Care Home: The Mill House

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What the care home does well This inspection found, as did previous inspections, that resident`s needs are met at this home. Residents were seen to be relaxed and enjoyed good relationships with their care workers. Since the last inspection a number of initiatives have been undertaken by the manager. People are now asked if they would like to write any questions they may have for staff that are to be recruited. This is the first step to residents joining interview panels and having a real say in who they wish to work at the home. Person centred care plans are undertaken, with the full involvement of residents, who also attend all reviews. People are supported in writing on flip charts their views and requests for the type of care that they prefer, which they present to their review. Six of the eight people living in this home attend college placements, undertaking educational and vocational training. Activities are discussed with residents who complete their own programmes for both activities and meals that they prefer. All individual activity programmes are posted on the notice board for the information of residents and staff. One resident stated that she came to look at the home before moving in and staff made her feel welcome. She also stated that staff are kind to her and that `it is a very good home, better than others` she has been in. She also felt that she liked the activities available to her, especially working with the birds of prey. What has improved since the last inspection? The manager commented that the training programme has ensured that the majority of staff have either enrolled or completed a national training course level 2 in caring for people with a learning disability. There is also a computer training system which all staff are required to complete, which addresses the induction training of staff, as well as various other training requirements. The staff rota has changed since the last visit into a more flexible timetable based on the needs of residents and courses or activities they attend. What the care home could do better: The manager was advised about the Mental Capacity Act 2005 and how this addresses the rights of residents. Care plans now need to reflect any assessments, decision making and planning if a person does not have mental capacity. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Mill House The Mill House Cliff Top Ingham Lincolnshire LN1 2YQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Douglas Tunmore     Date: 2 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Mill House The Mill House Cliff Top Ingham Lincolnshire LN1 2YQ 01522730130 01522730153 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Thelma Turner Homes Limited Name of registered manager (if applicable) Mrs Lynne Louise Gaskin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Mill House is an adapted detached property, situated on the edge of the village Ingham. Local facilities include a post office, village shop, GP surgery and public house. The home has its own mini-bus to enable residents to access other facilities within the community. The property stands in its own grounds and gardens, which includes aviaries, with birds of prey and other small animals that service users care for. The home provides accommodation for 8 service users who have a learning disability and accompanying challenging needs and behaviours. Communal facilities are on the ground floor, as is one service users bedroom. All service users have single room accommodation, with one room having en-suite facilities. A detached bungalow at the front of the main building offers separate accommodation with en-suite facilities for 2 service users working towards independent living. There are car-parking facilities to the front of the building. Care Homes for Adults (18-65 years) Page 4 of 29 care home 8 Over 65 0 8 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is three star. This means the people who use this service experience excellent quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). We took into account previous information held by us, including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Care Homes for Adults (18-65 years) Page 6 of 29 Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We received five surveys from residents in which a few were supported for its completion. The main method used to carry out the inspection is called case tracking; this includes following the care of a sample of one person through their records and assessing their care. We spoke with one staff member, the registered manager and the residents social worker who was being case tracked. The manager was informed of the general outcomes of this inspection. The current weekly charges for the service as confirmed by the manager is one thousand three hundred and nineteen pounds, an additional cost of eleven pounds fifty two pence is charged for one to one supervision of a resident per hour. Information about the day-to-day operation of the home, including a copy of the last inspection report, can be found in the homes statement of purpose and service user guide. