caring life long friends that I will treasure for ever. Another comment, I have had some happy, sad and wonderful memories at Rivers Street and I cant wait to gain more in the future. The staff spoke respectively to the residents, knocking on their bedroom doors prior to entering. The service makes an effort to cater for different types of dietary requirements. For instance a resident often likes to eat ethnic type foodstuff, the staff team showed knowledge of where to purchase such products and shares this knowledge with the rest of the residents within the home. This results in everyone having a taste of different types of food. A menu rota was seen and showed that residents take part in shopping and cooking the meals of the day. This also involved planning the meal. The mealtime is a family affair where residents and staff get involved. The menu was seen to be healthy and contained variety. Residents said, The food here is marvellous others said I get the chance to choose the food, another resident said, I sometimes bake the cakes. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.People have access to remedial and healthcare services and benefit from the personal care and support they prefer. People are protected from medication errors by effective practices supported by procedures and guidance. Evidence: Personal healthcare needs which include specialist help from the District Nurses (DN) are recorded in peoples care plans; a comprehensive plan of care shows when there are changes in peoples health needs. For example, residents with specialist health needs which involve careful attention to infection control. The staff team follow the guidelines which have been suggested in the care plans which ensures the control of infection within the home is kept to a minimum. The homes AQAA states that the care plans cover all aspects of a persons needs and are backed up with daily progress and Drs notes. The inspection confirmed that peoples care plans contained detailed guidelines to help manage any changes to peoples healthcare needs. A resident said we are able to see the GP sometimes; sometimes we do see a nurse or dentist. A resident said I get a lot of support since my operation. The service has an effective medication procedure, which was assessed during the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: inspection. For instance, the home uses the Boots method where the tablets are in blister packs and colour coded. All residents medication files were seen and no omissions were detected. No drug errors were found which shows that the homes practice and procedures keeps people free from errors with medication. 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 adequate 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 open culture, which encourages people to express their views and concerns. The complaints procedure is available in a number of formats to help people make a complaint. People would greatly benefit from staff receiving regular updates which would ensure that people are protected from abuse and neglect Evidence: The home uses the Dimensions organisational procedures and practices for handling any concerns or complaints made in the home. The complaints procedure is available in a variety of accessible formats which people can use. People who use the service have additional access to the Dimensions Advocacy Group, which provides support when making a complaint. At the time of the inspection the home has not received any recent complaints. The complaints log was seen. An entry dated 23.08.08 showed the issues were settled within two weeks. This demonstrates that the service has an open culture where people feel safe and supported to share concerns and any concerns are dealt with in a timely manner. Many compliments were shared during the inspection and include; Big thank you in helping my relative to build their confidence. A healthcare professional said if a person has concerns the service responds in a proactive and supportive manner; they have provided support to a residents physio and rehab programme. The staff team working in the home are fully trained in the protection of vulnerable adults. However according to the homes staff mandatory training information sheet there are a number of members of staff who are overdue their vulnerable adults updates. It is important for regular updates to be Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: maintained in order to keep people free from abuse and neglect. The service has adequate arrangements for the safekeeping of peoples monies and they are supported to manage their funds. Residents monies were being checked at the time of the inspection and is rechecked at the time of the handover. 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 atmosphere is pleasant and welcoming; the home is comfortable and a safe place for people who use the service to live, although the layout of the house could be a challenging experience for those with reduced mobility. Evidence: 44-45 Rivers Street is a Grade I listed Georgian property which has been converted in to one large building with the removal of the adjoining wall. Originally it was two Georgian terrace houses which have been transformed. The accommodation is over four floors which is accessible via a stair lift. There are two people who share a large double bedroom, this is made by special arrangement; the other rooms are for single occupancy. Each of the bedrooms varies in size and has good fixtures and fittings which are in keeping with the overall decor of the house. There is a large kitchen, several quiet areas and sufficient bathrooms for residents needs. A well organised laundry room where people are supported with their chores. There is a sitting tenant who continues to occupy a section of the house. There is a basement flat which is shared by individuals who wish to live a more independent lifestyle. The staff team provide support to these people from a distance and on their request. The property does have a number of stairs for each of the floors; a stair lift is available however the layout of the house can be a challenge for those with reduced mobility. Although the house may meet residents physical needs a health professional said, The layout of Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: the house can be challenging for those with limited mobility. The home has a good system for logging all repairs and records visits made by the contractors. Since the last inspection the home has been redecorated with positive results; the home looks fresh, pleasant and homely for the people who use the service. There is no private parking for the home; on street parking with the use of the pay and display meter is available. The rear of the property has an adequate size garden which has been landscaped in parts. The garden was neat and well maintained. The property can be found in the central part of Bath, which is close to a number of facilities; such as numerous greenways and parks, shops, clubs, bars and church clubs. Public transport is available such as bus, taxi and trains and are easily accessible. A number of photographs of the residents were seen around the house and each bedroom reflects peoples tastes and preferences. For instance people chose their own colour schemes for their bedrooms. The home was clean and fresh with no offensive smells detected. Residents said always to the question are the home clean and fresh? 