Care Home: Sands Lodge

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What the care home does well The documentation, information and records are well organised. One survey returned by a care professional stated that, This particular home is one of several homes that I work with and I consider this to be the best. The staff on duty were spoken with and came across as well trained, experienced and knew all the residents well. Another survey from a care professional stated that, Staff seem experienced and helpful. Residents through surveys and spoken with all said they are happy and satisfied with the staff support and service they receive. What has improved since the last inspection? The manager has introduced fresh fruit everyday and a record around healthy eating for individuals is well recorded. An allotment within the homes garden has been introduced so that people can grow and cook their own vegetables. A computer has been purchased just for residents use. Monthly residents meeting are held. There has been the introduction of planned supervisions and yearly appraisals for all staff. All requirements and recommendations from the last key inspection have been achieved. What the care home could do better: As well as the in-house induction process, new staff need to follow the Skills for Care sector criteria for induction. The provider should document her regulation 26 visits and keep copies of these within the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sands Lodge 15 Kings Road Westcliff On Sea Essex SS0 8LL     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah Hannington     Date: 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. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.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: Sands Lodge 15 Kings Road Westcliff On Sea Essex SS0 8LL 01702340501 01702346494 patthorndyke@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Rowntree Graham Co Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 18 Number of places (if applicable): Under 65 Over 65 2 16 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 2 16 Sands Lodge offers personal care, support and accommodation for up to 18 younger adults with a mental disorder. The home is registered to provide care for up to two residents who have a learning disability included within the numbers for which it is registered. There are five double bedrooms and eight single rooms. Some rooms are available on the ground floor. Residents have the use of a large front lounge, a separate dining room, conservatory lounge, a small visitors room/telephone room and an accessible garden. Smoking is permitted in a separate garden room. Sands Lodge is situated in a quiet residential area of Westcliff on Sea, within close Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home proximity of local amenities including two churches. There is parking to the front of the property. Residents have access to a local bus service and Westcliff train station is nearby. The home is also close to the seafront. Information provided by the home advises that the current weekly fees range between £550 and £700 per week. In addition, residents are required to pay for hairdressing, chiropody, toiletries and newspapers and magazines. Transport fees are included in the weekly charges, as are escorts to appointments etc. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced site visit took seven hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the newly appointed manager and later on the provider and current registered manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. The last key inspection for this home was held on the 14th April 2007. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since the last inspection. Five staff and four residents were spoken with during the site inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties and Care Homes for Adults (18-65 years) Page 6 of 28 11 were returned to us. Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us (CQC), that asked how well the home is meeting the needs of the people who live at Sands Lodge. All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. 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.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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is a statement of purpose and residents guide, which provides information about the home to help people decide if they would be happy there. The manager told us that a copy of the social services or local authority needs assessment is also obtained and that people are invited to visit the home before they move in and once they do a contract would be agreed. These were seen in all residents files and daily notes of any visits which had taken place. When we visited the home we looked at the way in which eight peoples needs had been assessed. We saw that the assessment covered details of the persons physical and health needs as well as the support the individual required to maintain personal and oral hygiene. In all documentation each persons communication needs, their likes, dislikes and hobbies would also be recorded to help determine that the home would be able to meet their needs. We saw that statement of purpose and Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: residents guide is in place and up-to-date. These documents gave information about the staff structure, their qualifications, the complaint process, support, accommodation, local area, health and specialist services and activities. Two residents told us, They were asked if they wanted to move into the home and that they had enough information given to them before they moved into the service. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. Evidence: The manager told us in the Annual Quality Assurance Assessment that each person had a care plan and that they were involved in this process, four residents we spoke with confirmed that this. All eight of the Care Plans seen were reviewed at least every twelve months or more often where this was appropriate. The manager told us that emphasis was put on enabling residents to make decisions and choices about their daily lives. When we visited we looked at all care plans for the residents living in the home, we saw that staff recorded well the goals of individuals and there was evidence that the plans and goal setting had been carried out with residents, for example in one residents care plan goals around wanting to maintain a personal relationship they had before moving into the home were recorded well. This person views about these goals or how they could be achieved was recorded in the plan and speaking with this Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: individual they said they were happy in the way in which staff supported them. We saw that other residents were involved in making choices such as new activities introduced, food and menu choice, contact with family or friends and work opportunities. In other areas there was good evidence that residents were supported in making decisions, participating or contributing to the running of the home. The manager said that residents meetings were held that would help to enable residents understand them or to express their views about how the home was run. Meeting topics covered issues such as, take away night, staffing issues (new manager and manager leaving), swimming lessons, medication issues, the new cooked breakfast on menu, outings and feedback from each resident on how they were feeling. Risks to residents health and safety were well managed while allowing residents to participate in activities such as preparing meals or accessing the community. Where the level of risk to a person was assessed as high and there was the likelihood that the person may injure themselves (such as risks associated with handling sharp kitchen items or risks associated with hot water) then staff imposed some limitations on access to these items or areas and supervised residents as needed. Where this was necessary then it was recorded and always agreed with the individual within the plan of care. One survey returned by a care professional told us that, Recorded information is always good. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that they will have the opportunities for personal development and build upon their daily living skills so that they are able to lead a lifestyle that they choose. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents are supported to develop skills and to participate in activities of their choice both in and outside of the home. When we visited the home we looked at all of the residents care plans. We saw that all residents had a plan of care which described their wishes for the activities they wish to participate in. Some of the residents were more capable of living a more independent lifestyle and this was reflected in their care plans. We saw that these people attended educational day centres and classes to increase their knowledge about daily living skills they needed to achieve further independence. All people Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: carried out domestic chores in order to give them a sense of purpose, such as laundry, cleaning of rooms and choosing from day to day their activities making sure people who live at Sands Lodge were involved generally around the home. All people also accessed activities such as clubs and pubs within the local community. We looked at records kept by staff about the activities that all residents participated in. It was clear that the activities were suitable for the resident and they included pursuits, which the resident liked to participate in. We saw that within the all care plans that there was evidence of the person being supported to participate in these activities by means of daily recording. We looked at the arrangements for supporting residents when choosing and preparing food and meals. We saw that staff supported resident in buying and preparing food and that there was a planned menu, which reflected residents likes and dislikes. Each resident had a care plan which described the support the individual needed. One person spoken with told us that they went out regularly to choose food and observation showed us that before meals were prepared all residents were asked what they wanted to eat. We saw that fresh fruit is delivered on a daily basis, a monthly take away and a cooked breakfast has been introduced as a result of residents requesting this. There was a four week menu in place that showed us that the likes of residents that were recorded in their information were reflected in the meals provided and that they had a varied and good quality of diet. One survey returned by a health care professional told us that, I get good information about the food and fluids people have. 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. Residents assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: The manager told us in the Annual Quality Assurance Assessment that the health and personal care needs of residents are met and that staff are trained to administer medicines safely. When we visited the home we looked at how the personal and health care needs of the residents were assessed and how residents were supported. The health care plans of all 8 residents showed us that they were actively consulted, that views were recorded, and that risk assessments were current and reflected the persons support needs. Health care issues assessed included, physical, mental, dietary, personal care, independence, emotional and wishes of individuals if their health deteriorated for any reason. Through all documentation held there were minutes of meetings, letters and conversation recorded with a number of other specialist services, such as Community psychiatric nurses, consultants, social workers and generally a number of NHS community facilities. One survey returned by a health care professional stated that, I feel sands were good at meeting healthcare needs. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: We saw that all residents were supported in attending routine appointments for health care monitoring and that had access to medical, dental and optician services when needed. It was recorded that residents enjoyed good health and residents looked well cared for. When we visited the home we saw that the administration records were maintained in accordance with agreed procedures and the royal pharmaceutical legislation. At the time of the inspection none of the residents living in the home were capable of safely keeping and administering their medicines, therefore a monitored medication dosage system is in place for each resident. We looked at medicine administration records and these were completed accurately to show that residents received the medicines, which were prescribed for them. We saw that all staff training was complete and up-to-date. There have been no incidents reported around medication issues or practice would suggest that medication is kept to a strict protocol and is maintained consistently to a good standard. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: We were told in the Annual Quality Assurance Assessment that any complaints or safeguarding alerts would be dealt with openly and thoroughly. The manager told us that residents relatives are provided with information on how to complain and how their concerns would be dealt with. The manager told us that there had been no formal complaints made about the service within the past twelve months. They also told us that staff received information about dealing with complaints and whistle blowing when they commence work at the home. When we visited the home we looked at the policy and procedure in place for recording and dealing with complaints. The manager has a good complaints procedure in place. All complaints were recorded, maintained and outcomes recorded. We observed that a pictorial format is available to all people who live at Sands Lodge so that they could understand this procedure more clearly. All seven staff surveys returned told us that they felt, they knew what course of action to take if there was a concern or complaint that was made. Four residents told us that they felt the manager and staff listened to them and felt that if they raised a concern then it had been dealt with satisfactory. There was a safeguarding policy and procedure in place and the manager told us that Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: all staff were given this information when they commenced work at the home. Three members of staff were on duty during the inspection and they told us that they had received safeguarding training and they demonstrated that they understood their responsibilities if they witnessed or suspected any ill treatment of residents. There was a whistle blowing policy which staff had access to and when speaking with staff they told us they were aware of this. This helps assure staff that they will be protected from harassment should they need to raise concerns about the home or other staff. We saw that all staff had received safeguarding training to keep them up to date with local policies and procedures and help ensure that all concerns would be treated properly. One survey returned by a health care professional told us that, Whenever issues or concerns have been raised, the manager and staff have dealt with this straight away or as soon as possible.Another told us that, For the last eight years of working with sands lodge staff I have never had to complain about staff not carrying out my advice. 