Care Home: The Respite House

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What the care home does well People spending time at Respite House are cared for and supported by a well trained and knowledgeable staff team that has remained unchanged, which has helped them to maintain their health and well-being. Residents continue to follow routines of their choosing, which was seen during our visit. People commented, `I go to the respite house rather than stop in hospital as hospital doesn`t suit me and I don`t get better I only get worse`. Other comments included `This is home from home and so friendly`. `Staff really do care and look after you. I would have no hesitation in recommending this service to anybody. Its a great service` and `The staff were very supportive and were always there if I needed to talk`. The manager works hard to ensure that areas of improvement are addressed. Further daily checks have been introduced in relation to health and safety. Staff training and development continues to be addressed with relevant training provided as and when required. Staff continue to receive training to enable them to develop their understanding of the needs of those living at the home, especially in relation to their mental health needs. Records in relation to Health and Safety and medication ensure people`s health and well-being is not affected. What has improved since the last inspection? Action identified at the last inspection has been addressed with lockable space being provided for people in the downstairs bedroom. A new conservatory has been built. Further work is also being carried out to the environment including redecoration and refurbishment of rooms and the second lounge. Once completed this will enhance the property further providing a good standard of accommodation for people. Those people completing exit interviews stated `it was home from home`, `the home was spotless` and `My room was clean and nice`. What the care home could do better: No recommendations or requirements were made at this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Respite House The Respite House 2-4 New Lane Breightmet Bolton Lancashire BL2 5BN     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: Michael Murphy     Date: 2 2 0 4 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 27 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 27 Information about the care home Name of care home: Address: The Respite House 2-4 New Lane The Respite House Breightmet Bolton Lancashire BL2 5BN 01204337830 01204337831 vivienne.savage@bolton.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bolton Metropolitan Borough Council Name of registered manager (if applicable) Ms Vivienne Savage Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The home is registered for a maximum of 6 service users, to include: *Up to 6 service users in the category of MD (Mental Disorder under 65 years of age). *Up to 1 service user in the category of MD (E) (Mental Disorder over 65 years of age). Date of last inspection Brief description of the care home The home aims to provide a supportive alternative for people with mental health needs who are facing a time in their lives when they or their families/carers need to seek respite. The home provides a service for people with mental health problems in crisis where hospital admission is neither appropriate or necessary. 6 Over 65 0 care home 6 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection, which included a site visit and took place over one day for a period of five hours. The service did not know that the inspector was going to visit. As part of the inspection process the provider was asked to complete a self assessment information document called an Annual Quality Assurance Assessment AQAA to tell us what they did at present, what they felt they did well and what they felt they needed to do better. This helps us to determine if the management of the home see the service they provide in the same way that we do. The AQAA was sent to the home before the inspection and had been completed by the registered manager and was returned to us prior to the site visit. Care Homes for Adults (18-65 years) Page 5 of 27 During the visit we spent time looking at care records as well as information about Health and Safety. We also spent time talking with the manager, two staff and one resident. We also spent time looking at comments made by people who use the service and looking around the home. 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 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 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. All people are thoroughly assessed prior to admission ensuring the placement is suitable and able to meet their needs. Evidence: All prospective service users are fully assessed prior to admission to the home. This is to ensure that their needs, especially in relation to their mental health can be met. Each person that spends time at the home is admitted on a temporary basis either for a short period of respite care or is referred from the crisis intervention team from the local hospital as an alternative to in-patient care. Those admitted in an emergency are usually suffering from an acute deterioration in their mental health. The records of two people resident in the home showed that there were comprehensive up to date assessments in place. Information had been provided by the relevant health and social care professionals. This included a copy of the last care planning assessment (CPA), comprehensive risk screening tool and an assessment of the support needed whilst staying at the home. Those people admitted for care and Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: their families were usually involved in the pre-admission assessment. One person spoken with stated that he was involved in his assessment and said that he was happy to go to the respite house rather than stop in hospital as hospital doesnt suit me and I dont get better I only get worse. The manager explained that if the person was thought to be suitable for respite care then arrangements would be made with their social worker for them to visit the home if they wanted to. This could include day time visits and if the person attended the day centre then it may involve an activity such as cooking, with a support worker from the home, who also spends time in the day centre. This