Care Home: Sunnybrook Close (6)

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sunnybrook Close (6) 6 Sunnybrook Close Aston Clinton Aylesbury Buckinghamshire HP22 5ER     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: Date: 2     8 0 4 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: Sunnybrook Close (6) 6 Sunnybrook Close Aston Clinton Aylesbury Buckinghamshire HP22 5ER 01296 630038 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Hightown Praetorian & Churches Housing Association Kevin Roy Hills care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 0 Over 65 0 Date of last inspection Brief description of the care home 6 Sunnybrook Close is a detached property, situated at the end of a cul de sac in the village of Aston Clinton on the outskirts of Aylesbury. The home provides care and accommodation for adults with learning and physical disabilities and is registered for up to three people who use the service. The home is run and managed by Hightown Praetorian and Churches Housing. Sunnybrook Close provides single room accommodation for all people who use the service and has been sympathetically refurbished to provide for their needs. There is a private garden to the rear of the Care Homes for Adults (18-65 years) Page 4 of 29 property. To the front of the home there is parking space for approximately six vehicles. The home is conveniently situated for local pubs, Green Park, local shops and other amenities. Care Homes for Adults (18-65 years) Page 5 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 peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out by one inspector in April 2008. The inspection process included consideration of documents provided by managers in advance of the inspection, a visit to the home, a tour of the home and garden, examination of records, interaction with residents, managers and staff, and examination of documents (including care plans). The fees around the time of this inspection were £2149.50 per week. 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: The manager must ensure that new staff do not take up employment until the information required under the Regulations, as listed under Schedule 3, has been received. Where new staff start work under a POVA First basis, supervision arrangements which conform to Department of Health guidance must be in place. Care Homes for Adults (18-65 years) Page 7 of 29 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. 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 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. The needs of prospective residents are assessed before admission to ensure that the service can meet the persons needs and that the person is happy living in the home. Evidence: Enquiries may be made to the home by Care Managers employed by health and local authorities. Referrals are initially considered by the Operations or Area Manager based at the organisations head office in Hemel Hempstead. Further information is acquired where necessary. Where the referral is progressed arrangements are made for an assessment of the prospective residents needs. This takes account of assessments already carried out by the care manager and other professionals. Where it is felt that the home can meet the persons needs, an offer of a place is made. Where this is accepted arrangements for admission are made. A review meeting between all parties takes place after three months. Care Homes for Adults (18-65 years) Page 10 of 29 Care Homes for Adults (18-65 years) Page 11 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. A comprehensive care plan is in place for each resident. Care plans include risk assessments and evidence of liaison with health and social care agencies in the community. Together, these aim to ensure that peoples’ needs are met, that risk is minimised, and that the independence of people living in the home is supported. Evidence: A care plan is in place for each resident. Care plans comprise two main documents (a red and a blue folder) plus a daily diary. The information on each person includes: a photograph, basic personal information, religion, culture, ethnicity, details of people who are important to the person, a communication profile, contact details for a number of people, How I learn, physical care, things that are important to the person, information on their family, medical information, and medication. Some Care Homes for Adults (18-65 years) Page 12 of 29 sections of the care plan are in easy read picture, large print and Widgit form. Documents include information on where the person has lived in the past, their daily routine, leisure likes and dislikes, mobility, key information on personal care, support required in getting dressed, cooking, nutrition, support required in carrying out tasks such as making their bed and keeping their room tidy, and the persons night time routine. Risk assessments cover a range of activities including; the risk of choking particularly when eating, cleaning teeth, shaving, seizures, bathing, risks associated with specific care activities such as cutting nails, and risk related to activities while out of the home (while travelling or shopping for example). Care plans included; daily routine, a lifestyle plan (Monday to Sunday activities), and a year planner. There was evidence of liaison with local health and social care organisations including a copy of a Buckinghamshire NHS Learning Disability Person Centred Plan. Staff support residents to participate in decisions while carrying out day to day activities, in house meetings, menu planning, and through the use of scrapbooks or other prompts or support