Care Home: Teignmead

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What the care home does well Teignmead is a comfortable and homely place to live.People get the chance to visit the home before they decide to move in. The home makes sure it can meet their needs before they move in.There are good plans so that staff know what people need and how to support them. People can make choices about what they want to do each day.There is good support for people to join in activities in the local community. They also have the chance to do new things and develop their skills and interests.The home helps people to stay healthyPeople`s complaints are taken seriously. Staff know how to keep people safe and protect them from abuseStaff are well trained and supported to do their work. They know what help each person needs.Managers make sure the home is run for the benefit of people who live there. What has improved since the last inspection? This is the first time the home has been inspected. What the care home could do better: We have not made any requirements or recommendations Key inspection report Care homes for adults (18-65 years) Name: Address: Teignmead 48 Newton Road Bishopsteignton Teignmouth Devon TQ149PP The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Graham Thomas Date: 2 9 1 0 2 0 0 9 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 34 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 34 Information about the care home Name of care home: Address: Teignmead 48 Newton Road Bishopsteignton Teignmouth Devon TQ149PP 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Atlas Project Team Ltd Name of registered manager (if applicable) Mr Russell Hewitt Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: The maximum number of service users who can be accommodated is 4. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Teignmead is one of a number of homes in Devon and Berkshire owned and run by Atlas Project Team Ltd. The home is a detached residential property enjoying a range of river and rural views from the front of the house. It is situated on the edge of the Bishopsteignton, just outside the seaside town of Teigmnouth and approximately eight miles from Torquay an 12 miles from Exeter. The home provides four places for people with a learning disability whose Care Homes for Adults (18-65 years) Page 5 of 34 behaviours challenge services. People have individual rooms within the home and are supported by staff who receive training specific to the needs of this group. Support is provided for people safely to access activities and facilities in the wider community and develop their skills and interests. Fees are negotiated on an individual basis and range between approximately £1,150 and £3,700 per week Care Homes for Adults (18-65 years) Page 6 of 34 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 34 How we did our inspection: This is what the inspector did when they were at the care home We looked at our records about Teignmead before we visited. We checked if there had been any complaints and information the home had sent us called notifications. While we were there we looked around to check if the home was a safe and comfortable for people Care Homes for Adults (18-65 years) Page 8 of 34 Two peoples care plans told us what people needed. We spoke with staff and looked at what was going on to check if they were getting the right support. We looked at staff records to make sure that the right checks were made to keep people safe. We also spoke with staff about their work and the training they had. Managers spoke with us and we looked at records to check whether the home was run for peoples benefit. Care Homes for Adults (18-65 years) Page 9 of 34 What the care home does well Teignmead is a comfortable and homely place to live. People get the chance to visit the home before they decide to move in. The home makes sure it can meet their needs before they move in. Care Homes for Adults (18-65 years) Page 10 of 34 There are good plans so that staff know what people need and how to support them. People can make choices about what they want to do each day. There is good support for people to join in activities in the local community. They also have the chance to do new things and develop their skills and interests. The home helps people to stay healthy Care Homes for Adults (18-65 years) Page 11 of 34 Peoples complaints are taken seriously. Staff know how to keep people safe and protect them from abuse Staff are well trained and supported to do their work. They know what help each person needs. Managers make sure the home is run for the benefit of people who live there. Care Homes for Adults (18-65 years) Page 12 of 34 What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 13 of 34 If you want to speak to the inspector please contact Graham Thomas CQC South West Citygate Gallowgate Newcastle upon Tyne NE1 4PA Tel: 03000 616161 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 14 of 34 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 15 of 34 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. Standards 2 and 4 The home has good systems in place to make sure it can meet the needs of people who might move in. This includes well-managed trial visits. Evidence: In the AQAA self assessment sent to us before the inspection, the home told us Newly admitted service users are fully involved in their admission, given lots of opportunity to find out about the home, the people and what their life would be like there. Their needs are fully assessed and understood before they are admitted. The organisation have policies and procedures in place which provide comprehensive guidance to ensure that a thorough assessment of needs is undertaken prior to a place being offered to a new service user. At the time of our visit one person on a trial placement. We looked at records concerning the admission process and discussed the process with staff