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Care Homes for Adults (18-65 years) Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home receive clear and detailed information to suit their needs to enable them or their relatives, social workers and advocates to make an informed choice as to whether or not they wish to live in this home. Where a person is referred to the home they receive a comprehensive assessment to ensure that their needs can be met. Evidence: A review of all information available prior to this inspection and evidence seen at a previous inspection carried out in 2007 demonstrates that the home would admit residents only after a full care needs assessment has been undertaken with other health care agencies. Social workers and psychiatrists and other health care workers carry out assessments if required. We looked at the file of one person who was being case tracked, which demonstrated that an assessment of care needs had been carried out and included the prospective resident, their family, social worker and the manager. Other reports were also Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: available from a psychiatrist and a previous placement. The prospective resident also undertook pre-admission visits to get to know other residents and view her bedroom. A letter was also sent confirming that the provider could meet the residents needs. The files showed that the resident had been given a service users guide and the care needs assessment was found to give detailed information relating to the residents health care needs, behaviours and those prompts required to ensure the well being of the resident. The admission process was carried out in a sensitive manner focusing on the positive outcomes for this resident in ensuring that facilities and a key worker and especially specialist services would be provided. The resident confirmed that she was made welcome at the home and that, two care staff from her previous home escorted her to Mill House on three separate occasions before she was admitted. The providers AQAA confirms that they are currently supporting a resident where a mental capacity assessment has been undertaken in relation to her best interests and their duty of care. Five surveys from people showed that they had visited prior to moving into the home. Specific comments were that I came on a day visit with questions I needed to ask. I had two day visits and an overnight stay, a social worker and my mum and my advocate asked me to visit the home and participate in activities. A survey showed that people had received a welcome pack informing them about what the home has to offer. Care Homes for Adults (18-65 years) Page 12 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. Residents are fully involved with their care planning including their risk assessments. People are encouraged to make decisions for themselves and be independent with the support and guidance of staff. Evidence: A review of all information available prior to this inspection and previous key inspections show that residents had an individual detailed care plan. We looked at those care plans of a resident who was being case tracked and found reviews are undertaken on a regular basis and reflected the changing needs of the resident. The home has a care plan questionnaire, which explores with residents their care plans, risk assessments and there purpose. These questionnaires were seen and evidenced that residents are actively involved with planning their care and understanding what their individual care plan is for. All care plans seen were different and creative and showed that the service puts value Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: on improving the quality of life for people using this service. A resident confirmed that she had been doing questionnaires relating to her care for a review which was held on the 25th March 2009. She had also completed with support from her key worker a flip chart highlighting her views, requests and future needs using writing and smiley faces for this meeting. This information is kept and used as part of her care plan for mapping her future needs. Residents files seen showed that relatives are contacted regarding issues affecting their sons or daughters. This visit found that residents risk assessments and reviews are signed by residents agreeing to the risk identified and or the change in their care plan and how this might effect their daily living. We looked at one file and found that it is visited regularly by the resident with their key worker and all entries are documented and signed by both parties. A social worker was contacted who stated that I have a lot of time for this home they are excellent for what they do. The management of the young people shows that they have insights and knowledge of Prada Willi Syndrome. I have placed two people here and both have lost weight and done very well. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be involved in meaningful and appropriate activities, which include educational and recreational activities. They enjoy varied and nutritious meals which they are fully involved in planning. Evidence: Regular house meetings are held in which residents are empowered to raise any issues and discuss the running of the home. Residents surveys show that I attend meetings and have a key worker that helps me. Other specific comments were I have a activities programme that I have chosen. I decide what I want to do. I like college. All surveys evidenced that they have an activities coordinator who plans all activities with individual residents. Surveys also showed that people make decisions about what they want to do each day. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: During this visit residents were seen writing their weekly timetable with the support of their key worker. Weekly programmes are on display in the dining room for the information of residents so that they know each days events they are undertaking. We looked at these timetables which showed that; a full and diverse programme is available for individual residents. The programme includes both activities and outings such as, working with the birds of prey and other small mammals, outings for shopping, visits to the local leisure centre and developing independent living skills. Residents also attend club 87 where they meet residents from other care homes. The minutes of the last residents meeting also identified that residents are engaged in planning holidays and outings for the coming year. Five people also attend college courses in different parts of the county due to their specific learning requirements. Courses provide National Vocational