Care Home: White Acres

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What the care home does well Residents care needs are assessed and documented to ensure their safety.Support plans are well detailed and include the health action plans adding to the Person Centred Plan (PCP).Risk assessments are put in place to lessen risks to people.Residents have good access to healthcare services to meet their individual needs.Residents are treated with respect and their privacy and dignity is recognised.Residents have a number of choices based around their individual needs, promoting people`s independence and decision making.There are planned outings where people are assisted with trips out of the home.Peoples opinions about meals and menus, pastimes and outings are assessed at residents meetings.Decisions that the residents make are recorded in the daily notes.Complaints information is available in the home, and staff know how the process works.Staff have supervision regularly, this helps toward staff development and planning.People’s safety is important and there are processes in place to ensure this.Comments about the homeWhat the residents said the home did well. "like the staff and one to ones" "art, paint and board games" "Its a nice place" "Its nice living here" "clean home, caring for me and baking" "I like having my one to one, I like the staff" "clean home and caring for me" What peoples relatives said the home did well "tries to encompass the needs of the residents" "provides a clean modernhome, and replaced B`s old furniture" "they always do all they can to contribute to C`s welfare, we are happy with the care and the manager is a saint" "provides care efficiently for each individual" "the standard of service is beginning to improve, thanks to the promotion of the manager at the end of 2009" What has improved since the last inspection? There were seven requirements made at the last visit. Support plans have improved.Peoples are in more direct control of their financesRisk assessments are reviewed regularlyStaff files have the necessary recruitment informationReporting of incidents to CQC has improvedHealth action plans have been introducedPerson Centred Plans (PCP`s) are continuing to be developed What the care home could do better: The acting manager highlighted the following areas in the home where improvements are being planned. Manager to complete her professional qualificationsTo review information packs to give a better overview of the home before visitingNew Health Action PlansWe are working to introduce a new format for the Health Action PlansTo develop a personalisation project for residents roomsTo develop the complaints system to give residents more opportunities to raise concerns Access more external training courses and improve the training and development for senior staff.Page 17 of 37Care Homes for Adults (18-65 years)What the residents said the Comments about the home home could do better "staff to be friendlier and nice" "I want to go back college in September" two residents made this comment. "games room and more activities" "I like some one to help me" "game room" What peoples relatives said the home could do better "more staff, they always seem to have a shortage" "information about outings and holidays so we don`t clash" "more information could be given to families without asking" "provide information regarding the recruitment of new staff, there have been a lot of"give residents information about relatives birthdays etc, and then helping to send birthday cards etc" "entertainment or occupational therapy, monitor television programmes that they are suitable entertainment" "there should be more personalisation, there are never enough staff to enable residents to go out either individually or in a small group" "changes and residents get used to care workers" Key inspection report Care homes for adults (18-65 years) Name: Address: White Acres 15 Leicester Road Shepshed Loughborough Leicestershire LE12 9DF The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson Date: 2 1 0 6 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 37 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 37 Information about the care home Name of care home: Address: White Acres 15 Leicester Road Shepshed Loughborough Leicestershire LE12 9DF 01509502845 01509502845 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 12 Number of places (if applicable): Under 65 Over 65 12 0 learning disability Additional conditions: To be able to admit the named person of category LD/ MD as identified in correspondence with the previous registration authority dated 10/08/01. To be able to admit the named person of category LD/SI as identified in correspondence with the previous registration authority dated 11/05/00. Date of last inspection 1 2 1 1 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 37 A bit about the care home White Acres is part of the Prime Life Group and is in Shepshed, Leicestershire. White Acres provides care and support for people with learning disabilities. It is close to shops and the health centre. The home has two floors and there are stairs to get to the first floor. Some bedrooms are on the ground floor and some on the first floor. Each person has their own room. One bedroom has its own bathroom. There are shared bathrooms on the ground and first floor. Care Homes for Adults (18-65 years) Page 5 of 37 There is a living room with a dining area, a separate living room and a kitchen on the ground floor. There is also a garden. You can get to White Acres by bus or by car. White Acres has its own mini bus. People living in the home use this to go on trips and to get to appointments. You can get information about the home called the service users guide. You can also get copies of our reports about the home. People pay different amounts of money to live at White Acres. You should contact the manager to find out how much you would have to pay to live here. Care Homes for Adults (18-65 years) Page 6 of 37 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 37 How we did our inspection: This is what the inspector did when they were at the care home Before we visited White Acres we looked at information sent to us about what has happened there since we last visited on 12th November 2009 We visited White Acres on 12 November 2009. We arrived at 9 OClock in the afternoon and left at 4 OClock in the afternoon. Four