Care Home: The Oaks

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What the care home does well Detailed care planning involving the individual means people living at the home know their personal, health and social care needs will be met in a way they prefer. People living at the home are encouraged and supported to make choices about their daily lives and influence the running of the home. People have opportunities to make their own decisions about their lifestyle, including whether to take courses at colleges, take part in activities at the home and make decisions about holidays they want to go on. Medication practices protect the wellbeing of people living at the home. Procedures are in place to enable people living at the home and their representatives to make complaints about the service. What has improved since the last inspection? Policies and procedures about the protection of vulnerable adults that include details about the local authority`s safeguarding procedures are now in place and all staff receive training about the protection of vulnerable adult. Improvements have been made to staffing issues including ensuring all recruitment checks are obtained prior to a person commencing employment at the home, regular formal supervision for staffmembers, improved provision of training and consistent staffing numbers. There is a staff team in suitable numbers that has the knowledge and skills to support the people living at the home. Improvements have been made to the environment. These include the provision of tracking hoists, replacement of broken furniture, the provision of laminate flooring and improvements to the cleanliness of the home. There is now a registered manger running the home. What the care home could do better: No requirements have been as a result of this inspection, but the manager has highlighted several areas for further improvement in the forthcoming year. These include the provision of suitable storage space for staff members to secure their personal belongings and exploring ways to support people living at the home to access leisure activities in the evenings. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Oaks 91 Hulbert Road Bedhampton Havant Hampshire PO9 3TB 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: Gina Pickering Date: 2 6 0 1 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. 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 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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.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: The Oaks 91 Hulbert Road Bedhampton Havant Hampshire PO9 3TB 02392412430 02392413193 dolphin.homes5@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dolphin Homes Ltd care home 8 Number of places (if applicable): Under 65 Over 65 8 8 8 0 0 0 learning disability physical disability sensory impairment Additional conditions: 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). Physical disability (PD) Sensory impairment (SI). The maximum number of service users to be accommodated is 8. Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home The Oaks is a large detached house that has been converted to provide support and accommodation for up to 8 people who have learning disabilities and associated physical disabilities. Bedrooms are situated on the ground and first floor and there is a lift, which provides access to the upper floor. All bedrooms and communal areas are fully wheelchair accessible. The home is situated in a quiet residential area and is situated close to local shops and access to public transport services. The home has a minibus that is equipped to provide transport for physically disabled service users. Dolphin Homes Limited manages the home. Basic fees at the home range between £900 - £1249 per week. Service users are responsible for paying for their own chiropody, toiletries and items of a personal or luxury nature. 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 Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The inspection process considered information received by the Commission about the service since the last key inspection in February 2008. This includes information provided to us in the form of an Annual Quality Assurance Assessment which was completed by the registered manager in which he told us how the service has developed over the past twelve months and how he proposes to continue to improve the service. We surveyed people who use the service , staff and health care professionals who have input into the service. We received responses from five people living at the home and two staff members. Information received from these surveys has been used to inform the inspection process. We visited the home on 26th January 2009 during which time we spoke with all people living at the home and and three staff members as well touring the environment and looking at documentation as part of the inspection process. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well What has got better from the last inspection Policies and procedures about the protection of vulnerable adults that include details about the local authoritys safeguarding procedures are now in place and all staff receive training about the protection of vulnerable adult. Improvements have been made to staffing issues including ensuring all recruitment checks are obtained prior to a person commencing employment at the home, regular formal supervision for staff Care Homes for Adults (18-65 years) Page 8 of 29 members, improved provision of training and consistent staffing numbers. There is a staff team in suitable numbers that has the knowledge and skills to support the people living at the home. Improvements have been made to the environment. These include the provision of tracking hoists, replacement of broken furniture, the provision of laminate flooring and improvements to the cleanliness of the home. There is now a registered manger running the home. 