Inspection on 18/12/08 for Ca Na Gardens

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ca Na Gardens 17/11/09

Ca Na Gardens 28/04/09

Ca Na Gardens 27/11/08

Ca Na Gardens 29/04/08

Ca Na Gardens 23/05/07

Ca Na Gardens 23/05/06

Ca Na Gardens 19/09/05

Ca Na Gardens 16/05/05

Ca Na Gardens 08/10/04

Ca Na Gardens 07/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ca Na Gardens 174 Scraptoft Lane Leicester LE5 1HX The quality rating for this care home is: zero star poor 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: Keith Williamson Date: 1 8 1 2 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 36 Information about the care home Name of care home: Address: Ca Na Gardens 174 Scraptoft Lane Leicester LE5 1HX 01162413337 01162202772 Biggsy_31@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Hamra Associates Limited care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: No additional conditions of registration apply. Date of last inspection A bit about the care home Ca Na Gardens is a care home providing personal care and accommodation for up to eight people with a learning disability. The home, which is Care Homes for Adults (18-65 years) Page 4 of 36 located on the outskirts of Leicester city centre, offers six single and one shared bedroom. Communal facilities include a lounge and a separate lounge/dining area. Both of these rooms have patio doors, which lead onto a large garden to the rear of the home. There are a variety of local amenities close by including a large supermarket, small local shops, health centres, temples, churches and takeaways. There is a bus route nearby, and travel to and from the city centre is about 20minutes. Care Homes for Adults (18-65 years) Page 5 of 36 Current charges are between £344 and £352 per person per week. Cost Inspection reports regarding the home are available and can be accessed via the CSCI website: www.csci.org.uk. A copy of the most recent inspection report is also displayed in the reception area. Further information about the home, and copies of reports are available from the registered manager. Care Homes for Adults (18-65 years) Page 6 of 36 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: zero star poor 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 Care Homes for Adults (18-65 years) Page 7 of 36 How we did our inspection: This is what the inspector did when they were at the care home The focus of inspections is on outcomes for Service Users and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case one Service User was chosen. This visit took place over one day, commencing at 9.30pm and took seven hours to complete. Care Homes for Adults (18-65 years) Page 8 of 36 An opportunity was taken to talk with the Manager staff, look around the home, view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment, which gives information on the Service Users, home and the staff group. Two staff were spoken with, and four Service Users were seen, and their interactions with the staff group observed. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. Care Homes for Adults (18-65 years) Page 9 of 36 What the care home does well Assessments and care plans are completed promptly, with enough detail to instruct staff how to care for people. Copies of documents used in the assessment process are produced using the easy read format and are freely available in the home. Complaints information is displayed throughout the home, and staff were aware of the procedures involved in reporting suspected abuses on behalf of Service Users. Staff are also aware of how the whistleblowing procedure works. This is where staff can report on to external agencies such as the police, or Social Care Homes for Adults (18-65 years) Page 10 of 36 Services of any suspected abuse. Decisions that the Service Users make are recorded on a daily basis. Service Users have a timetable, which covers day centre, college courses and social care time. These activities are detailed in care plans. These and other documents are held securely in the home. This is important as it shows personal details are held securely. The policies and procedures used by staff have been reviewed and the staff numbers are reflective of current Service User needs. Staff appraisals, which form the basis for planning individual staff training and development Care Homes for Adults (18-65 years) Page 11 of 36 needs, in line with the assistance Service Users, are also in place. The home is comfortable and clean, and staff were aware how to keep infections spreading from one person to another. Care Homes for Adults (18-65 years) Page 12 of 36 What has got better from the last inspection The Statement of Purpose and Service User Guide have been reviewed, and copies are available in the foyer of the home. These documents are partly produced in an easy read format. Service Users care plans are also now being reviewed on a regular basis, and some people have copies, and sign them to agree their content. A staff training file is in place, and a range of courses have been arranged for the incoming months. Records of the meals that people have requested are in place, these differ from the set menu and demonstrates that Service Users have a choice at meal times. Care Homes for Adults (18-65 years) Page 13 of 36 What the care home could do better Medicines are not administered safely; staff showed a poor knowledge of the processes involved. There is no guidance in place for staff when medicine should be given on a PRN or occasional basis, There is limited information on medicines that are held from one month to another. These issues place