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.An effective team of staff meet peoples needs and are confident in the staff that cares for them. The staff rotas show there are sufficient staffing levels which reflect the needs of the people who use the service. People benefit from staff that are regularly supervised. Evidence: The staff team consist of a core of care workers who provide 24 hour care and the manager is usually on site. Residents said always when asked do the staff team treat you well? Other residents said, If I want to know anything I always ring and ask and the staff are helpful with my query. Relatives said the staff are good, other relatives said Lots of support from the staff team. The staff rota show sufficient numbers of staff on each shift and the manager made it very clear during the inspection that she would not seek any assistance from agency staff that does not have experience with people with complex needs. This shows that the manager takes onboard peoples needs and their safety. The staff team are skilled in the job they do and the residents are confident that the staff team meet their needs. The staff training matrix show that staff mandatory has been arranged for 2009. Training includes; health and safety, basic food hygiene, manual handling and fire training. Training in competency in medicines is part of the induction practice and the organisation has their training in medication procedures. The induction pack was seen and found to be comprehensive. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The staff files are held at the Dimensions head quarters and the commission has an arrangement to inspect these at periodic intervals. The home did have members of staff Criminal Records Bureau (CRB) enhanced checks, which were seen during the inspection. At the time of the inspection a new member of staff was being inducted in to support worker role. A resident said, the new staff are good. The new member of staff was able to describe their recruitment procedure and said I am going to enjoy working here they are a lovely bunch. The training for the staff is continual and range from the induction of all new employees to development programmes for the senior managers. The continuous programmes begins with the induction staff have the choice to take part in a foundation and National Vocational Qualification courses, (NVQ). The new employee said there is room for personal development and I have the option to take more courses. According to the homes SoP Dimensions has an established NVQ centre in The ale. The staff certificates were sent and show the staff team have the skills to meet peoples needs. The manager said The residents are also trained to participate in the interviewing of potential employees and show them around the house its only right that the residents have an active role as it is their home and they have a right to decide who can work here. One resident confirmed this and said I ask questions of the new candidate. The health professionals said the staff team usually have the right skills and experience to support peoples social and healthcare needs Another said, with support from the local Community Learning Disabilities Team as and when necessary. The staff team have regular supervision as the notes were seen during the inspection this session takes place on a monthly basis. 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.People benefit from a service that is managed well: effective management of care, good communication and the use of procedures and practices ensure that people who use the service continue to have a good quality of life Evidence: The present manager has been managing this service for several years. Relatives have been complimentary about the service and the compliments include: its a lovely place another said the home is excellent I have been coming here for several weeks; I get a lot of support to maintain contact with my relative. Residents said, we get Saturday night treats. The manager ensures that a secure environment for the residents is maintained. This is evident in the residents care plans; their risk assessments their daily notes. Many of the residents were able to discuss their activities and showed a DVD which was packed with information about how people spend their time, at Rivers Street. The relatives and health professionals were equally complimentary about the service and had recently celebrated its 25th anniversary of providing care to people with learning disabilities. The manager takes steps to learn about other cultures for instance information about peoples personal care with regard Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: to skin and hair care stimulated a discussion with the resident. The manager showed interest and welcomed additional suggestions made on the purchase of products and how to look after ethnic hair. This service can be described as a special place where the culture is open and the staff team enjoy supporting the residents. This was evident throughout the inspection and particularly during the lunchtime where this was a social occasion with lots of activity around the table. The home has a system for self monitoring, where examples of the questionnaires were seen; the questions promoted feedback from the stakeholders which identifies any areas for improvements. This ensures that people who use the service would continue to benefit from a good standard of care. Additionally the home has all day house meetings which give people more opportunity to voice their opinions. The service also has regular staff meetings where issues are discussed and cascaded within the household. Three months of the homes monthly visits were seen no actions were needed which would suggest the service is functioning at a good level. The home exercises good health and safety practices, for instance the water checks; the portable appliance tests (PAT), the fridge/freezer which displayed date of opening foodstuff and perishables. All the health and safety checks were in order. This shows that the property is a safe place for all those who live in, work in and visit the home. 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 Care Homes for Adults (18-65 years) Page 27 of 28 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). 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. 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