residents were seen and all spoken with; two staff were also spoken with, and their exchanges with the residents observed. Care Homes for Adults (18-65 years) Page 8 of 37 We looked at 3 peoples care plans. We spoke to staff about how they support people. We spoke to staff about the training they did. We looked at staff records. These told us about the checks done to make sure staff have the right skills and are safe to work in the home. We spoke to the acting manager about how she runs the home Care Homes for Adults (18-65 years) Page 9 of 37 Good service The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. What the care home does well Residents care needs are assessed and documented to ensure their safety. Support plans are well detailed and include the health action plans adding to the Person Centred Plan (PCP). Risk assessments are put in place to lessen risks to people. Care Homes for Adults (18-65 years) Page 10 of 37 Residents have good access to healthcare services to meet their individual needs. Residents are treated with respect and their privacy and dignity is recognised. Residents have a number of choices based around their individual needs, promoting peoples independence and decision making. There are planned outings where people are assisted with trips out of the home. Care Homes for Adults (18-65 years) Page 11 of 37 Peoples opinions about meals and menus, pastimes and outings are assessed at residents meetings. Decisions that the residents make are recorded in the daily notes. Complaints information is available in the home, and staff know how the process works. Staff have supervision regularly, this helps toward staff development and planning. Care Homes for Adults (18-65 years) Page 12 of 37 People’s safety is important and there are processes in place to ensure this. Comments about the home What the residents said the home did well. like the staff and one to ones art, paint and board games Its a nice place Its nice living here clean home, caring for me and baking I like having my one to one, I like the staff clean home and caring for me What peoples relatives said the home did well tries to encompass the needs of the residents provides a clean modern Care Homes for Adults (18-65 years) Page 13 of 37 home, and replaced Bs old furniture they always do all they can to contribute to Cs welfare, we are happy with the care and the manager is a saint provides care efficiently for each individual the standard of service is beginning to improve, thanks to the promotion of the manager at the end of 2009 What has got better from the last inspection There were seven requirements made at the last visit. Support plans have improved. Care Homes for Adults (18-65 years) Page 14 of 37 Peoples are in more direct control of their finances Risk assessments are reviewed regularly Staff files have the necessary recruitment information Reporting of incidents to CQC has improved Care Homes for Adults (18-65 years) Page 15 of 37 Health action plans have been introduced Person Centred Plans (PCPs) are continuing to be developed What the care home could do better The acting manager highlighted the following areas in the home where improvements are being planned. Manager to complete her professional qualifications Care Homes for Adults (18-65 years) Page 16 of 37 To review information packs to give a better overview of the home before visiting New Health Action Plans We are working to introduce a new format for the Health Action Plans To develop a personalisation project for residents rooms To develop the complaints system to give residents more opportunities to raise concerns Access more external training courses and improve the training and development for senior staff. Page 17 of 37 Care Homes for Adults (18-65 years) What the residents said the Comments about the home home could do better staff to be friendlier and nice I want to go back college in September two residents made this comment. games room and more activities I like some one to help me game room What peoples relatives said the home could do better more staff, they always seem to have a shortage information about outings and holidays so we dont clash more information could be given to families without asking provide information regarding the recruitment of new staff, there have been a lot of Care Homes for Adults (18-65 years) Page 18 of 37 give residents information about relatives birthdays etc, and then helping to send birthday cards etc entertainment or occupational therapy, monitor television programmes that they are suitable entertainment there should be more personalisation, there are never enough staff to enable residents to go out either individually or in a small group changes and residents get used to care workers Care Homes for Adults (18-65 years) Page 19 of 37 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Keith Williamson Care Quality Commission Citygate, Gallowgate Newcastle upon Tyne NE1 4PA 03000 61 61 61 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 20 of 37 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 21 of 37 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. Service Users are offered a tailored introduction to the service. Evidence: The staff have developed a comprehensive statement of purpose and service users guide, which is specific to the current group of people in the home. The information is available in different formats when necessary, and this ensures everyone in the home can understand it. People have their needs assessed prior to moving into the home. The assessments were detailed and included updated information, recognising any changes in the persons abilities and needs. The process is directed to suit the individual, ensuring the move is well planned. Care Homes for Adults (18-65 years) Page 22 of 37 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. Improvements in care plans and risk assessments have resulted in positive outcomes for residents at the home. Evidence: We looked at the care records of people. We found them to be descriptive of the care and support offered to them. Care plans are put in place from the initial assessment information. Care plans are routinely up-dated to ensure they reflected the changing support needs of people living in the home. The transfer of care records to Person Centred Plans (PCPs) has progressed very well. The acting manager has completed PCPs for