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Inspection on 25/06/09 for Orient St Adult Respite Unit

Also see our care home review for Orient St Adult Respite Unit for more information

This is the latest available inspection report for this service, carried out on 25th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

Staff keep good written information about how people want to be supported and cared for during their respite visit and residents and their families are consulted about their care. Records are kept up to date and there is good communication between relatives and home staff. People feedback to us that they enjoy going to the respite centre and enjoy their time there. They like the food and the outings and activities. They like the staff. The home is clean and comfortable and there is enough room for people.

What has improved since the last inspection?

Staff roles are better defined. Staff can make referrals for health care for the people using the service if needed.

What the care home could do better:

The respite unit must produce a proper guide to the services provided so that people thinking about using the service can look at It and people already using the service have a handy brochure. The home is in need of redecoration. The home must get a new medication cabinet with a special storage area for controlled medications.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Orient St Adult Respite Unit 19 Orient Street Kennington London SE11 4SR The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sonia McKay Date: 2 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Orient St Adult Respite Unit 19 Orient Street Kennington London SE11 4SR 02075825907 02075825344 wendy.palmer@southwark.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southwark Social Services care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 28 A bit about the care home Orient Street Respite Unit is run by Southwark Council to provide a shortterm respite care service to a maximum of four adults with learning disabilities. The home is situated in a quiet cul-desac in Kennington, within walking distance from the shopping centre with leisure facilities and close to public transport routes to central and South London. The home has a car park in which visitors may park and it is used for the homes minibus. Otherwise parking is restricted in Orient Street. The building also houses a respite care unit for children and the childrens unit is the subject of a separate inspection that is carried out by Ofsted. A central administration area separates the units and a garden to the rear of the building is shared between the adults and childrens units. A copy of the most recent Commission inspection report is available in the reception area, and a pack of information about the service provided is available to prospective clients and their families. This service can only be used by Southwark residents and all placements are arranged by Southwark Social Services. 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 Care Homes for Adults (18-65 years) Page 6 of 28 How we did our inspection: This is what the inspector did when they were at the care home We sent surveys to staff and to people using the service. We received completed surveys from seven members of staff and nine of the people using the service. We looked at the information that the respite centre have sent to us about how the service is being run and at any notifications we have received. We visited the service and talked with the manager and staff. We also spoke with a relative. We toured the premises and we looked at records relating to care and staffing. What the care home does well Staff keep good written information about how people want to be supported and cared for during their respite visit and residents and their families are consulted about their care. Records are kept up to date and there is good communication between relatives and home staff. People feedback to us that they enjoy going to the respite centre and enjoy their time there. They like the food and the outings and activities. They like the staff. The home is clean and comfortable and there is enough room for people. Care Homes for Adults (18-65 years) Page 7 of 28 What has got better from the last inspection What the care home could do better The respite unit must produce a proper guide to the services provided so that people thinking about using the service can look at It and people already using the service have a handy brochure. The home is in need of redecoration. The home must get a new medication cabinet with a special storage area for controlled medications. Care Homes for Adults (18-65 years) Page 8 of 28 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 Sonia McKay 33 Greycoat Street London SW1P 2QF 02079792000 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 9 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 10 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. Prospective service users have the information they need about the service and ample opportunity to experience life in the service before staying there for a period of respite care. The numerous information leaflets and letters given to prospective service users must be compiled into an accessible guide to the respite service. Evidence: There is a detailed statement of purpose. A copy is available in the reception area. The statement of purpose contains all of the information required by regulation and the minimum standards and provides interested parties with detailed information about the respite unit. There is also a set of information leaflets and letters for people who are or might be considering using the service. These leaflets and letters aim to provide information about the respite service and how it runs. These various and numerous information leaflets and letters must be developed into a service users guide. The guide must contain all areas of information required by regulation and minimum standards. The home manager said there are plans to publish a brochure with all of the required information. A copy must be supplied to the Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Commission on completion. This respite unit is run by Southwark Social Services for residents of the borough. Admission is by application. The local authority also supplies a copy of the referred persons community care assessment of need. Senior staff review this information and decide if the referral is appropriate. Staff then visit the prospective service user and get to know them better by talking to them and meeting their family members or carers. Staff sometimes already know the person because they have used the adjacent Orient Street childrens respite unit. People are given time to get to know the service and there are plenty of opportunities for short visits before they decide to use the service for longer respite periods. A member of staff said that this is never rushed and it is done at a pace dictated by the prospective resident, even if it takes a long time. Care Homes for Adults (18-65 years) Page 12 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. Service users can be assured that their individual needs and choices will be considered properly when they stay at this respite centre. Staff keep good records of how people wish to be supported and cared for. Service users and their families are consulted about individual care arrangements and also about wider issues relating to the running of the unit. Evidence: Each person who uses the service has a key worker from within the team and a set of written plans for how they wish to be cared for and supported. Written information for three people who use the service was looked at during this inspection. The plans are sufficiently detailed and cover all aspects of required care and support. The plans are reviewed regularly and amended as required. There is good background information about cultural needs and preferences and users and their family members are encouraged to assist in making the plans where possible. The plans are signed by the service user or a relative, as recommended in the previous inspection report. In addition, before every respite stay, staff contact the family by telephone to get an update of any changes or issues and these are also documented. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Staff keep records of what happens for each person during their stay. There are no gaps in recording and staff record useful information that assists staff coming on duty for the next shift. There is a quick reference sheet for staff and this information, along with written plans and telephone updates provide staff with accessible and current information. There is also an assessment of any risks and if a risk is identified a management plan is put in place, for example, how to respond to any challenging behavior. There are regular meetings and events that provide chances for service users and families to get involved in the running of the unit. The manager also writes an open letter to provide service updates. During the last inspection it was noted that staff were unsure of the safest way to transfer people into the mini-bus. Discussion with the staff and manager during this inspection indicates that this issue has been resolved and staff know what to do now. The mother of one of the service users visited the unit on the day of the inspection. She gave positive feedback about the respite centre and the staff working there. Its brilliant here because my son is happy that he is here. The staff are very nice and polite and if there are any problems you just have to talk to the manager or deputies, they are always helpful. Care Homes for Adults (18-65 years) Page 14 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. People who use this service experience an excellent opportunity for an enjoyable lifestyle whilst staying there. They are able to take part in a wide range of activities and their personal preferences and needs are used to inform the planning of the service. Residents enjoy spending time with the staff at Orient Street. Evidence: People using the service are able to carry on attending their usual daytime activities whilst staying at the respite centre. For example, attending a day service or college. Visitors are welcome, but have to leave by 9.PM. Family and friends can also keep in touch by telephone or letter. Staff support people to engage in a range of activities within the unit and in the community. This includes activities in the evening and at the weekend. Discussion with staff and care records shows that current users enjoy going to the pub, doing arts and crafts, playing and listening to music, football and bowling, going out to the shops or the park and day trips to other places of interest. There is a large garden for relaxing Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: in and playing outdoor games. Some of the service users attend Church services, with staff from the centre or with their family members. Participation levels are monitored and recorded and ideas and suggestions put forward in meetings with people using the service are added to the activities plans and menu preferences. A person who uses the service said We have residents meetings to discuss what we want to do and can do what he wants to do with staff help, he likes having a joke with the staff and seeing his Friends. Another respite resident said I like coming to Orient street. I like coming to the parties and my mum and dad are happy for me to go to Orient street. Another resident said I like TV and outings. Staff are funny and we have fun. We go out, especially at the weekends. I would like to come here more!. Another said, I like to play play station and sonic. Soft play and trips. A member of staff said We look at peoples abilities rather than their disabilities. Another member of staff thought that the service did well at adapting to the changes in the service provided. There is a domestic style kitchen and a cook who has worked in the home for many years and knows the people who use the service and their dietary, cultural and personal preferences well. Quick reference sheets are available in the kitchen for all staff to be reminded. Food stocks are good and shopping is done according to the preferences of the people using the service each week. There are fresh food and vegetables and the kitchen is clean and well appointed. Food is stored properly. Staff share meals and mealtimes with the people using the service and there is a dining room next to the kitchen. Care plans are in place if people need assistance with eating and drinking and records are kept of what each person eats. People who use the service are encouraged to take as much responsibility for their daily lives as they are able to. This may mean making their bed and tidying their room or helping with other household chores. Care Homes for Adults (18-65 years) Page 16 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. Service users receive support with personal care in the way that they prefer and require and health care needs are addressed. Service users are protected by procedures relating to the administration of medications, although better storage must be provided in case a controlled drug is ever prescribed. Evidence: Personal care plans record the way in which each person manages their personal care. The level of staff support required is clearly identified. This means that people get the right amount of support without reducing their opportunities for as much self care as possible. Support with personal care is carried out in the privacy of bedrooms and bathrooms by a member of staff of the same gender. Health issues are recorded and updated before each admission and there is an arrangement with a local GP practice for health care. A detailed report is made of any health care appointment attended whilst at the centre so that accurate feedback can be given to families or carers. A service user said, Staff are good. They help me with bathing and they they wont push me to do something I dont want. Another service user said, The staff look after me well. If I am upset, hurt or unwell Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: they help to sort me out quickly. The manager cites one area of improved health care as being the centres ability to make healthier referrals directly. There is also evidence that the staff work with families around important health care such as requesting