and the management team. This process involves links with the local Additional Support Team. An initial visit is made to assess the person and information gathered from relevant professionals such as Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: Occupational Therapists and Speech and Language Therapists. Where possible the homes staff meet with the persons parents or representatives who can visit the home. This is followed by a three night trial stay in the home so that an informed choice can be made. Information about the home is made available to people involved in the decision for someone to move in. The home provides a service to people whose bahaviour presents significant challenges to services. We saw that the staff and management were managing the trial placement well and had thought carefully about the needs of the person and people already living in the home. Much emphasis was being placed on maintaining calm within the home and staff were skilled and thoughtful in achieving this goal. Staff were deployed to provide activities and outings during the day and were present in sufficient numbers to ensure that the process would provide a good experience for the person new to the home. Care Homes for Adults (18-65 years) Page 17 of 34 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. Standards 6, 7 and 9 People living at Teignmead can be assured that their needs, interests and goals are well understood. They are supported to achieve their goals through an excellent approach to risk assessment and management. Evidence: We looked at the care plans and individual records of two people living in the home. In the individual plans we saw that information was clearly and concisely presented. The plans identified clear goals for each individual based on their needs, choices and interests. This included, for example, attending the local community college. There were also comprehensive accounts in the plans of the individual challenges people might present to the service. The approach evident in this element of the plans reflected the level of specialist experience, expertise, training and leadership in the service. Daily records were detailed and objective and confirmed that staff were supporting individuals towards meeting the individual goals in their plans Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: Our discussion with staff and observation of life in the home confirmed that they clearly understood peoples individual needs and challenges. Staff confirmed that they referred to individual plans for guidance on meeting individual needs. They also gave clear accounts of how peoples individual challenges might be anticipated and managed in a positive way. During our visit we saw people being offered choices and supported to make decisions about their daily activities and routines. Each persons plan contained a detailed set of individual risk assessments relating to routine activities such as shaving, cooking, ironing and other developmental activities such as cycling and canoeing. These provided staff with clear and specific guidance on the risks, their management and why taking these managed risks was important for the individual. Staff had signed these assessments to demonstrate that they understood and agreed with them. We saw that the homes approach to risk and its assessment supported individual development by offering a wide range of opportunities based on individual need and interest. The care plans and risk assessments showed evidence of review and adjustment according to ongoing assessment and changing needs. Care Homes for Adults (18-65 years) Page 19 of 34 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. Standards 12, 13, 14, 15, 16 and 17 There is excellent individualised support for people living at Teignmead to pursue their chosen activities and develop their skills. Evidence: The Annual Quality Assurance questionnaire returned to us by the home told us, Service users are encouraged to develop their skills and knowledge. Service users receive development incentives which might be a wage or additional activity; it would demonstrate a value on what has been achieved. There is excellent opportunity for hobbies and interests. These currently include photography, golf, darts, swimming, films and music. Individual holidays are organised where appropriate.Outings for work and leisure are a normal feature of life at the home. During our visit we saw that people living in the home were being very well supported to follow individual routines according to their choice. One person was on a trial placement. There were sufficient staff on duty to support this person as well as maintain the lifestyle Care Homes for Adults (18-65 years) Page 20 of 34 Evidence: of others living in the home. This included support for spontaneous trips and activities that were taking place during our visit. Individual records showed that activities were tailored to individual needs and interests. As well as risk assessments, the individual records gave staff very specific guidance and instructions on supporting people in activities such as swimming, cooking, cycling and canoeing. We also spoke with one person about the holidays they had enjoyed whilst supported by the homes staff. We saw that one person had been supported to attend a course at a local community college. Another person was being supported with a specific job schedule. People were being encouraged to develop their individual skills through the development incentives mentioned in the services AQAA. These were individually arranged to suit each persons motivation and needs. Each persons plan described the arrangements for family contact. Other records confirmed that people were able to spend time with their families. The home has a cordless telephone facility for people living there. Our inspection of the home confirmed that the home was well stocked with plenty of food including fresh fruit and