Care Home: Salvation Army Harbour Recovery Centre (The)

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What the care home does well The service has a 61% completion rate. This percentage relates to the number of individuals who complete the detoxification programme. The service is committed to constantly improving this rate and is open to any requests for change which come from service users or any other quarter. The service is responsive. The service gives psychological and emotional support as well as meeting incidental health care needs. It is well structured and staff roles are defined and clear. There is a wealth of experience and expertise within the staff group. The service fully embraces the values of equality and diversity and integrates cultural needs into the work. What has improved since the last inspection? Completion rates have improved. The service continues to develop its knowledge of the special needs of the Moslem group. It has provided more structure and found this works for people. The service has taken on a cook so that Asian meals can be provided in the evenings. A mentoring programme has been set up with previous service users who have completed the programme. What the care home could do better: The service must address complaints and safeguarding and ensure that they have robust policies and procedures in place and that their practice fully reflects them. They must ensure that staff receive regular ongoing training in core basics. Health and safety practices must be fully followed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Salvation Army Harbour Recovery Centre (The) Riverside House 20 Garford Street London E14 8JG     The quality rating for this care home is:   two star good 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: Anne Chamberlain     Date: 2 5 1 1 2 0 0 8 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home Name of care home: Address: Salvation Army Harbour Recovery Centre (The) 20 Garford Street Riverside House London E14 8JG 02075382097 02079878942 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Salvation Army care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present drug dependence Additional conditions: Date of last inspection Brief description of the care home The Harbour Recovery Centre is an 8 bedded unit which is run as a detoxification centre by the Salvation Army. The service is commissioned by the London Borough of Tower Hamlets. They have perceived a need among young Bangladeshi men to detoxify from non-injected heroin and this is the speciality of the unit, although the admission criteria does not exclude non- Bangladeshi service users. The detoxification programme lasts between 7 to 16 days when service users will transfer to rehabilitation services to continue their recovery. The unit is next door to another Salvation Army detoxification centre. One manager is registered to manage both services. The Harbour Recovery staffing consists of a team leader and five registered nurses and four project workers. Fees are set at #1210 per week. 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The service completed an Annual Quality Assurance (AQAA) prior to the inspection. This provided evidence which was used in the inspection. The site visit took place on one day over approximately 5 hours. The key standards were inspected. We were assisted by the manager and spoke with two staff members. We inspected two service user files, two staff files, records and key documentation. We inspected the arrangements for the administration of medication and made a tour of the premises. We would like to take this opportunity to thank all those who contributed to the inspection. Care Homes for Adults (18-65 years) Page 5 of 29 Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 7 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Needs are well assessed before any service user comes into the service. Evidence: The London Borough of Tower Hamlets commissions the service and generally people refer themselves. There is a referral criteria for the service and we were shown this. The service is for male non-complex drug users aged 18 - 65 years. We noted that the admission form has plenty of space to include medical and psychological information, emotional experiences and history of drug use. Assessment is in two stages. At the initial stage prospective service users are given some information, usually on the telphone. When a place is available they attend the unit to be further assessed. The assessment information is considered by the manager and the doctor, and a decision is taken to offer a placement. The persons name is then added to a waiting list. The list is not long and people usually come in within four weeks. The manager said that having a waiting list gives people time to commit to the changes they need to make and discourages a revolving door situation. Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: The AQAA submitted by the service states that pre admission visits are encouraged. Care Homes for Adults (18-65 years) Page 10 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have individual care plans to meet their needs. They are encouraged to make decisions for themselves and risks are assessed carefully. Evidence: All service users have a care plan. However the care plan is not fully determined at the start of the service. It builds up each day. Sometimes service users sign a single document but they may sign individual one to one sessions instead. This was evidenced in the two files which we viewed. We noted that daily records were well completed. Service users are encouraged to take decisions within the constraints of the programme. They can state a preference for which detox substitute medication they use, and this will be considered. A major decision they need to take is regarding their aftercare plan. A number of service users go on to use the Island day programme (run by Nafas) to support their rehabilitation. Another