would then provide ample opportunity for both the home and the person to make a decision about whether it would be suitable. Two staff spoken with also confirmed that all assessments prior to admission were current and up to date and provided the service with enough information to be able to make a decision as to whether to admit any individual to the home. This was evident especially in the files of people admitted from the crisis intervention team. The manager makes every effort to ensure that all relevant information has been received and is shared with staff so that they too are kept informed. Care Homes for Adults (18-65 years) Page 10 of 27 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. Information about people is reviewed and updated so that it reflects their current needs ensuring they are supported in a way in which promotes their health and well being. Evidence: The Respite house provides accommodation for a maximum of 6 service users at any one time in a large residential style setting. Accommodation is split between having 2 crisis beds and 4 short term respite care beds. At the time of this inspection 3 people were resident in the home, 2 being on respite and 1 occupying a crisis bed. Experienced care staff provide highly individualised packages of care for people using the service. Records are securely kept in the office and are easily accessible to staff. Information was looked at for two people. One for a person on respite and one for a person occupying a crisis bed. Records were orderly and easy to follow. Both people were subject to the care programme plan (CPA) and therefore regular reviews were Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: arranged with mental health professionals to ensure they remained well. Information included all personal details, relevant contact details for people involved in their support, an individual care plan detailing their support needs, comprehensive risk assessments, record of health appointments if required, daily record of events, an admission report noting a key-worker, records of diet, correspondence and a signed agreement. The home is relatively small therefore informal day-to-day contact is made between residents and staff with the views and opinions of both parties being easily aired. Time was spent chatting informally with a person as well as observing their daily routines. They had just returned from a morning out having been for a coffee and a short walk. The person commented that they had been involved in developing their care plan with the support of their social worker and the manager and support staff from the home. They said that they planned their day and that the support staff helped him to get back on his feet and to start doing things again. He stated that This is home from home and so friendly, I would have no hesitation in recommending this service to anybody. Its a great service Exit surveys completed by people using the service, gave a clear picture that people were also involved in all aspects of life within the home and these and regular Resident Action Group meetings help to get feedback to plan a service that is tailor made to the needs of those people who use the service. People were highly complimentary about staff with comments such as staff spent a lot of time with me and they are all excellent. Care Homes for Adults (18-65 years) Page 12 of 27 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 are able to follow a lifestyle of their choosing with encouragement and support to meet their personal needs. Evidence: Routines within the home remain relaxed and informal. Generally people spent time either at home relaxing, for example watching television, reading papers or books, doing puzzles, playing pool or alternatively participating in planned activities of their choice. Those choosing to spend time at home had the use of televisions, DVDs and stereos in their rooms or in the communal lounge. People were relaxed and made the inspector welcome. Some examples of activities that people had helped to plan, involved them accessing the local shops, restaurants, cafes, pubs, going on train trips, cookery sessions, going Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: out for drives as well as attending art and crafts groups. Further ideas are also gained from the quarterly Resident Action Group meetings held at the day centre, where many of the users of Respite house also attend the day service. People are also involved with household tasks, including cooking, cleaning and laundry. The manager and support staff said this was to encourage them to develop and maintain their independent living skills. Support is provided where necessary. Consideration is given to the religious and cultural needs of people who use the service. One of the support workers has been helping in the day centre and has encouraged some of the Asian users of the day centre, who would not necessarily use Respite house, to attend cookery sessions in the home and to view what the service has to offer. He has also offered informal support to the group by helping them with letters, paying bills and translating things that they may have not been able to understand. Discussion with the manager highlighted that this was an important part of providing a service for this section of the community. The support worker spoke the same language and had an understanding of there religious and cultural needs and that they were being supported by someone they could trust. It is now hoped that more people will access the service from this group of people. People can continue to maintain contact with family and friends if this is deemed appropriate to do so, but on some occasions this is not so as there has been a break down in individual and family relationships. Individuals are able to see visitors in private using the large lounge, the newly built conservatory or their bedrooms. With regards to meals, these are flexible and are planned on a daily basis depending on what people want. People are generally encouraged to prepare their own meals by staff. Discussion with the manager and support workers and viewing records gave a clear indication that consideration is given to diet and healthy eating and that this is an important part of daily life in the home especially when some people do not look after themselves due to their mental ill health. Records in relation to