Inspection on 12/01/09 for The Merchant`s House

This is the latest available inspection report for this service, carried out on 12th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Merchant`s House 13/02/06

The Merchant`s House 18/08/05

The Merchant`s House 25/02/05

The Merchant`s House 09/11/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Merchant`s House 80 Prenton Road East Prenton Birkenhead Wirral CH42 7LH     The quality rating for this care home is:   two star good 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: John Mullen     Date: 1 2 0 1 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. the things that people have said are important to them: They reflect 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Merchant`s House 80 Prenton Road East Prenton Birkenhead Wirral CH42 7LH 01516456280 01516459483 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Christopher O`Shea Type of registration: Number of places registered: Inclusive Lifestyles care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category/ies 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 The maximum number of service users who can be accommodated is: 6. Date of last inspection Brief description of the care home The Merchants House is registered to provide personal care for 6 adults with a learning disability. It is owned by Inclusive Lifestyles and the registered manager is Christopher OShea. In addition to Merchants House, Inclusive Lifestyles operates a domiciliary care agency and another care home. It is to open a further care home in the near future. Its headquarters is in Chester and at the time of the inspection had a total of thirty five people which it supports. The Merchants House is a large detached property in the Prenton area of the Wirral. The accommodation in the home is specifically designed and equipped to meet the needs of people who use the service. There is a Care Homes for Adults (18-65 years) Page 4 of 27 6 Over 65 0 Brief description of the care home lift, hoists and walk in showers available. The accommodation provided is in single bedrooms with an en-suite facility. On the ground floor, there is a lounge and dining room and on the second floor there is a further lounge. There is an enclosed garden to the rear of the property. Limited parking is available in the grounds of the home and is available on the road outside the home. The home provides a vehicle to give people who use the service the opportunity to go out individually or together. At the time of the inspection, the yearly cost for the service was £160,000 per person with additional charges if extra staff support is required . Care Homes for Adults (18-65 years) Page 5 of 27 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: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. This was a key unannounced inspection of the Merchants House Care Home which included a site visit. All key standards were assessed in addition to a selection of other standards. This inspection encompassed information received since the last key inspection. In addition it included information provided by the home through its pre-inspection questionnaire and supporting documents. Care Homes for Adults (18-65 years) Page 6 of 27 Interviews took place with the managing director, the registered manager of the domiciliary care agency, a team leader and a senior support worker. Two people who use the service were case tracked, that is their records and care were examined in detail and they were observed in the home. Comment cards were sent to a random selection of staff and people who use the service and they were both observed and spoken to. The premises were inspected and a large amount of documentation examined. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 27 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. The home provides and receives full information on its work so that it can meet the needs of people using the service. Evidence: The pre-inspection material stated that the information provided to people using the service has been updated to meet deficits found at the last inspection. The site visit confirmed this. The Statement of Purpose had been reviewed in March 2008 and covers all relevant subjects. In addition, each file examined had a personalised Service User Guide, signed by people using the service, which covered relevant information, including any additional charges which may be made. Conversations with people using the service revealed no concerns about the terms under which they are accommodated and they appeared well settled in the home. Files of people using the service found a full care needs assessment in each which could be used as a tool to plan work. These assessments were thorough and covered all relevant points to confirm their usefulness. Interviews with managers and staff revealed a good knowledge of the needs of people using the service and this was helped by the fact that some senior Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: staff have been with the home since its opening. Comment cards from staff also were positive about knowing and meeting needs which is helped by the small number of people accommodated. Care Homes for Adults (18-65 years) Page 11 of 27 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 care of people using the service is undertaken in a safe and appropriate manner. Evidence: The pre-inspection material stated that there was an individualised care programme in place to ensure that the needs if people using the service were met. Examination of these files confirmed very detailed care plans which were comprehensive and had been reviewed regularly to confirm relevance. The care plans had evidence also of people who use the service and family involvement which showed they were the result of a cooperative effort. Staff interviewed were aware of the care plans but comment cards received from staff included one that stated there was not enough time to read care plans regularly. This comment was agreed by a team leader interviewed who felt that the handover time was insufficent for full consideration. This was not agreed by another senior care worker interviewed although she did say that communication could be a problem at times. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The last key inspection found that the home was promoting decision making to the extent that the capacities of people using the service allow. This was confirmed by this site visit which showed that people using the service have, for example, individualised their bedrooms based on their own wishes. A tour of the premises and discussions with people using the service also confirmed that they, depending on capacity, had their own keys to their bedrooms, were individually dressed and could show that their individual choices were respected. An examination of files of people using the service found very detailed risk assessments in place which had been reviewed to confirm their relevance. Interviews with managers of the home showed that they were aware of the risks associated with individual people and the site visit confirmed that these risks are managed appropriately in the interests of the safety of staff and people using the service. The site also confirmed that where incidents take place these are now thoroughly recorded, which was a deficit from the last inspection, and means that these risks are documented and reassessed where necessary. Care Homes for Adults (18-65 years) Page 13 of 27 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. The procedures of the home allow for an individualised and supportive lifestyle for people who use the service Evidence: The pre-inspection material stated that the home encourages individual activities based on personal preferences. This inspection confirmed this, showing that, dependent on capacity, people using the service engage in activities and interests based on their personal choice. One showed his bedroom full of games and personal effects which clearly showed his individualised interests. Examination of files of people using the service showed that their likes and dislikes are recorded and that individual activity planning was in place with detailed instructions to staff on how to support them so this is done effectively and safely. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The home has been in existence for approximately five years and appears well integrated into the local community. Interviews with managers showed that people using the service can be supported to access local facilities due to the very good staffing ratios available. The home employs extra staff at particular times to specifically assist people using the service to use these facilities. This was documented in the files examined to confirm an active approach to their interests. Interviews with people who use the service and comment cards received from them were complimentary about their care in the home. Interviews with managers confirmed that the home promotes family contact, including regular visits to the South of England for one person. It was also confirmed in interviews that the home has an open visiting policy so that contact is furthered and promoted. Examination of files of people who use the service showed that family contact is documented so that this can be demonstrated and reviewed. Contact with people who use the service revealed no problems with the promotion of relationships by the home which showed that this was being managed appropriately. A tour of the premises included visits to bedrooms and showed that people who use the service were given a key where appropriate to promote their independence. In addition, the tour showed that people who use the service were being supported appropriately and with sufficient numbers of staff so that they were cared for safely. Observed interaction between staff and people who use the service was friendly and appropriate. People who use the service were spoken to confirmed that they are encouraged to participate in the home to the extent that their safety and capacity allow. At the time of the site visit the cook was absent but managers could demonstrate that a full menu is in place, including choices, so that people who use the service are being appropriately supported in this area. Examination of their files showed that their preferences in respect of food and drink were documented and, therefore, known to staff. An interview with a senior support worker confirmed that mealtimes can be staggered to meet individual preferences and needs and that one person eats alone for this reason. Care Homes for Adults (18-65 years) Page 15 of 27 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 home provides individualised personal and healthcare support so that people who use the service are accommodated appropriately and safely. Evidence: Comment cards received from staff and a care manager prior to the site visit confirmed a high opinion of the level of personal care being provided in the home. The care manager stated that she has two clients both of which have done extremely well. Examination of files of people who use the service showed that there were very detailed and clear instructions to staff on how to support their specific needs. Given the level of disability of some people who use the service these instructions are necessary as well as beneficial. An interview with a manager confirmed that the company has been concentrating on providing more vocational training to underpin practice and this has been reflected in a substantial increase in the number of staff with such a qualification. This was confirmed by interviews with staff and training documented seen during the site visit. Observations showed that people who use the service were being supported appropriately and with sufficient numbers to maintain safety. Documentation in the files of people who use the service showed that particular Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: staff have specific responsibilities towards them and these are known and acted upon. The level of disability of some people who use the service means that their health needs are complex and managers interviewed confirmed that this is a priority for the home. An examination of their files showed that their health needs were fully documented and reviewed regularly to ensure that their needs are identified and met. The documents also showed that the home accesses healthcare provision as required and that people who use the service are supported to attend appointments as required. Contact with staff revealed a good knowledge of their health needs and an active approach to meeting these. Previous inspections of this home have found deficits in the medication procedures which required attention. The site visit showed that these have been rectified. The home has improved its recording of medicines received and dispatched so that a full audit is now available. In addition, the sheets recording medication taken were correctly completed so that the system was shown to be safe and comprehensive. A tour of the premises found that medicines are safely stored. Interviews with staff and training records seen confirmed that staff administering medicines have been trained in this subject and that this training has been recently refreshed so that they remain competent in this area. Care Homes for Adults (18-65 years) Page 17 of 27 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. The home protects people who use the service through appropriate policies and procedures. Evidence: The home has a full complaints procedure that is well publicised so that people who use the service and families are aware of the procedures. Neither comment cards from them nor contact during the site visit revealed any complaint about the home. The pre-inspection questionnaire revealed there had been no complaint over the previous twelve months which confirmed a good level of satisfaction with the service. Information given to us since the last inspection included some issues surrounding safeguarding. An interview with the managing director confirmed that they had been dealt with appropriately for the safety of people using the service. An examination of the homes safeguarding policy showed that it was in accordance with good practice and gave good direction to staff. Training documents seen showed that staff are being trained in this subject so that they remain up to date in this area. Care Homes for Adults (18-65 years) Page 18 of 27 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 accommodation of people using the service being both comfortable and hygienic. Evidence: The pre-inspection material confirmed the suitability of the home and that it continues to be improved physically for the benefit of people using the service. A tour of the premises found this to be the case with a good level of furnishings, floor covering and decoration. All the bedrooms are for single occupancy and are en-suite and had been adapted for the specific use of individual people so that they can be accommodated safely. The bedrooms did not have a comfortable chair which potentially lessens their usefulness for people using the service to entertain and relax. Interviews with them found them pleased with the accommodation and, in particular, their bedrooms in which they demonstrated some pride. The home is sufficently large to give good living space for people using the service, including the outside area, which is pleasant and accessible. There has been no concern with the cleanliness of the premises, confirming its suitability. A tour of the premises found it clean and hygienic for the accommodation of people using the service. There were no odours detectable throughout. The home Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: employs three domestic staff which is sufficient to maintain a good level of hygiene. It had a laundry facility with appropriate equipment to maintain standards. The home has appropriate policies and procedures to maintain the standards of hygiene required. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment, training and support of staff needs to be further developed and recorded to enable full systems to be effective. Evidence: An interview with a manager confirmed the pre-inspection information that there had been a very large increase in the number of vocationally trained staff to confirm the companys commitment to training. The figure has increased from 26 to 77 which means that the home now meets guidance on the proportion of staff to receive such training. This was confirmed by interviews with staff which also showed that more advanced training is being taken by some to further their knowledge. The home is fully staffed and deploys staff in sufficient number to enable it to fulfil its purpose. Interviews with a team leader and a senior support worker showed that they had been with the home since its inception to allow a continuity of care. Comment cards from people who use the service were generally positive although one was ambivalent in its attitude but this was not typical and was not confirmed by the site visit. Observed interaction between people who use the service and staff was positive and appropriate. An interview with the managing director showed that the company has introduced a new computerised method of recording personnel matters, including in the area of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: recruitment and selection. The managing director demonstrated this system and conceded that it was not totally effective at this stage of its development. However, the system could show that appropriate checks are being taken on staff for the safety of people using the service. Comment cards from staff confirmed that the recruitment process was fair and robust. Interviews with managers showed that recruitment and selection is based on sound principles for the protection of people using the service and staff alike. The managing director demonstrated the training records on the computerised system and conceded that, at present, the system is not effective. In addition, manual records produced during the site visit when compared to the evidence found at interview, showed that these were not accurate either. However, documentary evidence did show that relevant training is being provided for individual staff so that they remain competent in their work. Furthermore, an interview with a manager confirmed that the company is using a specialist training organisation as a means of increasing the level of training available. The managing director stated that the company has employed new personnel to implement a training programme although the systems are at present not fully effective. Pre-inspection comments from staff were favourable about the amount of support they receive in their work. This was confirmed by interviews during the site visit to show that informal methods are used to good effect. However, an examination of supervision records, when they were available, also did show that the level of formal support is below that which is required. A team leader showed examples of the supervision format which is appropriate and detailed for the direction of staff. Staff however, did concede that formal supervision is not taking place as frequently as expected by the company. Care Homes for Adults (18-65 years) Page 22 of 27 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 being being managed effectively and safely for the protection of people who use the service. Evidence: Since the last inspection, the home has appointed a registered manager to comply with the requirements of legislation. The registered manager was on leave at the time of the inspection but all documents relating to him confirm that he is fully qualified for the post and that he has improved the home since his appointment. An interview with another manager confirmed that he felt the registered manager had made a significant improvement to the home and this was confirmed by other staff spoken to. Evidence during the site visit showed that the home has advanced in a number of ways since the last key inspection which reflects well on the registered manager and staff generally. The pre-inspection material stated that there was a full quality assurance procedure in place to monitor and improve the home. These included external visits to the home, Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: annual reviews and surveys of people who use the service. The first of these is evidenced by reports sent to us which show that there is an effective audit by an external manager. Unfortunately, other elements were not accessible as the registered manager was on leave and other managers either did not have access to documents or could not locate them. Although it is important that the principle of confidentiality is maintained this would not be compromised by access to records by other managers. In addition, it is important that other managers are aware of the location of documents for ease of reference and the progress of the home. The last inspection found some deficits in the procedures relating to safe working practices which were potentially unsafe. This site visit found that these had been rectified with a full check on the safety of gas and electricity and training of staff in fire procedures for the safety of people using the service and staff alike. In addition, the site visit found that the fire book was being correctly completed, water temperatures were at the correct level and that fridge and freezer temperatures were being taken regularly for the protection of people using the service. In addition, both a fire risk assessment and an environmental risk assessment had been taken to ensure the safety of the premises. A tour of the premises found that safe practices were being promoted, including the monitoring of individual people who use the service, so that risks were being minimised. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 The home to implement a full training plan. To enable training to be systematically planned. 01/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 The home should review its handover process to ensure that all staff are aware of any change in circumstances of people using the service. The home should assess the suitability of a comfortable chair for each bedroom to allow greater use of this area. Formal supervision to be increased so that staff can be fully directed in their work. In the absence of the registered manager, other managers should have access to all relevant documents and be aware of their location so that the progress of the home remains unhindered. 2 3 4 24 36 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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). 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!