Inspection on 30/06/09 for 11 Kilford Court

This inspection was carried out on 30th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

11 Kilford Court 05/07/07

11 Kilford Court 11/10/06

11 Kilford Court 09/09/05

11 Kilford Court 14/10/04

11 Kilford Court 05/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/02/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 11 Kilford Court Mortimer Road Botley Southampton Hampshire SO30 2TN     The quality rating for this care home is:   one star adequate 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: Beverley Rand     Date: 3 0 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. 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. 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.cqc.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: 11 Kilford Court Mortimer Road Botley Southampton Hampshire SO30 2TN 01489790949 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) : elmo82@hotmail.co.uk Choice Support care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6 The registered person may provide care to service users in the following category 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 category :Learning disability (LD) Date of last inspection Brief description of the care home 11 Kilford Court is purpose built as a residential care home for people who have learning disabilities and associated physical disabilities. There are four bedrooms on the ground floor, which are fully wheelchair accessible, and two bedrooms upstairs for service users who are more physically able. The home is situated on a small housing estate in Botley, approximately a quarter of a mile from local shops and pubs and access to public transport services. The home has a minibus that is equipped to provide transport for physically disabled service users. The home is managed by Choice Support. Service users are responsible for paying for Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home rent, food, mileage for the homes car when they use it, their own toiletries and items of a personal or luxury nature. 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection and took place over a full day. Before we visited the home we looked at the last inspection report and other information which the home had sent us since the last inspection. We received the Annual Quality Assurance Assessment, (AQAA) which the manager sent to us which included some of the information we asked for. During the inspection we spoke with staff and one service user. We looked around the home and looked at various records. We also asked to see the AQAA, but we could not see the completed document due to a computer problem. Care Homes for Adults (18-65 years) Page 6 of 27 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.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 7 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 8 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that service users only move in if the home can meet their needs. Service users may not be aware how much the service costs them. Evidence: The home has not had any new service users since the last inspection. The AQAA states that there is an assessment process in place and that prospective service users would visit the home if possible before they were offered a room. Not all service users had details of the fees, or contracts in their files. There was a variety of, often, out of date information regarding individual assessments and some information about extra costs such as rent, food and diesel. This means that service users or their representatives are not aware of how much the service is costing them. Care Homes for Adults (18-65 years) Page 9 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 home ensures that service users have a support plan in place which reflects their personal choices and wishes. Service users are supported to take responsible risks. Evidence: We saw that service users had a Cultural Needs Assessment in place, which included information about what food people preferred, whether any special utensils were needed, hair and skin care needs, gender roles within the service users culture and so on. Support plans showed how service users preferred to be supported with personal care and included clear step by step instructions to ensure that staff were consistent. The plans are reviewed every six weeks and activities are monitored. We identified two pieces of information which staff said were out of date in support plans which means the review process has not monitored the changes. However, the home is small and the staff team is consistent and know their service users well. We saw evidence around the home and in files that showed service users are Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: supported to make decisions, for example, a service user had decided to buy some new furniture and a television for their room. Files contained risk assessments and these were in pictures so that service users could understand them. The records also showed that staff supported service users to take risks in everyday situations. Care Homes for Adults (18-65 years) Page 11 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 home ensures that service users take part in activities of their choosing. Service users benefit from choice at mealtimes and their dietary needs are met. Evidence: The AQAA stated that service users take part in a number of courses and activities in the community, including massage, social clubs, swimming and keep fit. Some service users had been recently supported to access new clubs of interest to them which had broadened their social links. The service users enjoy gardening and the home has entered a local competition, Botley in Bloom. Staff have supported service users to run community events as part of a local scheme. The home has pets which service users help to look after and two service users have their own pets. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: We were told that food was provided according to individual health needs, likes and dislikes and that menus were decided with service users. Staff cook the food and were able to tell us the different dietary needs, for example, food being mashed or cut into bite size pieces. We spoke to staff cooking the main meal of the day and they explained the choices made at that mealtime by the service users. Staff also said that a slow cooker had been bought and that this worked very well for service users who need softer food. We saw on support plans and by being in the kitchen at teatime, that service users have individual plates and bowls which meet their individual needs, such as plates with guards. Food intake is recorded so that staff can monitor individual diets. Care Homes for Adults (18-65 years) Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users health and social care needs are met but medication systems are not sufficiently robust enough to ensure medication risks are minimised. Evidence: The AQAA stated that the home provides gender appropriate care as far as is reasonably possible. We saw that cultural needs assessments identified whether service users had a preference for same gender care and whether or not it was essential. In response to this, we spoke to staff about the occasions when two men were working at night and were told that the current service users did not need intimate personal care at night. Support plans gave good, detailed information about support needed, for example, the use of the hoist. There was evidence that the home consults healthcare professionals when necessary. District nurses have visited the home when needed to treat service users. The manager told us in the AQAA that staff had successfully made a complaint about the level of service being received by service users with regard to a healthcare team and that the situation has improved. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The home supports service users with their medication. We looked at the medication administration charts, (MAR). Where these were completed, there were no gaps other than for one service user, on one ocassion. However, several of the MARs showed that a number of medications had not been given. We spoke to staff about this and were told that these medications had been stopped but that the MAR had not been amended when they were printed by the pharmacy. MAR charts must be accurate to reduce the risks of medication being given incorrectly. Some charts gave instructions such as, give one or two, up to four times a day in respect of painkillers. We asked if there were any care plans in place so that staff knew how many to give. Staff were unsure but later they found a good careplan which showed how to give the medication to meet an individuals needs. We found a discrepancy regarding a prescription for paracetomol, which appeared on a MAR chart and showed that 100 tablets had come into the home although none had been given to the service user. However, the communication book showed that the home did not have any and more were sought from the pharmacist during the same period. We asked about this and staff thought that the old tablets were out of date and returned to the pharmacist, although this was not recorded in the returns book. Therefore, the home was not able to account for all the medication which should be in the home according to the MAR charts and we could not establish whether the service user had needed this medication but did not receive it. The AQAA did not make specific reference to the administration of medication or training in medication. During the inspection we were told that all staff give medication to service users. Training about medication is included on induction for new staff which covers different medication and different ways of administering it. New staff do not administer medication straight away, but when they feel ready, they shadow other staff before administering medication whilst being shadowed themselves. We were also told that the manager assesses competence and we looked at the form used to record competence and this was thorough. Records showed that some staff underwent this assessment on an annual basis, but four staff did not have a record of any assessment. Two other staff had last had an assessment in 2007. Therefore, records did not demonstrate that staff were competent to administer medication. Care Homes for Adults (18-65 years) Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to enable service users to complain. The home does not have systems in place to ensure service users financial interests are protected. Evidence: The AQAA says that the home seeks feedback from service users where possible, which involves all staff having a good knowledge of service users communication. The manager identified in the AQAA that the home could have the complaints procedure in different formats but that the procedure is now available in a picture format to make it more accessible to service users. We looked at the complaints log book and there were not any complaints recorded. The AQAA states that all staff have annual training in safeguarding vulnerable adults. We looked at the homes safeguarding procedure and found that it identified the need to make safeguarding referrals to the local authority adult services department. The home looks after money on behalf of all the service users and everyone has financial assessment, which shows whether service users understand the value of money, recognise coins and notes etc. We became aware that service users contribute to the food and diesel budgets and pay rent. Everyone pays the same for the food. However, the diesel is worked out on an individual basis, using two budgets, which appeared to be a complex system, which was not well understood by staff. A record is Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: kept by the driver of the homes car, which indicates who has gone where and why. Sometimes, two service users go out together and the cost is shared in a proportional way, as recorded by the driver. Data from this record is then copied onto another form and service users are charged according to the second record. We found that the two sets of records did not match, and that one service user appeared to have been under charged for the miles travelled in the car, and two were apparently over charged. This is especially significant as the current service users have little or no understanding of money and would not realise that mistakes were being made. Staff support service users to go to places such as cafes in the community. We asked how staff food and drink was paid for and were told that there was a particular budget provided by the organisation for this. However, we found a receipt for one service user which showed that two snacks and two drinks had been purchased on one ocassion. A staff member then said that if this budget had run out at the end of the month then the service user would pay for staff food and drink. This was not an agreed part of support plans or part of the financial assessments. We were told that the money did not run out often, but that it had this month. We looked at the records for this month and found that the budget had reduced to 50pence, but that the manager had topped it up with more money. However, there was not anything written in the communication book about this which meant staff we spoke to did not know it was there. We spoke with two other staff who said the money has run out ocassionally but they have paid for their own refreshments. Both of these issues are of concern because the service users have limited understanding of money and their financial interests are not protected, in the absence of robust policies and procedures. Care Homes for Adults (18-65 years) Page 17 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. Service users live in a clean and homely environment. Evidence: The home has a lounge with a sensory area at one end and a kitchen/diner. Some bedroom doors were open and we saw that the decoration of the rooms was clearly individual, with furniture chosen by service users. Service users like gardening and flowers and vegetables are grown by them. The AQAA states that weekly health and safety checks are carried out and any issues are recorded in the maintenance book to be reported to the relevant people. The AQAA also said that all the service users have had their bedroom carpets replaced in the last two years and the hall carpets were replaced in the last year. We spoke with a service user who said they chose the colour of the paint in their room. The home has a seperate laundry. The home was clean and we saw that there was plenty of protective clothing such as disposable gloves and aprons. Care Homes for Adults (18-65 years) Page 18 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 lack of recruitment records means that staff may not have been recruited according to the homes procedures. Some staff are qualified but staff may not have received training to perform the work they do. Service users do not benefit from being supported by staff who are regularly