Key inspection report

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1 Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Lonsdale House 8 Lichfield Road Walsall West Midlands WS4 2DH 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: Date: Dawn Dillion

2 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 or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: Online ordering from the Stationery Office is also available: 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 Care Homes for Adults (18-65 years) Page 2 of 30

3 Reader Information Document Purpose Author Audience Further copies from Copyright Internet address Inspection report CSCI General public (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. Care Homes for Adults (18-65 years) Page 3 of 30

4 Information about the care home Name of care home: Address: Lonsdale House 8 Lichfield Road Walsall West Midlands WS4 2DH Telephone number: Fax number: address: Provider web address: Name of registered provider(s): Caldmore Area Housing Association Limited Name of registered manager (if applicable) Angela Crisp Type of registration: care home Number of places registered: 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 mental disorder, excluding learning disability or dementia 15 0 Additional conditions: Three service users may be accommodated at the home in the category MD(E). This will remain until such time that the identified service users placement is terminated. Date of last inspection Brief description of the care home Lonsdale House is a residential home located in Walsall, West Midlands. The home provides a service for people who have mental health needs. The large detached house is situated near Walsall Town Centre, having access to public transport and all local amenities. The property offers three self-contained flats, 10 single bedrooms. Coach houses located at the rear of the property provide a further two accommodation. People have access to two lounges, dining room, kitchen and a well-maintained garden. The coach houses provide an open plan lounge/kitchen; single bedroom and a shower Care Homes for Adults (18-65 years) Page 4 of 30

5 Brief description of the care home room is located on the first floor. Staffing is provided on a 24-hour basis, this ensures people are provided with support and assistance when required. The fees charged for the service provided at Lonsdale House is p. These fees applied on the day of our visit, the reader may wish to contact the service for up to date information. Care Homes for Adults (18-65 years) Page 5 of 30

6 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: three star excellent service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The last unannounced key inspection of Lonsdale House was undertaken on 01 January The unannounced key inspection of Lonsdale House was undertaken within eight hours. The inspection methods used to establish the quality of care provided and the effectiveness of the management of the home, involved looking at care records. Talking to people who use the service and staff members. We, the Commission for Social Care Inspection looked around the home to ensure it was suitable and safe to meet people's needs. Care Homes for Adults (18-65 years) Page 6 of 30

7 Information from the service Annual Quality Assurance Assessment (AQAA) is also included in this report. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. We received nine surveys from people who use the service and seven from staff members. This told us what people thought about the quality of the service provided. The registered manager was present on the day our visit.

8 What the care home does well: The home strives to promote independence and enhance people's skills and confidence enabling them to live independently in the future. People benefit from having their care and support needs met by suitably trained and competent staff. Staff recruitment practices promote the safety of people and ensure staff members are suitable to work in the home. People are encouraged to be actively involved in decisions promoting choice, independence and individuality. What has improved since the last inspection? The previous inspection report identified a requirement that risk assessments should be reviewed regularly to reflect any changing needs. The risk assessment was included in the care plan and was reviewed regularly with people's involvement to promote their independence and safety. The home's quality assurance system had also been reviewed and involved the participation of people to maintain quality standards. What they could do better: The home continues to provide good outcomes for people. No requirements have been identified within the contents of this report. The home's procedure for the storage and administration of medicines ensured people receive their medicines safely. We saw that staff had written over entries in the control drugs record to disguise errors. This practice should cease to ensure the home is able to maintain a clear audit trail of medicines. 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 You can get printed copies from or by telephoning our order line Care Homes for Adults (18-65 years) Page 8 of 30

9 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 9 of 30

10 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service are provided with relevant information enabling them to make a decision of the homes suitability to meet their assessed care needs. Appropriate assessment of people's care needs ensure they will receive the support they need to promote their mental health and welfare. Evidence: The service AQAA showed the home had recently up dated the Statement of Purpose and Service User Guide. This should ensure people are provided with information that reflects the current service provided. Two people told us they were given relevant information about the service before they moved into the home, enabling them to establish the suitability of the home to meet their assessed care needs. For example, people had access to the service's Statement of Purpose and Service User Guide. These documents provided information about staff's experience and qualification, the admission criteria, access to healthcare Care Homes for Adults (18-65 years) Page 10 of 30