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 9 of 29 If you want to speak to the inspector please contact Gina Pickering 33 Greycoat Street London SW1P 2QF 02079792000 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 Care Homes for Adults (18-65 years) Page 10 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 11 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 . Information is provided to people at the home so they have understanding about the running of the home and the service provided at the home. Procedures are in place to ensure the home is be able to meet a persons needs when moving into the home. Evidence: The AQAA told us the statement of purpose and service user guide have been revised and are included in each persons care planning documents. This document is written in plain English and has pictorial images to demonstrate the information in the document to assist peoples understanding of the content. People we spoke with at the home were able to confirm they have seen the service user guide and in each persons file there is a signed statement from the manager detailing that he has read and discussed the service users guide and statement of purpose with the person living at the home. No new people have moved into the home since the last inspection. Policies and procedures are in place that include visits to the home and assessments of the persons need should there be vacancy at the home. The manager demonstrated his understanding of the importance of assessing the persons needs and allowing time for the person to visit the home to ensure the home will be able to meet that persons Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: needs. Care Homes for Adults (18-65 years) Page 13 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 . People living at the home know how their changing needs will be met by the use of clear care plans. People are encouraged to make choices and are supported to take risks to lead an independent life as possible. Evidence: All people living at the home have their own individual plan of care. At the previous key inspection in fenruary 2008 it was reported that manager was in the process of updating care plans making them more age appropriate for people living at the home. We looked at three care plans, with two of the people living at the home showing us the details in their care plans and confirming to us the plan details their choices about the lifestyle they like to live. Plans detail the persons needs, aspirations, likes, dislikes, wishes and social interests. Each plan includes details about how the individual likes to be supported in respect of communitarian and how to support them if they are anxious. For example one plan has descriptions and photos of the persons favourite communication signs(makaton), another describes the support to be provided by staff to help that person manage his emotions and needs when he becomes upset. Plans are written in language that can be easily understood and for Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: people who have communication problems pictures and symbols are included to represent relevant information. Two people living at the home were able to discus the details in their care plan and told us they understand the details in the plan. It was evident from observation and discussion people living at the home people make decisions about their life and daily activities. People confirmed in conversations they had chosen to discontinue attending college and attend in house activities and learning opportunities experiences as an alternative. House meetings are held and records of these indicated people have a choice over the meals provided activities happening within and outside the home and with the routines of the home. People living at the home are encouraged to be as independent as possible. The AQAA told us that risk assessments are in place to identify risks or hazards and details are included about how identified risks are to be minimised. Risk assessments are included in the service user plan that detail the risk, the persons understanding of the risk, the support needed and ways in which the risk can be minimised. Care Homes for Adults (18-65 years) Page 15 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 . People living at the home have the opportunity to make choices about their lifestyle and are able to take part in activities and learning experiences they enjoy. People have healthy diets are are involved in the choice of meals. Evidence: Information about each persons interests and activities are detailed in the individuals care plan documents. Examples of this include one person likes trampolining, swimming and shopping whilst another person prefers chatting, going out for meals and having their hair pampered. It was evident from observation that the daily routine is developed around the interests and activities that people living at the home are taking part in. Some attend one of two local colleges, whilst others who chose not to attend college take opportunity of activities arranged by a visiting organisation such as cooking, gardening and arts and crafts. People we had conversations with told us about their interests and college courses they were attending and confirmed they chose what activities and course to take part in. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: People living at the home do not have many family visitors, only one has regular contact with family members. The manager spoke about how support and training has been provided to the family members so the individual is well supported by his family when visiting them. People living at the home are encouraged to be involved in all decisions about the running the home. Weekly house meetings are held to which all people living at the home are invited. A record is kept of these meetings, evidencing that people can raise concerns or requests during these meeting as well as planning menus, individual activity and house activities. One of these meting took place whilst we were at the home. During the meeting the menu for the day and the week was discussed along with plans for group activities. Pictures of meals are provided to support people in making choices about their meals. It was noted that for lunch, meals were being made individually according to the wishes of each person living at the home and the main meal in the evening was resulting in the cooking of two different meals according ot the wishes of people. A record is kept of the food choices. 