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. People live in a clean safe environment. Evidence: The manager told us in the Annual Quality Assurance Assessment that it is clean, comfortable and well maintained. That they have an action plan that addresses general maintenance issue so that the up keep of the service as a whole is gradually addressed and put into place. The provider told us that are longer term plans to eventually redecorate the whole of the home. Recently the home has been provided with new chairs in the main lounge and the kitchen is shortly to be refurbished with new appliances and units. Within the home there are plenty of communal areas to use. There is a large lounge, two offices, a large conservatory, dinning room and kitchen. The back garden houses a laundry room and a medium sized smoking room. The garden itself has plenty of seating areas and a large lawn. Recently a new vegetables patch has been created so that people can grow and cook their own vegetables. We carried out a tour of the premises when we visited the home. The home was seen to be clean and comfortable and was decorated and furnished with items which reflected the peoples personality and likes (such as pictures, ornaments, games, music and films ). Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Four residents told us that the house was decorated to their taste and the furniture and their bedrooms were personalised how they wanted and that they are consulted with regarding re-decoration, colour schemes and choices of new furniture. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are offered positive relationships by well-supported and caring staff and are protected by staff recruitment, induction and training. Evidence: The manager told us in the Annual Quality Assurance Assessment that the home did not rely on the use of temporary agency staff. That all staff were recruited thoroughly, that staff were well trained and that staffing levels meet the needs of all residents. When we visited the home we saw by observation and by looking at the staff rota that there were enough staff to cater for all residents needs. Residents who completed surveys said that staff listen to them and act on what they say. When we visited the home we saw by observation that, staff interact well with residents, were motivated, competent and listened to people. The manager told us that all staff had been at the home for some years and that only two new staff had been employed since the last key inspection. Looking through the two new staff files they showed us that all Criminal Records Bureau disclosure and POVA First checks had been carried out and the people had been interviewed. Once staff commenced work at the home they undertook a period of induction to help familiarise themselves with policies, procedures and the needs of residents. The Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: manager told us that they were implementing the Common Induction Standards induction. This is a set of nationally recognised standards and helps to ensure consistency in the delivery of care and support to people who receive social care. All seven staff surveys returned told us that they felt, they had up-to-date information provided to them regarding the people they care for, had a good thorough induction and covered everything they needed to know before starting the job and that they were given training relevant to their role and that they were updated regularly. We saw that staff had received training in safe moving and handling, safeguarding, administration of medicines, communication, infection control and health and safety. Staff had received training in respect of caring for people who have learning disabilities, such using makaton or training around supporting people to make choices. The manager told us that over 50 of the staff is NVQ trained, and we saw that out of 14 staff, 6 staff have completed the NVQ2, one member of staff is working towards the NVQ3 and two are working towards the NVQ2. The last staff minutes of 29th April 2009, showed us that the manager and provider had open communication between them, for example, we saw on part of the minutes it had a section called Nags and Niggles this is a section that recorded staffs concerns or any issue they had. We saw by the minutes held, that at meetings individuals residents, team practices, training and general information sharing were discussed. This shows us that the team are discussing the relevant issues and reducing of risks by highlighting what needs to be prioritised. This keeps the residents safe and maintains their health and welfare. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The current registered manager has put in her resignation and will be leaving in June 09. The providers have secured a new manager who is presently working alongside the registered manager for eight weeks until this time. The registered manager has been in post for many years, has achieved much and holds a wealth of experience and knowledge of the current resident group. Working in this way it secures the health, safety and welfare of all residents. It also provides consistency of care and supports staff to maintain the quality of care given to people. The new manager is presently in the process of registering with CQC. The manager told us in the Annual Quality Assurance Assessment that there was a system in place for monitoring the quality of the service, including obtaining the views of residents. When we visited the home we looked at the arrangements in place for Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: obtaining the views of the people who live in the home, people who are important to them such as family and advocates and other people who are involved in their care. We saw that people were provided with questionnaires and that residents were asked if they were happy with their surroundings, lifestyles and opportunities available. They were also asked if staff allow them privacy, dignity, independence and choice. The manager told us in the Annual Quality Assurance Assessment that the new owners, management are approachable and friendly. When we visited the home four residents told us that the new manager has worked well with them, listens and that their opinions matter to her. Similarly four of the staff on duty felt that she supports them well and have confidence that she will do a good job of managing the home. We looked at how the home was managed and maintained. There were records and certificates to show that the home was maintained and fit for purpose. Checks were carried out to ensure that systems and equipment such as heating and hot water systems, fire detection installations and electrical equipment were maintained in good safe working order, the service has insurance cover for the registered managers legal liabilities to employees, people using the service and third parties. We saw reports from the local environmental health officers and these indicated that the manager complied with their regulations. We looked at accident records and there had been no accidents or incidents affecting the health, safety or welfare of residents within the previous twelve months. 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 or Textphone: 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!