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Inspection on 15/04/09 for 3 Pendarves Road

Also see our care home review for 3 Pendarves Road for more information

This is the latest available inspection report for this service, carried out on 15th April 2009.

CQC found this care home to be providing an Good 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Pendarves Road 3 Pendarves Road Camborne Cornwall TR14 7QB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Wright     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 3 Pendarves Road 3 Pendarves Road Camborne Cornwall TR14 7QB 01209610827 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : alan.hegarty@dcact.eu.com Spectrum (Devon and Cornwall Autistic Community Trust) care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is 4. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home 3 Pendarves Road provides accommodation and personal care for up to four adults with a learning disability. The registered provider is Spectrum, an organisation that provides specialist services for people with autistic spectrum disorders. Spectrum employs a manager and a team of staff to run the home on a day-to-day basis. The home is located in the town of Camborne, within easy reach of all the towns facilities. There are shops within walking distance of the home. The home has transport which is used by the people who use the service. The home is a two-storey building, set in its own grounds. All of the bedrooms are large single rooms some of which are en suite. There is a shared bathroom on the first Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home floor. The home has an office on the first floor. Downstairs there is a communal kitchen/ dining room and large lounge. The home currently does not provide specific facilities for people with physical disabilities. Fees are from £1200 per week (subject to individual assessment). The fees exclude charges for individual toiletries, chiropody etc. Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place in seven and a quarter hours in one day. All the key standards were inspected. The methodology used for this inspection was: (1) To case track three people using the service. This included inspecting their records, and talking with the people concerned about their experiences of the service. (2) Discussing care practices with staff and management. (3) Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. Care Homes for Adults (18-65 years) Page 6 of 30 Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 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 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. Information provided to people who use the service (e.g. regarding services offered) is good. For example all people who use the service (and /or their representatives ) receive a statement of terms and conditions of residency or contract when they move in. This ensures people are aware of their rights and responsibilities. Pre admission assessment procedures are satisfactory and ensure the registered persons check they can meet the persons needs before admission is arranged. Evidence: We inspected a copy of the homes statement of purpose and service user guide. These contain satisfactory information about the service. The registered provider has a satisfactory assessment procedure. For example prospective clients and their families can visit the home before admission is arranged. Senior staff visit the person to meet them as part of the assessment process. There have been no admissions to the service since the last inspection. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: We were able to inspect contracts / statements of terms and conditions of residency for people using the service. Information inspected was satisfactory. Care Homes for Adults (18-65 years) Page 11 of 30 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. Satisfactory care planning procedures are in place. There is satisfactory opportunity for people to participate in making choices and be involved in decision making. Staff enable people using the service to take an appropriate level of risk so they can pursue as independent a lifestyle as possible. These measures ensure the needs of people who use the service are met and they are given the opportunity to make choices how they lead their lives. Evidence: A care plan was contained on the file for each person we case tracked. Care plans are accessible to staff. There is a review process in operation, and people who use the service (and / or their representatives) are invited to review meetings which occur. From discussion and observation, people who use the service are involved in making decisions about their lives, and how the home is run. There needs to be some improvement regarding physical restrictions in place-as outlined in the environment Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: section i.e. in regard to locks on the communal room doors. Suitable risk taking seems to take place to enable people using the service to live as independently as possible. The home has its own transport, which enables people to participate in community activities. Suitable risk assessments are kept on file, and reviewed as necessary. Personal monies are managed by staff on behalf of people using the service. Money is held in cash tins, and these are locked away. Suitable records are kept recording any expenditure. Management have appropriate systems to ensure records are checked. Care Homes for Adults (18-65 years) Page 13 of 30 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. The registered persons ensure people living in the home can live a lifestyle which meets their needs and