people in the home at risk. The checks carried out prior to staff being employed in the home to ensure Service Users safety are not fully undertaken. These are necessary to protect people in the home. The privacy and dignity of people in the home, is in question due to the type and Care Homes for Adults (18-65 years) Page 14 of 36 condition of some window coverings. Appropriate door locks must also be fitted to some areas within the home. Quality Assurance, which is the process where the staff seek the views of Service Users, and any other interested party, to guide and develop of the home, has yet to be started. There is a lack of written instruction in place to enable staff to deal with any emergency situation action. This is necessary to ensure the safety of people in the home. A list of menu choices could be drawn up for the people on specific diets. This would enable staff to offer a consistent and equitable level of food choices. Care Homes for Adults (18-65 years) Page 15 of 36 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Keith Williamson CPCI Capital Park Fulbourn Cambridge CB21 5XE 01223 771300 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 16 of 36 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 17 of 36 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 assessment process is effective resulting in accurate information for prospective Service Users and staff. Evidence: The Service Users assessment information contains details relating to their needs and abilities. This is important as this information forms the basis for any care plan. All Service User assessments are held together with the original assessment documents from the Service Users placing authority. A contract or the terms and conditions of the persons stay, is also in place. These documents are important to state what the person should expect during their stay. Care Homes for Adults (18-65 years) Page 18 of 36 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The individual needs and choices of people are documented and provide staff with the necessary information to support people who live there. Evidence: We looked at the care records of a person living at the home. We found individual records supporting the care given to them at the home. Care plans are in a format understood by people who live there. Care records are up-dated to ensure they reflect the changing care needs of the person. this was a requirement at the last visit and has been adequately dealt with. We saw that staff have a good understanding of the risks relating to each person who lives there, this is important as it reduces the risks involved in living in the home. Service Users confirmed that they have choices given to them by the staff. This is important as it shows that Service Users are able to influence how their care is structured and delivered. Care Homes for Adults (18-65 years) Page 19 of 36 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service Users enjoy a positive lifestyle, with individual support from staff. Evidence: Service Users enjoy a positive lifestyle, with individual support from staff. This is detailed in a personal timetable of day centre, social care and activities. Most of the Service Users have courses arranged at day centres and local colleges. This is good as it leads to a varied and positive lifestyle. Service Users are encouraged to continue relationships with people outside the home. One of the Service Users spoke of having recent visits from relatives. The menu system was seen, and this offers the Service Users individual cultural dietary needs, and is backed up by a likes and dislikes list. There is also a book, that contains the choices Service Users have opted for at meal times, if these are not what was offered on the menu. One of the Service Users is on a special diet with the staff having a separate cupboard Care Homes for Adults (18-65 years) Page 20 of 36 Evidence: in which to store their particular food items. Staff confirmed Service Users have the choice to take part in the weekly grocery shopping, and some meal preparation. On the day of the visit one of the Service Users had been out to a local cafe for lunch. On his return, he declined to comment on the content of his meal or satisfaction at going out away from the home. Care Homes for Adults (18-65 years) Page 21 of 36 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service Users health and personal care needs are adequately met. The poor management of the medication system, has the potential to put those people in the home in danger. Evidence: Personal support is offered to Service Users on an individual basis. This is in line with the plan of care, which accurately records the level of assistance each person requires. The care plan also indicates likes and dislikes such as which staff members people preferred to receive support from. Service Users also have information in their plan of care, about their health management and have regular access to their doctor, dental and optical services. Their is also input from other people such as consultant psychiatrists and psychologists. This is important as it shows the staff cares for peoples greater health needs. Medication continues to be poorly managed with a lack of accurate information on the mar charts (Medication Administation Record). These are used to record the individual medications administered throughout any given period. There is no audit system for medication that is carried over from one month to another, this is necessary to ensure Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: medication being handled