supervised. Evidence: The organisation keeps recruitment records centrally and this has been previously agreed by the Commission for Social Care Inspection. However, it was also agreed that basic information would be held in the service. We asked to look at the files for two new staff. One had basic information on file and we asked for information regarding references and other checks. The information was supplied and the checks were in place before the person started work. The file kept at the service also showed that the staff member had completed a six week induction, a three and six month review and foundation training. However, there was not a file in the home for another staff member which is not in keeping with the organisations agreement with the previous commission. Records must be available for inspection. The AQAA stated that staff have regular bespoke training as well as mandatory training, team meetings and away days. Staff told us that they did their mandatory Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: training every year which included health and safety and fire safety. We asked to look at training records but these were held on individual staff files. We saw that staff had completed one or two courses last year, with some completing more but it was not possible to see whether staff had undertaken all mandatory training in the last year. We asked for a training matrix to be sent to us and this was agreed but we have not received it at the time of writing this report. We were told that eight staff have a National Vocational Qualification in care at level 2 or above which means that service users are supported by qualified staff. We were told that responsibility for staff supervision is shared between the manager and the deputy manager. We looked at records of supervision dates and found that supervision was not regular. One staff member had not had a supervision session since February, one had a session in March but before that had received three sessions in 2007. One had three sessions last year and only two so far this year. Another staff member had received regular supervision, having received three sessions this year. Some staff have not had an annual appraisal since 2007. Care Homes for Adults (18-65 years) Page 20 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is not well run as there is not a registered manager and service users experience some adequate outcomes. Procedures are in place to seek the views of service users but the quality assurance systems are not complete. Some maintenance issues have recurred which means service users may be at risk. Evidence: The manager is not registered with us and was on leave on the day of the inspection. We were told that the manager had managed the home for about two and a half years. We are dealing with this situation outside of this report. The AQAA detailed a variety of ways that the organisation seeks the views of service users. Each year service users receive a survey and family or advocates are asked to support service users to complete the survey. Service users also have time to give feedback during support plan reviews and person centered planning sessions. Each service user also has a Service Delivery Planning meeting which also reviews care and support being provided. Each service user has a keyworker who supports them to Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: complete six weekly reviews of activities and day to day structures. A service user forum has been set up which meets in a local office every month which all service users are welcome to attend. Staff told us that there had not been any service user meetings at the home. Regulation 26 visits must be made monthly by the registered individual or their representative and form part of the quality assurance systems. They are particularly important when the home does not have a registered manager. We asked to see the records of these and found that there were three reports for this year and four in 2008. This means that the reports have not been monthly. We looked at the content of the reports and saw that issues were raised such as a lack of team meetings, lack of service user meetings, the maintenance book not being completed and ongoing, recurrent issues with the fire doors. Other records confirmed that, for example, the last staff meeting was held in January.This means that issues identified in the reports have not been followed up or monitored which has contributed to adequate outcomes for service users. We saw certificates which showed that equipment such as bath hoists and the call system had been serviced regularly. Health and safety checks are regularly completed around the home. Hot water temperatures are recorded on a weekly basis but staff told us that they tested the temperature of each bath run for a service user by, dipping their elbow in. This practice does not ensure the safety of service users. We were told that issues of concern previously raised by the fire authority had been addressed and resolved. However, records showed ongoing problems with fire doors within the home and a suggestion being made about the need for a risk assessment in this regard. Cleaning fluids are kept in a cupboard in the laundry, which was not locked when we visited. Staff said it should be locked and on closer investigation by a staff member, the lock was found to be faulty. Staff also told us that there had been a problem with this lock before but that it had been previously sorted out. Care Homes for Adults (18-65 years) Page 22 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 23 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 5 5 Contracts must be provided to service users or their representatives which show the full cost of the service provided. To ensure service users know how much the service costs them. 21/08/2009 2 20 13 Medication records must be accurate and all medication must be accounted for. To ensure that service users receive their medication as prescribed. 20/08/2009 3 20 13 The registered provider must ensure that all staff who administer medication are trained and competent to do so. To ensure the safety of service users. 20/08/2009 Care Homes for Adults (18-65 years) Page 24 of 27 4 23 13 Accurate records must be kept regarding the cost of extras charged to service users to ensure accurate charges are made. To ensure service users financial interests are protected. 21/08/2009 5 34 19 Records and information regarding the recruitment of new staff must be available for inspection. To ensure the home is following recruitment procedures to protect service users. 21/08/2009 6 35 18 The registered provider must demonstrate that staff have received mandatory training within an appropriate timescale. To ensure service users are supported by staff who are trained in the work they are to perform. 21/08/2009 7 36 18 Staff must received regular supervision. To ensure service users are supported by well supervised staff. 21/08/2009 8 39 26 The registered provider must ensure that monthly visits are made to the home and recorded, according to the regulation. To promote better outcomes for service users. 21/08/2009 Care Homes for Adults (18-65 years) Page 25 of 27 9 42 12 The home and any equipment must be well maintained. To minimise the risks to service users from faulty equipment or furniture. 21/08/2009 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 Care Homes for Adults (18-65 years) Page 26 of 27 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. 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