Inspection on 19/08/09 for 1 Johnson Close

This is the latest available inspection report for this service, carried out on 19th August 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1 Johnson Close 21/09/05

1 Johnson Close 05/04/05

1 Johnson Close 30/11/04

1 Johnson Close 05/07/04

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Insight - Eastchurch

Southfields

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Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Johnson Close 1 Johnson Close St Leonards-on-sea East Sussex TN37 7BG     The quality rating for this care home is:   three star excellent 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: Michele Etherton     Date: 1 9 0 8 2 0 0 9 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 1 Johnson Close 1 Johnson Close St Leonards-on-sea East Sussex TN37 7BG 01424853339 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.eastviewhousing.co.uk East View Housing Management Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users ot be accommodated is 4 The registered person may provice the following category of service only:Care home only(PC) to service users of the following gender: Either whose primary care needs on admission to the service are within the following category: Learning disability (LD) Date of last inspection Brief description of the care home 1 Johnson Close is a 4-bedroom detached house situated in a quiet residential Close. The home is registered for 4 younger adults with learning disabilities, and at present all residents are female in their forties. The home is a spacious residence, offering a large lounge, a further communal room and a large kitchen dining room. The office is in a separate room by the front door. There is a separate utility room with domestic style washing machine and tumble dryer. All residents have their own bedrooms. The house has a good front and back garden. There are no immediate local amenities within walking distance, however, Johnson Close is situated off the main Battle Road that has bus routes to the locals towns of Battle and Hastings. The home is part of East Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 Brief description of the care home View Housing Management Limited (EVH). Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term service user to describe those living in care home settings. For the purpose of this report, those living at 1 Johnson Close are referred to asresidents. A key inspection of this service has been conducted. This has taken account of information we have been told about the service and also information provided by the service itself including an Annual Quality Assurance Assessment(AQAA). This was returned when we asked for it and was comprehensively completed providing us with all the information we needed, we have discussed with the manager some minor improvements that could further enhance content overall. Residents and staff were sent Have your say surveys and two of these have been returned and comments made have contributed to the overall judgment of the service Care Homes for Adults (18-65 years) Page 6 of 27 and have been incorporated into the report. Since the last inspection there has been one adult safeguarding alert and one complaint both have been satisfactorily resolved. During our visit to the home we met all four of the people living there and also spoke with the registered manager and two staff. The people at the home were chatty and excited and happy to talk to us about things they like to do and their life at the home. One resident told us like it here. During our visit we also examined a range of documentation maintained by the home, this included: support plans, risk information , medication, accident and complaints records. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? Since the last inspection the home manager informs us through AQAA information that: New, more person centered my life plans have been implemented with which residents are more actively involved. Increased opportunities for staff training have been made available to ensure staff are provided with the necessary skills to support residents effectively. There has been improved networking with other agencies e.g. CLDT, and this has raised staff awareness and understanding of other agencies, who in turn have been complimentary towards the service in regard to the quality of their communication with residents. New decking has been added to enable residents to make better use of the garden, Care Homes for Adults (18-65 years) Page 8 of 27 replacement furniture and furnishings are on order. Staff wages have increased and overall communication and contact with the senior management team improved 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 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be confident of receiving information about the service in a suitable format, their needs are assessed prior to admission to ensure these can be met. Evidence: The AQAA dataset that the home sent, informs us that there has been no change in the make up of the present resident group or any significant changes in needs since the last inspection. Residents have settled well and relate better to each other. The needs of the present resident group are taken account of and would influence any future admissions if a vacancy occurred. The homes assessment procedure has previously been assessed as good. The manager states that the Statement of purpose and user guide are reviewed to ensure they are still accurate; she advised that some minor name and address changes are now needed. Information about the service is provided to prospective residents in a format suited Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: to their own needs. The home works with residents to be actively involved in the development of their support plans, we are advised that external agencies have been complimentary of the quality of communication offered to residents within the serice. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information that tells staff how best to work with people living in the home is detailed and refelctive of individuals preferences but does not make clear how often this is reviewed. Evidence: When we looked at examples of support plans we found that these are more detailed and personalized to reflect individual preferences and aspirations. They provide staff with information about communication styles and how best to work with individual residents. Documentation viewed could not tell us how often people in the home are consulted about their plan and when parts of it change. When we observed staff working with the people in the home we were able to see how residents are provided with opportunities to make informed decisions and choices for themselves in their daily lives. Staff commented that : Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: we treat clients as individuals, with respect and dignity The home delivers care on an individual basis We help to treat them as independently as possible strive for equality, care and support to the highest level The manager and staff demonstrate a commitment to enabling people in the home to lead active and fulfilling lifestyles, maximize their potential for independence and experiencing risk. When we looked at risk assessments information for individual residents although detailed and informative making clear the risk reduction measures to be adopted, we could not be sure if this was up to date and therefore still effective as dates of review were unclear. Although satisfied that people living in the home are fully consulted about their support plan, and any risks to their well being are fully assessed. Recording of reviewing and updates has drifted and we recommend that this is more clearly evidenced to ensure this is happening regularly. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home enjoy a busy active and healthy lifestyle, they are supported to maximize their potential and live the life they choose. They are helped to maintain and develop relationships that are important to them. Evidence: There is a good atmosphere in the home with the people living there chatty and excited about their day and wanting to talk with staff and any visitors. All of the people living in the home attend day centres during the week and have a full individualized programme of activities that they enjoy. One person had previously attended a different resource on a daily basis and the home have accommodated this so that the individual concerned has continuity. Some of the residents enjoy gardening and whilst we were visiting a small crop of Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: tomatoes were gathered by a resident to be used in the evening meal, they were very excited about this. We are informed that the residents are engaged in growing other vegetables for use in the home. The benefit of two staff on duty routinely in the evenings and at weekends means that people in the home can also enjoy a wider range of interests and social events during these times, and this helps with socializing and meeting friends. The manager and staff listen to the aspirations of the people living in the home and facilitate opportunities to achieve these where possible. Information to help residents with choosing and decision making is made accessible to them in a format that best suits their communication style. When we spoke with some of the people at the home they told us about the contacts they have with their families and friends, with three enjoying regular contact and stays with their relatives. The home staff have been supportive of another person at the home re-establishing contact with their family member also. The right of individual residents to holiday without the company of the other people they live with has been respected and people we spoke with were able to tell us about past and future holiday arrangements that they have enjoyed or are looking forward to, one person reporting they will be going on a mini cruise and another will be going to the west country. The manager and staff have an awareness of healthy living and everyone living at the home is provided with opportunities for physical exercise e.g .regular swimming, one person we spoke with particularly enjoys sport and was able to show a range of medals they have won at sports events for disabled people. People in the home are consulted about menu development and what they would like to eat, they are offered alternatives and we observed staff and people in the home discussing what to have for the evening meal, with different choices being catered for, people we spoke with said they go shopping with staff and activity programme indicate individuals take turns in helping with food preparation. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal, physical and emotional well being of people living at the home are excellently supported by staff although some minor improvements are needed to medication arrangements. Evidence: People in the home benefit from continuity within the staff team which means staff have a sound understanding and awareness of individual needs and preferences around personal care routines and preferred communication styles. Documentation examined during our visit highlights that all the people at the home are supported to access routine health care appointments, and that the home is proactive in seeking specialist interventions where necessary. Weights are regularly monitored. Very good records are maintained of all health care contacts. The home staff are conscious of the need to encourage people in the home to take a more active responsibility for making and keeping health appointments. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: People in the home are not self administering and are resistant currently to any proposed changes to this, the home staff will be working with individuals to become more actively involved in their medication regime and to take responsibility for storing their own medication. We found medication records are mostly handwritten on a monthly basis, and although those viewed were accurate without omissions, they appear messy. Changes to handwritten entries are sometimes signed but not dated, and we have discussed the need to do so. All staff are trained to administer and competencies assessed but no sample signature and initials register is maintained for audit purposes. We have recommended improved practice in the areas we have highlighted Medication is supplied on a monthly basis and starts the same day as the MAR charts for that month, medication which spans more than one month is dated upon opening but this does not always extend to some creams we saw in use, we would recommend this is standard practice for all prescribed medications used. We noted that some residents have a lot of as required medications and guidelines for its usage were noted for each individual. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are afforded opportunities to express their views and feel listened to. Sound procedures are in place that safeguard them from harm. Evidence: People living in the home are provided with opportunities to express their views to staff, they are vocal and confident in their dealings with staff and each other, staff welcome and value comments and views expressed by residents and will act upon these where possible. Only one complaint has been received since the last inspection from a neighbor and this was resolved immediately. Staff have received adult safeguarding training and refresher training is offered. Since the last inspection there has been one adult alert and this has now been closed. We have discussed with the manager the need to make clearer within AQAA information how adult safeguarding is being addressed within the service. Individual guidelines are provided to help staff work with people when they become upset or angry. Procedures to protect the finances of people in the home are being adhered to and we checked the finance records of two people in the home against cash sums held on their behalf and found these to be accurate. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent 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 clean, safe, homely, and comfortable environment. Their accommodation has been adapted to take account of their needs and wishes and they are actively involved in domestic tasks to maintain it. They are consulted about any changes to their home. Evidence: Residents live in a comfortable safe and well maintained environment, they are consulted about changes to their home and take an active role in the domestic upkeep of the house. They have been supported to personalize their own rooms to reflect their own tastes and interests. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are always enough staff to help people in the home lead the life they choose, and they are safeguarded by systems for the recruitment and training of support staff. Evidence: Staffing rotas are developed to ensure that people in the home have enough staff on duty when they need them, this ensures that people in the home have support to attend a range of activities throughout the week in the evening and at weekends. Whilst the home is not staffed during the day when the people living there are away, this can respond flexibly to those occasions where residents may choose to stay at home. The staff team remains stable providing excellent continuity to people in the home, an additional staff member has been recruited and when we looked at their file we noted that all necessary vetting and checks are in place, some information that should be in the staff file had not been forwarded form head office and we would urge that the content of staff files maintained in homes is complaint with legislation. Gaps in employment are being explored at interview and we have suggested to improved recording of this. When we spoke with a new staff member they confirmed they had not previously Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: worked in learning disability services but had a lot of previous experience in working in other care settings, they told us that they had received induction and we noted documentary evidence that they are still working through this, they commented that Ive been supported 100 since coming to work here. Staff we spoke with commented that the organizations induction is very comprehensive, and includes LDAF, although this is usually provided post induction, as this is meant to underpin the knowledge and skills of staff new to learning disability we have discussed the rationale for the delay in introducing new staff to this training with the manager and senior management staff and this is to be reviewed. Staff comments received through direct discussion and survey feedback are: I really enjoy my job All staff are extremely supportive and adaptable Ive never seen a more well run home I feel the traiing is very sufficient, I am being funded to complete my NVQ There is a training matrix and the organization provides a rolling programme of mandatory training and opportunities for specialist training, staff are up to date in their training, and we noted certificates for this. The development of individual training profiles would make it easier for the manager to review individual staff and we have discussed this with the manager. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is excellently managed in the best interests of the people living there Evidence: There has been no change to the management of the service and this continues to be excellentlyorganised in the best interests of the residents. Staff tell us that: The manager is extremely supportive and very approachable The manager is always avaialble to support staff and clients Mechanisms are in place to ensure that people living in the home are fully consulted about every aspect of the running of the home. They have opportunities each day to spend one to one time with a worke, when they can talk about their day and raise any issues they may have. They also have resident meetings. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: When we spoke with the people in the home and observed interactions between themselves and support staff, it is clear that they are fully consulted about all aspects of their daily lives and their views and opinions are encouraged and valued, discussions with staff indicates measurable improvements for all residents in this nurturing environment. Although there are some stand alone audits and service quality monitoring has been recognized by Investors in people, there is currently no cohesive programme of quality assurance to allow for the internal audit and review of systems. In discussion with senior management staff within the organization we are informed a programme of periodic review is to be re-instated and we would recommend this is progressed. Staff and people who live in the home feel their views are valued and taken account of. The organization is supportive of the professional development of the manager and staff, and practice and performance are discussed during supervision. People living in the home who do not currently have the skills to take full control of aspects of their daily lives are encouraged and supported to work towards this. The AQAA information provided informs us that all policies and procedures have been reviewed. All health and safety servicing has been undertaken, and there is organisatinal monitoring to ensure the health and safety of staff and people in the home is safeguarded. We noted in one bedroom a detailed fire procedure was attached to the door when we asked the resident what this was telling them about, they could not understand it and clearly a more accessible version that the home has produced should now replace these. We have queried with the organization some dates of servicing and are satisfied that these have either been updated or plans are underway to do so shortly, historically the service has been compliant with regulation and committed to ensuring residents are kept safe. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The registered manager should ensure that care plans evidence routine reviewing, and that the consent of residents is recorded clearly. The registered manager should ensure that there is clear evidence that risk information is routinely reviewed for effectiveness and changes are clearly recorded Handwritten changes on MAR charts should be dated as well as signed by he person making he change. A register of sample signatures/initials of administering staff should be maintained for audit purposes. Prescribed creams should always be dated upon opening. 2 9 3 20 4 39 The Registered Provider should progress plans to re-instate periodic review of the service, to ensure service quality is monitored and can evidence consultation with people living in the home Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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