Inspection on 16/09/09 for Burden Road (43)

This is the latest available inspection report for this service, carried out on 16th September 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Burden Road (43) 17/07/07

Burden Road (43) 28/09/06

Burden Road (43) 09/12/05

Burden Road (43) 31/05/05

Burden Road (43) 06/01/05

Burden Road (43) 16/06/04

Burden Road (43) 31/01/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Burden Road (43) 43 Burden Road Moreton Wirral CH46 6BG     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: Lorraine Farrar     Date: 1 6 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Burden Road (43) 43 Burden Road Moreton Wirral CH46 6BG 01516789962 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) : burdenroad@c-i-c.co.uk Community Integrated Care care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home 43 Burden Road is based in a family area of Moreton, near to local facilites and transport. It supports up to for three adults who have a learning disability. CIC (community Integrated Care) run Burden Road. They are a large organisation who provide care services across the country. The house provides everyone living there with their own bedroom. People share a lounge, small dining kitchen and downstairs bathroom. There are a number of aids and adaptations provided to support people with their mobility and personal care. These include an adapted shower, grab rails and a ramp. Staff are available twenty four hours a day to support the people living at Burden Road. Care Homes for Adults (18-65 years) Page 4 of 29 Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before we visited we sent surveys forms to the staff who work at Burden Road, five members of staff returned these to us. We also sent a self assessment form to the manager. This gave her with the opportunity to tell us about the areas the home are doing well in, any improvements they have made and plans they have for future improvements. It also told us about staff, health and safety and how they support people. We looked at any information we have been given about Burden Road since our last big inspection. This all helped us to plan our visit and write this report. We visited Burden Road on 16th September 2009. They did not know we were visiting. We met both of the people living there and two members of staff and talked to the manager on the phone. We spent time reading records, looking around the house and looking at the support given to the people living there. Care Homes for Adults (18-65 years) Page 6 of 29 It costs from three hundred and seventy five pounds, ninety five pence each week to live at Burden Road. 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. Care Homes for Adults (18-65 years) Page 8 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is obtained about and given to people thinking of moving into Burden Road. However the information given to people is not always up to date or easy to understand, which may impact on their understanding of the service and support they can expect. Evidence: The people who live at Burden Road have lived there for many years. Therefore it was not possible for us to practically assess the support that would be offered to anyone considering moving in. However there is a policy in place from the organisation for introducing people to the home and a member of staff was able to explain how this works in practice. Before anyone is offered a place to live at Burden Road, a full assessment of their needs and choices would be carried out. They would also be offered the opportunity to visit, meet the people living there and staff and stay overnight if they wanted to. This helps everyone to decide if Burden Road is the right place for the person to live. It would Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: also help staff to plan how they could support the person successfully. A booklet about Burden Road is available to give to people and their relatives. This tells people about how the home is run and the support they can expect. The booklet uses photographs to help people understand the information. However there is a lot of writing on some of the pages and not all of the words used are as easy to understand as they could be. Some of the information is out of date. For example it does not give the right name and address for people to contact ourselves if they want to. The manager told us that she plans to update this so the information is easier to understand and up to date. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Burden Road are supported by a staff team who know them well and can work with them to meet their needs and choices. Care planning and records do not always fully reflect this which could lead to unfamiliar staff not supporting people as well as possible. Evidence: Staff told us in their comment cards that they are always given up to date information about the needs of the people they support. One member of staff commented, we update our care plans to make sure we all follow them and we discuss any changes at team meetings and another that, care plans are reviewed regularly and updated if any of the service users needs change. This was further evident during our site visit when staff were able to give a good explanation of peoples different needs and choices and how they communicate these non-verbally. Individual care files and records are in place for the people living at Burden Road. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: These contain brief guidance on the support people need in areas of their life such as personal care and their mobility. Discussions with staff showed that they have a more in-depth knowledge of peoples support needs than is written down in the basic care plans. For example a plan for personal care stated, assist with personal care. However staff were able to explain how they assist the person and the things the person can do independently. This lack of in-depth written guidance could lead to unfamiliar staff not supporting people in the way they prefer. Each person at the home also has an essential lifestyle plan in place. These use pictures to aid peoples understanding and contain more information about the person. This includes the things they like and dislike and how they communicate as well as how to support them effectively in a way they prefer. They also contain information about peoples health and the things they enjoy doing. Files also contained individual risk assessments for the person that cover areas such as support with health and personal care and going out and about. These risk assessments look at the risk to the person and others and give guidance for staff to minimise the risks involved whilst people go about their everyday lives. Care plans and risk assessments had been reviewed and updated to reflect any changes to the persons support needs and choices. This helps to ensure that any issues can be quickly noted and addressed. Staff were able to explain how the people living at Burden Road make everyday decisions for themselves. For example they explained one person will take their hand and lead them to a drink or occasionally bring their coat when going out. Staff displayed a good awareness of the importance of supporting people to make as many decisions for themselves as possible, with one member of staff explaining, the more decisions (name) can make the better. A decision making document had been used to support the decision for the two people living there to share the cost of a motability vehicle. This lists the reasons why it may or may not be a good idea and how the decision was reached. This type of written decision making is in keeping with laws about supporting people with decisions they are unable to make them for themselves and should be used for all major decisions in peoples lives, which they are unable to make for themselves. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Burden Road are supported to live a lifestyle of their choice and to become a part of their local community. Evidence: Records in the home showed that the people living there are supported to go out and about on a daily basis, often receiving one to one support from staff. A member of staff explained that they regularly use local shops, pubs and facilities, therefore the people living there are well known in their local community. Some of the places people had been in recent days included, going out for a drive, shopping and for walk and picnic. In discussions with staff they had a good knowledge of the different places people like to go and things they enjoy doing. Whilst at home we observed the people living there Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: spending time in all areas of their home as they chose. Staff used their knowledge to talk with one person and establish that they wanted to listen to a CD and responded positively to requests from another person for a drink. As the people living at Burden Road do not use verbal forms of communication the level of knowledge staff have along with their ability to read peoples communication helps to support people to live a lifestyle of their choice. Routines at Burden Road are flexible with people getting up and going to bed when they wish, having meals and drinks at times that suit them and spending their time doing the things they enjoy. The small dining table in the kitchen only seats two or three people. This means that staff cannot sit with people to help make meals a more sociable occasion. We noted at our last inspection that menus did not fully reflect the meals provided and therefore it was difficult to establish if people were being offered a healthy diet. The manager told us in the self assessment form that this has since improved. During this visit menus showed that people are offered a varied diet with fruit and vegetables. Staff had a good knowledge of the support people need at meal times and this was backed up with information in the persons care plan. Food is bought at local shops and supermarkets which again provides the people living there with an opportunity to become a part of their local community. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Burden Road receive the support they need to remain as healthy as possible. Evidence: In meeting the people living at Burden Road it was clear that they had received support with their personal care and appearance. In discussions with staff they were able to explain the support each person needs along with the things they can do more independently. However as stated elsewhere in this report information in care plans does not always reflect staff knowledge or their attention to detail when supporting people. This could lead to unfamiliar staff not supporting people in the way they prefer. Records showed that people receive support from staff to make and attend health appointments. This includes regular appointments such as the Optician and Chiropodist along with more specialist appointments when needed. Staff had a good knowledge of peoples health care needs and were able to explain the signs that someone may be feeling unwell as well as the everyday support they provide to support people to stay Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: healthy. Care plans contained a health passport for each person which includes information on their health history along with information about how they communicate. They also contained an anticipatory care calendar from the local Primary Care Trust for each person. This is filled in regularly by staff and helps to quickly note and therefore deal with any changes to the persons health or wellbeing. Staff who support people with their medication have received training in this area. A locked cabinet is provided to store medication correctly and we saw this being used during our visit. Clear records are kept of medication received into the home and given to the people living there. We looked at samples of the medication held and records relating to it and found them to be accurate. The clear systems in place for dealing with medication, along with staff training, help to reduce the risk of mistakes occurring that could impact on peoples health. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place at Burden Road to support the people living there to remain safe. Evidence: Staff told us in their comment cards that they know what action to take if anyone raises a concern or complaint with them about the home. One member of staff explained, speak with line manager and also have a flow chart on what to do. This was confirmed in discussions with staff who knew the indicators to look for that abuse may be occurring and were clear about the actions they should take. A relative of one of the people living at Burden Road has previously confirmed to us that they are aware of CICs complaints procedure and how to raise any concerns or complaints they may have. No complaints or concerns have been raised about Burden Road since our last inspection. However copies of CIC and local authority procedures are available in the home to guide staff if needed. Information is made available to the people living at or thinking of moving to Burden Road about how to make a complaint. This is via an easy to read complaints procedure that uses pictures to help people understand as much as possible. This open approach to dealing with concerns or complaints, along with staff knowledge Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: and training helps to ensure the people living at Burden Road are safe whilst living there and that any issues can be quickly noted and acted upon. Our last big inspection at the home raised a requirement about the way that the organisation support people to manage their money. At this inspection we found clear records of how peoples money is managed for them, along with clear recording of decisions made when spending a large amounts of money on peoples behalf for a vehicle. This is good practice as it provides a clear audit trail and ensures peoples money is managed safely and in their best interests. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Burden Road provides a safe, comfortable home for people to live in. However parts of the house would benefit from redecoration and refurbishment. Evidence: 43 Burden Road is a detached house in a family area of Moreton and fits in well with other houses in the local area. The people living there share a large lounge and small dining kitchen with a second smaller lounge upstairs. People also share an adapted downstairs bathroom. This provides them with an accessible shower, bath and toilet facilities. There is a second toilet and sink upstairs, however this room looks shabby and dark, with peeling wallpaper. The small dining kitchen only provides room for two people to eat a meal. This means that staff cannot sit with people at mealtimes to help make the occasion more sociable. Staff do however accompany people when they eat out. Everyone living at Burden Road has their own bedroom, which has been personalised to suit their needs and tastes. For example people have a double bed in their room and one person has a sofa so that they can comfortably sit in there, if they wish to do so. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: All areas of the house were clean and tidy during our visit. However as noted at our last inspection the kitchen is beginning to look shabby with some parts of the sealant peeling and parts of the worktops chipping. The lounge has recently been decorated with new furniture providing a more relaxing and homely room for people to use. Outside the house had some off street parking with further parking available on the street. Small gardens surround the house on three sides. We noted at our last inspection that gardens appeared shabby and uncared for. The front gate has since been replaced, however during this visit grass was overgrown, hedges appeared high for and there was no pleasant seating area or planting. This may affect the enjoyment people would get from using their garden in warmer months. There are several aids and adaptations in place at Burden Road, including a ramp to the front door, grab rails, walk in shower and highlighted steps. These help to support people with their personal care and mobility. Staff we spoke with had a good knowledge of infection control. A laundry room provides suitable washing and drying facilities with protective clothing and equipment in place to help prevent an outbreak or spread of infection. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Burden Road are supported by an experienced staff team who understand how they communicate and can work with them to meet their needs and choices. However staff do not receive regular training, which may mean they are not up to date in how to support people in line with current good practice. Evidence: It was clear during our visit that the people living at Burden Road feel comfortable with the staff who support them. Staff responded positively to non-verbal requests for support and spent time socialising and interacting with people as well as meeting their basic support needs. In discussions with staff they displayed a good knowledge of the people living at Burden Road and the support they both need and choose. The staff rota showed that during the day there are usually two members of staff working in the house with one awake member of staff at night. A member of staff told us in their comment card, We have lots of time for activities one to one. Plenty of time for personal care, we feel lucky to have the staff ratio to service users. Records showed that before anyone is appointed to work at Burden Road a series of checks are carried out. These include obtaining written references and checking with Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: the Criminal Records Bureau (CRB) and register of people unsuited to work with vulnerable adults. These checks help to ensure staff are suitable to work with people who may be vulnerable. Staff told us both in their comment cards and during our visit that they get the training they need to support people safely and well. However this was not fully reflected in the training records we looked at for three of the care staff working there. These showed that several staff have obtained a national care qualification (NVQ). However records for one staff recorded that they had not had training in moving and handling people for several years. A training record for another member of staff recorded only one training course within the past couple of years. Information on issues such as infection, the Mental Capacity Act and dealing with heat waves was available in the home for staff to follow and they told us the manager keeps them informed of new issues. In addition CIC have a training calendar that was available at Burden Road, this evidences that they offer training in basic areas of care as well as more specialist areas. Since the site visit the manager has contacted us with dates staff are booked on training in basic areas of care. However it is important that staff receive regular training and updates to ensure they are up to date with new laws and current good practice in how to support people safety and well. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 43 Burden Road is well managed for the benefit of the people who live there. Evidence: The registered manager at Burden Road is experienced in managing care services for adults who have a learning disability. She holds qualifications in this area and records showed that she attends regular training to keep herself up to date. Staff told us that they find her supportive and approachable and that she gives advice and keeps them up to date. There are several systems in place at Burden Road for checking the quality of the service they provide. These include regularly reviewing care plans, checking medication and carrying out health and safety checks. CIC carry out a survey each year for all the people who use their services. A copy of last years results is available at Burden Road for people to view. This provides people with a way to formally comment on the services they receive and help plan future improvements. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: A full audit at Burden Road was carried out in June 2009, this is based on national standards for care. It covered areas within the home such as the environment, health and safety, medication and records. Once completed an action plan was written for any areas of improvement noted. However although some of this work had been carried out, the plan had not been updated to reflect this. Regular updating and checking of audits and action plans would provide a good way to ensure identified improvements occur in a timely manner. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances, the gas supply and regular fire checks. These checks help to ensure that Burden Road is a safe place to live and work. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 A training plan for individual staff must be compiled and adhered to. This will ensure staff have up to date knowledge in supporting people safely and well. 02/11/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The service user guide should be updated. It should use plain words and less writing on each page. This will help people to understand as much as possible about the service they can expect. The use of two separate care files should be reviewed along with the use of brief care plans. This would lessen the risk of unfamiliar staff not providing all of the support people need and choose. The use of decision making forms for supporting people with decisions they are unable to make themselves should be expanded. This Will help to ensure any decisions made for the person are in their best interests. 2 6 3 7 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!