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 . Effective care planning means people receive care and support in the way they like and their health needs are met. Good medication practices mean people have their health protected. Evidence: Care plans give clear details about how personal care should be given. Examples include I am able to brush my own teeth, but will need you to put the tooth paste on my toothbrush. and I need a lot of verbal encouragement and verbal prompting to carry out many of the hygiene tasks. It is clear from conversations with people living at the home that the detail in the plan is an accurate description of how they like to be supported with their personal care. Care plans detail the involvement of a wide range of health care professionals including the learning disability team, orthoptists, GPs, dietitians and opticians. The manager discussed with us the close working with health care professionals to improve the health and wellbeing of people living at the home. This includes working with GPs and the dental services to support people to have dental work undertaken, and working with the learning disability team to reduce the anxieties of one person about accessing the community. The home also works with health care professionals to Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: develop care plans for specific health issues. For example for a person with diabetes a care plan has been developed by the community nurse detailing how to recognise if that person is suffering from low or high blood sugar levels and the action to take in each scenario. Policies and procedures are in place for the management of medication, including procedures of people managing their own medications. At the present time no one living at the home manages their own medications. We looked at the medication administration records (MAR) sheets for people living at the home. Two members of staff sign for every medication given, one person administering the medication and one witnessing the administration. The record clearly details the medication administered at what time and what dosage. For medications prescribed to be taken as required clear information is included in the medication records detailing the indications that show the medication is needed, the expected outcome after having the medication, the dose and any contraindications to having the medication. 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 . People living at the home are protected against the effects of abuse by a staff team that has a good understanding about safeguarding procedures. Procedures are in place to enable people to voice complaints. Evidence: People living at the home have access to a clear complaints procedure. Each person has a copy of the procedure on their care plan file. The manager has signed that he has read and discussed the procedure with each person. Discussion we had with people living at the home indicated they would happily express concerns or complaints to staff members or the manager. The complaint log book details that no formal complaints have been recieved by the home in the past twelve months. Records detailed concerns are discussed and resolutions found for them during the regular house meetings. Staff we spoke with indicated they would respond to complaints made about the service in line with the homes complaints procedure. Since the last inspection then the home has obtained a copy of the local authorities adult protection procedure. Staff told us they have received instruction about safeguarding and safeguarding issues are discussed on a regular occurrence specially at supervision sessions. Staff we spoke with demonstrated a good understanding about the different types of abuse a person can suffer and they would take the appropriate action if they suspected an act of abuse was occurring. 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 . People live in a home that is well maintained and has the relevant equipment to meet their needs. Evidence: At the last key inspection in some areas of the environment were not well maintained and a requirement was made that the environment must be well maintained and kept safe at all times. The AQAA told us about improvements made to the environment and we looked at these during our visit to the home. Improvements include replacing carpets with laminate flooring which has made it easier to keep clean and easier fo people to use their wheelchairs on, replacement of broken furniture and the provision of a tracking hoist in two bedrooms to further assist with the moving and handling of the persons whose bedroom it is. One of the people who now has a tracking hoist confirmed with us that this and the provision of a new bed has made her transfers from bed to wheelchair more comfortable. People living at the home invited us to look at their bedrooms. All are personalised with choice of their own furniture and belongings in the room. The decor and furnishing of their rooms reflects their personalities and interest. For example one person had pictures of sailing boats and associated items expressing his interest in sailing, another person had separate tanks of fish and terrapins expressing her interests in having and looking after pets. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Concerns were noted with the cleanliness of the home during the last key inspection. The manager told us a cleaning schedule has been implemented. The home was clean and tidy on the day of our visit. Monthly audits of the environment detail maintenance issues referred to the providers maintenance team. Laundering is completed in the homes laundry room which was clean and tidy on the day of our visit with the walls and floors being easily cleanable to reduce any risks of cross infection. Records indicate staff have recieved training about the prevention of infection. 