11 Evidence: services, social activities, the accommodation and how to make a complaint, amongst others. The registered manager confirmed that people have a 'Needs and Aspiration Assessment' before moving into the home. This assessment enables the home to find out whether they would be able to meet the person's assessed care needs to promote their health and welfare. We looked at three care records, which showed a 'Needs and Aspiration Assessment' was undertaken before people moved into the home. The service AQAA stated, "Our assessment is very client focused and can take up to a month to complete, sometimes longer depending on the complexity of the clients needs." We spoke to a number of people who confirmed they were actively involved with their assessment before moving into the home. This promoted people's rights and choice about where they wish to live. A survey received from a person who uses the service stated, "I was showed around first, then stopped a couple of nights, then I moved in." Care Homes for Adults (18-65 years) Page 11 of 30

12 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 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 their assessed care needs will be met to promote their independence and ensure their safety whilst doing so. People can make decisions on the support and assistance they need to enhance their skills and promote their health and welfare. Evidence: Lonsdale House offers rehabilitation to people who have mental health needs, the emphasis of the service is to promote and enhance people's skills enabling them to live independently in the future. We looked at three care plans, these told us about the person's mental health needs and the support and assistance required in promoting their independence and safety. For example one care record stated, "I feel more confident with my life." The care plan showed that staff should ensure the person has regular access to a Community Care Homes for Adults (18-65 years) Page 12 of 30

13 Evidence: Psychiatric Nurse. This person told us they had regular access to their Community Psychiatric Nurse and Consultant. This should ensure the person's mental health is monitored to promote their health. Another care plan stated, "I am happy to have my medication administered by staff." The care plan showed that staff should support this person, enabling them to take their medication independently. This person confirmed staff were supporting them to take their medication but they were not yet confident to take them independently. The service AQAA and care records showed people were involved in planning their care. We spoke to three people who also confirmed this. One person said, "The service is good, we are involved in everything." Discussions with people and surveys we received, confirmed they were involved in making decisions in areas affecting their lifestyle and welfare. One person told us that regular meetings were undertaken with people who use the service. They showed us a copy of the minutes of the last meeting, which identified discussions about social activities, domestic arrangements and healthy eating. A survey received from a member of staff said, "The service puts the clients first and always involves the clients with every aspect of their care." The Service User Guide told us and discussions with people confirmed they had access to a self-advocacy service. This service provides independent support to people. The service AQAA stated, "We welcome input from advocacy services to help our clients make choices and to plan for the future and reach their goals." Risk assessments were included in care plans, this promoted people's independence whilst ensuring their safety. For example, people were encouraged to take their own medication. Care records showed people skills were assessed and detailed risk assessments were in place to ensure they were taking their medicines regularly and safely to promote their health. The service AQAA stated, "We encourage our clients to take controlled risks to enable them to have some stability in their lives." One person said, "The support from staff has enabled me to use the bus independently." This gave the person more confidence to live a lifestyle of their choice. Care Homes for Adults (18-65 years) Page 13 of 30

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15 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. Appropriate care planning ensure people are given the necessary support, to pursue their chosen social activity and maintain contact with their local community, promoting their rights and independence. People are supported to maintain their dietary needs to reflect their choice and promote their health. Evidence: The service AQAA stated, "We work closely with occupational therapists who provide one to one support to our clients to assess their needs regards leisure, education and employment needs." "We have engaged with our volunteer co-coordinator who has worked hard with the client in accessing training and employment." Care Homes for Adults (18-65 years) Page 15 of 30

16 Evidence: Staff told us people have access to 'Links for Work.' This is a scheme that assists people to find suitable employment. On the day of our visit we heard a person contacting this scheme for support in finding employment. We spoke to three people who told us they were not currently employed. One person said, "I want to get better and get a job." Another person informed us they would like to work with people who have mental health needs." The service AQAA confirmed, "We work with an outreach support worker who works with a number of our clients in setting up social networks." "These social net works continue for our clients also once they move into the community to prevent isolation." The care records and discussions with people confirmed they had access to leisure services within their local community. One person told us they visited 'Black Sisters.' This is a social community centre for people from an ethnic background. Another person said they attended 'Rethink,' this service provided social activities. They also informed us they enjoyed dining out. The service AQAA stated, "We encourage visits to the home from friends and family and understand the importance of maintaining these links." Care records and discussions with people confirmed they were able to maintain contact with their family and friends. This should ensure people are able to maintain contact with people important to them. We observed the routine within the home to be relaxed. One person said, "We don't have many restrictions, we can smoke, I have a key to my bedroom and front door." This should ensure people's privacy is respected. One person said, "If we're going to stay out late, we have to tell the staff." Another person stated, "The staff respect my privacy and rights." "When you want to be on your own, they respect that." Staff said people are assessed regarding their cooking skills to identify the level of support required for shopping and cooking. One person said, "I have now completed my catering assessment with my key worker and I am doing my own tea twice a week." Discussions with one person from an ethnic background confirmed they did their own food shopping and were able to cook meals that reflect their cultural dietary needs. Care Homes for Adults (18-65 years) Page 16 of 30

