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Inspection on 08/06/10 for Sea View Lodge

Also see our care home review for Sea View Lodge for more information

This is the latest available inspection report for this service, carried out on 8th June 2010.

CQC found this care home to be providing an Good 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.

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

From the surveys returned to us and through discussion with service users and staff there is a high level of satisfaction with the service offered by the home. Amongst the comments made by people who use the service were, `It`s a very friendly home, it`s our home` and `I go out with staff shopping and i`ve always got things to do. The food is good as well. Everyone gets on.` Staff in the home told us, `All staff get on well with each other, the manager is very supportive` and `We have an excellent care home in all respects`. Service users are able to benefit from a homely atmosphere and a good range of activities and lifestyle choices. All of the people who use the service have consistently told us that the food in the home is good, that the staff are very caring and that staff and service users all get on well with each other. Medication processes are well managed and all of the records kept up to date. The manager is a qualified pharmacist and oversees the management of medication.

What has improved since the last inspection?

A number of improvements have been made since the last site visit inspection. The home now has a new manager who is registered with us. He has introduced some stability and organisation within the home`s record keeping. He has undertaken his NVQ 4/RMA and completed additional training to support his role. Substantial environmental improvements have been made including the refurbishment of the rear of the service creating an additional en-suite bedroom, office space and a downstairs toilet. Other improvements promoting disabled access have also been made along with the continuation of a redecoration plan. The kitchen has also been refurbished to some degree. Evidence was available to demonstrate that Individual Service User files have been updated to reflect current and changing needs. These are now kept under regular review. Healthcare provision and monitoring has also improved. Equipment and environmental adaptations have been made to meet the needs of two service users in the home. Issues relating to the management of risk have also been reviewed and updated and now include manual handling and fire risk assessments. An audit and updates have taken place in relation to the recruitment processes in the service, ensuring that all required checks are completed. Staff management issues have been reviewed. Staff now receive regular formal supervision and staff meetings take place once a month. The manager reported that staff have recently had a pay rise.

What the care home could do better:

No requirements under the Care Standards Act 2000 have been made as a result of this inspection process. Four best practice recommendations have been made, which include: Continued development of the service user guide to maximize accessibility for people with learning disabilities. Updating and reviewing the staff rota to make sure that only currently employed staff are included and that their role and the senior person in charge is stated at all times. Continued development of the staff training programme. There has been a high turnover of care staff and many of the staff team are within their first 6 months of employment. Within this time the service needs to make sure that all staff receive all mandatory training and other courses specific to the needs of the service. The results of surveys from service users, relatives and professionals should be collated in a report format showing outcomes and actions takes as the result of any constructive criticism.

