Inspection on 02/10/08 for 12 Downview

This inspection was carried out on 2nd October 2008.

CSCI 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.

Other inspections for this house

12 Downview 04/10/06

12 Downview 05/12/05

12 Downview 19/07/05

12 Downview 01/03/05

12 Downview 01/03/05

12 Downview 01/03/05

12 Downview 01/03/05

12 Downview 25/08/04

12 Downview 25/08/04

12 Downview 25/08/04

12 Downview 25/08/04

12 Downview 02/03/04

12 Downview 02/03/04

12 Downview 02/03/04

12 Downview 02/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 12 Downview 12 Downview The Cottage Hungerford Berkshire RG17 0ED     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: Kerry Kingston     Date: 0 2 1 0 2 0 0 8 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 28 Information about the care home Name of care home: Address: 12 Downview 12 Downview The Cottage Hungerford Berkshire RG17 0ED 01488683087 F/P01488683087 shoey@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Mr Terry Shoesmith,Mrs Susan Shoesmith The registered provider is responsible for running the service Name of registered manager (if applicable) Deborah Colburn Type of registration: Number of places registered: care home 7 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 7. The registered person may provide the following category 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 Disabiliies (LD) Date of last inspection Brief description of the care home 12, Downview and The Cottage provide accommodation for up to 7 Service users of either sex, aged between 18 and 65, who have a learning disability. The Home is situated in Hungerford within easy reach of all local amenities. The Objective of the home is offer encouragement, instruction and stimulation whilst encouraging Care Homes for Adults (18-65 years) Page 4 of 28 7 Over 65 0 Brief description of the care home independence. The home has one double room for Service Users and there is a Cottage offering accommodation to two people within the grounds. 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: The last inspection for this service was on the 6th October 2006. The service costs are between 798.86 and 1714.26 dependant upon the assessed needs of the individual. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 10.30 am and and 4.30 pm on the the 2nd October 2008. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the service manager. Surveys were sent to the people who are supported by the service and all seven were returned. Discussions with the manager and two staff members took place. People who use the service have difficulty communicating with people who do not know them so observation of people and their Care Homes for Adults (18-65 years) Page 6 of 28 interactions with staff took place during the visit to the home, two people were able to communicate their views clearly. Reviewing records of the people who use the service and other records and procedures was also used to collect information on the day of the visit. All information received by the Commission since the last inspection, about this service was also taken into account when producing this inspection report. 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 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home fully assess people prior to their admission to the home, to ensure that they can meet their needs. The assessment is reviewed regularly with the individual to check that the home can continue to meet their needs. Evidence: The service has offered a home to one new person since the last inspection. An admission was made in May 2007, two assessments are in the persons record. One is completed by the care manager called the Community residential/nursing placement assessment and the other is an assessment of peoples practical abilities completed by a staff member from the home, generally the manager. The assessments cover all areas of need and this is developed into a detailed care plan within one month of the person being admitted to the home. The placement and assessment was reviewed in October 2007 to ensure that the home was meeting the needs of the individual. The home complete an end of year report to note any developments or areas for development or any difficulties or changes of need for the individual, the person who Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: uses the service is fully involved in this. People did not have a contract or statement of terms and conditions, which include the fees, available to them in the home. The manager confirmed that the proprietor had these at their home but that she would ensure that they were added to everybodys care plan as soon as possible. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home develops an individual plan for everyone who lives there which clearly describes their needs and goals. People are encouraged to make as many decisions for themselves as they are able to. Risk assessments assist people to retain and develop as much indpendence as possible. Evidence: Three care plans were seen, all were very comprehensive and person centred, focussing on individuals needs and adressing any diversity or equality issues. The daily plan that staff work to is called the essential lifestyle plan, and includes all the necessary information for the proper support of individuals. The Essential Lifestyle Plans are being produced in a pictorial and sign format, as appropriate for the individual, to assist them to understand it. The care plans include a detailed communication plan that includes how we talk to the individual how we respect them and what their responsibilities are. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The people, who use the service are totally involved in the development of the care plan which include peoples choice records such as keys to their rooms, where to spend holidays, chosen activities and daily choices of routine. Those who are able to, sign their choices and decisions records. Peoples goals and areas for development are also noted in their care plans and there are monthly key worker meetings, which include the resident, to look at all areas to see if there are any issues and record any progress made. It also gives the people the opportunity to discuss any concerns or worries they may have. One person who is unable to verbally communicate was seen to be communicating with staff and other people who use the service alike, they were able to make themselves understood by all , with good support by the staff team. Detailed risk assessments are in place, as necessary, they were seen for four people and were up-to-date, they were focussed on the areas of risk and areas of independence that were imprortant for that particular individual, such as independant bathing for one person and totally supervised bathing for another. People sign the risk assessments if they are able to demonstrate that they agree with the assessment. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home makes sure people are able to have an interesting and rewarding lifestyle.They are helped to be as independent as possible to ensure they feel valued. People are offered nutritious food and are involved in the planning and preparation of meals. Evidence: Individuals all have a choice chart listing what activities they would like to do. This consists of a comprehensive list of activities on each day, that people can choose from. Those people who have motivation issues are encouraged to choose those activities that they are known to enjoy. Currently all activities are provided by staff who make good use of the community. People are accepted members of the local community attending local coffee mornings, using the library and local leisure facilities. Activities include walks, aqua aerobics, gym, reading, daily living skills, rescue dog walking, pub Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: visits, church, coffee mornings and visits to family and friends. All activities are noted on an activities plan, which clearly shows the activities that inividuals participate in, it is an invaluable record of peoples motivation and emotional well being, and on peoples individual daily notes. People have an annual holiday, as a group. All the residents but one have good family contact. That one person, who has very limited contact, has an advocate who was visiting them on the day of the site visit. Families and Friends visit the home and people visit their family homes, some on a regular basis. There was evidence of the home working closely with family in order to assist that person to modify their behaviour. People have friends who come to lunch and meals in Downview. One resident told me that she has always got plenty of things to do she is never bored, another said that they enjoyed dog walking and was very pleased to have someone to take them to the pub. Another said that they have plenty to do, and like their activities. On the day of the site visit people had been dog walking, to the town and swimming at the leisure centre, some people were planning to go to aqua aerobics in the evening. The manager noted that people go out in the evenings on a regular basis. Care plans note how people are to be respected and what responsibilities they have and are able to take. People are very involved in menu and meal planning, everyone cooks once a week, they choose the meal (with support) shop and help to prepare it. The home has an allotment, many of the residents also get involved with and make the connection with growing and eating their own food. People eat meals out and sometimes have takeaways at weekends. Peoples weight is monitored regularly and any necessary action is taken, if health becomes an issue. Menus seen were varied and nutritious and a person who uses the service was seen helping a staff member to prepare the evening meal. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are effectively supported with their personal needs in the way that they prefer. Emotional and physical health needs are properly met, with the assistance of other professionals, as necessary. There is a robust and detailed medication administration system that staff are trained in and that is generally adhered to. Evidence: Care Plans for three people were seen, the newest care plans have pictorial representations so that residents can understand them and include details of peoples preferences, how they want to be supported and likes and dislikes. people choices and preferences are individually recorded and signed by people, if they are able to. People have Health care action plans which include health booklets that people can take to the surgery with them and all about me booklets that people can take with them if they have to have a hospital admission. The home has a detailed record of any health appointments, including those with psychologists or psychiatrists. People are weighed regularly, as necessary and weight records, menstruation records and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: behavioural records are kept. Evidence was seen that one persons health and well being has improved greatly over the past twelve months. The psychology service for people with learning disabilities provides strategies to the home so that staff are able to help people to modify their behaviour. The home may need to develop more detailed behaviour programmes for individuals so that staff can offer a consistent response to particular aggressive or distressing behaviours. The home work closely with the appropriate external health professionals to ensure that people receive appropriate levels of health care. Health and well being is assessed regularly as it is a heading on the monthly key worker reviews. The home uses a monitored dosage system for medication administration. Medication securely stored and all staff are trained in medication administration. None of the residents administer their own medication. Two gaps were noted on the administration records , that is medication had been given but the staff member had not initialled the record to confirm this. The manager is to take action to ensure the staff member follows the medication procedure in the future. There was a discussion about whether staff should use to use codes or initials when they do not actually administer the medication such as giving people medication for weekend use, or as part of an Independence programme. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are listened to and know who to complain to if they are unhappy. People are kept safe from all forms of abuse. Evidence: All residents had a complaints policy and procedure in their file, there was a discussion with the manager about making it more user friendly. In key worker meetings, held monthly people are reminded how to complain. Two people spoken to knew how to complain and who to, they were confident that they could talk to staff or their families if they had any worries or concerns. There have been no recorded complaints since march 2006. All staff have completed safeguarding training and two staff spoken to were confident about what to do if there were any concerns about the well being of the people who live in the home. Staff were very clear about what good practice and what poor practice is. The local authority provide safeguarding training and refresher courses for all staff are booked. The home has the new local authority safeguarding procedures booklet available in the office. The manager attended the launch of the new procedures by the local authority. The manager confirmed that there had been no safeguarding issues during the past 12 months. The Commission has received no complaints or safeguarding information about this service. Two financial records were seen, the cash held by home was accurate. Monies are paid Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: directly into peoples individual bank accounts. People pay an amount per month to a holiday account, there was no record in the home of the holiday account, the manager believes it is held by the proprietors. It was discussed that there is a need for transparent record keeping and the issuing of receipts to people for large expenditure. The home seek advice from the psychology department to assist people with behaviours that cause distress to the individual or others. Strategies are developed by the psychology department on how to deal with difficult behaviours. The home does not use physical restraint but do complete training to enable them to react appropriately to any challenging behaviours that might be presented by the people who use the service. It was discussed that more detailed guidelines may be more positive for people who use the service and the staff. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and homely and offers a pleasant environment that meet individuals and the groups needs. Evidence: Seven people live in the home which consists of two buildings, the main house and a cottage in the grounds. The kitchen in the house is refurbished to a high standard and although it is small it is functional and effective. There is a dining room, large conservatory and large sitting room which are well used by the people who live there. Furniture and fittings throughout the house are of a good standard and homely.Bathrooms and toilets are clean and hygienic. Two people share a bedroom, they have done so for many years and happy with the arrangement at this time. Two people live in the cottage which is kept to the same good standard as the house, the people who live there are risk assessed to support them with their semi -independent lifestyle. There is some thought about how to ensure the safety of one person who lives there because of some medical issues. There are examples of peoples craft work and photographs throughout the home. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The laundry and office are outside the house, in the garden. The home is well kept and was clean and hygienic on the day of the visit. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an efficient and effective staff team, with good staffing ratios ensuring that they can meet the diverse needs of all the people who use the service. There is a robust recruitemnt procedure that ensures that the staff appointed are suitable and safe to care for people. Evidence: The home has 11 staff in total, with a minimum of three staff per shift. Generally, during daytime hours there are four staff to ensure that people are able to access their daily activities. There is one staff member sleeping in , the people in the cottage contact the house by telephone in emergency. Residents spoken to confirmed that there is always someone to help you if you need it. One person has been assessed to need a 1:1 staffing ratio to meet their current needs. Two staff spoken to confirmed that there are enough staff to complete their tasks and responsibilities. The staff spokent to had an in depth knowledge of the needs of the people in their care. Seven staff have completed N.V.Q training and four are in the process of completing it. Training records are well kept and show that all mandatory training is up-to-date. Staff spoken to confirmed that there are good opportunities for training and they receive up-dates to training regularly. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Staff were observed working sensitively and respectfully with people who were confident when dealing with staff, asking for explanations and disagreeing with them, as they wished. There was a good rapport between staff and the people who use the service. People were very communicative wih each other, the staff team and visitors. Some comments from peoples surveys are staff do treat me very well and I am happy. The recruitement records for the two newest staff were seen, they included all the necessary information. There are some personal relationships between staff members, the manager needs to stay alert to this incase it creates any issues within the staff team that impact on the care of the people who use the service. Staff confirmed that they are supervised regularly and they find this supportive and helpful in carrying out their roles, effectively. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, considers and acts upon the views of the people who use the service and keeps people as safe as possible by adhering to Health and Safety Policies and procedures. Evidence: The current manager was registered on the 10th May 2007, she completed her Registered Managers Award in July 2007 and has been working in the care field for approximately four years. The manager works closely with the proprietors, one of the proprietors is her deputy. Staff spoken to felt that overall she gives good support and regular supervision. They felt that the home is a good service run with the interests of the residents as its priority. One staff member said that it was very good management and there had been lots of improvements over the past year. Another comment was that people were given brilliant care and that the home receives positive feedback from the local community. Residents spoken to said that they could talk to the manager if they were not happy about something. The manager does not have responsibility for budgets or any financial systems. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home has a robust Quality Assurance system that involves annual questionnaires sent to all interested parties, including people who use the service. Some comments from the questionnaires sent by the home in July 2008 were everyone looks after me just good and I like living at Downview, these responses from people who use the service were similar to those received by the Commission. Other comments from professionals and carers were I get the support of the staff, sometimes under difficult circumstances, is lucky to have such a lovely home with such lovely carers and it is possibly the best group home there is. An annual development plan is produced from the collated results of the questionnaires, the monthly key worker meetings, staff meetings and the residents meetings. The action plan produced has timescales and is regularly reviewed. Some improvements made as a direct result of peoples views are more outings, 1:1 care for an individual, redecorating and people more involved in cooking. The home does not have monthly visits by the proprietors as they work in the home on a regular basis. A sample of Health and Safety records showed that maintenance checks are completed at the correct intervals, there are safe working practice risk assessments and a detailed Health and Safety Policy is adhered to. Detailed incident and accident forms are kept and the manager audits them on a monthly basis to ensure that any necessary action is taken to reduce the likelihood of recurrence 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 20 Ensure that the medication administration policy and procedure is adhered to by all staff at all times and that there are no unexplained gaps on the administration records, to be absolutely sure that people receive their medication at the correct times. Ensure that people are issued for a receipt of monies paid out of their accounts, especially withdrawals noted for the holiday fund so that their withdrawals can be easily tracked and the manager can safeguard them from any form of financial abuse. 2 23 Care Homes for Adults (18-65 years) Page 27 of 28 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 © (2008) 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. 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