17 Evidence: Staff told us there were some people who were not able to maintain their dietary needs independently. Hence, the home had a seasonal menu, providing a choice of well balanced meals. One person said, "I have meals provided by the home, they feed you well." "There is always food available." Staff confirmed no one had a special dietary requirement due to health or religious needs. One person told us they had arranged for a dietician to attend the last 'resident's' meeting to talk about healthy eating. Care Homes for Adults (18-65 years) Page 17 of 30

18 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 to ensure their assessed care needs are met enabling them to live a healthy lifestyle. Medication practices promote people's independence and ensure their safety. Evidence: Care records were detailed and provided staff with a clear guidance on how to meet people's assessed care needs. A survey received from a member of staff stated, "I feel that our service provides a good standard of care for our clients." The service AQAA stated, "Our aim is to support clients in daily living skills to aid their independence and transition back into the community." One person said, "All the staff are great, they show empathy and they have lots of care." Care Homes for Adults (18-65 years) Page 18 of 30

19 Evidence: Care records showed the support people required to access other healthcare professionals. For example, we saw that people had access to a Community Psychiatric Nurse, General, Practitioner and a Consultant Psychiatrist. This should promote people's physical and mental wellbeing. We looked at the home's medication system and practices, we saw that medicines were stored and administered appropriately to ensure people receive their prescribed medicines regularly and safely. We saw that each person had a 'Medication Plan and Risk Assessment.' This showed what medicines were prescribed, the side affects, what the medicines were for, dosage and the time intervals. Staff said people are assessed to ensure they have the skills to self administer their medicines safely. One person said, "Staff help me with my medication." "I will be going to see my doctor to see if I can start self medicating." Staff told us people are supported over a period, enabling them to take their medicines independently. Discussions with staff and records confirmed people were monitored to ensure they were taking their medicines appropriately. We saw controlled medicines were appropriately stored, records showed staff had written over entries to disguise errors. Discussions with the registered manager confirmed this practice was inappropriate in ensuring an audit trail. She confirmed this would be addressed with staff members. Care Homes for Adults (18-65 years) Page 19 of 30

20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to the home's complaint procedure, enabling them to share their concerns and promote their rights. Policies and procedures adopted by the home protect people from the risk of abuse. Evidence: People had access to the home's complaint procedure, which was published in plain English, promoting people's understanding. The home's Statement of Purpose and Service User Guide also told people how to make a complaint to ensure their rights. One person said they were aware of the home's complaint procedure and told us leaflets were around the home, telling you how to share your concerns. They said this was discussed at the last resident's meeting and every one is aware of the complaints procedure. Another person said, "If I had a complaint I would speak to the Manageress." A staff survey stated, "This employer constantly encourages awareness of the complaints procedure and seeks feedback from anyone involved in client's welfare." Care Homes for Adults (18-65 years) Page 20 of 30

21 Evidence: The registered manager confirmed the home had not received any complaints since the last inspection visit. The service AQAA told us and discussions with the registered manager confirmed the home had not had received any safeguarding referrals since our last visit. Safeguarding is where there is an allegation of potential abuse. Staff training records showed staff had received safeguarding training, this was also confirmed by the staff. This should ensure staff members have the skills to recognise abuse and to protect people. The home had a safeguarding policy, this provided staff with a guidance on how to recognise abuse and what action should be taken to protect people potential harm. We saw leaflets around the home about recognising abuse, which also showed useful contact telephone numbers, enabling people to obtain support and assistance from independent agencies. We looked at staff personnel records, which showed the appropriate safety checks had been undertaken to ensure people were suitable to work in the home. Discussions with the registered manager confirmed people were able to manage their financial affairs independently but some people requested the home to maintain their money in safe keeping. We looked at three records and funds, which showed people's finances were well managed to protect them from potential financial abuse. Care Homes for Adults (18-65 years) Page 21 of 30