Key inspection report Care homes for adults (18-65 years) Name: Address: Sea View Lodge 116 Central Parade Herne Bay Kent CT6 5JN     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: Joseph Harris     Date: 0 8 0 6 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Sea View Lodge 116 Central Parade Herne Bay Kent CT6 5JN 01227375253 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): seaviewlodge@aol.com Mr Shahid Sheikh,Mrs Nelofar Sheikh Name of registered manager (if applicable) Mr Haris Shahid Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 10. The registered person may provide the following category/ies of service only: Care home only ? (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 (LD) Date of last inspection Brief description of the care home Sea View Lodge is a 10-bedded home for people with learning disabilities in the town of Herne Bay. The house is located on the seafront close to the pier and a short distance from the centre of town with a good range of amenities and facilities. There are reasonable public transport from the town including bus routes and a train station. The home is set out over two floors. The ground floor mainly comprising of communal space with two bedrooms. A major refurbishment will provide an additional en-suite Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 10 1 8 0 5 2 0 0 9 Brief description of the care home bedroom, toilet and office area. The first floor consists of bedrooms and toilets/bathing facilities. There is adequate communal space throughout the home. There is a small, enclosed courtyard to the rear of the home and a larger paved area with parking space to the front of the home. Information on the home fees, services and the CQC reports for prospective service users will be detailed in the statement of purpose and service user guide and are available from 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: 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 key inspection process culminated in a site visit to the service on 8th June 2010. The site visit commenced at 09:30 hours and lasted for approximately 6 hours. Prior to the site visit we reviewed all of the data and information that we have about the service. This included the Annual Quality Assurance Assessment (AQAA) which is a self-assessment tool completed by the home that focuses on the outcomes for people living in the home. We also looked at all of the notifications, which are a legal requirement, submitted to us by the service regarding untoward incidents and occurrences. We reviewed any complaints that have been made and how the service has managed these and the results of any safeguarding vulnerable adult alerts. We reviewed any information that we have received from other bodies and interested parties including those of key professionals. Surveys were returned to us by 7 service users and 5 staff members. Care Homes for Adults (18-65 years) Page 6 of 28 At the site visit a tour of the premises was conducted including viewing the refurbished rear part of the home. Discussions were held with service users, staff on duty, a visiting professional, the manager and the service provider. A range of documentation was examined including individual service user files, staff personnel files, training certificates, medication processes, health and safety issues and other records relating to the day-to day running of the home. 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: No requirements under the Care Standards Act 2000 have been made as a result of this inspection process. Four best practice recommendations have been made, which include: Continued development of the service user guide to maximize accessibility for people Care Homes for Adults (18-65 years) Page 8 of 28 with learning disabilities. Updating and reviewing the staff rota to make sure that only currently employed staff are included and that their role and the senior person in charge is stated at all times. Continued development of the staff training programme. There has been a high turnover of care staff and many of the staff team are within their first 6 months of employment. Within this time the service needs to make sure that all staff receive all mandatory training and other courses specific to the needs of the service. The results of surveys from service users, relatives and professionals should be collated in a report format showing outcomes and actions takes as the result of any constructive criticism. 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 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. Service users are able to make an informed choice about moving into the home and their needs are assessed. Evidence: The home has developed a Statement of Purpose and a Service User Guide. The guide has recently been updated to enable improved accessibility for some people with learning disabilities with the inclusion of some signs and pictures. The layout of the guide has also been changed. Further improvements to the guide can still be completed to maximize the understanding of prospective service users. Refer to recommendation 1. There have been no new admissions to the service since the last inspection site visit. The home has well-developed assessment processes that includes liaison with the service user, care manager and any other relevant individuals. The contract covering terms and conditions of residency has been updated to include all relevant information. A signed copy of the contract is kept on file for each Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: individual. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual needs and choices of service users are met. Evidence: Two individual service user plans were examined. Discussions were held with the service users they relate to. The plans address all of the key areas of need providing suitable and clear guidance for staff. The plans show evidence of regular review and have been updated to reflect the current changing needs of service users. A life history is included in each file and the choices and preferences of individuals recorded. Assessment tools for moving and handling and fire risks are in place. Greater clarity could be introduced into the moving and handling assessment, but the key information is present. There is a risk matrix developed for each service user providing guidance to minimise other identified risks. The matrix is reviewed on a regular basis. Service users have consistently told us that they are happy living in the home and that the staff treat them with dignity and respect. One person said, We have a friendly home, the staff are lovely. Very helpful and caring. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Staff were observed to be thoughtful and respectful in their interactions with residents. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have lifestyle that suits their needs. Evidence: Service users can access a range of activities in and out of the home. An activity plan is developed for each resident. There is an activities afternoon every day of the week providing exercise classes, arts and crafts and music sessions amongst other things. A number of service users attend outside activities such as day centres and clubs. One person does some voluntary work in a local charity shop. Visitors are welcomed into the home and have told us that there is friendly and positive atmosphere. The manager liaises with relatives appropriately. Service users are involved in the planning of menus and the home works to meet individual requirements and choices. Menu records are maintained and the kitchen which is at the heart of the home has recently been refurbished. Service users are able to be involved in the cooking process and shopping for food. Residents tell us that Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: they are very happy with the quality of food in the home. Special diets are catered for such as diabetic, weight reducing and cultural preferences. 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. The health and personal care needs of service users are met. Evidence: The personal care needs of service users are clearly detailed within the individual service user plans. Personal preferences and choices are documented and clear guidance is in place. Service users have told us that they are happy with the care and support that they receive and it is provided in a manner that they prefer. Care staff spoke with understanding about the needs of each service user and are aware of personal preferences. Healthcare records relating to each individual are kept up to date. The system for recording healthcare appointments and their outcomes could be streamlined, but the key information is provided. There is evidence that service users are supported to appointments and health issues are referred to relevant professionals. A range of healthcare professionals currently visit service users in the home such as Occupational Therapists, Physiotherapists and a diabetic nurse amongst others. Complimentary healthcare needs such as chiropody and dentistry are provided. The healthcare needs of each service user are clearly documented in the individual service user files. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Medication issues are well managed in the service. There are suitable storage facilities and records are kept up to date. The manager is a qualified pharmacist and oversees the management of medication. Policies and procedures are in place and staff who administer medication have received the required training. 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. Service users views are listened to and they are protected from abuse. Evidence: There is a complaints process in place that is on display within the home. The manager has begun to develop a more outcomes-based approach to managing complaints. No complaints have been raised in connection with the service since the last inspection site visit. Residents and relatives have told us that they feel able to make their views known and know how to make a complaint should they have one. Policies and procedures relating to issues of abuse and adult protection are in place. Care staff receive training in Adult Protection within their first 6 months of employment. Some instruction has also been provided covering the Mental Capacity Act and the Deprivation of Liberty Safeguards. Staff demonstrated a good understanding of how to deal effectively with issues relating to abuse awareness and reporting. There have been no adult protection alerts raised in connection with the service since the last inspection site visit. The adult protection alert that was open during the last inspection process has subsequently been closed and all actions followed through. 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 premises are suitable for the needs of the service users. Evidence: The service provider has begun to make some significant improvements to the home the most notable of which is the conversion of the rear of the building into an en-suite bedroom, downstairs toilet, meeting room and office. The work on this part of the home was almost completed when we visited. In addition to this areas of the home have undergone redecoration including the kitchen and some bedrooms. The patio area at the side of the home has been cleared and is now a more functional space. There is also wheelchair access now leading to the outside. The manager stated that there are further plans for improvement, which will include the increase of occupancy numbers to 11 in time. Various adaptations have been made to the home to aid the support of more physically dependent service users including the widening of doorways, improvements to one persons en-suite facility and recommended equipment. The premises have comfortable furniture and are well decorated. The service is clean and hygienic. No evident issues were noted during the tour of the premises. Service users told us that they are happy with their bedrooms and the general environment. Many of the service users users have lived in the home for over 20 years and regard the service as their home. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: It was reported that the home complies with the regulations and recommendations of the fire and environmental health departments. 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. There are sufficiently trained staff who are recruited with the safety of service users protected. Evidence: The staff rota was examined that demonstrates suitable numbers of staff are on duty to ensure that the needs of the service users can be met. The rota needs to be updated ensuring that only current staff are shown, in what capacity and the carer in charge of the shift to ensure accountability. Refer to recommendation 2. There has been a high turnover of staff in the past 12 months. This was discussed with the manager and the service provider. They stated that they now have a stable core staff team and aim to build upon this over the coming year. They stated that staff benefits have been improved to promote staff retention. 0 percent of the staff team have achieved a National Vocational Qualification or equivalent at level 2 or above. One staff member is currently working towards her level 3 award. It is expected that new staff will undertake NVQ training. Three staff personnel files were examined. the manager has recently audited and reviewed staff recruitment records and all files examined contained the required information including CRB/POVA checks, two written references, employment histories and proof of identity. The staff raining matrix was examined and certificates held as evidence of training on Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: staff files. The matrix needs to be updated removing staff who no longer work in the service. The evidence demonstrated that staff receive all mandatory training within the first six months of employment, however the majority of carers have yet to reach this milestone. Refer to recommendation 3. New staff work through an induction process including an in-house induction and completion of the Common Induction Standards. The manager stated that they have reviewed the way new staff are supported and they work in a supernumerary capacity until competency levels have been assessed. Care staff spoken to during the course of the site visit demonstrated good all round competence with regard to topics discussed. The manager has implemented a system of formal supervision ensuring staff receive 1:1 support at least 6 times per year and an annual appraisal. Regular staff meetings have been introduced and are documented showing that pertinent topics are discussed. 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 managed in the best interests of the service users and health and safety issues are addressed. Evidence: The new service manager has been registered with us, having successfully progressed through the registration process. He is a qualified pharmacist and has undertaken his NVQ level 4 and Registered Managers Award. There is evidence that he has completed other training in connection to his role in the home. Staff spoke positively about his impact in the home and stated that the service provider frequently visits the service every week. He has introduced a number of improvements to the home from an organisational perspective. This includes regular staff meetings, auditing processes and improved administration. The home has established suitable Quality Assurance processes. These include annual satisfaction surveys for service users, relatives and professionals. The most recent returned surveys were examined which demonstrated that largely positive comments and feedback have been made. The manager should make efforts to collate the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: information returned into an annual report demonstrating any actions arising from the surveys. Refer to recommendation 4. Regular staff meetings now take place as well as resident meetings. Audits have been completed in some key areas of service provision such as recruitment, medication and health and safety. Documentation relating to health and safety issues was examined. These demonstrated that required service checks such as electrical wiring, gas safety and fire are completed. The service has liaised with the department of building regulations regarding the structural changes made to the service and the manager stated his intention to liaise with the fire and environmental health departments once the work is complete. It was reported that the service currently meets the recommendations of the environmental health and fire departments. 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 1 1 To consider further development of the service user guide to maximize understanding for people with learning disabilities. To ensure that the staff duty rota reflects the care staff employed and the capacity in which they work. To continue to develop the staff training programme and ensure all staff receive the required mandatory training within the first 6 months of employment. To collate annual surveys into an annual quality report focusing on outcomes and actions taken as a result of the process. 2 3 31 35 4 39 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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