Inspection on 15/04/10 for Cabrini Care Limited

This is the latest available inspection report for this service, carried out on 15th April 2010.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Cabrini Care Limited 52 Cordy Lane Brinsley Nottingham Notts NG16 5BY The quality rating for this care home is: one star adequate 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: Susan Lewis Date: 1 5 0 4 2 0 1 0 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 35 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Cabrini Care Limited 52 Cordy Lane Brinsley Nottingham Notts NG16 5BY 01773765766 01773765766 cabrinicare@googlemail.com www.cabrinicare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cabrini Care Limited Name of registered manager (if applicable) Mrs Sheila Mary Kingdom Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 care home 7 learning disability Additional conditions: he maximum number of service users who can be accommodated is 7 The registered person may provide the following category of service only Care Home only PC To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Learning Disability Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 35 A bit about the care home Cabrini Care is a new service designed for young adults with learning disabilities who may also be on the autistic spectrum. It provides a homely environment for up to seven people in single rooms with en suite facilities, there is also a separate Jacuzzi bath. The accommodation is over two floors with a large kitchen/diner and separate living room. There are extensive grounds that include a barn that has been converted into a soft play space and woodland. Care Homes for Adults (18-65 years) Page 5 of 35 There is also access to on site day services which will be open to residents and non residents. It is on the edge of the village of Brinsley and within walking distance of local amenities. Care Homes for Adults (18-65 years) Page 6 of 35 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 35 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people using the service and their views on it. This process considers the providers ability to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection involved one inspector; it was announced and took place over 7 hours. Care Homes for Adults (18-65 years) Page 8 of 35 The main method of inspection used was called case tracking which involved selecting two residents and looking at the quality of the care they receive. We looked at the information held about these people, along with the services ability to meet their needs and expectations. Due to a recent safeguarding investigation the contracts for the people living in the home had been suspended and so there was no one living there at the time of the inspection visit. We also spent time talking with the manager and staff to find out more about the support they give people and their training and knowledge about this. Care Homes for Adults (18-65 years) Page 9 of 35 We used information provided by the service and other sources since the homes registration. We also looked at other documents and records held by the service to learn more about the care they provide. What the care home does well People who want to live at the service can expect to be supported through the transition period from where they currently live to the home. People can expect to live a clean and homely environment and their bedroom will be spacious and they will be able to personalise it. Care Homes for Adults (18-65 years) Page 10 of 35 People will be able to access a variety of activities during the day. People are supported by staff who go through a robust recruitment process and get lots of training and support before they start work. All staff are supported to continue training around the skills and knowledge they need to care for people using the service. Staff show good understanding for people and respect for their choices. Care Homes for Adults (18-65 years) Page 11 of 35 What has got better from the last inspection What the care home could do better The home was registered in October 2009 and started taking people to live at the home in November. The registered manager handed her notice in and the providers failed to notify the Commission. The acting manager is currently awaiting registration with the Commission. . Care Homes for Adults (18-65 years) Page 12 of 35 They failed to keep the Commission informed of incidents within the home that concerned people who lived there, they must ensure that the Commission is informed of any event that adversely affects the well being of people using the service. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Susan Lewis Care Quality Commission Care Homes for Adults (18-65 years) Page 13 of 35 Nottingham Office CQC Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000616161 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 14 of 35 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 15 of 35 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. Admissions are not made to the home until a full needs assessment has been undertaken. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment states We have a comprehensive assessment procedure, involving the service user, their family advocates and services schools they access, carried out by a competent person. Information from the assessment is used to inform the care plan. We looked at the care plans for two people who use the service and we saw that each person had an assessment carried out by the placing local authority and the service carried out their own assessment. The assessments were detailed and looked at the persons needs and abilities and included any risks the person may be in due to their needs. Staff spoken with confirmed that the manager visited any person wanting to move to the service to carry out an assessment and that anyone wanting to move to the home were encouraged to spend time as part of a getting to know the home first. We saw in Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: peoples care plans organised visits of varying lengths to help support people in the move to the home. The pre inspection questionnaires asked relatives Did you or relative receive enough information about this care service to help you make decisions?, those who replied said yes. Care Homes for Adults (18-65 years) Page 17 of 35 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. Service users are supported to make their own choices, take risks, and have an active independent lifestyle. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated Services users are supported by an effective care plan structure, which enables them to participate and make decisions about their daily lifestyle and promotes independence and risk taking where they are able to do so. Limitations and restrictions on freedom are recorded. The pre inspection questionnaires asked Does the care service give the support or care to your relative that you expect or agreed? Those relatives that replied told us yes. We looked at two support plans, these were detailed and showed that they had been created using the information from the assessment carried out by the placing authority and the assessment completed by the service. Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: We saw that plans described how staff were to provide support and if there were any restrictions on choice or freedom as a result of their needs. The plans provided staff with good information on how to support people if they were likely to display behaviour that may challenge focusing on positive behaviours. The plan was written in a person centred manner using pictures and plain language. Although there was evidence that relatives were involved in the assessment it was not clear if they were involved in the creation of the support plans. Staff spoken with were able to describe how they would support people using the service and said that they found the plans useful and detailed. They also told us that although the senior staff were responsible for creating the support plan in the first place it was every staff members responsibility to ensure they remained up to date and relevant to the support they provided to each person. Staff described how they supported people in making decisions about their daily lives such as what activities they took part in and what meals they had. Staff showed us pictures of different meals and different activities that people could choose from to aid communication. The care plans also included effective risk assessments to promote service users safety in the home and in the community. The care planning and risk assessment documentation had been reviewed appropriately to ensure service users needs and aspirations can be identified and met. Staff spoken with confirmed that the service users care plans and risk assessments are always available for reference and guidance. Care Homes for Adults (18-65 years) Page 19 of 35 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. Generally staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated Staff enable service users to have opportunities to maintain and develop social, emotional and communication skills. The ethos of Cabrini Care is to promote independence and to encourage service users to work towards their own identified and achievable goals. The pre inspection surveys asked Does the care service support people to live the live they choose? People who replied told us usually They also told us We always felt welcome and at ease when visiting and the staff were always informative. Relatives also told us The service has a lot of potential but we feel our relative was unable to access activities such as bowling and swimming. Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: We looked at support plans and we saw that each person had an activity planner that showed what activities they could do. Diary notes showed that people were able to get out during the day, this usually entailed going for a walk into the local area. Other activities included watching DVDs or playing ball. Support plans showed that in some cases people who used the service preferred going to bed early. The provider showed us the buildings that will be used for the day service they intend to set up for people who use the service and the barn that has been converted into a soft play area. The provider also told us of his plans to turn a field at the back of the property into a recreational area that would include allotments and picnic area. The work on this has not started yet. A set menu is not provided as service users are encouraged to choose what they want to eat on a daily basis. Staff spoken with said that they found out what people wanted to eat by using the picture menus or showing them different meals. We looked at past menus and these showed that balanced healthy meals were provided for people. Care Homes for Adults (18-65 years) Page 21 of 35 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. Service users health and personal care support is of a good standard. Medicine management promotes the service users safety and independence. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated All service users have an annual health check also receive personal support in the way they prefer, ensuring all health care needs are met. The principles of respect, dignity and privacy are promoted at all times. The safe management of medicines within the home protects service users. We looked at support plans diary notes and these showed us that people receive their personal and health care in a way they prefer. They have access to health care professionals such as doctors and dentists. The Commission had received information about a complaint regarding the administration of medication within the service. This was passed to the local authority to investigate and they did not uphold it. As part of this visit we looked medication policies and procedures and medication records. We saw that the procedures in place were there to support and protect people from Care Homes for Adults (18-65 years) Page 22 of 35 Evidence: having the wrong medication and staff spoken with were very clear about their role in administering medication. They also told us that only trained staff were allowed to administer medication. We looked at training records and saw that most staff had received Safe Handling of Medication Training. We looked at the medication administration sheets, there were no unexplained gaps and support plans detailed peoples medication, this included the dose and any side effects they may experience. The medication is stored in a locked trolley in a locked room and the trolley is secured to the wall. Care Homes for Adults (18-65 years) Page 23 of 35 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 living in the home know how to make a complaint. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated Complaints procedures are accessible to service users. Service users are protected from abuse, neglect and self harm. We received a survey back from a relative who told us they knew who to speak to if they were unhappy with the care their relative received. The complaints procedure is written in a clear easy read format with pictures to assist the people who live in the home and it forms part of the information given to people prior to admission to the home. On the day of the inspection visit the procedure was displayed in the home for people to refer to. Staff told us that they knew what to do if someone raised a concern with them about the home. The Commission has received information raising concerns regarding this service which were passed to the local safeguarding team to investigate. The concerns were regarding the care and treatment of people who lived in the home and the potential that they were having their movements restricted in the home and not receiving the support they needed to manage any challenging behaviour due to poor care planning and risk Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: assessments. As a result of these allegations the contract for the people living in the home was suspended and they were removed. Following the investigation five out of the nine allegations were substantiated with one being partially substantiated. The provider is working closely with the Commission and the local authorities to improve areas that caused concern, improve practice and for the contract to be renewed. At the time of writing this report one contract was being renewed and the second was still in negotiation. We spoke with staff about safeguarding adults procedures and they had a good understanding of them and we saw evidence that staff have all received training in the last twelve months. As part of the safeguarding recommendations staff have also received further training on working with people with challenging behaviour including MAPPA (Management of Actual or Potential Aggression). This training is to ensure staff know how to safely reduce situations where people may become agitated and distressed. Prior to the safeguarding staff had received training as well as having access to policies and procedures, the provider showed us evidence that the MAPPA trainer considered this previous practice to be suitable for its purpose. Care Homes for Adults (18-65 years) Page 25 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and homely environment with facilities which reflect the interests and needs of people living in the home. Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated Service users live in a home that is appropriate to their specific needs, it is clean, smells fresh and staff adhere to infection control policies to reduce the risk of infection. We carried out a partial tour of the home and looked at a selection of bedrooms we saw that they were well decorated with modern domestic furniture. Each room was personalised and has a variety of equipment in for the person to use if they became agitated. There are extensive gardens around the property and there are plans for different areas to be transformed into places of interest for people living in the home. These are to include a vegetable plot, an area to keep chickens and a day service. We spoke to staff who told us that the home was well maintained and if they needed anything doing they wrote it in a book and it was done quickly. We looked at the maintenance records and these showed that any issues raised were dealt with promptly. Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: The home was very clean and well maintained. The home has health and safety practices and procedures in place. There are infection control systems in place to prevent the spread of infection and staff are trained to maintain the systems. The laundry area is suitable to meet the needs of the people who use the service. Care Homes for Adults (18-65 years) Page 27 of 35 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. People are supported and protected by the homes recruitment practices and training Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated A well supported, well trained, fully supervised and committed staff team supports service users. Robust recruitment practice ensures service users safety. Excellent sickness record, hence good attendance and high morale amongst the team. We looked at a sample of staff recruitment records, and saw that all the necessary checks were made to safeguard people who live at the home. We looked at training records and this confirmed that staff have undertaken a wide range of training to help them in their roles, some of this before working with service users. Training is organised from in house as well as external sources. All staff spoken with said they were supported well to do their job, through induction training, on going training and regular supervision. As there is currently no one living in the home we were unable to observe staff working with people who use the service. We looked at rotas from when the people who used the service were still in residence. It Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: was not always clear that if people wanted to go out of the home to do activities there would be sufficient staff to support this, particularly in the evenings. However there was no evidence from support plans this impacted on the outcomes for people who used the service. The provider told us that there were people on call who lived locally who could cover if people wanted to go out. Care Homes for Adults (18-65 years) Page 29 of 35 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. All staff and carers know the service’s statement of purpose and aims and objectives Evidence: Information provided by the acting manager within the Annual Quality Assurance Assessment stated Service users benefit from a well run home with good record keeping. Service users appear confident their views underpin all self monitoring review and development of the home. The health safety and welfare of service users are promoted and protected. The acting manager was previously the senior carer and is new to the post and is yet to register with the Commission. She currently does not have the Registered Managers Award and this is her first management role. The providers have employed a supporting manager for a year to act as mentor to the new manager. Staff spoke highly of the acting manager saying she was supportive and was there for advice and support if they needed it. Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: Although there is a quality assurance system in place due to the service being new then the people who use the service moving out due to the safeguarding the quality assurance has not been fully completed. Records did show however that regular team meetings took place and staff were routinely asked about ways to improve the service. We looked at staff training records and these showed that staff had completed all the necessary training to ensure the health and safety of people who use the service. We looked at maintenance records and saw that the necessary checks for fire and routine safety were also carried out at the necessary intervals. All accidents and incidents are recorded, however prior to the safeguarding the manager was not routinely informing the Commission about these incidents to ensure we knew what was happening in the home. These incidents included where people using the service had become agitated and aggressive towards staff, staff had needed to use techniques to reduce people’s agitation and had supported them to return to their bedroom. They had also not notified us about the registered manager leaving. We spoke to one of the providers and they agreed that in future they would notify us of all incidents. Care Homes for Adults (18-65 years) Page 31 of 35 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 32 of 35 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 33 18 There should be enough trained and competent staff available at all times. 19/05/2010 This will ensure that people who use the service are able to access the community and carry out activities when they choose to safely. 2 42 37 The Commission must be notified about any incident that adversely affects the well being of the person living in the home. 19/05/2010 This is to ensure that people are fully protected 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 Care Homes for Adults (18-65 years) Page 33 of 35 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 37 39 Ensure that the acting manager is registered as a fit person to manage the service as soon as possible. Ensure that the quality assurance is completed at soon as practical. Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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