Care Home: Southwood Avenue

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What the care home does well The service provides a person centred service to the students who use it. Students have their needs fully assessed before they move to the service. Students are fully involved in the development of their plans and supported to develop their skills in education and daily life. Students who use the service are able to be part of the local community and participate in leisure activities which interest them. Detailed plans ensure that students have their health and emotional needs met. Students know how to complain when they are unhappy and say they are listened to. Staff who work in the service are supported with both child and adult protection training. Staff who work in the service are properly recruited and trained to ensure students are protected. The service`s development is based on listening to the students. The home is well managed. What has improved since the last inspection? There were no requirements or recommendations made at the last key inspection in 2006. What the care home could do better: At the end of this inspection there are no requirements or recommendations. Key inspection report Care homes for adults (18-65 years) Name: Address: Southwood Avenue 14 Southwood Avenue Southbourne Bournemouth Dorset BH6 3QA     The quality rating for this care home is:   three star excellent 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: Tracey Cockburn     Date: 2 4 1 1 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) 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. The material should be acknowledged as CQC 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: Southwood Avenue 14 Southwood Avenue Southbourne Bournemouth Dorset BH6 3QA 01202436140 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): michelle.timms@cambiangroup.com Cambian Asperger Syndrome Services Ltd Name of registered manager (if applicable) Mrs Anne Harris Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The age range of young men to be accommodated to be between 16 years and 19 years. Date of last inspection Brief description of the care home Southwood Avenue is a large detached house situated in a residential area of Southbourne. The home provides term-time education and care for eight young men aged between 16 and 19 years with a primary diagnosis of Asperger Syndrome. There are eight single bedrooms, the majority being en-suite. Communal areas include a lounge, dining room, kitchen, laundry and IT suite used mostly for class work and a small garden. The library, shops and recreational facilities are within walking distances and bus routes are similarly close. The students all attend The Wing Centre, a Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 Brief description of the care home residential and educational resource specialising in meeting the needs of young men diagnosed with Asperger Syndrome. Educational programmes include a curriculum coordinated at The Wing Centre, work experience and college courses organised by the Educational Vocational Manager who links with all local colleges assessing special educational needs on an individual basis. Some of the curriculum is delivered at Southwood Avenue where there is scope for the young men to practice independent daily living skills. Southwoood Avenue and The Wing Centre are part of the Cambian Group, an independent provider. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection. This home was previously rated as three star and had not been inspected since 2006. We sent surveys to the home for both staff and students to complete and their comments are used in the report. We spoke to students and staff about life in the home and we also observed practice. We spoke to the manager and service manager. We looked at individual records of both staff and students and we looked at training, health and safety and we toured the building. The service sent us and annual quality assurance assessment and this informed our inspection. Care Homes for Adults (18-65 years) Page 6 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 7 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 8 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 only move into the service following a detailed assessment of their needs and a clear transition plan. Evidence: The annual quality assurance assessment told us: We have had more student assessments days enabling them to stay over night. This has enabled the potential new students to meet current students and giving them more choice in the suitability of the home that they will live in. The initial assessments is gathered from a variety of sources including, past schools, psychologists, parents, students and the Statement of Educational Need. The majority of the core paperwork is held on file at the Wing Centre. There are additional standards in this outcome area for people aged sixteen and seventeen in relation to information in the statement of purpose about arrangements for leaving care and the transition to adulthood both are addressed by the service in relation to students moving on. The additional area in standard two is around placement plans which this service has in detail and fully involves the student in their development, we saw evidence of this Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: in one plan we looked at which had additional comments by the student. Care Homes for Adults (18-65 years) Page 10 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. People who use the service have individual plans of their support needs in which they are fully involved in developing. Evidence: They tell us in their annual quality assurance assessment that they are doing the following to support equality and diversity within the service: As part of our Life Skills curriculum all students access studies in cultural studies which is adapted to be particularly practical, relevant and experiential, to meet the social, moral, spiritual and cultural needs of those with Asperger Syndrome. They also told us how they support students to develop their plans: Each student is encouraged to build their own placement plan throughout their time with us and to take forward with them into the future. This enables staff to provide each student with individual personalised care programmes. The students are supported to develop their Independence, this includes a comprehensive individual risk assessment. Any limitations placed on a student are agreed with them and explained at the required Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: level to ensure understanding. One to one support is provided from Personal tutor system in place. The students are fully involved with their menu planning and some individuals manage their own food budget, with staff ensuring nutritional value is included. We looked in individual focus files which contain information on individual behaviour, risk assessments, developing independence and terms of residency. Behaviour risk assessments are in place for individuals and detail how they will be supported depending on their level of risk, these risk assessments detail the support each person needs and the boundaries and what action will be taken if they over step these boundaries including the physical interventions which may have to be used such as TCI ( Theraputic crisis intervention) and SCIP (Strategies for crisis interverntion and prevention) some of the interverntions listed to be used include active listening, re direction, touch support. We looked at one placement plan which details the support needed in daily living, their prefered m,ethod of communication and the support they