Qualifications (NVQ). Another resident also undertakes voluntary work during the week at a charity shop Previous inspections have found that residents have keys to their rooms and they confirmed that neither staff nor other residents can enter without getting their permission. They also stated at this inspection that they are involved in learning daily living skills by keeping their rooms clean and tidy, cleaning the mini-bus, budgeting and undertaking college courses which promote their independent living skills. A resident stated that she had a bedroom on the first floor and that staff have to knock before they can come in. She also confirmed that she undertakes activities and she especially liked working with the birds of prey. She felt that staff were very kind and stopped other residents getting involved when she is eating. The home was refurbished in 2007, with a separate pantry were food is kept locked due to a number of residents having Prader Willi Syndrome, which is an eating disorder where people are unaware when they have eaten enough. Due to this, residents and care staff work together to monitor food intakes and work out calorie needs of each resident. We looked at a residents file who was being case tracked, which showed that she is weighed on a regular basis as well as obtaining dietary advice when required. The inspector observed people completing weekly menu sheets which showed that they all had separate menus, which they signed to agree their food requirements for that week. Care Homes for Adults (18-65 years) Page 16 of 29 Care Homes for Adults (18-65 years) Page 17 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. People benefit from being fully involved in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that peoples health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. Evidence: Previous inspections have shown that there are satisfactory policies and procedures with systems in place relating to the administration of medication. This includes residents being responsible for their own medication if assessed as able to do so. One resident stated that she does not administer her own medication. The manager confirmed that none of the people in the home currently administer their own medication due to the high risk factors. Risk assessments were seen reflecting the reasons why individual residents do not self administer medication. These risk assessments had also been signed and dated by residents agreeing to this practise. The pharmacist visited on the 6th January 2009 and recorded that storage and stock Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: control was very good and no signatures were found to be missing from medication sheet. On the day of this visit an accurate record was available for medication given to residents. Training certificates dated 11th June 08 was seen relating to those care workers charged with the administration of medication. We looked at a residents file which showed dates of referrals and visits to or from doctors, psychiatrists, chiropodist and consultant physicians. Evidence was also available that eye tests had been undertaken as well as visits to the dentist. A residents file also showed that care plans highlighted those areas in which residents required prompts in various aspects of their daily living. A carer commented that all residents are very able but prompts are sometimes given regarding personal care issues. Care Homes for Adults (18-65 years) Page 19 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 a robust complaints procedure in place. There were good systems in place to ensure the safety of residents. People are listened to and action taken regarding their wishes and concerns. Evidence: Previous inspections have found that the homes complaints procedure is available in each residents bedroom. A pictorial format is also available for residents information. All complaints received are dealt with either by the key worker, manager or the providers. The resident is empowered to nominate who they wish to investigate their complaint. The homes complaints file showed that four complaints have been made since August 2008. All complaints had been dealt with and letters were sent to complainants informing them of the outcome of their complaint. There are residents suggestion forms which people can complete and post to the manager or the provider, these are treated as completely confidential. Restraint has been undertaken on twenty one occasions, seven being none physical and fourteen being physical restraint since August 2008. Full documentation was available, which showed that reviews were undertaken after such an event to ascertain action taken and reasons why the incident occurred. A file of one resident who was being case tracked showed that she had been involved in a review following being Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: restrained. The commission had been informed of all restraint undertaken by staff at this home. It was also documented that peoples social workers, psychiatrist and doctors had been involved in reviews regarding the restraint of residents. One resident said that staff are nice and they help me make my bed and keep my room tidy. She also confirmed that she has been restrained. She stated that she isnt restrained a lot and I dont think they should do it. The manager was informed of this comment and made contact with the residents social worker to arrange a best interest meeting for the week beginning the 30th March 2009. The manager stated that this issue must be reviewed and action taken regarding this residents wishes, which we take seriously. Training profiles seen showed that thirteen staff have undertaken applied physical restraint training, which is designed to protect people from physical harm. Training has also been undertaken in protecting vulnerable adults by all staff. A member of staff confirmed that she had undertaken the above mentioned training