wishes. Evidence: People using the service have the opportunity to pursue a range of activities such as going out walking, going to college, the leisure centre etc. Social and shopping trips are organised according to the wishes and needs of individuals. There is evidence from daily records that people participate in a lot of activities, and people are involved in the planning of these. People have opportunity to visit friends and relatives and these people also visit the home. The home provides cars for most of the people living in the home. One person currently does not have their own transport. There had been issues regarding the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: persons behaviour while in the car which could have caused danger to them, the driver and other passengers. Staff felt the current arrangement for this person only being able to use public transport restricted the opportunities available to them. It is therefore advisable the current arrangement is reviewed to ascertain if the person could now use a car / minibus with lower risk. Routines in the home seem appropriate according to individual needs. People living in the home are involved in housework and cooking. Records also show people appear to have a varied and nutritious diet. Care Homes for Adults (18-65 years) Page 15 of 30 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. Personal and healthcare needs of people living in the appear to be satisfactorily promoted and met. The management of medication is satisfactory. Evidence: We observed people using the service receiving suitable care and support from staff. Support was carried out in a professional manner. Documentation regarding how care tasks are completed is satisfactorily documented in care plans. People living in the home appear to have their personal hygiene needs met. When a member of staff was showing the inspector around, they did open the door of someones bedroom without knocking (while the person was in their room). This matter was discussed with the manager. It was concluded the member of staff was probably nervous, and the manager said staff would always usually knock before entering peoples bedrooms. Staff need to be reminded of the importance of this. All people using the service looked well cared for on the day of the inspection. Some people have epilepsy. The manager said staff receive training regarding this condition, Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: as part of the organisations medication training. People living in the service have suitable access to health care professionals such as GPs, dentists, district nurses, chiropodists, opticians etc. Record keeping regarding this needs to be improved, as it is difficult to track when somebody last saw some of the professionals involved. We inspected the medication system. The medication policy seems satisfactory. Medication is stored appropriately in a medication cupboard. Medication is administered via a monitored dosage system supplied by a local pharmacist. Staff have received appropriate training regarding handling medication. Administration and recording of medication seems satisfactory. Care Homes for Adults (18-65 years) Page 17 of 30 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 registered persons have satisfactory complaints and adult safeguarding procedures. This should help to ensure any concerns, complaints and safeguarding allegations are investigated appropriately. Evidence: Copies of the complaints and adult safeguarding procedures were inspected and are satisfactory. Staff on duty were not aware of any complaints or concerns. The Commission for Social Care Inspection or the Care Quality Commission has not received any complaints during this inspection period. We would advise the registered provider to include information regarding access to the social services complaints procedure, within their procedure and /or within individual service user guides. People who are funded by local authorities have a right to use this procedure if they are funded by social services, and subsequently they should be made aware of this. The registered providers adult safeguarding procedure is satisfactory. However, it should be contained in the homes policy file so it is more accessible to staff (rather than in the filing cabinet). There was other information on the wall of the office regarding what to do if any person suspected abuse was occurring in the home. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Training regarding safeguarding is delivered to care staff as part of their induction. Staff or people who use the service, who we spoke to, said they had no concerns regarding the attitudes of other staff or care practices in the home. Care Homes for Adults (18-65 years) Page 19 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pendarves provides a generally suitable facility for the people living there, although some improvement is required to improve these. Evidence: The building was inspected. Four people are accommodated at the home. The house has a spacious lounge, and a kitchen with dining space. People who use the service have individual bedrooms, some with an en suite toilet /shower. One person has his own lounge area, and there is a second communal lounge upstairs in the house which people can use. We did raise concerns about locks on the doors of some of the communal rooms. These should be removed if not used, or there needs to be clear risk assessments (preferably agreed with the multi disciplinary team) why they are used, and under what circumstances. There is suitable toilet and bathing facilities. It is advisable thermostatic valves are fitted to all bath and shower facilities to limit the risk of scalding, however water temperatures are checked when people bathe. There are satisfactory laundry facilities. There is an office. This contained a shower room, but this was removed due to a leak. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: This should be reinstated if required, or at least the decor needs improving as the room currently looks in a poor state. There is no dedicated sleep in room. Staff currently sleep in the lounge. This is not desirable, as this should be dedicated space for people using the service. Some people using the service may wish to use the area at night when staff are off duty. It is therefore important Spectrum look into providing more satisfactory staff facilities. Decorations and furnishings in the lounge, kitchen and bedrooms are generally to a good standard. The lounge and kitchen have been refurbished recently, and are to a good standard. The landing and hallways could do with some additional refurbishment. For example carpets are beginning to look stained and worn, and the walls would benefit with some pictures to help the areas look a bit more homely. There was some damage to walls, and an internal glass door pane was cracked. The manager said these matters had been reported, and the home was waiting for the matters to be attended to. The home has a large pleasant garden which are accessible to the people living in the home. There is suitable car parking areas available. The home is situated near the town of Camborne. The registered provider has transport so most people can move around the community. The home was clean, warm and light enough on the day of the inspection. The kitchen was generally clean, although the oven needed to be cleaned. The outside of the building and the gardens were maintained to a satisfactory standard. Care Homes for Adults (18-65 years) Page 21 of 30 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. Staffing levels appear satisfactory to meet the needs of people currently accommodated at the home. Recruitment checks are to a good standard. Some improvement is required regarding staff training. These measures ensure people who use the service are supported by suitably knowledgeable and skilled staff. Evidence: On the day of the inspection there were three members of staff on duty during the morning and afternoon /evening. One member of staff sleeps in. People using the service have one to one support. Personnel records were inspected for the staff on duty for the day of the inspection. These were satisfactory.Staff employed had two references, a Protection of Vulnerable Adults First check (POVA First) , a Criminal Records Bureau check (CRB) , a completed application form and evidence of identification. It would be helpful if a scanned copy of the POVA First check is stored with other personnel records on the Spectrum records system. This will help us validate this check has been completed before the member of staff has commenced employment. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: We inspected training records for the same sample group of staff. By law staff require the following training: (1) Regular fire training in accordance with the requirements of the fire authority. (2) There must always be at least one first aider on duty (at appointed person level) (3) All staff must have manual handling training and should have regular updates of this (e.g. annually) (4) All staff must have basic training in infection control. (5) Staff who handle food receive food hygiene training. (6) All staff must have an induction and there needs to be a record of this. (7) Awareness training regarding the needs of people accommodated. The delivery of training is generally satisfactory. The registered provider offers staff a comprehensive staff induction which covers the majority of the elements required by law. Staff subsequently attend follow up training which covers the areas in more detail. However, some of the staff files inspected show that some of the staff still need to attend the follow up training. For example one member of staff commenced employment in February 2008, and there was no evidence that the person had completed further training since the induction at that time. Another member of staff commenced employment in 1994. The person needs some training updates. There is also no record the person has received some training required by regulations (apart from receiving this on induction). For example in regard to basic manual handling training and infection control training. There is good opportunities for staff to obtain a National Vocational Qualification in care. When staff have received an NVQ 2 there is the opportunity to obtain an NVQ 3 in care if this is deemed by management as appropriate. Care Homes for Adults (18-65 years) Page 23 of 30 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 manager and the staff team are effective in ensuring the service is managed to a good standard. However the application for the registered manager still needs to be approved by the commission. Quality assurance procedures appear satisfactory, but there must be a policy in place. Policies and procedures need to be reviewed, and a comprehensive, up to date policy file needs to be put in place in the home. Health and safety procedures and checks need some improvement for example there needs to be an up to date gas safety certificate and evidence of measures taken to prevent legionnaires disease. Evidence: The registered provider is Spectrum, a registered charity supporting people with autism / aspergers syndrome. The manager is Alan Hegarty. Mr Hegarty submitted his application to be registered with the Commission for Social Care Inspection, and was