Care Home: The White House

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What the care home does well The service is good at ensuring they assess the needs of an individual before they are offered a service. People who use the service have detailed plans of the way they need and prefer to be supported and information on how they need to be communicated with to understand what is going on around them. People are supported to make decisions which are within their capabilities in their daily lives. People who use the service are supported to take risks. The home continue to seek a variety of activities both leisure and education to enable people to be part of the community. People are supported to maintain contact with family and friends and individual daily routines are respected. People using the service are encouraged to maintain an healthy diet. People who use the service are supported in the way they prefer both with personal care and in meeting their physical and emotional health needs. The service has a policy and procedure on safe handling of medication and staff are trained accordingly which ensures that people using the service are protected. Staff receive the training they need to ensure people are protected. People using the service live in safe, comfortable surrounding which are well maintained. The home is clean and staff receive training in infection control measures. Staff working in the home receive the training they need to support the people who live there. The home is managed by an experienced person who understands the needs of the people using the service and works to develop systems to reflect their involvement in reviewing the work done to develop the service. The health, safety and welfare of people using the service is promoted and protected by the systems in place. What has improved since the last inspection? At the end of the inspection in June 2007 there was one recommendation. At the last key inspection we said "The registered person should make sure they record in the persons personal file all the action taken to obtain two written references." When we looked at recruitment at this inspection we found this recommendation had been addressed. What the care home could do better: At the end of this inspection there is one recommendation. So that people who complaint about the service can be clear about how long a complaint investigation will take, the timescale for responses should be clearly written on the complaint procedure. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The White House 4 Walpole Road Boscombe Bournemouth Dorset BH1 4EZ     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: Tracey Cockburn     Date: 0 4 0 6 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 White House 4 Walpole Road Boscombe Bournemouth Dorset BH1 4EZ 01202399471 01202390473 steadwaycare@btopenworld.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) : Steadway Care Limited care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The maximum number of service users who can be accommodated is 7 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home The White House is a large property on a corner plot in a residential area of Boscombe. It is conveniently located for all the amenities of Boscombe that includes shops, restaurants, cafes, post office, library and places of worship. These are within a few minutes level walk of the home. Public transport is readily accessible close to the home and Bournemouth town centre is approximately 1 mile from the home. The home has its own transport that enables people to conveniently access some of the towns leisure facilities, particularly when group activities are arranged. The homes mission statement states that that it aims to support and care for adults with autism along the path towards independence. The White House has three floors and there is bedroom accommodation on the first and second floors. Two on the Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home second floor and five on the first. All bedrooms are single rooms and have en-suite WCs and baths and the decor and furnishings are the choice of the person occupying the room. Communal space is on the ground floor and comprises two lounges, a dining room, a large kitchen and a WC. There is also a management office, additional staff office and separate laundry room. The paved external garden area is accessible from one of the lounges and the dining room and contains a summerhouse. The current weekly fees are between 2479 pounds and 2666 pounds, which are inclusive of day care activities provided during the week. Additional charges are made for hairdressing, toiletries, and some activities. For further information on fee levels and contract visit the office of Fair Trading website: www.oft.gov.uk 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 peterchart Poor Adequate Good Excellent How we did our inspection: We visited the service without telling them we were coming. Throughout the report the term we is used to denote the evidence and judgments are the view of the care quality commission. In planning the site visit we looked at information received about the service since the last key inspection. We used information sent to us in survey forms. We also reviewed information sent to us by the service in the annual quality assurance assessment. During the site visit we observed activities taking place and spoke to some of the people using the service, we also spoke to the managers and staff who work in the home. We walked round the home and we looked at a variety of care records such as person centred plans and records of activities people have participated in. We also looked at recruitment and training records for staff as well as records which show how Care Homes for Adults (18-65 years) Page 6 of 29 well they manage medication for people. 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 Care Homes for Adults (18-65 years) Page 8 of 29 7535. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People only move into the home following an assessment part of which is based on their compatibility with the people already living there. Evidence: No one has been admitted to the service since the last inspection there are currently four people using the service which is registered for seven. The deputy manager told us that the home was working well at the moment. The annual quality assurance assessment said: Last year we developed a web site with our statement of purpose available as a download to ensure that initial information about our service is readily available to possible users, carers and professionals. This we monitor closely to see how effective the web site is in getting information across to interested parties. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peopel using the service are supported to participate as much as they are able in the planning and support they receive. Evidence: As part of the inspection one persons file was examined. This contained a personal profile and plan, which had information on a wide range of needs including communication, personal care, relationships, behaviours and risks. There was also information in the care plan on the persons ethnic background and culture and what this might mean for them in terms of support and activities. There was written evidence that both the individual and their family had been consulted prior to the review. The service has a skills monitoring system for each person, which details progress and achievements in a wide variety of skills areas. This system includes activities both in and out of the home such as using a washing machine and bowling, This information is also part of the review process. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: There is information on each individuals vocabulary, lists of words they use, what they mean for that person. This gives the staff the information they need to support each person. The care plan looked at contained detailed information on the individuals behaviour and what action staff need to support that individual. In discussion with the manager she said that they work hard to use health care professionals who understand the needs of people who live in the service. So for this reason the dentist the home uses is in Poole and the optician is in Wareham. Some of the people using the service are able to make only limited choices in their daily lives. Care plans contain information on restrictions in their daily lives and the reasons why. During the inspection one person was in the home and this person was observed making choices about activities to do during the day and what to eat for lunch. Risk assessments were detailed and covered a variety of activities such as going to the bottle bank, going to the allotment, personal care, domestic activities. The risk assessments were reviewed and updated. Each care plan has a section entitled how I communicate with you and provides details such as When I say or do this: bang my wrists together it probably means this that I am angry or disappointed the care plan then goes on to say and you should do this Stay calm and usher me to a quiet place where I can calm down. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle and supported to develop their skills. Evidence: Each person has a weekly schedule with photographs on each day which shows what activity they are doing such as going trampolining, going to the allotment or completing a paper round. For example one person is cooking, one day another person is going to the Bottle Bank and park. One person is doing an English and drama course and another is working on money skills. We looked at the menu which started on the 1st June. There is a variety of choices including for lunch things on toast, beans, egg. Evening meals includes choices such as tuna steak, beef korma, salad. We observed one person making their own lunch they Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: were having beans and cheese on toast with salad. We also observed that other people where eating salad with their things on toast. We observed one person discussing with the member of staff what they need to do next to make their meal. The manager told us that the kitchen is being completely refurbished in July of this year, during the refurbishment all the people living in the home are going on a weeks holiday. The manager told us that to ensure there is minimal disruption to the people living in the home they are planning the process very carefully. The manager said that the residents get a great deal of pleasure from working at the allotment and especially enjoy bringing the vegetables back to cook and eat. The residents came back in the afternoon, but several then went off to take items to recycling. Staff were observed responding to individual requests and deciding what activities would be enjoyed. There is a large day activities programme chart on the wall in the hall. This uses a mixture of signs, symbols and pictures depending on each individuals preferred method of communication to demonstrate clearly what activities they have each day. The activity programme demonstrates that people are able to access the community and be part of the community on a daily basis. The home has a large vehicle so that the people can go out and about when they want to. Information about family contacts is clearly recorded on individual files. The homes service user guide makes it clear that individuals are encouraged to have regular contact with their families and friends. The document also states that residents have the right to choose who visits them. In the homes annual quality assurance assessment they state the different ways they try to improve the lifestyle for residents by discussing the issue at staff meetings. Other residents are also encouraged to develop their daily life skills including housework, being responsible for their own rooms and helping with things like unpacking the weekly shopping. The annual quality assurance assessment said Our Service Users activity plans show that they are offered a wide range of activities each week for example, bowling, swimming, outings to the pub, picnics during the summer months, car boots, beach etc. The AQAA also says: We have a skills monitoring system, which is held in a file for each of the Service Users in which staff record the progress and achievements made. The file covers a broad area of activities both in house and off site such as using a washing machine and bowling. This a useful tool for new members of staff who can see at what stage the service Users are with each of the skills. Our day care Manager produces activity agendas, which enable the Service Users to take part in learning activities as well as entertainment and social events. A weekly programme is tailored around individual needs. Preferences, ability and interests are always taken into consideration when plans are made. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: All activities are monitored to ensure that they remain appropriate, achievable and positive. The Service Users are encouraged to take responsibility for their own living space and to contribute to the running of the home. Staff work closely alongside the Service Users to promote independence. The service also told us in their AQAA that there have been some barriers to supporting people such as : Finding suitable external courses for our service users remains difficult since the new ability requirements were implemented for the Linking Scheme Courses.The Bournemouth Learning Council also have an entry requirement by means of a test paper that our service users are unable to complete. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy are pit into practice. Evidence: Each persons personal care needs are clearly documented in care plans covering all aspects of personal care such as washing, bathing, shaving, hair care. Individual health issues are clearly recorded in care plans. There was recorded evidence that people are supported to attend appointments with opticians and dentists. There was also written information on visits by other healthcare professionals such as the community nurse. People are taken to see the psychiatrist and psychologist when requested to or when they are concerned about someones behaviour or medication. The home has a policy on the management and administration of medication. No one living in the home at the time of the inspection had been assessed as able to self administer their own medication. Medication is stored securely in a locked metal cupboard. Records checked on the day of the inspection were found to be accurate and up to date. The manager Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: demonstrated what they now do if there are any changes to pre printed sheets. There is also a clear procedure for recording medication, which leaves the home when a person is out for the day or away with family for longer. The annual quality assurance assessment said: A Co-ordinator (key worker) is selected for each Service User to ensure a solid base for co-ordination of information and development. The co-ordinator is assigned to the Service User for approximately eight to nine months. We feel by changing co-ordinators regularly they are able to bring different elements to an efficient relationship thus preventing a stale association with their Service User. There is a member of staff dedicated to arranging repeat prescriptions, healthcare visits, the monitoring of medication and the purchasing/ordering of non prescription medication and supplies. A member of staff is elected to monitor and replenish all first aid boxes on a regular basis Doctors and Dentist visits are planned with maximum staff support to minimise anxiety or discomfort in an alien environment. The Individual Service User Plans provide guidance on the level of support needed for personal care and these principles are regularly reviewed. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to information on how to complain in a format they understand, however the timescale for responding to complaints is not clear which could lead to a misunderstanding. Evidence: There is a laminated complaints leaflet for people to read, however the address of the new commission does not reflect the commissions move to a national contact number. There is also no information on timescales for responding to a complaint. There is a detailed written policy and procedure about how to complain. The home has produced a leaflet both written and using pictures. The manager has written in the annual quality assurance assessment that they have an open door policy and encourage people to talk about issues or problems they encounter with the service. The manager says that they use the communication book, handover file and service user diaries to review information and concerns. This process of information gathering also feeds into their individual reviews. The manager has developed a feedback form to be completed by families after they have had home visits to establish any changes in behaviour, which might have occurred. The manager reported in the annual quality assurance assessment that this has not been as successful as they hoped. The home has a policy and procedure on the protection of vulnerable adults and how to report incidents of abuse. A sample of staff training records were reviewed and staff Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: have received training in this area. There has been no safeguarding alerts or investigations since the last key inspection in 2007. 