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 . People living at the home are supported by staff in sufficient numbers and who have the skills needed to be able to meet the needs of people living at the home. Evidence: At the previous inspection in February 2007 staffing numbers had been such that the support of people living at the home had been compromised resulting in people being more unsettled. A requirement was made that staffing levels must be consistent to meet the needs of people living at the home. We looked at the staff rota evidencing that four staff are on duty during the day and two staff on duty at night (7pm till 7am). With the exception of unexpected illness, staff rotas detailed that these staffing numbers are consistent. Discussion with staff members indicated they believe there are sufficient staff on duty at any one time to meet the personal and social needs of people living at the home. Indeed during our visit to the home one person living at the home decided he wanted to go into town for lunch and there were sufficient members of staff on duty for a staff member to support him in this impromptu activity. The manager told us he is in the process of negotiating changes to the shift times so that extra members of staff are on duty on Friday and Saturday evenings so people living at the home access the community such as going down to the local pub for a drink or going to the cinema. Concerns were noted at the last inspection that there was a lack of evidence that Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: recruitment checks were being completed prior to a person commencing employment at the home. A requirement was made about this. We looked at personal records for three staff members. They all detailed the persons start date, when Criminal Record Bureau checks were received and that two references have been received. The manager told us that prospective staff are invited back to the home after their first interview to discuss working at the home and meet people who live at the home. By dong this people living at the home are involved in the recruitment process in the fact they can ask questions and voice their opinions about the prospective staff member. Concerns were raised about the provision of training at the last inspection resulting in a requirement being made about the provision of training. The manager told us in the AQAA that improvements have been made to the provision of staff training. All new staff members complete induction training and all staff have personal development plans. We looked at records for three staff members and discussed training with two staff members. Records detailed that new staff have completed induction training that meets the induction guidelines set out by Skills for Care. The induction programme and personal development plan ensure staff receive training in health and safety topics such as moving and handling, fire safety, infection control and first aid as well as other training such as diabetes, epilepsy and water safety award to equip staff with the skills to meet the specific needs of people living at the home including having the qualification to support people to visit a swimming pool. Staff records also contain a plan for supervision sessions and records of supervision sessions. Staff confirmed they receive regular supervision from their manager. This means the home has complied with a requirement made about the provision of formal supervision following the last inspection. The manager told us in the AQAA that seven out of fourteen staff members have NVQ level 2 or above in care. The service indicated its commitment to having a workforce of more than the required 50 of staff members with NVQ level 2 or above in care with a further four staff members registering for NVQ studies, three at level three and one at level two. 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 . The home is run by a competent manager who develops the home to improve outcomes for people living at the home. Health and safety of people living at the home is protected. Evidence: The manager was registered by the Commission in August 2008. He has an NVQ level 4 and the Regsitered Managers Award. He has demonstrated his commitment to improving the service provided at the home and thus improve outcomes for people living there. Examples of this include improvements to the formal supervision and training provision for staff resulting in a skilled and knowledgeable workforce to support people living at the home, and improvements in care planning to make them more person centred. This results in people living at the home receiving care and support in the manner they like and being able to live the lifestyle they chose. Procedures are in place to assure the safety of peoples finances. The home looks after monies for all the people living at the home. money is kept in separately for each person in a locked safe and accurate records are kept of all income and expenditure. Each persons money is checked by two staff members on a daily basis to eliminate the Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: risk of any mishandling of the money. Quality assurance system is in place and used effectively to monitor the environment and care planning documents. A monthly report on the conduct of the care home is completed by the organisation. Continual dialogue and weekly house meetings mean that people living at the home are able to influence the running of the home. Policies and procedures are in place for health and safety issues. Staff training records and their development plans detail training has been provided about health and safety issues such as moving and handling, infection control and first aid. Monthly health and safety audits of the environment are completed. Records detail that concerns relating to the environment result in a request for action being made to the maintenance team and records kept of when the requests have been actioned. We looked at certificates for the servicing and maintenance of equipment at the home. These evidenced the health and safety of all at the home is protected by the regular maintenance of equipment and services as recommended by relevant legislation or manufacturers guidelines. The fire log book was seen. This evidenced that fire safety checks are completed in line with the fire and rescue services relevant legislation. The accident book is completed for all accidents or incidents occurring. The manager has commenced auditing the accident book, with the aim of highlighting any reoccurring themes and taking action accordingly to reduce the rate of accidents or incidents at the home. Care Homes for Adults (18-65 years) Page 26 of 29 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 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 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 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 © (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. 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