medication reviews. There are also plans to better promote healthy eating during residents meetings and menu planning. Staff keep behavioral monitoring charts as requested for any ongoing assessment work. Most residents require staff support to store and administer their medication, although a self medication policy and procedure is in place should it be required. Medication is stored in locked steel storage cabinet. The cabinet does not provide safe storage for any controlled drugs. This should be available in case any are prescribed. Medication administration records are kept properly and staff are trained in safe administration. Care Homes for Adults (18-65 years) Page 18 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. People who use this service can be assured that any concerns or complaints that they have will be investigated properly and they are safeguarded by trained staff who know what to do if they witness or suspect any abuse. Evidence: There is a procedure for making a complaint and there is an accessible guide and a video explaining how to do this. Surveys received show that service users know what to do if they are unhappy about something or want to make a complaint. A record is kept of all complaints and concerns raised and the actions taken by the manager and staff in the home to address them. There are only two complaints in the last twelve months and both dealt with properly. Feedback from relative visiting the unit on the day of the inspection is positive in regards to the manager and staff listening to and acting on any concerns raised. All staff have been trained in recognizing and responding properly to any indication of abuse and all staff have attended refresher training in the last twelve months. There have been no safeguarding investigations in the last twelve months. 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. The home is comfortable, clean and safe and there is enough space for people. The home needs to be redecorated a paintwork and decor are damaged in many rooms. Evidence: The centre is located in a quiet residential area, reasonably close to shops and public transport links. There is sufficient office space and staff sleeping in quarters. There are two communal lounges, dining room, kitchen and garden. There is also a soft play room. There are two bedrooms on the ground floor and two bedrooms on the first floor. There are ample bathing facilities and aids and adaptations are in place for people with a physical disability. All bedrooms have epilepsy monitors that can be disabled if they are not needed. The home employs a cleaner and the standard of cleanliness is high throughout. A resident said, I like to come to Orient Street. I like to have my own bedroom. Many of the rooms are in need of redecoration. There is damaged paintwork and areas of the home that have been repaired but not redecorated properly after wards. Care Homes for Adults (18-65 years) Page 20 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have clear roles and responsibilities and there are enough staff on duty to meet the needs of the residents. The staff are competent and qualified and there is good staff retention. Staff like working in the home and the residents give positive feedback about them. Staff are supervised and trained properly. Evidence: There is a centre manager, three deputy managers and a team of residential care officers. There are staff on duty at all times and the area manager is on call if there is an out of office hours emergency. There are a minimum of four staff on duty during the daytime and a night wake and sleeping in staff are on duty at night. If staff are needed in an emergency existing staff can do extra shifts or an agency staff member is used. The agency worker knows the unit well and also attends team training. This provides users of the service with good consistency and a chance to get to know the staff well. Feedback in surveys is positive about the staff team. Records are kept of when staff have worked in the home. Staff communicate with each well and appear to be enthusiastic, humorous and professional. Recruitment records are not kept at the centre. they are kept at the human resources office for Southwark Social Services, who run the unit. Records for new staff were brought to the unit to be inspected. Two new staff are employed and both have been checked properly before being employed. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: There are seventeen staff and twelve have attained a vocational qualification in care at level 2 or above. there is also a training programme and at the time of this inspection the unit had been closed to users for two days as the team were attending training sessions. A wide range of appropriate training is available and staff spoken with felt adequately trained and supported. Staff meet with a line manager for regular supervision on a one to one basis and there are regular team meetings. A resident said, Staff are always helpful and they do their jobs properly. Staff retention is good and many staff have worked in the home for many years and know the residents and their family members well. The deputy managers are each given a specific area of responsibility, for example, health and safety. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and run in the best interests of the people using the service. The manager is experienced and qualified. Health and safety is monitored well. Evidence: The registered manager has been in post for many years and she is qualified and experienced. Feedback about her management style is positive and a relative and member of staff said that she is approachable. Quality assurance systems are in place and the home manager produces an open letter and annual report updating stakeholders to new service issues. There is full occupancy and the service is in high demand, with a waiting list. Systems are in place to monitor health and safety and there are both internal and external checks of the environment and equipment in use. There is policy in regards to health and safety. The Commission is notified of any significant event in the home and record keeping is good. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 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 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 1 5 The unit must produce a service users guide (brochure) in accordance with current legislation and national minumum standards. 24/01/2010 To ensure that prospective service users have adequate information about the service. 2 20 13 There must be suitable 24/11/2009 arrangements for the storage and administration of any controlled drug. To comply with changes in legislation requiring residential homes to have correct storage for controlled drugs in case any are prescribed. Care Homes for Adults (18-65 years) Page 26 of 28 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 3 24 23 There must be a programme 24/01/2010 for the redecoration of bedrooms and some communal areas. The programme must address rooms where decor is damaged. To maintain a pleasant home environment. 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 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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