diet and weight were kept in individual care plans. One person has had the support of a dietician and has lost a considerable amount of weight. The home has a large kitchen where communal meals can be eaten. As already stated the cultural/religious preferences of residents are also catered for, where necessary. Care Homes for Adults (18-65 years) Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and encouraged to address their health and personal care needs so that their general well-being is maintained Evidence: Care plans and records were viewed which are maintained in relation to each individual, which are specific to them. These plans identify issues relating specifically to their mental and physical health and the support they require from staff during their stay at the home. Records are updated after each persons stay at the home and information is passed back to the relevant mental health and social care professionals so that peoples care needs can be monitored. Most people are subject to a care programme plan (CPA). This involves regular review meetings being undertaken with the relevant mental health and social care professionals to ensure that their health and well being is maintained. Where additional health needs are identified referrals are made to the relevant health care services so that the appropriate advice and support can be provided. Residents Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: are also supported to access other NHS entitlements such as GPs, hospital, clinics, nurses etc. if needed. Support is also offered to attend appointments. One person has been supported by a dietician to look at their lifestyle and a healthy diet and has lost weight. As part of the care planning process areas of risk are considered. These include areas such as self harm, harm to others, substance abuse, neglect, treatment, risks to staff, risks to others, community risk management and in patient risk management. Assessments are carried out and action is detailed outlining what support is to be provided by the staff team. People were able to manage their own personal care needs however staff will prompt and offer encouragement where necessary. On admission to the home each person is allocated a key worker to help them settle in to the home and who is responsible for keeping their records up to date. People were able to move around freely and did not require any physical support. The ground floor bedroom has been modified and adapted to be able to support people with a physical disability as well. The medication system was looked at. Items were seen to be stored safely in a lockable cupboard in the office. All items looked at had been booked in to the home in blister packs and had been booked in on the MAR sheets. A sample of MAR sheets were looked at which seen to be in order and all medication could be accounted for. The manager continues to complete regular audits to ensure that the administration of medication has been carried out in accordance with the prescription. At the time of this inspection no people were holding their own medication though there were lockable cupboards and a risk assessment procedure in place so that this could take happen if necessary. The home was not holding controlled drugs. Care Homes for Adults (18-65 years) Page 16 of 27 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. Systems are in place to ensure people are listened to and protected so that they are kept safe. Evidence: People living at the home are aware of the complaints procedure and who to speak with if they have any issues or concerns. There is a corporate complaints procedure produced in most commonly used languages, that each person receives with the service user guide. The details of the Commission are also prominently displayed within the home if people wish to contact us. One person spoken with said that they were happy to approach the manager if they had any concerns and that they were confident she would listen. He also said that was the same for the staff too. Information provided on the AQAA showed that there have been no complaints or concerns raised with the service over the last 12 months. No issues have been raised directly with us. This was confirmed in discussion with the manager and in records kept. The recruitment records for all staff are held centrally. The home ensures that the relevant checks are carried out when employing new staff. These include written references and criminal record checks and medical clearance, ensuring people working at the home are fit to do so. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: All staff had received Safeguarding Training and those spoken with were aware of who to contact and what to do should the need arise. The manager also confirmed that staff practice is observed on a regular basis. Comprehensive risk assessments both for individuals and the environment are undertaken and kept on peoples files. Health and Safety checks are undertaken on a daily basis by support staff and on a monthly basis by the manager or a senior manager of the department. Audits are also undertaken by the manager in relation to medication. Checks had also been carried out on such things as electrics and gas, small appliances and fire safety, with corresponding certificates. These audits and records help to ensure that both staff and people remain safe whilst at respite house. Care Homes for Adults (18-65 years) Page 18 of 27 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. Respite House is a pleasant home that provides safe, comfortable and homely accommodation for the people who live there. Evidence: Respite House is two large domestic dwellings knocked in to one house providing good sized accommodation. It is domestic in character and is not distinguishable as a care home. The home is comfortable, homely and welcoming and is situated on the outskirts of Bolton and is easily accessible by public transport and is close to local amenities. The house is well maintained with large gardens to the front and rear with disabled access by permanent ramps for those who require it. Accommodation comprises of 6 bedrooms, one of which includes a ground floor ensuite bedroom providing facilities for physically disabled people, 2 lounges, a conservatory, dining kitchen and small laundry area. There is also a staff office and sleep-in room situated on the first floor. The homes