Inspection on 15/10/08 for Bedes Close

This inspection was carried out on 15th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bedes Close 11/11/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Bedes Close 8/10/11 Bedes Close Thornton Bradford West Yorkshire BD13 3NQ     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: Caroline Long     Date: 1 5 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 30 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 30 Information about the care home Name of care home: Address: Bedes Close 8/10/11 Bedes Close Thornton Bradford West Yorkshire BD13 3NQ 01274831811 Telephone number: Fax number: Email address: Provider web address: patfeane@sjogcareservices.org.uk Name of registered provider(s): Name of registered manager (if applicable) Saint John of God Hospitaller Services Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Bedes Close is registered to provide nursing care and accommodation for up to eighteen people with learning difficulties. It is situated in an urban area of Bradford, close to open countryside but with easy access to shops, pubs, churches and a post office. The service consists of three purpose built bungalows interlinked by walkways. There are six bedrooms in each bungalow, each bungalow has its own kitchen where meals are prepared, and all have their own sluice and laundry areas. There are communal gardens for the use of residents. One of the bungalows also has a conservatory. 18 Over 65 18 Care Homes for Adults (18-65 years) Page 4 of 30 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 is what we used to write this report. We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire. We sent surveys to people living in the home. One inspector visited the home unannounced. This visit lasted over six hours and Care Homes for Adults (18-65 years) Page 5 of 30 included talking to the staff and the manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We looked at three peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Information provided by the temporary district manager on 31st October 2008 indicated that the current weekly fee for the home is from 360 to 450 pounds per week dependant upon peoples care needs. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. 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 7 of 30 Care Homes for Adults (18-65 years) Page 8 of 30 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 30 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. People will be assessed before admission to the home to make sure Bedes Close is the right place for them. Evidence: The home has been fully occupied since 2005, therefore we could not talk to anyone who had recently moved in about their experience or look at their records. However the new manager provided us with a copy of the referral procedure, this told us that people are normally referred to the home from Bradford District Care Trust and a full assessment of their health and personal care needs will be carried out before they move into Bedes Close. This is to make sure the home has the necessary equipment and staff have the necessary skills to meet peoples needs. The manager also told us information is made available to anyone interested in moving into the home and also the manager will visit them at home to complete an assessment to make sure Bedes Close will be able to provide a service that will meet Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: their needs. As part of this process she will also gather information from relatives and any other agencies involved. Where possible the person is then encouraged to visits the home, for a day or overnight providing them with the opportunity to meet everyone and to get a feel for the home. Care Homes for Adults (18-65 years) Page 11 of 30 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although staff understand the right of individuals to take control of their lives and to make their own decisions poor care records and the lack of a person centered approach means this does not always happen in practice. Evidence: Two relatives were very positive about the support their relatives receive at Bedes Close and describe it as marvellous and excellent. Three peoples case records were looked at in order to check that a plan had been formulated which would help staff provide support to people according to their needs and wishes. We found all three contained plans of care however these were not person centred and had not been reviewed or updated regularly and would not have provided staff with the information they needed to look after people properly. We showed these to the Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: operational manager who told us they would visit the home the next day and help the staff to update them. Person centred means staff are listening to and learning about what people want from their lives and helping people to think about what they want now and in the future, this helps the staff to provide the care and support people need. Risk assessments were in place but these had not been reviewed and for one person we found four similar risk assessments for a issue which was confusing. It is important risk assessments are relevant to the individual, and not repetative, otherwise they crowd out the ones that are meaningful. Some people were making some basic choices about how they wanted to spend their day. Where people had a difficulty in verbally communicating their personal preference, two staff told us they were aware of what peoples preferences were due to their experience of working with them. Also in one of the bungalows we did see people deciding whether they wanted to stay in their rooms or not. However the records did not have a person centred approach which would have enable peoples views to be taken into consideration and also we observed that staff were not asking people their personal preferences. The manager told us staff do have regular house meetings where people can make their views known however the last meeting was in May. Care Homes for Adults (18-65 years) Page 13 of 30 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. Improvements need to be made to make sure everyone is leading a full and active life. Evidence: The manager explained that some of the people living at Bedes Close previously went to day centres. When this was withdrawn to replace this people were provided with an extra five hours of one to one support from staff each week so they can help them to carry out their chosen activities. Where people are taken out or have aromatherapy or pampering sessions in the home. We were shown a therapy room and staff told us about the relaxing sensory baths that people have. We could also see evidence in the records that people were seeing their relatives regularly and two relatives told us how they were made very welcome. Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: Relatives told us that their relatives go to day centre and have been taken on holidays, which they really enjoyed. One relative described how helpful the staff had been and proactive when they had purchased equipment to enable their relative to go out more. But we found where people were not provided with this extra one to one support or going to day centres there was little evidence of them being escorted into the community by the staff and they remained mainly in the bungalows. Also the section in the care plan about daily activities was not always completed and where it was it lacked detail and had not been updated. We saw in one bungalow a person who was walking around did not leave the bungalow all day and just paced up and down in the lounge area, also looking at their records showed they had not been out for about two months. Staff told us about a second person going out in the bus however this was not to take them to a place of their choice but to accompany others to day services. An advocate told us about how they had attempted to introduce activities for a person but this had not been followed up by staff. We saw two other people who remained in the lounge area for most of the afternoon and we saw one person was taken to watch the TV however they were visually impaired and would not have been able to see it and their were no other activities available which would have suited their needs. The manager explained how she had hoped the introduction of the extra five hours a week for the people who were no longer offered their places at day centre would reduce the workload so that staff would have the time to take people out. However there is one nurse who oversees all of the bungalows and two support staff in each, two of the bungalows have people who due to their mobility need two support staff at all times. It is therefore difficult to see how staff can be spared to take people out. Also a five hour session a week of one to one support is not sufficient to fill a persons week. The manager needs to review the numbers of support staff to make sure their are enough available to enable people to carry out activities of their choice in the community. In each of the bungalows the support staff cook the food, in one they enjoyed lasagne, and in another spaghetti bolognaise. Two staff told us people can make a choice of what they have to eat and there is always enough food available. In one of the bungalows people were encouraged to sit around the table and the meal was made into an occassion. However in another although the support staff were kind to people and keen to see they recieved a nutritious diet the meal was seen as a task and people were helped seperately to eat. We also found for one person where a recommendation Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: had been made about their diet this had not been carried out. Care Homes for Adults (18-65 years) Page 16 of 30 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. People have access to health services to enable them to remain in good physical health, however improvements need to be made to make sure the staff are following the advice given to them by health professionals. Evidence: For the three people whose records we looked at in detail we found the care plans had not been reviewed when their health care needs had changed, and this had resulted in support staff not following the advice given by health professionals. Examples of this were; where it had been identified people needed to be weighed monthly to monitor their weights this had not been carried out. A physiotherapist had left staff specific instructions on how and when to help a person to walk and this had been slow to start and was not happening daily as they had requested. Also where another person was to have a special diet it was difficult to find out if they were receiving this diet. The records did not have details of how and when people preferred help with their personal care. For one person who had a special shampoo this was not documented. One person when we arrived was also observed to be wearing trousers which were Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: quite dirty. However other people were observed to be clean, in matching clothes and two relatives did confirm that this was normally the case when they visited. Also the support staff explained how everyone had a bath each day, the support staff were also seen to treat people with warmth and respect and kindness. The medication looked at was kept in locked cabinets and when dispensed recorded on a medicine administration record sheet. To reduce the risk of people receiving the wrong medication the home uses the normad system where medication is dispensed by the pharmacist into a box, with compartments for each time they have to be taken. The manager explained the boxes are renewed weekly, when she will carry out an audit to make sure everything is in order. She also confirmed anyone who administers medication is trained. she also explained she is to introduce a further monitoring system which the night staff will complete. Care Homes for Adults (18-65 years) Page 18 of 30 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. People cannot be confident their complaints will be listened to and acted upon. Evidence: We found conflicting information about whether peoples complaints are listened to and resolved. The record of the complaints showed us there had not been a complaint since 2005, however when we looked in peoples records we could identify that two complaints had been made but there were no records of how they were resolved. We have also recieved information from a relative which state their complaints have not been resolved to their satisfaction. However two relatives told us they would feel comfortable making a complaint to the manager and the manager and the acting regional manager were able to explain how the complaints we had found had been reviewed and resolved. They also acknowledged they need to make sure they are fully recording how they are responding to complaints as this will help them identify any recurring issues. We saw people were provided with advocates, these are independent staff who will support people to make their views known. Staff told us they have recieved adult protection training and the records also confirmed this. When we talked to them and the manager they were aware of what Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: actions they would take to keep people safe and how to alert the appropriate agency. The home has managed two safeguarding adult issues in 2008 where they have recieved support and advice from Bradford Adult Protection team. However we did find written in one persons care plan and risk assessment to be sat in the wheelchair only if too unpredictable or if staff unable to monitor where they are. This was shown to the acting regional manager who told us the chair was not used for restraint, however this does show us that staff need to be made aware of what could be seen as restraint. People are supported with their finances. Detailed records are kept of all financial transactions carried out by the individual or by staff on their behalf. Care Homes for Adults (18-65 years) Page 20 of 30 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. People live in a clean and well maintained home. Evidence: Bedes Close is three bungalows that accommodate six people in each bungalow. There are communal lounges and dining areas, and toilet and bath facilities and all the bedrooms are single. The bungalows have been adapted for peoples needs and there is specialist equipement available to help people move around the home. However one relative did explain how the toilets are not big enough for a wheelchair so can compromise peoples dignity, also we saw one persons wheelchair was dirty. We looked at three peoples rooms which were clean, and comfortable, and staff told us they have been decorated and furnished to peoples personal interests and tastes. There is a communal lounge and dining area, which was clean and tidy and suitable for people who use wheel chairs. Some people have access to gardens or patios from the