measures. Residents are involved in the informal aspects of staff appointments and are welcome to sit in on staff business meetings. Entries are made in each persons daily diary at the end of each staff shift i.e. three times a day. Care Homes for Adults (18-65 years) Page 13 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. Residents lead a varied lifestyle according to their individual needs, abilities and interests. This ensures that people experience a range of social and leisure activities and are supported in maintaining involvement with the local community. However, given gaps in current specialist provision in the area, the home should explore means of increasing the range of activities in keeping with residents needs. Evidence: Staff support residents in using a range of activities. There are numerous pictures around the home of activities which have taken place over recent years. Each resident Care Homes for Adults (18-65 years) Page 14 of 29 has a daily routine, weekly diary and year planner. Activities take place in the home and in the community. The manager said that specialist facilities for people with a learning disability in Buckinghamshire are limited. This opinion was supported by another member of staff who had previously worked in learning disability services in another county. To a certain extent, therefore, the home will have to continue attempting to fill gaps in provision and explore opportunities for increasing the range of activities. Residents use local amenities such as the pub across the road from the home, local general stores, a pharmacy and a local garden centre. They also use the larger shops, supermarkets, cafes and other amenities of Aylesbury, which is about three miles away. Some residents also attend the local church. The home has its own vehicle. All residents are in touch with their families although the frequency of contact varies. Residents did not have a holiday away from the home in 2007 but they are planning to go to Centre Parcs for a week or so later in 2008. Outings in 2007 included a day trip to Brighton. Annual festivals such as Christmas and Easter are celebrated and residents go to annual events such as the local carnival and county show. Some residents go to a specialist centre in Winslow. From April 2008 a music therapist runs a session in the home once a fortnight. A massage therapist visits on a regular basis and offers hot stone therapy (a therapy which involves the use of warm stones combined with massage and aromatherapy). The daily routine is flexible and can be varied to meet individual and group needs. Mealtimes are flexible. Meals are planned with residents. Staff are required to record how residents make their choices e.g. Pictures of menus and various food products were put on the kitchen table and all 3 residents were encouraged to touch and smell. Breakfast usually consists of fruit juice, cereals, bread or toast, and hot drinks. Lunch is usually served betwen noon and 1:00 pm. Selections from the lunch menu in March and April 2008 included: Omelette, Soup and Bread, German Sausages with Curry Sauce and Bread Rolls, and Corned Beef Salad. The time at which the evening meal is served also varies according to activity. Selection from the evening meal menu in February, March and April 2008 included: Chicken Pies, Potatoes, Peas and Carrots followed by Fruit and Custard, Chilli Con Carne with Rice followed by Jelly and Ice Cream, Tuna Pasta Bake with Garlic Bread followed by Fruit Salad, and Fish in Parsley Sauce, Mashed Potatoes, Peas and Sweet Corn followed by Chocolate Mousse. The advice of a dietician has been sought on menus. Residents are weighed Care Homes for Adults (18-65 years) Page 15 of 29 monthly. Lunch was observed during the inspection visit. Residents sat at the dining table. Staff provided assistance when required. Meals were provided in accordance with the residents preferences and abilities. Quiet music played on the radio in the background. Care Homes for Adults (18-65 years) Page 16 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. Residents are well supported bystaff. Arrangements for liaising with health and social care services in the community are satisfactory. Arrangements for the control and administration of medicines are good. These aim to ensure that residents healthcare needs are met. Evidence: The personal preferences of residents are recorded in their care plans. The home has some special equipment - a Parker bath or support rails in WC for example - to meet the current needs of residents. Further equipment would be installed if needed. All residents are registered with a GP practice in Aston Clinton and with the Community Learning Disability Team (CLDT) in Aylesbury. Residents visit a dentist at Manor House Hospital in Aylesbury when required. Opthalmic services are provided by Boots Opticians in Aylesbury. Residents general health is monitored by staff who inform the residents GP when necessary. Care Homes for Adults (18-65 years) Page 17 of 29 The administration of medicines is guided by the policy of the organisation. Medication is prescribed by the residents GP and dispensed in a weekly monitored dosage system by Lloyds Chemists in Aston Clinton. Medicines are stored in individual metal cabinets in each bedroom. Medicines requiring cool storage are kept in a locked box in the fridge. Stocks are checked at the lunchtime and evening handovers. Staff training is through the Boots Chemists one day course. Staff are required to undertake an in-house assessment before being considered competent to administer medicines. Medicines administered are recorded in individual medicines