and stored by the staff is done so accurately. There is also poor recording of medicines returned to the pharmacy for destruction. The records on the mar chart do not match those in the returns book which is a signed receipt for the medicine returned, by the pharmacist. An immediate requirement was left at the time of the key visit, regarding the medication system. There are no risk assesments in place, to instruct the staff when to give PRN or medicines used on an occasional basis. The final wishes of Service Users, are also included on the plan of care. This indicates that the persons ageing needs are dealt with appropriately. Care Homes for Adults (18-65 years) Page 23 of 36 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 . Service users are protected by an informed staff group. Evidence: There has been one complaint forwarded to the Commission for Social Care Inspection with regard to the home. This was the subject of a random inspection visit, two requirements were made at that visit. There have been no complaints recorded by the staff, since the last visit to the service. At the time of the visit the staff could not access the complaint information, though work being done at the time, and training since has ensured the information is now available. Complaints information is also displayed in the home and is enclosed in the Service User Guide. There is evidence of advocates and relatives being used in the complaints process. This is important as it shows the home involves other people in the complaints process. Staff told the Inspector what they knew about the complaints, adult protection and whistleblowing procedures. They showed a good understanding of the process involved in following such issues through. Adult Protection training for the staff is undertaken at regular intervals, more courses are planned for the near future. Service Users personal allowances are paid on a regular basis. There are clear paper trails involved to show where individual Service Users monies are held, and what balance is available to them. However sums of money deducted for petrol expenses are not explanitory enough, and require to be more detailed to ensure accurate auditing of peoples financial transactions. Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: There have been no protection issues forwarded to the Commission for Social Care Inspection. Care Homes for Adults (18-65 years) Page 25 of 36 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 . Service users live in an environment that is homely, comfortable and clean, though improvements need to be made to improve peoples levels of privacy. Evidence: The home is comfortable and clean. A programme for refurbishment and replacement of furniture and other items in the home is in place. The Service Users bedrooms are personalised, with a variety pictures furniture and electrical equipment. There is an issue of peoples privacy and dignity, where there is no lock to the toilet door, and the window covering to a first floor bedroom at the front of the home are in need of replacement. Staff are aware of cross contamination and cross infection issues, and agreed that there were plentiful supplies of protective clothing. This is important to protect people in the home. Care Homes for Adults (18-65 years) Page 26 of 36 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 inconsistent staff recruitment practices, and staff understanding of training, policies and procedures, have the potential of putting people at risk in the home. Evidence: The staffing rota showed that staff are employed to assist Service Users on an individual basis, this can be as many as two staff to one Service User, when required. This is good as it demonstrates that people are being safeguarded when out of the home. Staff are employed to sleep on the premises overnight. The hours worked by staff are flexible to enable Service Users to engage in education, day center and recreation and leisure activities. This is good as it ensures the Service User as being central to the care role. Staff are responsible for supporting the Service Users with self-care, cooking of meals, cleaning of the home and the washing and ironing. The staff employed at the home do not have the appropriate pre-employment checks before starting work at the home. The responsible person must ensure that references are obtained from people best suited to give them. This would ensure that a greater degree of protection was offered to those living and working in the home. Criminal Record Bureau (CRB) and Povafirst checks are in place, these are required by law, again to assist in the protection of those living in the home. Care Homes for Adults (18-65 years) Page 27 of 36 Evidence: Staff training is in place and the courses that staff have undertaken consist of those that by law must be run annually. There remain a number of courses that have yet to be arranged and delivered to staff, to ensure the safety of Service Users in the home. These are being planned in advance. Some of the staff do not have an adequate grasp of the courses they have undertaken. Staff supervision, which is one to one meetings between staff and the manager, continue to form a part of staff development. Staff meetings take place on a regular basis; these are minuted and share vital information between staff. Care Homes for Adults (18-65 years) Page 28 of 36 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Shortfalls in safe working practices and lack of appropriate documentation have the potential to put people at risk in the home. Evidence: The registered manager is qualified and has many