lounge areas, staff told us this was used during the summer The manager told us that several rooms are to be decorated, one kitchen is to be Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: replaced, all kitchen boilers to be replaced, and new carpets and lighting are to be fitted in number 11. The annual quality assessment questionnaire states maintenance contracts are set up for equipment maintenance, equipment check records are in place and the home has a maintenance worker. Regular audits are carried out to highlight any work or improvements that may need doing. Also a maintenance file is kept to highlight any work needed in order of importance. To help prevent the spread of infections and to make the home a clean and comfortable place to live a cleaner is employed. Anti bacterial soap dispensers are installed at wash points and staff are instructed to adhere to the infection control policies and procedures. Care Homes for Adults (18-65 years) Page 22 of 30 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 provider makes sure only suitable people are employed and staff in the home are generally trained and skilled. However the numbers of staff need to be reviewed to be sure people have the opportunity to access activities in the community Evidence: Staff told us each bungalow has two support staff during the day and one at night to support them and a registered nurse who covers all the bungalows. Four staff told us they felt this was enough staff to meet peoples needs. There are also some staff hours allocated for people who were no longer able to go to day centres. However we found two of the bungalows have very dependant people who need two support staff to help them with their personal care so staff were unable to take people out. So people who were not allocated any one to one support were restricted in the activites they could enjoy during the day due to staffing numbers. The manager needs to review the numbers of staff to make sure people are able to access social activities in the community. The staff and manager also told us there are vacant posts which they are recruiting to and many of the shifts have been carried out by agency staff which has caused some Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: inconsistancy in the care provided. We looked at three staff records to make sure the home are employing suitable people for the job. We found that they are generally taking the necessary precautions to make sure only suitable people are recruited to work at Bedes Close. Two staff told us there is an induction programme in place that ensures new staff members are given the right information to be able to do their jobs well. Staff told us they generally receive regular supervision and appraisals from their manager and do feel supported by the management. There is a training matrix in place which identifies any training which needs updating, this showed us that most of the basic training had been completed and was up to date. However where a persons care plan stated staff would recieve training in challenging behaviour to enable them to keep the person safe but staff told us they have not recieved any training in managing people with challenging behaviour. The manager needs to be sure staff recieve any specialist training they need and follow its recommendations. Staff confirmed they have regular meetings and the manager explained these are used as a opportunity to recap policies and to make sure staff are kept up to date and able to carry out their roles properly. The annual quality assessment questionnaire states that most of the staff have their National Vocational Qualification level two or above in care, this qualification helps to make sure staff are properly trained to carry out the work. Care Homes for Adults (18-65 years) Page 24 of 30 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 managers need to make improvements to make sure the home is run in peoples best interests. Evidence: Bedes Close has a new manager who has nursing qualification and several years experience as deputy service manager. She has also told us she is to undertake her National Vocational Qualification Level four in care and register with us. She is supported in her role by the acting regional manager and a deputy manager. During the site visit people were seen to be comfortable when approaching her to discuss the home, staff told us they felt well supported by the new manager. The AQAA was returned on time however it was brief but it did tell us about some of changes they have made and where they still need to make improvements in some areas. The data section of the AQAA is fully completed. The acting regional manager and the manager were present for most of the inspection Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: and the issues found in this report were discussed with them, both told us they were confident they would be able to make the necessary improvements. The home has the investors in people award and the manager told us they carry out annual service reviews, where people are asked about their views about the home. Also regular visits to the home are carried out by the provider. However this inspection has shown us this has not been enough for the provider to identify the decline in the service. The annual quality assessment questionnaire states the maintenance and service records are in order. Accident records were looked at and were being recorded. However when we looked at one persons bedrails they were loose and unsafe, the acting manager and the manager agreed to check everyones bedrails in the home to make sure they were all safe, they carried this out during our visit. Care Homes for Adults (18-65 years) Page 26 of 30 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 27 of 30 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 9 13 Risk assessment must be person centred and relevant to the individual and regularly updated. This is to make sure people are safe and to identify any possible risk to people. 01/12/2008 2 11 16 You must carry out a review of everyones daily life and activities to make sure any activities are tailored to reflect peoples individual needs. This will provide people with a fuller and more active lifestyle of their choice. 01/12/2008 3 19 12 Staff must follow the advice given by health care professional. This is to be sure that peoples health care needs are fully met. 01/12/2008 Care Homes for Adults (18-65 years) Page 28 of 30 4 31 18 You must make sure there 01/12/2008 are enough staff avialable to enable people to engage in social acitivies. This will enable people to pursue acitivies of their choice. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Care plans need to be person centred, upto date and reflect what people want now and in the future and the actions the staff need to make to enable people to do this. There must be a complaints policy for people to use.This must provide people with the time in which to expect a response. A record of all complaints must be kept. Following a complaint an investigation must take place and the complainant informed of the outcome any action to be taken. This is so people live in an environment that has an open culture where individuals feel safe and supported to share any concerns or complaints about the service. Staff should be provided with training about what consitutes restraint. 2 22 3 23 Care Homes for Adults (18-65 years) Page 29 of 30 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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