all but one of residents, this due to their recent admission. These more detailed care records are far more individual than the initial care plans and recognise peoples personal goals are recognised and planned for appropriately. We saw that staff have a good understanding of the risks relating to people, and have put risk assessments in place to reduce risks associated with each person. During our visit we observed staff being very mindful of how people might react to the change in events our visit caused. Staff ensured that appropriate action was taken to reduce the possibility of Care Homes for Adults (18-65 years) Page 23 of 37 Evidence: challenging situations. What peoples relatives said the home did well tries to encompass the needs of the residents they always do all they can to contribute to Cs welfare, we are happy with the care provides care efficiently for each individual Is there anything else you would like to tell us (from relative surveys) White Acres is a good home and after many difficult years for my brother it is good to see him happy and well cared for. I have no complaints, I know A is in good hands. White Acres is a happy friendly environment where all the residents seem happy and look after one another. Care Homes for Adults (18-65 years) Page 24 of 37 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 are encourage to develop a healthy and meaningful lifestyle based on self help skills. Evidence: We looked at the social care offered to people. This showed us people experienced a varied social life. People have individual programmes linked to their needs, self care and socialising. Residents undertake a wide range of activities both in the home and local area. These are risk assessed to enable people to undertake them alone or with staff assistance, and are designed to assist in their personal development. We saw that staff are sensitive to the individual needs of people living at the home. We saw staff talk to and interact well with people who live there. Staff also were aware of how to effectively communicate with people. Care Homes for Adults (18-65 years) Page 25 of 37 Evidence: We saw the menu on offer, this reflected residents individual needs and is compiled following residents meetings and information in the PCPs. This enables people to directly affect their day to day choices. The menu offers a balanced and healthy diet. What the residents said the home did well. like the staff and one to ones art, paint and board games Its a nice place Its nice living here clean home, caring for me and baking I like having my one to one, I like the staff clean home, caring for me What the residents said the home could do better staff to be friendlier and nice I want to go back college in September (two residents made this comment) games room, more activities I like some one to help me game room What peoples relatives said the home did well provides a clean modern home, and replaced Bs old furniture What peoples relatives said the home could do better information about outings and holidays so we dont clash more information could be given to families without asking provide information regarding the recruitment of new staff, there have been a lot of give residents information about relatives birthdays etc, and then helping to send birthday cards etc entertainment or occupational therapy, monitor television programmes that they are suitable entertainment there should be more personalisation, there are never enough staff to enable residents to go out either individually or in a small group Is there anything else you would like to tell us (from resident surveys) I would like new round tables Is there anything else you would like to tell us (from relative surveys) Staff are always polite and efficient in their care for the residents and provide outings and activities according to their budget. Care Homes for Adults (18-65 years) Page 26 of 37 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and medication needs met appropriately. Evidence: We looked at the personal and healthcare records of people. We saw that they have good access to healthcare services to meet their individual needs. Residents have a specific health care plan, as part of the PCP. We looked at these and they indicate peoples health care has improved dramatically following their admission to the home. We looked at the way staff give out medication and found that staff are administering medication safely to people. The policy and procedures followed by the staff are comprehensive. Medicine audits are carried out very regularly, and medicines that require to be kept in the manufacturers packaging, are also counted. This makes the system safer as staff are aware if people have had the correct medication. We saw staff records and these showed us that staff have undertaken training in the administration of medication. Care Homes for Adults (18-65 years) Page 27 of 37 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure that is clearly written and easy to understand and would enable people to raise concerns if needed. Evidence: We looked at the complaints procedure and saw that this was written in a way which people could understand it. We saw very good interaction between people who live in the home, and staff who support them. We saw evidence where residents have the opportunity to have support and can make a complaint through people and bodies independent of the home and its management. We saw by looking at staff training records and by talking to them that staff have a good understanding of safeguarding policies and procedures. Staff are aware what to do if they suspect that a person who lives in the home is being abused in any way. To date the safeguarding training has been done the companies own trainers. The acting manager has now sourced training from an external source, which should bring an added perspective to the staffs knowledge. We also saw by looking at staff records, by talking to and observing staff that they understand how to work with people with challenging behaviour. People who live in the home now have the choice of greater access and control of their own bank accounts. Staff support some people in being responsible for their money. We checked the financial records at the home and found accurate recording of money Care Homes for Adults (18-65 years) Page 28 of 37 Evidence: balances. Care Homes for Adults (18-65 years) Page 