vegetables. Our examination of menus and discussion with staff confirmed that meals are organised on a weekly basis taking account of the individual tastes and preferences of people living in the home. These preferences were identified in individual plans as well as any specific dietary health needs. Care Homes for Adults (18-65 years) Page 21 of 34 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. Standards 18, 19 and 20 People living at Teignmead receive good, individualised personal support and healthcare. Evidence: Before our visit the service told us in their Annual Quality Assurance assessment: Personal support is provided according to service users preferences, which are clearly documented in care plans. Bedtimes, baths and meals are flexible. These particular preferences are well understood by staff and adhered to. There are communication tools in evidence that are particular to individuals. Implementation of these aids have impacted positively on service users confidence and in conjunction with other intervention techniques have helped reduced the incidence of challenging behaviour overall. There is comprehensive evidence within care plans that consultation with a range of health care professionals is instigated by the home to ensure that service users health care needs are met. Staff know service users so well that any signs of distress or illness are acted upon and medical intervention is sought without delay. All service users received regular checks with dentists, audiologists, speech and language therapists and psychiatrists where appropriate. During our visit we saw that individual routines such as breakfast time were tailored to Care Homes for Adults (18-65 years) Page 22 of 34 Evidence: individual preferences we also saw that there was sufficient flexibility to allow for spontaneous activity. People were dressed in their own clothes in nidividual styles reflecting their own tastes. People living at Teignmead have all presented services with significant levels of challenge. Senior staff receive training at the Tizard Centre, a centre of excellence in this field. This understanding is translated into practice through staff training and clear guidance about the challenges each person might present, and how these might be averted and/or managed. Our conversations with staff confirmed that they were aware of and understood each persons support needs. The records we examined showed that the home maintained links with local specialist learning disability services and professionals such as Psychiatrists and Psychologists. We also saw individual records relating to routine health checks such as dental appointments and more specialist health needs such as plastic surgery. None of the people living at Teignmead has the capacity to manage their own medication and it is therefore administered by staff. We saw that medication in the home is securely stored, with additional security and recording for controlled drugs. Staff training records showed that staff administering medicines have received appropriate training. Medicines are supplied from the pharmacy in individual containers. the medicines are then transferred to individual packs by the homes staff. This practice is known as secondary dispensing and does not accord with the best practice recommended by the Royal Pharmaceutical Society. However, we saw that the home had robust checking systems to ensure that any errors could be identified immediately. We saw that there had been no medication errors and were satisfied that the system in place was sufficiently safe. Care Homes for Adults (18-65 years) Page 23 of 34 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. Standards 22 and 23 People living at Teignmead be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through the strong leadership culture of the service. Evidence: Examination of our own records before our visit showed that the Care Quality Commission has not received any complaints about the home. People living at Teignmead would be unlikely to use a formal complaints procedure. However, we saw that the home does have a complaints procedure in place and a system to record any such complaints. These records showed that no complaints had been received. We saw that people using the service were very relaxed in the presence of staff. The senior management of the service has a very robust approach to the protection of people from abuse. This was reflected in our discussion with senior managers and staff about safeguarding and staff disciplinary procedures. Our discussions with individual staff confirmed that they had received training in safeguarding vulnerable adults from abuse. Each staff member was able to identify clearly how they would report any abuse suspected or witnessed and what their expectations would be. Care Homes for Adults (18-65 years) Page 24 of 34 Care Homes for Adults (18-65 years) Page 25 of 34 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. Standards 24, 26, 28 and 30 People living at Teignmead enjoy a comfortable, well-maintained environment suited to their individual needs and preferences. Evidence: Teignmead is is a substantial property situated on the main road between Teignmouth and Newton Abbot. Access to the premises is via an automatic electric front gate. This allows free access in and out of the property whilst giving time for staff to intervene should anyone living in the home be at risk of wandering onto the main road. The area at the front of the property is used mainly for parking. There is further outside space at the rear of the property. Inside, we found the home to be decorated and furnished to a high standard in a homely and comfortable style. Peoples own accommodation reflected their individual tastes and preferences with plenty of space for personal possessions. Where peoples individual behaviour might place them and the property at risk, appropriate adaptations have been made such as, for