years care experience with the current Service User group. Policies and procedures are in place, and are reviewed on a regular basis. Some areas within health and safety are regularly monitored, with staff doing a number of tests on a periodic basis. Regular tests on the fire alarm and hot water system are up to date. However there were no COSHH data sheets for any chemicals held in the home. These are information sheets, that instruct the staff how to deal with cases of emergency. The financial balance held on behalf of Service Users was correct. Receipts were in place but these could be more detailed to enable a suitable audit to take place, ensuring a safe and secure system. The public liability insurance certificate was noted to be in date. Care Homes for Adults (18-65 years) Page 29 of 36 Evidence: Care Homes for Adults (18-65 years) Page 30 of 36 Are there any outstanding requirements from the last inspection? Yes  No  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 1 20 13(2) The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person must ensure that accurate, complete and up to date records are kept of all medication administered to service users to ensure that medication is administered safely, correctly and as prescribed. Service users need to be protected by accurate medication management and record keeping. 26/05/2008 2 23 17 All staff must be able to demonstrate an understanding of their responsibilities in relation to safeguarding adults and whistleblowing. 19/01/2009 This will enable staff to ensure that the people who live in the home are safe and protected from abuse. Care Homes for Adults (18-65 years) Page 31 of 36 3 23 17 Ensure written policies and procedures relating to safeguarding are in concurrence with local multi agency agreement/arrangements and DH publication No Secrets. 19/01/2009 This will provide staff with the appropriate guidance if they need to use the policy or procedure. 4 33 17 There must be an accurate 19/01/2009 staff roster in place, showing those staff on duty, and copies of the roster must be kept in the home for inspection purposes. This is to ensure the records are available for inspection purposes. 5 34 17 Staff in the home must have 19/01/2009 the appropriate checks in place, prior to commencing work with service users. This will ensure that the people who live in the home are safe and protected from abuse. Care Homes for Adults (18-65 years) Page 32 of 36 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 Description Timescale for action 1 20 13 The responsible person must 29/01/2009 ensure medication is ordered, held and administered appropriately. This would ensure the safety for those in the home. This requirement had a timescale of 26/05/08, which has not been met. Enforcement action is now being considered. 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 Description Timescale for action 1 19 13 When stocks of medication 26/02/2009 are carried over from one month to another, figures of medication carried forward could be marked onto the following months MAR chart. This would enable an accurate audit of medication to ensure safety of people in the home. Care Homes for Adults (18-65 years) Page 33 of 36 2 20 13 The responsible person must 26/02/2009 ensure that medication prescribed on a PRN or occasional basis, is accompanied by a risk assessment, and specific instruction when the medication should be administered by staff. this is to ensure staff are aware under what circumstances to give the medicine. 3 23 17 The responsible person must 11/02/2009 ensure that policies, procedures and records relating to peoples protection are explanitory enough to be understood by people in the home. This is to ensure that peoples monies can be accurately accounted for. 4 26 23 Suitable window covering must be maintained to all areas of the home. 20/02/2009 This would ensure that privacy is offered to, and dignity maintained for individuals in the home. 5 27 23 Appropriate door locks must be fitted to areas within the home. 13/02/2009 This would ensure that privacy is offered to individuals in the home. Care Homes for Adults (18-65 years) Page 34 of 36 6 34 19 The responsible Person must 26/02/2009 ensure all the necessary pre employment checks are undertaken prior to staff commencing in the home. This is to ensure the safety of the people in the home. 7 35 18 The responsible person must 26/03/2009 ensure that staff training is understood by the people undertaking the course. This is to ensure staff are able to act independently when required to do so. 8 42 23 The responsible person must 26/02/2009 ensure that written instructions are in place to enable staff to deal with any emergency action. This to ensure that safety is not compromised in the home. 9 43 24 The responsible person must 26/03/2009 ensure that Quality Assurance is carried out with the service users, and any other interested party and use the outcomes to inform the development of the home, and use the feedback in the service user guide. This is to ensure prospective service users to the home, are informed of developments in the home, and the opinions of the service user group on how Care Homes for Adults (18-65 years) Page 35 of 36 well the home is run. 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 17 A list of menu choices could be drawn up for the people on specific diets. This could be backed up with recipe instructions. This would enable staff to offer a consistent and equitable level of food choices. Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 36 of 36 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!