29 of 37 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 safe and secure environment. Evidence: We looked at the communal areas and the bedrooms of some of the people who live there. We found the communal areas to be well decorated and homely. The bedrooms were individually decorated to the needs and preferences of the people using them. This included many personal items such as family pictures and electrical goods. The acting manager indicated that the residents are to be involved in the planning of redecorating their bedrooms. The staff have an ongoing maintenance programme, this is regularly updated, as part of the quality control in the home and we saw how that translated in the home being well maintained. There have been a number of improvements since our last visit, where carpets, floor coverings and decorating have taken place. Staff are aware of hygiene and how to control the spread of infection. This is important as it keeps people safe in the home. Care Homes for Adults (18-65 years) Page 30 of 37 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. Improvements in recruitment practices ensures people are protected. Evidence: We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a range of training to help them in their roles, some of this before working with residents. Training included health and safety, medication management and working with challenging behaviour and is organised from in house as well as external sources. Staff have regular meetings and supervision. Supervision is where their interaction with residents and individual development is discussed. This indicates senior staff monitor how staff perform within the home, and arrange further training and intervention accordingly. Staff confirmed they were supported well to do their job, through induction training, on going training and regular supervision. We saw good interaction between staff and people who live in the home, and staff demonstrated a good understanding of the needs of people living there. We talked to staff and saw them communicating with people in a manner suited to them. People have a varying degree of support during the day, to ensure their support needs are being met. Care Homes for Adults (18-65 years) Page 31 of 37 Evidence: What peoples relatives said the home could do better more staff, they always seem to have a shortage Is there anything else you would like to tell us (from relative surveys) White Acres is usually a good home and the staff do a brilliant job, however we noticed in 2009 the standard of care slipped and this did concern us. The standard has greatly improved under the current manager. I think (training) certificates should be on display and staff wear name badges. Staff moral seems a little better. Care Homes for Adults (18-65 years) Page 32 of 37 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 detailed health and safety checks, support and monitoring in other areas ensure a safe environment. Evidence: The acting manager has recently moved to the home, and has commenced the process to become registered with the Care Quality Commission. Though new in post, support is at hand from senior managers and manager and reports are available to confirm this. There are many levels Quality Assurance(QA) and monitoring systems in place, and we noted a number of these. Staff are currently reviewing the style of the residents questionnaires and hope to send these out shortly. Other forms of QA include feedback from relatives and professionals, regular staff checks on the building and visits from senior managers. Outcomes from the quality assurance monitoring will be made available to people in the home, their representatives and those considering coming to stay at the home. We viewed a number of the policies and procedures that are produced by the parent organisation, these are available to staff and updated regularly. Care Homes for Adults (18-65 years) Page 33 of 37 Evidence: We looked at the records kept in the home, these are stored securely in the offices and are up to date. We looked at a number of tests the staff do to monitor areas such as the fire detection system, the hot water regulating system, and other areas such as electrical testing. These were up to date and showed us the staff monitoring of health and safety helps keep people safe in the home. The testing of the fire detection and the hot water regulating system are above the minimum standards, ensuring an extended system of safety. The acting manager has identified a number of areas in the AQAA where she shall be concentrating development of the home and staff. What peoples relatives said the home did well the manager is a saint the standard of service is beginning to improve, thanks to the promotion of the manager at the end of 2009 Is there anything else you would like to tell us (from relative surveys) After a poor couple of years this service is beginning to improve following the appointment of the third manager in two years. She is young but enthusiastic, I hope the company support her. Care Homes for Adults (18-65 years) Page 34 of 37 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 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 1 24 23 The registered person shall 23/07/2010 having regard to the number and needs of the service users ensure that, the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. Care Homes for Adults (18-65 years) Page 35 of 37 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 This is to ensure people have safe conditions underfoot. 2 42 23 Subject to regulation 4(3), 23/07/2010 the registered person shall not use remises for the purposes of a care home unless, make arrangements for persons working at the care home to receive suitable training in fire prevention; and (e) to ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life. This is to ensure all staff are well trained in fire and evacuation of the building. 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 1 Feedback from the recently distributed Quality Assurance exercise, could be fed back to prospective residents and their families through the Statement of Purpose. The complaints procedure and related information could contain the contact details of the local authority. Page 36 of 37 2 22 Care Homes for Adults (18-65 years) Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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