22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design and facilities provided within the home are suitable to meet people's assessed needs, to ensure their safety, independence and comfort. Evidence: Lonsdale House is located in Walsall; West Midlands near the town centre and is accessible via public transport. The service AQAA stated, "The home provides two self contained houses, three self contained flat-lets, 10 single rooms, a large kitchen, smaller training kitchen, dining room, one smoking room, office and separate sleeping area for staff." One person said, "I am happy with my room, it's the 'nices' room I have ever had." Equipment and adaptations were not provided but this was not currently needed for the people who used the service. Observations confirmed the home was suitable to meet people's assessed needs promoting their independence and privacy. Care Homes for Adults (18-65 years) Page 22 of 30

23 Evidence: A survey received from a person who used the service stated, "The home is exceptionally clean, the cleaner comes everyday." Care records showed what support people required to maintain the cleanliness of their bedrooms encouraging them to be independent. Care Homes for Adults (18-65 years) Page 23 of 30

24 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. Skilled and competent staff ensure people's assessed care needs are met promoting their independence, safety and welfare. Staff recruitment practices ensure people have a choice who works with them and ensure they are protected from potential abuse. Evidence: Discussions with the registered manager and information contained within the service AQAA, confirmed eight out of ten staff had obtained the National Vocational Qualification Level 2/3. We looked at staff training records, which confirmed this. People can be confident their assessed care needs will be met by skilled and competent staff. A staff survey stated, "This employer invests extremely well in staff training." Discussions with a person who used the service confirmed they were actively involved in staff recruitment. This ensures people have a choice who works with them to meet their care needs. The service AQAA showed staff had the necessary safety checks to ensure their Care Homes for Adults (18-65 years) Page 24 of 30

25 Evidence: suitability to work in the home, protecting people from potential abuse. We looked at three staff personnel records, which showed appropriate safety checks were undertaken. For example, we saw a Criminal Record Bureau (CRB) clearance, Protection of Vulnerable Adults (POVA 1st) and two written references. A staff survey stated, "I wasn't allowed to start work at Lonsdale until my checks were completed." The home's Service User Guide showed staff were experienced and had obtained the necessary training to ensure people's welfare. Discussions with a member of staff confirmed they had received the following training: First Aid, Adult Abuse, Mental Health Act, Fire Awareness, Moving and Handling, Food Hygiene and Medication training. They also told us they would be commencing the National Vocational Qualification Training. We looked at staff training records, which showed staff had access to relevant training, such as basic drug awareness, drugs and mental health, adult protection, dual diagnosis awareness, health and social care, working with personality disorders amongst others. A survey received from a person who used the service stated, "Staff are great and I get support and I think the world of Lonsdale House and everyone here." Care Homes for Adults (18-65 years) Page 25 of 30

26 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 management and administration is based on promoting people's independence and rights enabling them to live a lifestyle of their choice. Quality assurance systems ensure peoples views are respected to promote their welfare and safety. Evidence: The service AQAA stated, "The manager of the home has the Registered Managers Award and National Vocational Qualification, Level 4. Discussions with the registered manager and information contained within the home's Service User Guide also confirmed this information. This should ensure the manager has the skills to manage service effectively and maintain quality standards. The service AQAA stated, "There are good quality assurance and monitoring systems in place, supported by our Annual Development Plan. which reflects the aims and Care Homes for Adults (18-65 years) Page 26 of 30

27 Evidence: objectives of the home." The registered manager confirmed a 'Participation appraisal' questionnaires were given to people on an annually basis. One person told us they were involved in everything. This should ensure standards are maintained and the service is focused around people's needs. The registered manager told us that regular monitoring visits were undertaken. These visits were carried out by a responsible individual to ensure quality standards are maintained within the home. We looked at a report relating to the last monitoring visit, which showed the hygiene of the environment, fire safety and the Service User Guide were looked at. Records showed a Fire Safety Officer had undertaken an inspection of the property on 03 June Recommendations were made to improve the safety standards within the home. The registered manager confirmed these recommendations had been addressed. We also saw evidence of this contained within the home's fire risk assessment dated 06 October Care Homes for Adults (18-65 years) Page 27 of 30

28 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 28 of 30

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 20 To promote good practice, staff should refrain from writing over entries in the controlled medication record to disguise errors. Care Homes for Adults (18-65 years) Page 29 of 30

30 Helpline: Telephone: or Textphone: or Web: 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 30 of 30

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