Inspection on 03/02/09 for 83 Tennyson Road

This inspection was carried out on 3rd February 2009.

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

83 Tennyson Road 02/10/06

83 Tennyson Road 03/02/06

83 Tennyson Road 17/10/05

83 Tennyson Road 15/02/05

83 Tennyson Road 23/12/04

83 Tennyson Road 12/01/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 83 Tennyson Road 83 Tennyson Road Luton LU1 3RR     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: Andrea James     Date: 0 3 0 2 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 29 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 29 Information about the care home Name of care home: Address: 83 Tennyson Road 83 Tennyson Road Luton LU1 3RR 01582480641 F/P01582480641 ann.dalton@advanceuk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Advance Support Ltd Name of registered manager (if applicable) Ms Ann Dalton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 1. The registered person may provide the following category/ies of service only: Care home only Code PC 2. The maximum number of service users who can be accommodated is: 4 to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home 83 Tennyson Road is a semi-detached residential care home situated in Luton and provides care for four adults who have long-term mental health needs. Advance Housing and Support Ltd manage the home. The accommodation consists of three single service users bedrooms, a bathroom and toilet and the office/sleeping in room on the first floor. The ground floor contains a lounge, a single bedroom and a Care Homes for Adults (18-65 years) Page 4 of 29 care home 4 Over 65 0 0 1 4 Brief description of the care home kitchen/diner. The utility room is accessed via the kitchen back door. There is a garden at the rear of the house and looks very attractive. The home is within walking distance of the two parks, public places and a regular bus service is available to the town. The town centre is around one kilometre from the home. Ann Dalton is the registered manager. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection undertaken on the 4th of February 2009. It took place over a duration of 6 hours. The Registered Manager for the service was not available but a member of staff assisted in the inspection process. The inspection followed a case tracking methodology where a sample of people was randomly selected to speak to.These peoples files were inspected and where possible their key workers were spoken to . The report consists of information gathered from people who use the service, care staff, relatives and evidence gathered through the inspection of records or observations undertaken at the time of the inspection. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 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. Care Homes for Adults (18-65 years) Page 8 of 29 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 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 made appropriate arrangements to ensure sufficient information was available for people who may wish to use the service and comprehensive assessments were undertaken upon admission to the service. Evidence: The service had a Statement of Purpose and a Service User Guide that was last reviewed in August 2008. We were told that a social work student was in the process of reviewing these documents with the people who use the service, which is due to be completed by April 2009. The current Statement of Purpose that we viewed had details of the manager, the philosophy of care, the complaints procedure etc. The Service User Guide covered various elements of peoples every day lives such and a laundry, medication and support systems that are available to meet peoples needs. We saw evidence to suggest people received a comprehensive assessment of need Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: upon admission. These identified the care interventions staff were required to deliver and there was evidence that these needs were subjected to regular reviews. There was also evidence to suggest people had signed and dated contracts and placement agreements. Care Homes for Adults (18-65 years) Page 12 of 29 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. Effective care planning procedures were in place to ensure people recieve consisitent standards of care, however further development is needed to ensure people at potential risk has effective assessments in place. Evidence: The home had 4 people who used the service. We looked at 2 peoples care plans in detail. The files contained a lot if information about people to include a quick reference guide to the person, a picture of the person and missing persons information. There was evidence to suggest reviews were undertaken for people in 2008. The care plan documentation was signed and dated by the key worker, manager and the person to whom the care plan belonged. The care plan itself covered various aspects of the person to include their mental health diagnosis, mental health relapse indicators, physical health, dental needs, death and dying, activities, relationships, budgeting, cleaning, eating, personal care, going to bed etc. There was also a weekly activity plan which enabled the person to know when to make their bed, do their house chores or Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: engage in leisure activities. There was also a challenging behavior programmer, information on medication and what was being prescribed. Staff spoken to was able to confirm several of the information recorded in the care plan which showed that they had an in depth knowledge of the people that they cared for. The files inspected also contained a pen picture of the person with a full life history. People who use the service was supported to take risk in order to maximise their independence. Risk assessment policies and procedures were in place for people in regards to them accessing public transport, using electrical appliances, cleaning material, managing their money etc. These documents needed further development to ensure all aspects of people where they need support is risk assessed and the level of risk is clearly identified. For example one person fell over and broke his arm and their were no guidelines in place to suggest who to contact if people were in danger or who the first aiders were at the time of the event. Other aspects of peoples daily lives was recoginsed by professionals who we spoke to stating that sufficient risk assessments were not available for daily activities. People spoken to said they were able to make decisions about their daily lives. One person said, I get given a couple of choices of what I want to do or what I want to eat and I choose. We observed people being consulted about some aspects of their daily lives for example staff ask people what they want to eat. Two student social workers spoken to also confirmed that the staff had a good relationship with the people who use the service. Care Homes for Adults (18-65 years) Page 14 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities were available for people