records (MAR charts). MAR charts examined on the day of the inspection visit were in order. Protocols guide staff when administering analgesics. Good procedures are in place for recording errors and for returning spoilt or surplus medicines to the pharmacy. References for staff include a 2006 British National Formularly (BNF) and a 2002 BMA guide to medicines. It would be advisable to obtain a more recent edition of both texts and copies of current guidance on medicines in social care published by The Royal Pharmaceutical Society of Great Britain in 2007 and that published by CSCI in 2008. Care Homes for Adults (18-65 years) Page 18 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 home has good procedures for investigating complaints. It has a framework of policy and staff training with regard to safeguarding vulnerable adults. These aim to protect residents from abuse and to ensure that complaints are properly investigated. Weaknesses in the homes practice with regard to CRB and POVA checks prior to staff taking up post potentially undermines good practice in staff training and could place residents at risk. Evidence: The organisation has a complaints policy - a copy of which was on a noticeboard in the home. A pictorial version of the procedure was in each residents file and in each bedroom. The home had a copy of the organisations policy on safeguarding vulnerable adults. This was last reviewed in 2007. The policy is thorough and includes reference to the Mental Capacity Act 2005 which came into force in 2007. Contact details for CSCI will need to be updated. The subject of abuse awareness is included in the induction programme for new staff Care Homes for Adults (18-65 years) Page 19 of 29 and all staff are required to attend half-day update sessions at the organisations head office in Hemel Hempstead. The home had a copy of the Buckinghamshire Inter-Agency Guidelines on safeguarding vulnerable adults. The registered manager said that residents and their representative have access to the services of Aylesbury Vale Advocates if required. Examination of staff files (see later in this report) appeared to show that some staff had taken up employment in the home before an Enhanced CRB certificate or POVA First check had been received. This exposes residents to risk and is in breach of current guidance from the Department of Health on POVA. Care Homes for Adults (18-65 years) Page 20 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 home provides an accessible, pleasant and well-maintained environment which provides people living there with a comfortable and safe place to live. Evidence: The home is a detached bungalow, situated in a quiet residential close, not far from the centre of Aston Clinton. There is limited parking to the front of the building. There are limited bus services serving Aston Clinton from Aylesbury, Tring, Hemel Hempstead, Watford and Luton. The nearest rail station is Aylesbury (Chiltern Railways). There are a few local shops on the main road through Aston Clinton and a few pubs in the locality. Residents and staff occasionally go to a pub a short walk from the home. The home has its own transport. Entry to the home is controlled by staff. The door is alarmed. All the accommodation is at ground level and most is accessible by wheelchair. The accommodation comprises: entrance hall, office (which also serves as the staff sleep-in room), three single bedrooms, one bathroom with Parker bath, WC and shower, one shower and WC, laundry, and an open plan lounge, dining room and kitchen. Care Homes for Adults (18-65 years) Page 21 of 29 There is a fair sized garden to the rear of the home with views over open countryside. It includes a patio area with table and chairs, two areas of lawn, and two small sheds. The garden has a pleasant outlook and as noted in the previous inspection report has scope for development. There is a large boundary hedge with a neighbouring property. This is maintained by a Work skills group from another service managed by Hightown Praetorian and Churches Housing Association. The manager said that the home intends to develop a low maintenance garden over the next year or so. The lounge is comfortably furnished with domestic style armchairs, TV. DVD and video player, stereo and fish tank. The dining area appears large enough for current use. The kitchen is furnished with domestic storage units and work surfaces plus domestic refrigerator, dishwasher and cooker. The laundry is a small room equipped with a wahing machine and tumble dryer. The equipment is considered sufficient for current use. Bedrooms were comfortably furnished and well decorated. The manager said that redecoration of bedrooms was on the development plan for the next year or so. Bedroms have been furnished in accordance with residents needs and preferences. All areas of the home were tidy and clean and no untoward odours were noted. Care Homes for Adults (18-65 years) Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met through sufficient numbers of trained, experienced and well supported staff. Residents may be placed at risk through the appointment of staff before the results of a POVA First or CRB are received. Evidence: Current staffing provides for two care staff in the morning, two care staff in the afternoon, and one waking and one sleep-in care staff at night. These figures usually exclude the registered manager. Vacancies are advertised internally, in newspapers in Buckinghamshire and south Bedforshire, and occasionally through the organisations participation in recruitment fairs in Aylesbury. Staff are required to complete an application form, provide two