and was aware of who to contact if she had any concerns. All residents surveys indicated that they know how to make a complaint if they need to. Specific comments were, yes we all have a form for making a complaint,and I have made a complaint before and staff have helped me and the manger sorted it. All surveys evidenced that residents felt that staff treat them well. Comments were the staff are very good, they support me and help me if I have a difficult day, and staff listen to me, I worked hard to get my college. I have got a good key worker. Care Homes for Adults (18-65 years) Page 21 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 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 clean, safe, and comfortable accommodation suited to their needs. Evidence: A previous inspection of this home in 2007 found the home to be clean, tidy and comfortably furnished. This visit found the home to be clean and no offensive odours were detected. Staff confirmed that maintenance issues are attended to promptly. People we spoke to told us they liked their bedrooms. The manager confirmed that new washing machines and driers had been purchased since the last inspection and the utility room had been refurbished. Grab rails and hand rails had been fitted for the use of one resident and a wet room had also been created. The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use this service who live there. One residents confirmed that she likes her room and carries out chores to keep her room tidy 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a safely recruited, well-trained, established, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: This inspection found that recruitment practises were in place and one staff file contained all of the documentation required by law. It was also found that interview notes of a new care worker employed at the home are kept for possible future reference. One carer stated that she had undertaken the homes recruitment process and confirmed that references and criminal record bureau checks were acquired prior to stating work at this home. Information received from the provider prior to this inspection showed that there are guidelines relating to the recruitment of staff. Previous inspection has found that each worker in the home has been given the General Social Care councils pack relating to the registration of care workers and the philosophy of the Care Council for all social care homes. The homes training plan identified the registered manager and those care workers who Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: had undertaken training in 2008. Out of nineteen staff thirteen had completed National Vocational Qualifications level 2 or above and two staff are progressing in NVQ level two. One staff member stated that she has undertaken fire procedures, Prader Willi Syndrome training, health and safety and basic food hygiene, manual handling, medication, and non physical intervention. She was also able to demonstrate a clear understanding of her role and responsibilities. She also reflected on restraining residents and that we dont do it unless its really necessary as it is not good for their dignity or ours. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and staff benefit from the positive leadership of the manager. Management record systems show that residents health, welfare, safety and choices are promoted. The management team ensures that the people living in the home with the support of the staff have the opportunity to voice their views and opinions. Evidence: The manager has worked for this company for eight years and has achieved the registered managers award and NVQ level 4 in care. She has an open door approach to both residents and staff who require support and guidance. A social worker stated that this is a good home and I have two residents placed here. She also commented that there is good communication with the manager, family and herself. This team she said are very knowledgeable regarding the needs of my clients who have Prader Willi Syndrome. The manager provides an excellent role model for her staff. Over the years visiting professionals have made positive comments regarding her ability to successfully Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: manage this home and enable people living their to engage with her regarding their needs relating to having Prader Willi Syndrome. She has robust operational system and is highly competent is a range of areas. The manager keeps the commission informed of any absences and who would carry out her duties in the home. One member of staff confirmed that the manager is approachable and listens to any problems staff may have. She is also keen for us to undertake further training, which is beneficial to us and the residents. Residents surveys were very positive in relation to the outcomes for them in living in this home. Remarks made were, I feel it is a good home for me they know how to deal with things that I find hard. Mill House has helped me with my weight. Other comments were, I like it and I want to continue to live here and I like the flat and all the activities. In house surveys were seen to cover a variety of areas in which all eight residents made very positive comments. The outcome of these surveys are posted on the residents notice board along with the last commission inspection report. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks are carried out. Staff also receive fire training as part of the homes initial training and as a regular training event so as to help ensure the safety of residents and care staff. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that support plans include reference to the Mental Capacity Act, 2005 and the effects it has upon peoples lives. This is to ensure that their rights and choices are protected. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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