example, tamper-proof light fittings. Care Homes for Adults (18-65 years) Page 26 of 34 Evidence: We saw that risk assessments had been carried out for the environment including, for example, hot water and risks from hot surfaces. A high standard of maintenance was evident in our tour of the premises and was further demonstrated by records such as those for testing personal electrical appliances. We saw that all areas of the home were clean and free from obvious dangers such as hazardous substances which were kept in locked cupboards when not in use. We looked at the measures in place to control infections in the home. The laundry facilities included the capacity for hot washes and were clean and tidy. Arrangements for handling laundry were safe. Liquid soap was available around the home. Care Homes for Adults (18-65 years) Page 27 of 34 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. Standards 32, 34 and 35 People living at Teignmead are very well supported by an enthusiastic, well trained and supported staff group. Evidence: In surveys returned to us before our visit, staff commented very positively about their work and the support they received to do it. One commented, Its a great place to work - I can actually say its the best job I ever had!. Others referred to the exceptional training programme and good team approach Our observations when visiting the home confirmed this very positive attitude. Staff displayed a relaxed and supportive relationship with people living in the home. In conversation, they had a very clear understanding of their roles, responsibilities and the needs of the individuals they were supporting. We looked at the file of a recently recruited staff member. This showed that there was a robust recruitment procedure in place including a formal application, references and criminal records checks before the person started work in the home. This staff member confirmed that he was receiving a structured induction which includes Care Homes for Adults (18-65 years) Page 28 of 34 Evidence: staged reviews at one week, one month, three months and so on. This staff member described the support and close coaching provided during this induction as fantastic and described how work with people living in the home was carefully structured to account for his level of training and experience. In discussion, other more experienced staff displayed a very clear understanding of their roles and responsibilities. This included an understanding of the limits of their roles and a detailed understanding of the needs of individuals they were supporting. Training records were seen and training was discussed with individual staff members. This confirmed that people were receiving training in health and safety topics such as food hygiene and first aid. There was also training related to the particular needs of people living in the home. For example, all staff receive SCIP training about interventions when peoples behaviour challenges the service. A programme of training for National Vocational Qualifications (NVQ) was also in place. One person with whom we spoke was undertaking the services management training programme and was completing an NVQ at level 3. Care Homes for Adults (18-65 years) Page 29 of 34 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. Standards 37, 39 and 42 Teignmead is very well managed for the benefit of people living there. Evidence: The Registered Manager of Teignmead is a director of the company. He is experienced in meeting the needs of people with learning disabilities whose behaviours challenge services. In addition to management training he has also undertaken specialist training at the Tizard Centre, a centre of excellence in this field. The owner and managing director of the company also maintains a regular presence in the home. He also has considerable experience and specialist training in this field. Both were present during our inspection visit. Staff made very positive comments about the management team including: ....The management are very approachable and always strive to help sort out queries or problems. and good management team. Care Homes for Adults (18-65 years) Page 30 of 34 Evidence: In our discussions with staff and the management team it was apparent that everyone was very clear about their roles and responsibilities and that management support for staff was of a high standard. The records we saw were generally very well maintained and provided guidance for staff that was clear and easy to follow. Regular meetings are held with staff and the needs views of people living in the home appeared paramount in the ethos and practices we have described in the previous sections of the report. We saw evidence that regular visits to the home are conducted by the Responsible Individual as required by regulation. These form part of the homes system for monitoring the quality of the service provided. A quality assurance checklist was seen with key quality indicators based on the needs of the people living in the home. We saw that health and safety issues were being well managed. For example, we saw evidence of recent gas safety and electrical checks. We also saw an environmental Health report that referred to good standards hygiene in relation to food. Care Homes for Adults (18-65 years) Page 31 of 34 Are there any outstanding requirements from the last inspection? Yes  No  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 32 of 34 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 Description 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 Description 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 33 of 34 Helpline: Telephone: 03000 616161 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) 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. Care Homes for Adults (18-65 years) Page 34 of 34 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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