references, have an enhanced CRB check, and provide evidence of their fitness for a post. Three files were examined during the inspection visit. Application forms, references and evidence of fitness were satisfactory. None had a recent photograph of Care Homes for Adults (18-65 years) Page 23 of 29 the person as required by the Regulations. There appeared to be a discrepancy with regard to the home obtaining an Enhanced CRB prior to the person starting work. The interval between the person taking up employment and the home receiving a CRB was 3 days, 18 days and 28 days respectively. This period did not appear to have been covered by a POVA First and suitable supervision arrangements. An Enhanced CRB had been received for all three staff by the time of the inspection visit. New staff follow the Skills for Care induction programme. Staff are provided with a well designed workbook to work through during their first three or so months in post. New staff have a six month probationary period with reviews taking place at three and six months. With the exception of two new members, all staff, seven in total, have received training to NVQ2 or above - two of seven having acquired NVQ3. Hightown and Praetorian Churches Housing Association maintain an ongoing NVQ and internal staff training programme. All staff have an individual training record and training needs are discussed at supervision. The duty rota includes evidence of staff attending training events. It was reported that staff are sometimes unable to find places on training courses because of the level of demand. Update training is provided through E - Learning which has recently been introduced across the organisation. Staff described the home as a nice relaxed place, with a calm atmosphere, which enables residents to each pursue their own choices. Residents are treated as individuals. The deficiency in specialist community facilities in Buckinghamshire was noted and staff said the home was trying to fill some gaps . Managers were described as supportive. Care Homes for Adults (18-65 years) Page 24 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. This is generally a well managed home which is providing good care and support to residents. Arrangements for health and safety are thorough and aim to maintain a safe environment for residents, staff and visitors. Evidence: The Registered Manager has worked with Hightown Praetorian and Churches Housing Association the autumn of 2006 and has managed the home since October 2007. Before working with Hightown Praetorian and Churches the manager had gained extensive experience in the not for profit (or voluntary) sector of learning disability services and in the NHS. The manager has acquired NVQ4 and the Registered Managers Award. Care Homes for Adults (18-65 years) Page 25 of 29 At the time of this inspection visit the home did not carry out a stakeholder survey. The manager said that this was under consideration by the organisation. The quality of the service is assessed by managers being out and about with residents, observing residents general level of well-being, and being receptive to the views of others. Senior managers carry out monthly Regulation 26 visits, the results of which are written up in reports filed in the home. The reports are of good quality. A manager carried out a Regulation 26 visit to the home on the morning of the inspection visit and was noted to look around the environment, check records, and spend time with residents and staff. Monthly meetings are held with residents, the notes of which are in Widgit form and include scanned in images. It was noted that some documents in care plans also included scanned in images - a good practice. The home has a development plan for the 2008/09, a copy of which was seen during the inspection visit. Policies are reviewed periodically by the organisation. Arrangements for ensuring the health and safety of residents, staff and visitors appear satisfactory. Staff training is provided at induction, basic and update levels. All but two new staff were said to be up to date in food hygiene training. A fire risk assessment was carried out in June 2007. Staff attend fire training twice a year. The manager said that the home had recently been visited by the fire authority but that a report had not yet been received. The home has systems in place for regular checks of fire safety in the home. Contracts are in place for the maintenance of gas and electrical appliances and of fire safety equipment. Dates of the most recent checks were provided in advance of the inspection visit. Procedures for dealing with COSHH materials are satisfactory. Systems are in place for recording accidents. Copies are sent to the head office in Hemel Hempstead for reporting and analysis. Care Homes for Adults (18-65 years) Page 26 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 27 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 34 19 The registered manager must ensure that staff do not take up post until the information required under Schedule 2 is received. For the protection of residents 30/05/2008 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 15 14 It is recommended that the home explore means of increasing opportunties for residents to participate in activities, including those which involve time away from the home (with staff support) It is recommended that the registered manager obtain copies of current editions of reference texts on medicines including those published by The Royal Pharmaceutical Society of Great Britain and CSCI. 16 20 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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