designated smoking area is within the conservatory between permitted hours. The home has a small laundry area just through the kitchen area. The team supports those requiring assistance. Cleaning materials are stored safely and individuals are Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: encouraged to take part in cleaning the home where ever possible. Coshh assessments and general risk assessments have been reviewed and updated and suitable hand washing provisions are available to reduce the risk of any cross infection. Comments from exit interviews stated it was home from home, the home was spotless and My room was clean and nice. As identified on the AQAA work has been carried out within the home since the last inspection. This has included a new conservatory being built, refurbishment of bedrooms including new flooring, new curtains and new bedding and carpets. The downstairs bedroom now provides a lockable space. The manager explained that further work has been identified with the re-decoration of the second lounge soon to be started. Care Homes for Adults (18-65 years) Page 20 of 27 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. People can be confident that they will be supported by staff that are appropriately recruited and trained to meets their needs Evidence: The staff team at Respite House is made up of 6 support staff, of which 4 are female and 2 are male and the manager. Rotas showed that there were 2 support staff on duty throughout the day. The manager was also available on the day of the inspection and provides on-call support for the staff team. Information provided on the AQAA and discussion with the manager and staff showed that there have been no new staff over the last 12 months, ensuring continuity of care for those who use the service. The recruitment records for all staff are held centrally. Relevant checks are carried out when employing new staff. These include obtaining written references and criminal record checks and medical clearance, ensuring people working at the home are fit to do so. With regards to training, records are kept that show all staff had received comprehensive induction training which includes mandatory Health and Safety training in line with skills for care. Training over the last 12 months has included Deprivation of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Liberty, service user risk assessment, medication, First Aid refresher and Early onset of Dementia training. Most of this training is identified as being specific to people who use the service so that manager and staff can support them appropriately. Further training is planned and booked to ensure all the staff team have completed Deprivation of Liberty and service user risk assessment training. Other training has involved staff undertaking NVQs. Of the current team of 6 people 5 have completed NVQ level 3 promoting independence and 1 is currently completing the course. Staff are also encouraged to take further training in counseling at Level 1 and Level 2 and they can also apply for external training such as the Social work degree. In relation to staff supervisions, sessions are held every 6 to 8 weeks and records are held securely in the office. As the team is small, regular contact is maintained with all staff with information shared at hand overs. Regular weekly staff meetings are also held with records being kept. Positive comments were made about the staff. A comment from an exit interview looked at stated The staff were very supportive and were there if I needed to talk. A person spoken with stated Staff really do care and look after you. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being effectively and efficiently managed in the best interest of the people using the service. Evidence: The registered manager is a very experienced manager who holds the NVQ 4 Registered Managers Award. She is supported in her role by a qualified and dedicated staff team that has remained unchanged and worked at the home for a number of years and therefore have worked closely together. Staff spoken with said that she was supportive and understanding and put the people using the service first. It was clear that her management style was open, responsive and fair and that people could talk to her feeling totally at ease and that anything they said would be taken seriously. The manager is clear about her responsibilities and demonstrates a good understanding of the needs of people that the service supports. The manager keeps herself up to date and informed of current legislation and guidance as well as undertaking periodic training. Recent training has included the Deprivation of Liberty Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Safeguarding and Mental Capacity. Further training is planned for both her and the staff team to ensure that they have a good understanding of the new legislation/codes of practice ensuring practice within the home is safe and in the best interests of those living there. Systems are in place with regards to quality monitoring. This includes; regular staff training, supervision and support. Reviews are carried out ensuring the home is still able to meet the needs of people as well as maintaining good links with mental health and social care professionals. Feedback from people living at the home is done through both meetings and exit interviews as well as gaining feedback from mental health and social care professionals who have supported the individuals who have used the service. All of this this information is used to inform the homes development plan. Copies of this should be formalised and shared with people involved or who have an interest in the home, to show that it continues to progress and develop in the best interest of those that use it. In relation to health and safety, further checks are also now carried out on a daily basis within the environment to ensure people are safe as well as weekly checks and regular monthly management checks. This includes checks to both the inside and outside of the building, fire safety and water temperature and records kept within the home. A sample of servicing certificates was seen. These included; gas safety, fire alarm and emergency equipment and small appliances. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 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. 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