to develop and their dietary needs were being met but further development was needed to ensure people are able to make informed choices and are given more opportunities for mental and physical stimulation. Evidence: The home had developed in-house activity programs for people that detailed what activities were to be undertaken but this was mainly to do with household chores and did not reflect peoples interest and hobbies. Staff and social work students spoken to said the people in the home was very difficult to stimulate but agreed that a more structured activity was required. Staff spoke of one person who liked dancing but did not have the social skills to be able to access this in the community. It was suggested that a WII game could be purchased in order to Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: motivate people to exercise and embark on activities of interest such as dancing, bowling, playing music and other activities that could be undertaken in house as staff commented that it was difficult to get people to go out. Staff spoken to also said that because they ,mostly work alone it was not always possible to take people out unless all 4 people wanted to got to the same place at the same time. The home did not own their own transport. Opportunities for personal development was limited . We were informed that again this was due to the mental state of people who use the service that does not appear to want to do much. One person was seen cleaning the house while another helped to prepare the evening meal but this was as much as some would do for the day. One person was able to go th the post office on a weekly basis to collect her benefits. An attempt was made to encourage people to be a part of the local community. We were informed of a recent dinner outing where all the people in the house went for a meal out. This was a pleasant experience for most people but for one who suffered a broken arm it will prove more difficult to get him to repeat the experience. Staff said people just find the home environment to be a safe haven and dont want to go out. The meals times in the home appeared to be very enjoyable for all the people who use the service. On the day of the site visit people had fish steaks, mash potatoes and vegetables.People were heard saying, mmh another said , this is lovely and another person asked for seconds. People were also offered a dessert of apple strudel and custard. Fresh fruits and drinks were available throughout the day. The home had a menu implemented but this was not on display and none of the people spoken to were able to say what they were having that day for their main meal. It was therefore difficult to prove how choice was offered to people on a daily basis. Staff said people are able to choose something else if they did not like what was on offer. The food consumed by people on the day was recorded in their daily notes. Care Homes for Adults (18-65 years) Page 16 of 29 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 personal support and health care needs of people were being met, some work is needed to ensure controlled drugs can be administered and stored safely but outcomes for people at this inspection was good. Evidence: The home was effective in ensuring the health and personal needs of people are met. The people who use the service have Mental health needs and all documentation inspected suggested peoples mental health needs were being considered. People were subjected to annual reviews and had monthly review meetings with key workers. The home had access to external professionals who will manage people in times of crisis. The home had satisfactory policies and procedures in place for the safe administration, recording and storage of medication. Medicines were kept in the staff room in a metal cabinet fixed to the wall. Some tablets were stored in loose packets while others in a blister pack. The loose packets as explained by the staff member was because the consultants regularly change medication and it was easier to handle then this way. The home also had homely remedies such as cough drops and paracetamols. We informed Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: the staff member that paracetamol should not be a homely remedy used on a long term basis as this can be prescribed for individuals who needs it. All medications used and their side effects were recorded in individual files. The Medication Administration Records were satisfactorily maintained and a photograph of the person to whom the medication belonged was available. The home failed to have any procedure in place for the storage or recording of controlled drugs although at the time of the inspection no controlled drugs were being prescribed. There was evidence to suggest peoples wishes in the event of their death was sought and this information was recorded and kept on peoples files. Care Homes for Adults (18-65 years) Page 18 of 29 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 had satisfactory complaints policies and procedures and effective safeguards were in place to ensure people would be protected from abuse. Evidence: We were told that no complaints have been received since the last inspection. The records confirmed this. People spoken to to said they would know how to complain should they need to do so. The complaints procedure was also displayed in communal areas of the home.One relative spoken to said the home had a book where they could write their complaints for example if the bulbs needed changing but this was removed and kept in the office. The home was aware of the safeguarding procedure and staff said they received training this was confirmed by the training records inspected. One person spoken to said they treat me OK and I feel safe. Care Homes for Adults (18-65 years) Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and safe environment but further development is needed to ensure it is decorated and welcoming in all areas. Evidence: We were given a tour of the building and some people invited us to see their bedrooms.The first impression of the home was that people were happy and the home was clean and free from offensive odours. There was some lingering cigarette smoke in some areas of the home. The staff notice board was situated in the landing up the stairs and this was limited with various information that was not relevant to people who use the service and it detracted from the homeliness of the home. The home had sufficient toilet and bathroom facilities to meet the needs of people. However for the toilet on the ground floor the flooring had several cigarette burns and so made the floor appear dirty. The lounge was very nicely decorated and presented a spacious and calming environment however the leather settee was very uncomfortable to sit on and for one person the cushions had become so worn and flat that if he sat in it he was not able get up unaided. This piece of furniture was also torn and the leather was stripping Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: away from the rest of the chair. The television was outdated and as a result