Inspection on 14/09/09 for California House

This is the latest available inspection report for this service, carried out on 14th 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

California House 31/08/06

California House 24/02/06

California House 20/08/05

California House 13/03/05

California House 17/07/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

Key inspection report Care homes for adults (18-65 years) Name: Address: California House 23 California Road Kingstown Carlisle Cumbria CA3 0BT     The quality rating for this care home is:   two star good 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: Elizabeth Kelley     Date: 2 3 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: California House 23 California Road Kingstown Carlisle Cumbria CA3 0BT 01228674393 01228674393 carlislemencap@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Carlisle Mencap care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The registered person may provide the following categories 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 Physical disability - Code PD (maximum number of places 2) The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Carlisle District Society Mencap is the provider of respite care at California House for four people who have a learning disability. The home is situated close to junction 44 off the M6 motorway on the outskirts of the City of Carlisle. The location provides easy access to the city centre by the homes or public transport. The property is a semidetached house in a quiet residential road. The home has been adapted to accommodate people who have a physical disability. There are garden areas to the front and rear of the home. The Home has a wheelchair accessible mini bus for use by people during their stay. All referrals and bookings are made through social services Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 0 5 2 Brief description of the care home and the charges for respite care are arranged by Social Services. 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 was an unannounced visit to the home, meaning that the manager and staff did not know that the visit was to take place. This visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. During the visit we (Care Quality Commission) spent time with people staying at the home and the staff who were on duty during the day. Every year the manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment about the quality of their service. It also asks for information about plans to make any improvements to the service. This information, in part, is used to plan our inspection activity. Care Homes for Adults (18-65 years) Page 6 of 30 During the visit staff records and peoples care records were viewed, alongside policies and procedures that the home works to. We looked around all areas of the home, including communal and individual accommodation. People using the service and their families, and members of staff were asked their views regarding the home. These comments and the observations made by the inspector have informed the judgements made in this report. We also visited the Head office of the organisation to speak with the Director. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 30 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 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 10 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. People using the service are helped to make an informed choice and are carefully assessed before they start using the home which assists in successful placements. Evidence: California House currently provides respite care for three residents on a shortstay basis the average stay is three days to a week the length of stay can be varied in consultation with the home and Social Services. The home provides new people and their families with an information booklet about the home. Each time Social Services makes a referral to the home a thorough assessment process is implemented. The new person and their family are invited to come and look around the home. The family or carers will be asked to complete an indepth form that looks at the likes and dislikes of the person, normal daily routines, medical history and any other social or care needs they may have. The introduction to the home is flexible and can take from only one visit to months depending on the need and the pace required by each person. The organisation is flexible to supporting and encouraging friendship groups to stay in the home together and is mindful of ensuring that people are compatible. People spoken to said they really liked the fact they could choose to stay at the same time as their Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: friends, and could still go to the same clubs as when they were at home. All referrals are via Social Services the home does not currently take private fee payers. Two of the four beds are classed as an emergency bed and can be utilised by Social Services for emergency admissions, this information is given to everyone in case of last minute cancellations. The manager is currently in the process of updating its literature given out to new people to reflect recent developments such as a new manager and improvements to the homes facilities. These will be examined on the next inspection. The new manager, Wendy Wilson, in a short space of time has made good progress in updating systems and paper work within the home. Care Homes for Adults (18-65 years) Page 12 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans need to be strengthened by involving people more in ways they would like to develop and positive approaches in how they would like to be supported so that a stay in the home can be more than a holiday. Evidence: Each individual has a care plan that includes basic information necessary to deliver the persons care but it is not detailed or written in a person centered way. The Care Plan used is a set form with headings, which then limits involvement to the persons understanding of the written word. Most significantly areas about emotional and psychological support needs are not addressed. This also includes no mention of relationship or sexual development areas. Some Care Plans and risk assessments are written in a way that focuses on what a person cannot do and support needs are not addressed in an individual way. The care plan is not always used as a working document. This was evidenced by a person staying at the home experiencing a personal trauma but no mention was made of this in any of the supporting written material. The staff team however, when spoken to, were aware of this issue and were Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: sensitive to this persons needs. This demonstrates a lack of a planned approach to supporting this person through a psychologically difficult experience. Care plans are reviewed and updated as required but there was little evidence of how people are actively encouraged to be involved in its review, or in ways that