Inspection on 23/11/09 for Curlews

This is the latest available inspection report for this service, carried out on 23rd November 2009.

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

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

Other inspections for this house

Curlews 05/01/06

Curlews 20/10/05

Curlews 10/02/05

Curlews 22/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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: Curlews Dunsland Jacobstowe Okehampton Devon EX20 3RH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Graham Thomas     Date: 2 3 1 1 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 28 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 28 Information about the care home Name of care home: Address: Curlews Dunsland Jacobstowe Okehampton Devon EX20 3RH 01837810856 01837810819 curlews@apt-ltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Atlas Project Team Ltd care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Age 18 - 65 years Service Users with a Learning Disability (5) Date of last inspection Brief description of the care home Curlews provides accommodation, personal care and support for five people with learning disabilities whose behaviour may challenge services. It is owned by the Atlas Project Team Limited who also own several other care homes in Devon, Berkshire and Surrey. This home is located in a rural setting, and there are no close neighbours. The home provides transport for service users to access shops, pubs, and other amenities. The home was opened in 2002 and is comprised of a two-storey detached house. All the homes bedrooms are single and three of these have en suite toilet and shower facilities. There are separate lounge and dining rooms, as well as a large sunroom on the ground floor. The home has a very large garden, with parking facilities and a paddock at the back of the house. All areas are accessible to the people living in the home. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 Brief description of the care home Fees are negotiatined on an individual basis according to need. At the time of this visit weekly fees ranged between approximately £1,900 and £2,900. Additional charges are made for personal items and some holiday spending money. The most recent inspection report is available at the home on request. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We looked at our records about Curlews before we visited. We checked if there had been any complaints and information the home had sent us called notifications. Before our visit the home returned an Annual Quality Assurance Assessment (AQAA) which we reviewed. We also looked at surveys completed by staff and people living in the home While we were there we looked around to check if the home was a safe and comfortable for people. Two peoples care plans told us what people needed. We spoke with staff and looked at what was going on to check if they were getting the right support. We looked at staff records to make sure that the right checks were made to keep Care Homes for Adults (18-65 years) Page 6 of 28 people safe. We also spoke with staff about their work and the training they had. Managers spoke with us and we looked at records to check whether the home was run for peoples benefit. Care Homes for Adults (18-65 years) Page 7 of 28 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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. Standard 2 People considering a move to Curlews can feel assured that the home will make sure it can meet their needs before offering a place. Evidence: We looked at how the home assessed peoples needs before they moved in. In the Annual Quality Assurance Assessment returned to us before our visit, the home told us Newly admitted service users are fully involved in their admission, given lots of opportunity to find out about the home, the people and what their life would be like there. Their needs are fully assessed and understood before they are admitted. The organisation have policies and procedures in place which provide comprehensive guidance to ensure that a thorough assessment of needs is undertaken prior to a place being offered to a new service user. The person who had most recently moved in was an emergency admission. We saw in Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: their file that information had been gathered from other agencies and a care plan developed at the earliest opportunity. The information in the persons file showed ongoing assessment and review including, health, psychological and social needs. Examination of the homes policies and procedures and discussion with senior staff confirmed that there are sound admission procedures in place. These include providing information to the person and/or their representatives. Systems are also in place for assessments to be made of the persons needs before a place is offered. A person who might move in is offered visits to the home and a trial placement where possible. Care Homes for Adults (18-65 years) Page 11 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7 and 9 Curlews has excellent systems in place to meet peoples individual needs and support them to make choices about how they live. Evidence: In the Annual Quality Assurance Assessment (AQAA) completed and returned to us before our visit, the home told us; Service users are listened to, understood, and supported to enjoy a varied and fulfilling life. Risk is understood and well managed. Care plans are completed to a high standard and clearly reflect the changing needs of service users. Service users are supported to make decisions for themselves and to take managed risks where appropriate. The evidence obtained during our visit supported this account of the homes support for peoples individual needs and choices. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: We looked at two peoples individual files. Both files contained comprehensive plans of care including details of personal social and health care needs. These set out very clear, detailed information for carers about the persons needs and how to meet them as well as goals for development. For example, one persons plan indicated that they preferred not to go on holidays. This was confirmed by the person when we spoke with them and by staff who understood this persons social needs. There were however, details of a range of other activities in which the person was encouraged and supported to participate, such as bowling. On the day of our visit, a bowling trip had been arranged for the person. We saw how staff used and built upon peoples skills to communicate with them effectively and develop their independence. One persons plan described how they were being supported to manage particular areas of their behaviour. This was confirmed in our discussions with the person and our observations during our visit. Each persons plan contained a detailed set of individual risk assessments relating to routine activities as well as other developmental activities such as bowling, swimming and visits to community facilities such as local pubs. These provided staff with clear and specific guidance on the risks, their management and why taking these managed risks was important for the individual. Staff had signed these assessments to demonstrate that they understood and agreed with them. We saw that the homes approach to risk and its assessment supported individual development by offering a wide range of opportunities based on individual need and interest. The care plans and risk assessments showed evidence of review and adjustment according to ongoing assessment and changing needs. In discussion, staff were very clear about each individuals needs and how they could be met. Our discussions with staff and observations of their work showed that they clearly understood each persons needs and how to meet them. This was confirmed by one person with whom we spoke who remarked I love it here. Its much better than where Ive been before! Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 15, 16 and 17 People living at Curlews are very well supported to follow a lifestyle that suits their individual needs. They receive a varied and nutritious diet. Evidence: In their AQAA the home told us Service users are encouraged to develop their skills and knowledge. Service users receive development incentives which might be a wage or additional activity; it would demonstrate a value in what has been achieved. There is excellent opportunity for hobbies and interests. These currently include bowling, swimming, films, music and fishing. Individual holidays have been organised, individuals have visited amongst Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: other places National Trust Houses, Wales and Cornwall. Outings for work and leisure are a normal feature of life at the home. Service users take turns to choose the menu for a week. The fridges and freezers are kept well stocked. Fresh fruit is available at all times. The standard of food is excellent and appropriate to the age and needs of the service users. Each service user has an individually tailored programme of activities some of which are planned and regular such as cooking and gardening. Staff provide stimulation through teaching essential life skills, self help skills, arts and crafts and game sessions. Spontaneous activities also occur such as pub and cinema trips, rambling and sports. All activities are designed to take account of service users educational and recreational needs and are provided both within the home and outside to ensure participation in the community. During our visit we saw that there were sufficient staff to provide individual support for people to pursue their preferred activities and interests. A daily planning meeting involving staff and people living in the home was held during our visit. One person told us that they were looking forward to a bowling trip in the afternoon and that they had previously enjoyed this activity. People also confirmed individual activities such as shopping, swimming cycling and body boarding. We saw that the homes approach to care planning and risk assessment supported people to do things in which they were interested as well as encouraging and supporting them to try something new. During our visit people were supported to plan and prepare their own meals and participate in domestic activities such as cleaning. Incentive programmes are individually devised to encourage people to develop their skills. People living in the home told us that they were able to keep in touch with their families and supported to make and receive visits. There was plenty of food in the home at the time of our visit including fresh fruit and vegetables. Particular dietary requirements and preferences were identified in their care plans. Meals are planned with staff on a weekly basis based on the choices and preferences of people living in the home. Care Homes for Adults (18-65 years) Page 15 of 28 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. Standards 18, 19 and 20 People living at Curlews receive good, individualised personal support and health care. Evidence: We looked at the personal support received by people living in the home. Peoples individual plans of care set out detailed information for carers about the persons personal support needs and how to meet them. In our discussions with one person and with staff we heard how the person was being supported to manage their own behaviour that might be challenging to the service and others. People living in the home were dressed in the style of their choice and we saw that staff prompted and helped them to present themselves in a socially valued way. We looked at how peoples good health was being promoted and supported in the home. In individual files we saw records of how one person was being prompted and supported to follow a healthy diet and their dietary requirements. This person told us about how they had been supported to make healthy choices. Both files showed evidence of routine health checks such as optical appointments. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Other more specialist interventions were recorded. For example, we saw correspondence from one persons consultant Psychiatrist concerning a review and planned reduction in their medication. None of the people living at Curlews has the capacity to manage their own medication and it is therefore administered by staff. We saw that medication in the home is securely stored, with additional security and recording for controlled drugs. One of the people whose medication we examined was taking a medicine as required (PRN). In the persons file we saw that there was a clear protocol about the use of this medicine. Staff training records showed that staff administering medicines had received appropriate training. Medicines are supplied from the pharmacy in individual containers. The medicines are then transferred to individual packs by the homes staff. This practice is known as secondary dispensing and does not accord with the best practice recommended by the Royal Pharmaceutical Society. However, we saw that the home had robust checking systems to ensure that any errors could be identified immediately. We saw that there had been no medication errors and were satisfied that the system in place was sufficiently safe. Care Homes for Adults (18-65 years) Page 17 of 28 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. Standards 22 and 23 People living at Curlews can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through the strong