people had limited viewing pleasure. It was not digitally adaptable and so people could not have the pleasure of up to date technology. Some bedrooms appeared welcoming and reflected the needs of individual people. One person invited us to see his new flat screen television and his music centre while other people bedrooms was very basic and was in need of redecoration as some paint work and wall paper had become discoloured. The bedrooms inspected failed to provide lockable facilities for people to be able to store their valuables. Staff were observed cleaning the home throughout the day. One person also helped with the hoovering. The safety aspects of the home were satisfactory. We saw evidence to suggest hot water temperatures, fridge and freezer temperatures, electrical testings and other aspects of the homes safety was maintained. Care Homes for Adults (18-65 years) Page 21 of 29 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 home ensured people benefited from a staff team that was skilled and competent in delivering good care but further development is needed to ensure sufficient numbers of staff are available to provide meaningful stimulation throughout the day. Evidence: The home employed a team of staff that appeared competent and qualified to do their job. On the day of the site visit only one member of staff was employed to care for 4 people. The member of staff is expected to clean the home, undertake activities and prepare the main meal. This appeared to put a lot of pressure on the staff member as the people who use the service does very Little. Some staff members spoken to said they felt that the amount of work they were expected to do in any one shift is too much for one person. Staff commented that when people have appointments such as doctors visits that a second member of staff is rostered on. Some staff spoken to said, One reason for limited activities is that if all the clients does not want to do the same thing then staff cannot facilitate all the people at the same time. The home had satisfactory recruitment procedures and two staff files inspected Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: suggested satisfactory clearances, references and medical checks were undertaken prior to employment being offered. All staff spoken to said they received a good induction prior to commencing employment. their was evidence on file that new employees were also subjected to probation and a report was undertaken at the end of this period. staff had individual training and development programmers which showed the extent of the staff teams competence and experience. Staff training records suggested staff were trained in epilepsy, anger management, health and safety, safeguarding, medication and 4 of the 6 staff members had achieved their NVQ level 3 qualification. Training needs for 2009 was also identified and staff spoken to were able to confirm that they were due to embark on Mental Capacity Act training, Diversity and alcohol abuse. Staff spoken to said they received supervision and the records seen was able to confirm that supervisions were undertaken on a regular basis. Care Homes for Adults (18-65 years) Page 23 of 29 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 management of the home was effective and as a result people benefited from a well run home. Evidence: The management of the home proved effective in meeting the needs of people who use the service and ensuring the home runs smoothly. On the day of the inspection the manager was not available but the staff member who facilitated the inspection was competent in doing so. Relatives spoken to said the home was well run, one relative said, I am very please with the running of the home and my sister is happy. Staff spoken to appeared happy with the management of the home. One staff said the manager is approachable and i feel supported by her. Another staff said Advance care is a good place to work. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: The home kept accurate records of the financial needs of people who use the service. A sample of peoples monies were checks and all were found to be satisfactorily maintained. The home had a quality assurance system in place that showed the views of people were regularly monitored. There was evidence of monthly regulation 26 visits, audits on care plans and health and safety which covered fire alarms and lone working. The analysis of how well the home meet peoples needs was not yet completed. However we were given evidence to suggest questionnaires were sent to care staff and relatives. One relative spoken to was able to confirm that he completed a questionnaire in recent months. People who use the service also received questionnaires in January 2009. The health and safety measures in the home were satisfactory and various records showed that people and staff were aware of the importance of safety. Regular fire checks, fridge /freezer temperatures and water temperatures were maintained. We were concerned that some people were being allowed to smoke in their bedrooms which could become a fire hazard. Their was evidence to suggest some people also smoked in communal areas of the home which could make the environment unpleasant for non smokers. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 13 12 Arrangements must be made to ensure people are enabled to participate in community based activities. To ensure people receive sufficient mental stimulation. 30/04/2009 2 14 12 Arrangements should be made to ensure people are encouraged to take part in leisure activities. So people can feel supported in pursuing their own interests and hobbies. 30/04/2009 3 20 13 Satisfactory procedures for controlled drugs must be implemented. To ensure people if administered controlled drugs will receive their medication safely. 30/04/2009 4 24 23 Arrangements must be made to ensure all areas in the home are decorated to ensure a homely 30/04/2009 Care Homes for Adults (18-65 years) Page 27 of 29 environment can be maintained. To ensure the premises are in keeping the style and ambience that reflects the homes purpose. 5 26 23 Suitable furnishings must be 30/04/2009 provided in the main lounge. To ensure people are able to lounge in comfort. 6 33 18 Arrangements must be made to ensure sufficient numbers of staff are available to meet the needs of the people who use the service at all times. To maximise peoples opportunities to live a fulfilled life style. 30/04/2009 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 2 9 26 All areas of peoples lives that may potenially cause harm ar restrictions should be risk assessed. A lockable facility should be available for people who use the service to ensure they are able to store valuables safely. A suitable television should be purchased that will give people more opportunities for viewing pleasure. Arrangements should be made to ensure the smoking policy implemented in reinforced so people can smoke safely and non smokers are not affected. 3 4 26 42 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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