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 who use the service live in safe, well maintained and comfortable surroundings which supports their independence. Evidence: We walked round the building, the communal toilet on the ground floor does not have liquid soap or paper towels. We asked the manager about this, they told us that some of the people in the home would possibly drink the liquid hand soap causing harm to themselves and put the paper towels down the toilet. The manager told us that it was important people in the home had access to the toilet when they wanted and for this reason soap and hand towels were used. We consider it important that the hand towels are changed regularly throughout the day. We spoke to the manager about the changes being made to the decor in the home. The lounge and dining room have already been up dated and it is now the turn of the kitchen. The kitchen is being gutted and refurbished. During the week this is taking place all the people living in the home are going on holiday. The manager has ensured that there will be minimum disruption during the process by planning every detail and discussing it with the people in the home. One of the bedrooms has been turned into the sleep in room for staff. The room also Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: has a desk for staff to us to study. The annual quality assurance assessment said : The adaptations that have been made to the home such as, key fire call points in preference to break glass, non slip floor covering to bathrooms, kitchen and utility areas and some Service Users bedrooms, washable curtains in one of the bedrooms. The wallpaper has been removed from the communal rooms, stairs and landing and the walls have been re-plastered or artexed then painted. This action was taken because one of the Service Users stripped and ate wallpaper. During the Service Users holiday, staff that remained at the home decorated and spring cleaned the house. Carpets have been cleaned professionally during the past year. 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: We looked at the staff roster for the week beginning 1st June. We found there are two staff on duty from 7:30am to 3pm and two staff on duty from 2:30 to 10:00pm. The day care manager is on duty each day from 9:00am to 5:00pm. The home has a registered manager, deputy manager and day care manager. At present there is no training co-ordinator and the manager is actively seeking a training provider. Senior support workers are responsible for supervision of support workers. The information staff receive in induction enables them to understand the needs of the people who live in the home. The manager says they try to employ people who demonstrate an aptitude for working with their residents. They assess this during their probationary period. All staff are encouraged to participate in NVQ training and the home have reached the target of more than 50 of staff achieving a care NVQ 2 or above. The AQAA says: All but 1 member of staff have NVQ 2 and above The senior support worker said that she had undertaken a supervisory course before undertaking this role as well as a team-leading course. The deputy manager has NVQ Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: level four. In the annual quality assurance assessment provided by the home they say they have a comprehensive recruitment and selection process. One file for a new member of staff was reviewed and this had a satisfactory criminal records bureau check, the protection of vulnerable adults list had also been checked and this had come back clear. There was a completed application and notes from the interview process. There was a signed contract with terms and conditions on the file. There were two written references. A recommendation at the last inspection suggested that the management should have a clear audit trail for action taken to secure a reference. We found evidence that this had been done. Each member of staff has a training needs assessment, records show the training which has taken place and the updates needs. Courses provided include first aid, health and safety, medication and infection control. The home has a 12week induction for new staff. We looked at the training profile of one person who completed the following: Mental Capacity Act training on 22/12/08, medication on 21/12/08 Emergency first aid on 6/11/08 Food hygiene training on 3/01/09. The manager told us that they are looking for another training provider. The training record shows when certificates are out of date and when refresher training is required. The annual quality assurance assessment said: We continue to fund a Health Plan for the staff that provides free/subsidised health care checks and treatment and free counselling. 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. Management of the service is based on openness and respect, there is an effective quality assurance system which uses a variety of methods to seek the views of people using the service. Evidence: The home has submitted an annual quality assurance assessment to the commission. We checked fire records and found that the checks were up to date, the last fire alarm test 16/05/09, emergency lighting,25/05/09, fire drill, 24/04/09, fire equipment 25/04/09. The annual quality assurance assessment said: We constantly look at ways to improve our service. Managers take on board suggestions and requirements brought to them by staff, carers and Service Users and these issues are discussed at management meetings and decisions made. Matters that involve a substantial financial outlay or major change to the home are then discussed at a directors meeting. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The Annual Quality Assurance Assessment also says: We continue to regularly seek the Service Users views of the home and prior to their six monthly reviews we gather information from them with regard to our service. For those who are unable to contribute due to communication difficulties, we rely on Parents,Carers, Care Managers and outside professionals to make comments on their behalf. We continually review the Service Users reactions to activities and day to day living to provide constant feedback on their attitude to what we are doing. 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 22 The registered provider should have a clear timescale for responding to a complaint in the leaflet. 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). 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. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!