leadership culture of the service. Evidence: Examination of our own records before our visit showed that the Care Quality Commission has not received any complaints about the home. Some people living at Curlews would be unlikely to use a formal complaints procedure. However, we saw that the home does have a complaints procedure in place and a system to record any such complaints. These records showed that no complaint had been received since 2007. We saw that people using the service were very relaxed in the presence of staff. The senior management of the service has a very robust approach to the protection of people from abuse. This was reflected in our discussion with senior managers and staff about safeguarding and staff disciplinary procedures. Our discussions with individual staff confirmed that they had received training in safeguarding vulnerable adults from abuse. Each staff member was able to identify clearly how they would report any abuse suspected or witnessed and what their Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: expectations would be. Care Homes for Adults (18-65 years) Page 19 of 28 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. Standards 24 and 30 People living at Curlews enjoy a comfortable, well-maintained environment suited to their individual needs and preferences. Evidence: Curlews is a modern two storey building set in a remote location. Support to travel elsewhere is provided by the home. In our tour of the home we saw that it is furnished and equipped to a high standard in a modern domestic style. People told us that they were pleased with their accommodation and that they found it homely and comfortable. When we visited we found that all areas of the home were clean, fresh, light and well-maintained. Visual inspection revealed that the home was routinely redecorated and refurbished as required. Each room was decorated according to its occupants tastes and preferences. One person took pride in showing us new furniture that they had chosen for their room. Personal possessions, ornaments and pictures were seen in all the individual rooms except one. This room had been specially adapted to accommodate the particular challenges posed by its occupant. For instance, the person was not able to have a Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: radiator in the room. Instead, heating had been provided in an adapted cupboard with vents into the room. Laundry facilities are domestic in scale and suitable for meeting the needs of people living in the home. Each persons laundry is managed separately. Outside there are extensive grounds which people living in the home help to maintain. Additional land at the rear of the property was being drained at the time of our visit to provide further usable external space for people living in the home. A base had been laid for a new outbuilding to increase storage for equipment, bicycles, garden furniture and so on. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 34 and 35 People living at Curlews are very well supported by an enthusiastic, well trained and supported staff group. Evidence: Our observations and discussion with staff confirmed that they had a very positive attitude towards people living in the home and their work in general. Staff displayed a relaxed and supportive relationship with people living in the home. In conversation, they had a very clear understanding of their roles, responsibilities and the needs of the individuals they were supporting. We looked at the files of two members of staff. This confirmed that there was a robust recruitment procedure in place including a formal application, references and criminal records checks before the person started work in the home. A recently recruited staff member confirmed that they were receiving a structured induction which includes staged reviews at one week, one month, three months and so on. This person told us that Support within Atlas is fantastic! During our visit we saw records of staff meetings that focused on the individual needs Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: of people living in the home. In discussion, staff displayed a very clear understanding of their roles and responsibilities. This included an understanding of the limits of their roles and a detailed understanding of the needs of individuals they were supporting. For example, one staff member described in detail the procedures for supporting one person on trips outside the home. They were also able to describe the dietary and weight monitoring needs of another person. Training records were seen and training was discussed with individual staff members. This confirmed that people were receiving training in health and safety topics such as food hygiene and first aid. There was also training related to the particular needs of people living in the home. For example, all staff receive SCIP training about interventions when peoples behaviour challenges the service. A programme of training for National Vocational Qualifications (NVQ) was also in place. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 and 42 Curlews is very well managed for the benefit of people living there. Evidence: In our discussions with staff and the management team it was apparent that everyone was very clear about their roles and responsibilities and that management support for staff was of a high standard. Staff confirmed that the directors of the company visited the home regularly and that there was always a member of the management team on call if they were not immediately available. The records we saw were generally very well maintained and provided guidance for staff that was clear and easy to follow. It was evident that records are not simply paper exercises but are used as working tools by staff. One staff member, for example, told us that they regularly refer to the homes policies and procedures for guidance and refreshing their knowledge. Regular meetings are held with staff and the needs views of people living in the home Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: appeared paramount in the ethos and practices we have described in the previous sections of the report. We saw evidence that regular visits to the home are conducted by the Responsible Individual as required by regulation. These form part of the homes system for monitoring the quality of the service provided. A quality assurance checklist is used by the service with key quality indicators based on the needs of the people living in the home. We saw that health and safety issues were being well managed. For example, we saw environmental risk assessments and records concerning the maintenance of equipment and fittings. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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