want from family and friends. We were told that the service is planning to develop a more person centred approach to plans and focussing on outcomes for people who use the service. They are planning to do the following over the next twelve months: To look more closely at the Transition department. To introduce CASPA(educational tracking software) which tracks realistic progress over real time, thus enabling the student to clearly see their own levels of progression, resulting in increased levels of motivation. Students are fully aware of their care files and are key contributors to their development. Care plans are reviewed regularly. Copies of review documentation support that this is maintained. The inspector noted that all recommendations from previous reviews had been transferred to the care plans examined. Staff confirmed their role in preparing for a review, which includes writing a progress report. Staff spoken to were fully aware of the students needs. Students are encouraged and enabled to make decisions about their own lives, evidence of this was supported by the care file contents and conversations with the students. Examples given included, support to manage their own finances and to develop their own independent leisure opportunities. In addition students have a formal house meeting each week plus an informal meeting to arrange menus for the forthcoming week. The Manager also reported that students are involved in a joint meeting with staff, which is reported to have been very successful. Recently students had also been encouraged and supported to participate on interview panels for recruiting staff. The home has a vast array of risk assessments to demonstrate that they are keen to ensure that students have access to life experiences and the community but within reasonable controls. Each student is assessed for his individual risk factors and strategies were in evidence to manage any potential concerns. Before a student is Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: deemed safe to carry out any specific activity he has to successfully achieve the expectation on five separate occasions. Evidence of these risk assessments were seen on files. There are additional points in standard six covering the students care plans and involvement of funding authorities in moving on plans. 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 are able to lead the lives they want to with support. Evidence: They told us in their annual quality assurance assessment that they are planning to: We have listened to the views of our students and as a result they have had more choice about who they live with at Southwood Avenue. The students are going to have a house Christmas lunch this year, to enhance the homely atmosphere. We have listened to what and where they wish to study and education plans and individual timetables put in place. We also listen to their recreational requests and put in place individual and group activities. They also said: We are in the process of supporting the students to gain more independence by individualised food budgets and food storage areas. This is to enable each student to have more control of their menu and at what time they eat. We are also looking at wide range of work experience to support the students to gain further skills and qualifications. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: One member of staff who returned a survey form told us that the students are offered a good range of activities to participate in. Staff encourage students to take responsibilities within the home and to be active participants in the daily routines of the home. This includes laundry, shopping cooking and cleaning. Independence is encouraged in all aspects of their lives and is one of the key outcomes expected of students time at the home. Students have keys to their rooms and staff respect their privacy by knocking before entering a bedroom. Students develop menus during their informal house meeting held weekly. Menus seen offered a healthy balance whilst incorporating their choice. Students supported by staff cook meals on rotation. Themed cultural evenings are held on a weekly basis and there is provision for take out meals. On the day of our visit the theme was Mexican. Students cook the food they suggested in the weekly menu for example one student chose to cook lasagne for everyone. All those involved in the preparation of meals had undertaken food hygiene training. In this outcome area there are additional points covering personal development, education, leisure and meals. The service supports the students in developing their life skills as well as supporting them in development relationships. Students are supported to participate in leisure activities such as going to clubs, participating in hobbies such as going to comedy clubs or listening to live music. 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 are supported to maintain their health. Evidence: They told us in their annual quality assurance assessment that they have done the following to support the students: We have a medical file for each student which is kept safe, secure and confidential information is only accessible to those persons authorised. Each staff member is trained in first aid and there are adequate staff to provide 24 hrs emergency care who hold a 4 day first aid certificate. We use local GPs close to each house within the community. Medication risk assessments for students who are able to self medicate. See our controlled drugs and medical policies and procedures, statement of purpose, prospectus. Students are designated with a personal tutor key worker, which ensure continuity of care. Care records confirmed that students needs are identified and met accordingly. Southwood Avenue staff demonstrated an awareness of the need to support with sensitivity ensuring privacy and dignity. Routines of the home, are flexible and afford each student the scope to receive support according to their needs at a time, which is suitable for them. Medication policy and practice is clearly followed. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: One student told us in their survey form that they are always able to do what they want each day, they also told us they are able to do what they want at the weekends. Students receive support and guidance from staff who have received training on alcohol and illegal substance abuse as well as sex eduction. 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. People who use the service know how to complain. Evidence: They told us they do the following to support students to complain: It is our desire to resolve any issues with families and students that may from time to time arise as speedily and smoothly as possible. Our complaints policy and procedure is available on admission. We ask each student on a weekly basis through personal tutor meetings one to one with them if they are happy. When a student, carer, neighbour complains we have a set procedure to enable the individual to feel supported and ensure they are guided through the complaints procedure. The procedure ensures that we take all matters seriously and there is a positive outcome. The annual quality assurance assessment says: We have Harrassment co-ordinators in each house. They receive regular refresher training. Our staff now have external POVA and child safeguarding training. We also have sexuality co-ordinators. The home adheres to a corporate complaint procedure, which includes the expectation that complaints are handled swiftly and within 28 days. The procedure includes stages and supports complainants in referring the complaint forward if they remain dissatisfied. Students have access to several contacts should they wish to raise a worry or complaint. The inspector saw simplified complaint leaflets and posters. On admission each student is given this information. If a complaint is received a record is Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: made. All staff receive training in both child and adult protection and policies and procedures on both are available in the service. The service also has a policy on countering bullying the harrasment co-ordinator is part of this process. The service has a written procedure in place for any student who is absent without authority. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an ordinary house which is furnished to meet their needs. Evidence: The annual quality assurance assessment says the following about the communal rooms in the home: A selection of communal rooms are provided and friends and families are encouraged to visit. This includes a games room and an ICT Suite. There is also a BBQ and beach activities for summer months. Each student has a key to their own room. We find creative solutions to cater for each individual also bearing in mind the needs of our future students. There is a kitchen area which is used for communal cooking, also to support students developing their independent cooking skills. There is a large dining room which is also used as a music, games room providing students space to paint, practice music or play table football together. The laundry room provided caters for our students needs to help them to develop domestic independent skills and transferable skills for future placements. The home is an ordinary house in the street and not distinguishable from others. The communal areas are well decorated and furnished to appeal to a younger adult. Only four people are using the service at the time of the site visit so we looked in some of the unoccupied rooms. The students lock their rooms when they go out to college. the home was clean. There is a piano in the lounge for students to use. We spoke to D Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: who was about to leave for college and was anxious about an exam that day. He ran upstairs and shouted to us to come quick there are dangerous chemicals left unattended up here which could hurt me. The cleaner was upstairs and the cupboard was open while she got cleaning fluids out. A member of staff who returned a survey form told us they thought the home could do with a study room for the students. During our visit one student was using the television room to study in, which at the time of our visit was not being used by anyone else. The annual quality assurance assessment tells us: The premises were clean, hygienic and free from offensive odours. Systems are in place to control the spread of infection and are in accordance with relevant legislation, published professional guidance and the purpose of the home. Laundry facilities are sited so should there be any soiled articles, clothing and infected linen are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on students. The laundry floor finish is impermeable and the wall finishes readily cleanable. There are areas in the home suitable for each student to use to study. 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. People who use the service are supported by staff who understand their needs and treat them as individuals. Evidence: The annual quality assurance assessment tells us: All staff have a Continuous Personal Development file. Specialist training is given e.g. Therapeutic Crisis Intervention and Asperger Syndrome and associated disorder training, developing a positive approach which includes Strategies of Crisis Intervention Prevention. There is a probation period for all staff at all levels. Rotas to promote the students needs. We talked to two staff about training, we also case tracked one member of staff on duty and looked at her recruitment and training with the provider. Both files we looked at contained information on proof of identity as well as Criminal Records Bureau checks and two written references all obtained before the person started working in the service. Training includes for both NVQ level 3, medication training as well as SCIP training, communication, Health and safety, drug and alcohol abuse awareness, behaviour support and safeguarding. All staff have 10 training days a year mainly at the beginning and end of the academic year before the students start and after they go home for the holidays. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: All staff are inducted according to skills for care induction standards. All staff files are currently held off site at the head office but they are rethinking this policy. All staff have professional personal development folders. Both staff we spoke to were very positive about the training and support they receive to do the job. We looked at the training calendar which runs through to August 2010 and includes team Building, epilepsy, positive behaviour support, Mental Capacity Act, Adult Safeguarding, child protection and induction training. All seventeen staff who are employed to work at Southwood Avenue have completed infection control and nutrition training. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and people who use the service are at the centre of the services development. Evidence: The annual quality assurance assessment tells us the following about the management of the home: We have quality monitoring systems on seeking the views of the students, families and the relevant professionals in order to measure the success achieving the aims and objectives and the statement of purpose. The Manager has complete involvement in the implementation of reviewing and developing our policies and procedures. On a termly basis we audit our service unannounced to ensure quality assurance, this is carried out by our Care Services Manager. We also half termly complete unannounced night visits and on a monthly basis an Independent Person completes an unannounced visit. The Registered Care Manager has regular meetings with the Care Services Manager. Managers provide an excellent role modeling for employees. The home has effective quality assurance and quality monitoring systems, which are Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: based on seeking the views of the students, the families and the relevant professionals that work with the service in order to measure success in achieving the aims and objectives and the statement of purpose. In addition quality assurance is measured through the companys own termly audit of the National Minimum Standards, Regulation 26 visits carried out by independent personnel and six unannounced night visits, per year, carried out by Managers within the company. The home also undergoes regular Health and Safety audits. The home has an up to date fire risk assessment and a variety of environmental and generic risk assessments. Weekly and monthly health and safety audits are also undertaken. All staff had completed relevant first aid training and had undertaken food hygiene training. These training courses are provided on a rolling rota system to ensure all staff are appropriately trained. Temperatures of fridge freezer and food cooking were all recorded. Coshh substances were stored safely and had accompanying data. Water temperatures are kept at 43 degrees C and are also tested regularly. PAT testing is undertaken on a regular basis. All fire records were complete and show that necessary in house and specialist checks, fire training and fire drills had been undertaken. 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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