are meaningful to them. Staff on the whole are able to communicate with people using the service, and understand what their needs are. However, communication methods can be basic and there was little evidence of innovative or individual communication styles. There is some evidence that individuals are involved in areas of decision making about the home such as day-to-day living and social activities but this tends to be the people using the service whose communication styles are more easily understood by staff. For example those people who are more vocal can choose not to go to a club that the majority of people attend. The training profile of the staff team reflects the shortfalls identified above, for example only a few staff have makaton training even though in peoples care plans this is a method of communicating, and training in person centered approach was also variable. Risk assessments are completed but these are basic and mainly focus on keeping people safe. Both care plans and risk assessments should be written in a person centered way, and in a way that involves people and their development needs and aspirations. For example if a person is planning on living independently then looking at the tasks and skills to enable this ie cooking skills, money skills, housework tasks, and personal safety. Staff reported that people can do cooking and baking in the kitchen, but sometimes there was not enough time to fit it in between day centres and clubs. There was evidence that people were being supported to develop such skills but this did not appear co-ordinated or demonstrated in a person care plan. Care Homes for Adults (18-65 years) Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who stay at California House can make some choices about how to spend their time. They are encouraged and supported in participating in activities. Evidence: We were able to speak to people who were staying at the home and they said they have a choice how to spend their time. Routines are mostly kept the same as when people are in their own homes so that most people carry on attending day centres, or work as they do when at home. People said they enjoyed being able to choose who they would like to stay with. Until person centered plans are introduced it is difficult to ascertain what decison-making people are involved in and what choices they wish to make. The home consults people about their satisfaction with the service they are receiving. The new manager is looking to develop how this happens to better engage people in Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: the process. However, as part of this the home should consider its use of the term Guest for people using the service as this implies connotations of being looked after and not really being empowered about the running of the service. People can, if they wish, participate in daily living activities such as helping with the dishes and preparation of meals. They can go with the staff for the main shopping each week and are encouraged to choose the meals they would like during their stay. The main meal is chosen and prepared on a daily basis when the people return from the days activities. Care Homes for Adults (18-65 years) Page 16 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. People using this service have access to healthcare professionals, which ensures their physical and medical needs are met. Evidence: Medications in the home are well managed with an orderly medicine cabinet and well ordered and accurate medication charts. Staff have received training in the care and dispensing of medications and this was an area well managed by the home. Medication is received in a variety of ways bottles, boxes and monitored dosage systems and staff have completed training in safe handling of medication. We looked at the medication records and found all to be in order. The home has developed efficient medication policy, procedure and practice guidance. Staff all has access to the written information and understand their role and responsibilities. Quality assurance systems confirm that policy is put into practice. Any personal care is delivered in peoples own bedrooms and staff demonstrated that they are aware of issues of dignity and privacy. Interactions were observed between staff and people staying at the home, and this was carried out in a sensitive and respectful Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: manner. Staff are trained and competent in health care matters. The home arranges training on health care topics that relate to the health care needs of the people, for example care of people with epilepsy and diabetes. The home has a dedicated moving and handling facilitaor to advise staff on the best way to support people. Care Homes for Adults (18-65 years) Page 18 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. Policies and practices are in place that safe guard and protect people using the service. Evidence: The service has a complaints procedure that is up to date clearly written and is easy to understand. It can be made available on request in a number of formats including large print to enable anyone associated with the service to complain or make suggestions for improvement. The home places emphasis on speaking to people directly to ensure they understand and feel comfortable with speaking up. People living at the home were observed freely expressing opinions to staff, and other ways of expressing views more formally via the complainants procedure were seen. The open atmosphere created within the home ensures that people feel free to express their opinions and are confident that they will be listened to and concerns acted upon. People have good and varied links with outside organisations and advocate groups which ensures they have channels to express views and concerns if necessary. Information is available regarding complaints and relatives or representatives have access to this. The policies and procedures regarding protection of individuals are clear and are regularly reviewed and updated. The service knows when incidents need external input and who to refer incidents to. Staff are informed of the policies and procedures relating to adult protection matters and how to safeguard the health and welfare of people in the home. This is incorportated into an 8 day induction course and then this is topped up with a stand alone course in Safeguarding people from abuse. Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: This ensures that protecting vulnerable adults is integrated into the training and development plan for each member of staff. A member of staff spoken to gave a good account of the actions she would take if she had any concerns. The Annual Quality Assuarance Assessment (AQAA) completed by the manager states: Families have expressed their satisfaction with the contact with the home and have said that communication has been good. These measures and the approach of the staff team ensures that people are safeguarded from harm and their rights promoted. Care Homes for Adults (18-65 years) Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a warm, safe and comfortable environment in which to live. Evidence: The home is well maintained and tastefully decorated throughout. There are five single bedrooms, a large lounge dining room and kitchen facilities. A conservatory adds extra space. There is sufficient communal space for activities and watching television. The manager has already carried out an audit and and improvements for example providing new blinds for privacy, and further funding has been secured for redecoration, new lounge and bedroom furniture. The gardens are well maintained and attractive being an asset for people to spend time in, for bar-b-ques and garden parties. Bathing facilities are suitable for any people who may have a physical disability and there are aids available for any who need them. Laundry facilities are available, however the manager was advised to carry out a risk assessment due to the location within the kitchen. Instructions should be devised for staff to minimise risk of infection. Aids and equipment are provided to encourage maximum independence for people Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: using services these are regularly reviewed and replaced to accommodate changing needs. Specialist advice is sought by the home to ensure effective use of equipment. Care Homes for Adults (18-65 years) Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by an effective staff team making their stay an enjoyable one. Evidence: The home has a core group of experienced staff, and health care and social services staff report that they listen to advice and provide good care to people. Based on discussions with staff and people living at the home, the staff team are well motivated and committed. They were actively involved in supporting peoples holidays, hobbies and organising day trips. The manager says they have a degree of flexibility in staffing levels, for example if someone is sick during their stay and cannot attend day services. Information from the organisation indicates: All staff receive induction which meets the requirements for Skills for Care. We use a recognised provider for learning disabilities, the course lasting 8 days, and includes first aid, moving and handling, food hygiene, communication, challenging behaviour, abuse and learning disability. Additional to this course all staff complete 1.5 day medication course. The organisation running the home, Carlisle Mencap, has a good rolling programme of training offered to all its staff teams. This is monitored by a training person who produces lists for managers to demonstrate who has had what training. These training updates could be improved, the system that records staff training was difficult to read, Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: and it was not clear if staff had received training or whether it had just not been recorded. For example gaps were apparent in moving and handling, fire instruction, and person centered planning. The manager should carry out a training profile for each person to determine core skills and training specific to the needs of people staying at the home. For example the number of staff with a minimum of NVQ level2 is below the 50 required level, it is currently at 25 . Identifying this type of deficiency in training should then be built into a staff training Plan for the service. Staff have clear and thorough job descriptions and are, therefore, clear on their roles and responsibilities. Staff stated they are now receiving regular and effective supervision and annual appraisal has also been carried out. Staff said they felt well supported and felt able to raise any issues with both the manager of the home and senior managers. Care Homes for Adults (18-65 years) Page 24 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 management of the home has changed recently and the increase in checks and audits are beginning to have an impact in improving the quality of service offered to people living at the home. Evidence: The manager is qualified in care and in a managers award, as set out in the national minimum standards (NMS) to run the Home; she is aware of and works to the processes set out in the NMS. However more in-depth knowledge would be beneficial on good practice guidance issued by Care Qualtiy Commission (CQC) and other professional bodies, for example Key Lines of Regulatory Assessment and Guidance logs. However, the new manager, Wendy Wilson, in a short space of time has made good progress in updating systems and paper work within the home. The manager is starting to develop measures that monitor practice and compliance with the homes plans, policies and procedures. For example her input and checking of care planning was in evidence on this visit. More work is needed in this area, and the manager stated that she intends to review each care plans as people next come for Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: respite. The organsiation has a Quality tool to measure outcomes in the home, but currently this is not picking up some key areas. For example identifying gaps noted in fire training and Practice drills. As not all staff had received up-to-date training a requirement is made to ensure this happens especially as all staff at some point sleep over in the house, and are in charge in the event of a fire. A reccomednation was made to develop a Fire Risk Assessment specific to the home, and to ensure that the use of out dated paperwork is discontinued. The home does not provide a qualified first aider for each shift. They need to carry out an assessment to determine if this is necessary or not and make this assessment available to CQC. 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 42 23 All staff must receive fire training and instructions on a regular basis. All staff carry out sleep overs and therefore must have fire training and instructions on a more frequently in order to keep people safe from harm. 12/11/2009 2 42 23 A fire Risk Assessment must 10/11/2009 be carried out specific to the home. This will identify hazards specifc to the home and reduce the risk of fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Care plans should be written in away that is meaningful to each person and give staff clear instruction on how they wish to be supported Care Homes for Adults (18-65 years) Page 28 of 30 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 2 3 30 35 A risk assessment should be carried out to allow the safe use of a laundry to be based off the kitchen. A training and development plan should be be developed specifically for the home, including a needs assessment for both the individual and the staff team as a whole. The manager should undertake an assessment to determine the level of qualified first aiders required in the home, as described in the CSCI Guidance Logs. 4 42 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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