interviewed two months previously to the inspection. Mr Hegarty said he had not been informed about the commissions decision. The inspector stated it was reasonable that Mr Hegarty should receive an update regarding this. The inspector subsequently Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: contacted the commissions registration team to ask them to contact Mr Hegarty, and to finalise the application as soon as possible. The home seems to operate to a good standard. The inspector had no concerns about Mr Hegartys fitness to be registered. For example Mr Hegarty is currently undertaking training regarding a National Vocational Qualification in care, and also the Registered Managers Award. The registered provider has a satisfactory approach to quality assurance. However,there does not appear to be a policy regarding quality assurance, and if this is the case this must be developed by the registered provider. We did see an annual development plan for the service, and this appeared satisfactory. The registered provider has supplied the commission with their Annual Quality Assurance Assessment (AQAA) (an annual dataset, and self assessment required by CSCI). This was completed to a good standard, although we did have to send reminders for the information to be returned. Any notifications, required by the commission (e.g. regarding untoward incidents) appear to have been received by us. The policies and procedure files in the home are dated May 2003. Some policies were absent from the file. For example the adult safeguarding policy was in a filing cabinet, and there was no quality assurance policy / procedure. It is essential an up to date set of policies (particularly those required by regulation) are kept in the home and are accessible to staff. It is essential that policies are reviewed yearly, and updated accordingly. Staff need to be aware of the existence of policies they need to have a knowledge of. The registered provider has a health and safety policy. There is a fire risk assessment. Testing of fire extinguishers and the fire system appear to have been completed appropriately by external contractors. Internal checks on the fire system appear to have been completed appropriately by staff (e.g.emergency call points and emergency lighting). Health and safety risk assessments have been completed. However, we did not view any risk assessment or routine testing records regarding the prevention of legionella. If this is not occurring this needs to be organised. The Health and Safety Executive publish a useful document regarding this matter via their website. As stated earlier in the report, it is strongly advisable that the temperature of hot water is controlled via thermostat to reduce the risk of scalding. The Environmental Health Department may require this particularly considering the needs of the current people accommodated at the home. Suitable records regarding accidents and incidents are kept. Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: Portable electrical appliances have been tested and appear satisfactory (for example there were testing stickers on some appliances). However there was no schedule of test results, and the manager said he would chase this up. The electrical hardwire circuit has been tested and the results are satisfactory. However, gas appliances were last serviced at the end of February 2008, and these need to be retested so they can be deemed safe. An up to date certificate of insurance is displayed. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 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 1 24 16 Carry out improvements 31/08/2009 identified in the report to the building. Review the provision of locks on doors of communal areas. This will assist in providing an improved facility for the people living in the home. Staff need to receive training as outlined in the body of the report. This will ensure all staff have appropriate knowledge and skills, in accordance with the law and to meet the needs of the people accommodated in the home. 31/08/2009 2 35 18 3 40 12 Update policies and procedures in the home. This needs to include a policy regarding quality assurance. This measure will ensure the management of the home is guided by an effective and 31/08/2009 Care Homes for Adults (18-65 years) Page 28 of 30 up to date set of policies developed by the organisation. 4 42 12 Ensure there are satisfactory 31/08/2009 health and safety precautions in place. For example control measures regarding the prevention of legionella, and an up to date gas safety certificate. A copy of the gas safety certificate needs to be forwarded to the commission when this test is completed. This should help to ensure staff and people who use the service are protected from health and safety risks in these areas. 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 2 13 19 Review transport provision for one person using the service Keep up to date records of all medical appointments attended by people who use the service (e.g. dentist, chiropodist, GP, optician etc.) It should be possible to track when the person last saw one of these practitioners. This will help ensure management /staff can track that people are receiving appropriate healthcare. Ensure there is reference to the Social Services Complaints procedure, in the homes complaints procedure, and /or service user guide, as people funded by local authorities have a right to use this if they have a concern or a complaint. To reduce the risk of scalding, fit thermostatic valves to bathing facilities to control the temperature of hot water. 3 22 4 29 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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