decision they take is whether to use Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: a preparation which blocks the effects of drugs. If appropriate service users can be referred to the project which operates in the same building as Harbour Recovery. This is a homeless hostel project which takes prople recovering from drug and alcohol addictions. The referral criteria states that A previous history of violence will be individually assessed. A current risk assessment must accompany the referral. Risks are assessed under a general risk assessment. If risks are identified actions are identified to reduce them and these are built into the care plan. This was evidenced in files. Care Homes for Adults (18-65 years) Page 12 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a good daily routine with appropriate occupations and an opportunity to access the community safely. It supports relationships and the food provided is nutritious and varied. Evidence: Groups are run in the mornings at the service, including harm reduction and relapse prevention. Once a week a Shiatsu group takes place and Nafas come into the service to make a presentation. Acupuncture and massage are available. Attendance at groups is not compulsory. This is at the specific request of the funders who believe that groups are not always acceptable to Asian men. Community links can be a threat to the success of the detoxification programme. The service exists in a close knit community. Service users accessing the community need Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: protection from relapse as their contacts and dealers are in close proximity. Service users are allowed out with an escort after the fourth day. Volunteers can take on the role of escort. Service users are allowed to have visitors, three times a week, and the manager stated that family are generally quite involved. Children are not allowed as this is the rule of the landlords in the building. As mentioned above groups are run in the mornings. There was evidence around the project of artwork which had been created by service users. They also play games, table tennis and pool, and hand held electronic games are permitted, provided they do not have any access to the internet. They also watch TV, DVDs, and listen to music. The AQAA states that special jugs have been provided in the toilets for Muslim service users. Also that there are some culturally specific games. The service plans to purchase a more comfortable sofa and a flat sceen television. We noted on inspection that the service employs a multi-racial staff team. The service is aimed at young Asian men and young Bangladeshi men are the main users. However they come from all backgrounds and orientations. There is an equality and diversity policy and the service user guide underlines the right to equal treatment. Non compliance with the values of equality and diversity can lead to discharge. An area for prayer is provided at the service. At one time the wearing of longhis was not allowed as the service felt they were a bit like pyjamas. However it has been accepted that this is what many Asian men wear around the house and is what they feel comfortable in. Longhis are now permitted. There is a weekly meeting at the service of Nafas which is a muslim drug support agency. A counselling service is also available. Service users have the option to cook their own evening meal if they wish, and we noted on file a disclaimer relating to this which service users sign. However three meals a day are provided. Breakfast is a help yourself affair, lunch comes over from the sister project next door and there is always a vegetarian alternative. Dinner is asian food and is cooked by a cook who comes into the project every evening to prepare the meal. We looked at the food stored in refrigerators and noted a large jar of mayonnaise, nearly finished, but with no opened on date. All fresh food stored in refrigerators must have the date of opening marked. Care Homes for Adults (18-65 years) Page 14 of 29 Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides appropriate individual personal support. Health needs are understood and addressed and the administration of medication is sound. Evidence: The referral criteria states that the service is for non-complex drug users and it places some health restrictions on admission. Service users with polydrug use are admitted. The manager stated that service users generally have far fewer physical and medical needs than individuals admitted to the sister project. They are generally fit young men between the ages of 26 and 38 and they dont usually bring any medications in with them. Blood presssure and pulse are taken and recorded every morning. Service users have to be independent in personal care and unfortunately the service cannot accept an assistance dog due to the lack of outdoor space. A doctor visits the project every day and oversees the treatment of service users. All service users have two keyworkers and work with them on a one to one basis. They can use these sessions to talk through decisions about any aspect of their lives. Counsellng is offered with a male or female counsellor. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: We inspected the medication arrangements at the service. These are quite complicated because of the nature of the work undertaken. There is a step pattern. The manager explained that the dose of medication given at the outset is low because it is not known how much drugs the person has in their system when they are admitted. The level is then adjusted to a higher amount and decreased step by step, unless there is some reason not to follow this pattern. We looked at the Medication Administration Record (MAR) charts for the two service users we were case-tracking. Each had a photograph of the service user and we found no errors or discrepancies. One of the service users had had to go to hospital with a severe chest infection. He had returned to the service and continued his detox when he was discharged. The charts reflected this. We were told that there is no stock of controlled drugs kept in the service. However individuals may be prescribed controlled drugs and we viewed the controlled drugs book which is kept like a ledger. It raised no issues or queries. We noted that when controlled drugs are returned to the pharmacist he signs the book for them. Other drugs which are returned to the pharmacist are taken with the drugs from the sister project next door. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service does listen to the view of service users but needs to tighten up on practice in this area. Service users are protected from abuse, neglect and self harm but policy and procedures need to be explicit and to follow local guidance. Evidence: We looked at the complaints information and records. We noted that the complaints form was used. An group of service users made a complaint on 27/9/08. The centre manager investigated by e-mail on 8/10/08 and made a response to the complainant on 14/10/08. This was the first formal response the complainants had had, although the centre manager did state that she had spoken to some of the complainants prior to investigating i.e. between 27/9/08 and 8/10/08, but she did not record these conversations. The centre manager had not responded to all the complainants because some of them had been discharged. She stated that she had decided that the complaint was a misunderstanding and did not feel she had to advise all the complainants of the outcome. The above is not acceptable practice. Good practice dictates that an early acknowledgement of the complaint is made to all complainants and all complainants receive a timely formal response which advises them of the outcome of the investigation. All these actions should be recored in the complaints log. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: The complaints log is shared with the sister project next door. The log needs to be developed so that the progress of the complaint can be properly recorded including the final resolution. The registered manager ultimately has the responsibility for ensuring that complaints are properly dealt with in the service. Notwithstanding the above there is a wealth of quality assurance evidence that the views of service users are heard and considered, and that changes can result. The manager stated that there had been no safeguarding incidents since the last key inspection. She said the arrangements for safeguarding are identical to those at the sister project. We spoke to two staff members and the manager about how they would deal with an adult protection allegation. The view from all was that the manager would investigate. Following these discussions we were concerned that the training staff had undergone, which was awareness training, had not informed them on procedures to be followed in the workplace. We were also concerned that the training certificate which they had been given lasts for three years. At present the national guidance document No Secrets is being reivewed and we feel that is is unrealistic to offer a certificate for three years in the area of adult safeguarding. We checked the safeguarding policy. It does not state that the service would in the first instance, make a safeguarding alert to the local authority. It does state that the service must have a copy of the local authority policy and must work in conjunction with it. The service downloaded a copy of this document following the inspection of the sister service next door (one week before this inspection). Further the service does not have in place a safeguarding procedure to be followed. The manager stated that she will write one and ensure that staff are in house trained on it. Notwithstanding the above we felt that the vulnerability of service users is protected and any safeguarding issue would be robustly dealt with. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a good environment conducive to its work. The environment is clean and hygienic. Evidence: We inspected the environment of the service. The service operates on the fourth floor of a building which is owned by a landlord. It operates independently of the rest of the building which is used for another purpose. However the landlord takes responsibility for the safety and maintenance issues in the building and this will be reported on under health and safety later in the report. The general environment of the service is good. There is a multi purpose common room where poeple eat, relax, watch television etc. We felt that this was an asset to the project as a service user can generally find company in that room. The manager mentioned that they intend to repaint the walls including in the individual rooms, using colours, as they are all rather bland at the moment. The service is comfortably furnished but the manager hopes to upgrade the sofa in the common room. There is another room which houses the pool table. The service does not have foul linen. Service users do their own laundry and Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: satisfactory facilities are provided. The service uses the yellow bag service for disposing of gloves, urine tests, vomit bowls etc. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff at the home are well qualified, competent and experienced. They are generally safely recruited but procedure must be tightened up. Proper regular training also needs to be provided. Evidence: The service employs 5 registered mental health nurses and 4 project workers. The manager of the sister project next door manages the project and there is a vacant post for a team leader. The project has very clearly defined roles for staff. They also have enough staff to avoid blurred role boundaries. The manager stated that however many beds are in use there are always two staff members on duty, a nurse and a careworker. We interviewed two staff members and we inspected their two staff files. One member of staff was very new and one had worked on and off at the project for years. The staff were very clear about their duties, responsibilites and the overall aim of the project to detoxify service users and assist them to remain clean. They were well qualified. One was a registered mental health nurse and the other had NVQ 3 and a lot of experience in the work. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: We were very concerned to discover that the new member of staff was working without a Criminal Records Bureau (CRB) disclosure in the name of the service. She had worked at the service for 2 years as a bank staff with a CRB in the name of the agency. However she did not have a CRB in the name of the service before starting as a permanent member of staff. The manager stated the CRB has been requested. She further stated that staff are rarely alone with service users and she would ensure that until a clear CRB disclosure comes through for this staff member she will not work alone with service users. She stated that she will avoid this situation in future by sending off for the CRB at the applicatation stage and no-one will be permitted to start work before the disclosure is received. The staff files evidenced that recruitment includes an application form and the taking up of two professional references. The new member of staff confirmed that she was undergoing induction. training. She said that as a bank staff she had joined in various training courses with the service. However on checking training records we are concerned that staff are not refreshing their core basics on an annual basis. As previously mentioned we were concerned that despite staff having recently undertaken safeguarding training neither of the staff interviewed were able to describe the correct procedure following an allegation or suspicion of abuse. As previously mentioned the manager has undertaken to write a procedure and train staff on it in house. There was evidence on file of supervision of staff on a regular basis although this was not as frequent as six times per year. The new member of staff stated that she had had a lot of input from the manager who had been over to see her on a daily basis since she started. Regular appraisal is not taking place yet, but the manager stated that appraisers are being trained and this will soon be in place. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well run, quality assurance is robust, and working practices are safe. Evidence: The service is generally well run and the evidence is that it achieves its purpose with an increasing number of people. We were told that completion rates are 61 and rising. As previously stated the London Borough of Tower Hamlets commissions the service and the manager stated that quarterly meetings are held with them. The service has now been open for just over a year so a a full service reivew will be carried out. The service states in its AQAA that questionairres are handed to service users on discharge and their comments are taken to the management meetings and discussed. Changes are implemented if they do not compromise the security and safety of the service. They further state that weekly service user meetings are held where people can Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: comment on the service. Minutes are posted and discussed at managers meetings. The AQAA states that referring drug teams are also consulted for their views. The health and safety arrangements of the service were viewed. As previously mentioned there is a landlord for the building and they are responsible for the safety and maintanance. We were given evidence as follows Fire alarms tested on floors 3 and 4 by Titan on 2/10/08 In common areas 2/10/08 Fire Protection (extinguishers) Gas tested by KIER on 1/7/08 Lifts checked by OTIS on 17/9/08 Hygiene and water treatment including shower heads (outside contractor) 11/11/08 Weekly testing of fire alarms and emergency lighting Evacuation drill last held on 10/9/08 The water temperatures are not routinely monitored and the manager agreed that the maintenance person from the sister project will forthwith include these in his round. The whole building including the fourth floor where the service is located is cleaned by a contractor. We saw the cleaners cupboard where the Control of Substances Hazardous to Health (COSHH) substances are stored and we also noted the COSHH data sheets kept there. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 17 12 Fresh food stored in refrigerators must be marked with the date of opening. For reasons of food hygiene. 01/01/2009 2 22 22 The service must acknowledge complaints promptly and respond to them within a reasonable timescale. So that complainants have their concerns acknowledged. 01/01/2009 3 23 13 The service must ensure that its safeguarding policy states that in the first instance the manager must inform the local authority of any allegation or suspicion of abuse A copy of the local authority policy must be kept in the office. 01/01/2009 Care Homes for Adults (18-65 years) Page 27 of 29 The manager must write a safeguarding procedure. To protect service users. 4 34 19 The service must not allow staff to start work without a CRB disclosure in the name of the service. To protect service users. 5 35 18 The manager must ensure that mandatory refresher training is delivered to staff. 01/01/2009 01/01/2009 For the safety and well being of service users. 6 42 12 The manager must ensure that the water temperatures are regularly checked. To protect service users. 01/01/2009 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 6 We recommend that if a service user does not sign the care plan they sign the records of the one to one sessions of which it is comprised. Care Homes for Adults (18-65 years) Page 28 of 29 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 © (2008) Commission for Social Care Inspection (CSCI). 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